Journal of Education and Health Promotion

Abstract BACKGROUND: Online learning is the newest and most popular form of distance education today;
within the past decade it has had a major impact on education. The aim of the present study was to
know the effect of online learning basketball using social media on learners’ performance of some
fundamental skills in basketball and determine difference between online learning and in‑person
learning, knowing which one is better than the other.
MATERIALS AND METHODS: The present experimental study was conducted in Sports Academy
for Basketball in Zagazig‑Egypt during March–April 2022. Thirty two female junior basketball players
volunteered to participate in the study from Sports Academy for Basketball (age: 16.23 ± 0.66 years;
body height: 164.5 ± 3.32 cm; body mass: 65.25 ± 3.22 kg). They were divided into two equally sized
experimental groups, online learning (ONL) group (n = 16) and in‑person learning (INL) group (n = 16),
to perform (15) educational sessions for (5) weeks, (3) sessions per week, and the session time
was 90 minutes. Junior basketball players were assessed before and after five‑week training period.
Data were collected by Basketball Passing test, Dribbling Skill test, Lay Up Shoot test, Speed Spot
Shooting, and Free‑Throw Shooting test. The collected data were analyzed using SPSS version 22
software using the descriptive statistical test. The level of significance was set at P ≤0.05.
RESULTS: The results showed that the two groups made significant improvements in all variables but
INL group had significantly greater improvements than ONL group. The percentage of improvement
ranged from 13% to 223% for INL group versus 8% to 158% for ONL group.
CONCLUSION: We conclude that in‑person basketball learning was better than online learning
basketball. Therefore, teachers and trainers must rely primarily on in‑person learning and not rely
on distance learning, especially with regard to learning motor skills, except in emergency cases.

Abstract During the COVID‑19 pandemic, people are using social media more than usual routine because they
rely on online sources to seek health information for themselves and their loved ones. The spread of
inaccurate and misleading information via social media has a number of detrimental psychological
effects on members of society. The aim of this systematic review was to describe the impact of social
media on the mental health of the general population. An extensive systematic search was done till the
last month of 2021 for collecting the evidence using the PRISMA technique. The search was mainly
focused on the article leading with keywords and search engines used during the course of the study
were Pubmed, Semantic Scholar, Mendeley, and Science direct. Articles for this study were selected
based on the predetermined eligibility criteria and performed quality assessment by using the NHLBI
quality assessment tool. Most of the studies included in this review are found fair (score between
9 and 12) quality. Out of 866 publications, 533 articles were included in the initial screening, after
duplication removal 46 full‑text articles were assessed for eligibility and 14 studies were selected for
systematic review. In most of the studies, maximum participants used social media as a primary source
of information. Relatively high rates of symptoms of depression (14.14% to 48.3%), anxiety (7.4% to
47.82%), and prevalence of stress increased to 37.67% are reported after exposure to social media
for coverage of COVID‑19 news in the general population. Risk factors of psychological distress are
associated with female gender, younger age group, marital status, staying alone, and duration of
exposure to mass media. Increased exposure to COVID‑19 information through mass/social media
is associated with highly significant levels of psychological health issues; mitigating the hazardous
effect of social media exposure during the COVID‑19 pandemic on the psychological health of the
general population is an international public health priority.

Abstract BACKGROUND: Social media has become a most inseparable part of young adults’ lives with the 
rapid development of information and communication technology. The study aimed to assess the 
use of social media and its association with academic performance, well‑being, and interpersonal 
relation of the health sciences undergraduates.
MATERIALS AND METHODS: A descriptive cross‑sectional study was conducted among 
undergraduates in Faculty of Allied Health Sciences (n = 220), University of Sri Jayewardenepura, 
Sri Lanka. Data were collected using a pretested, self‑administered questionnaire and analyzed 
using descriptive and inferential statistics.
RESULTS: The response rate was 79.5%. All undergraduates (n = 175) had social media accounts, 
and WhatsApp was the most frequently used social media site (96.0%), followed by Facebook (70.9%), 
mainly for communicating (85.1%), entertainment (83.4%), and online learning (65.7%). Most 
undergraduates (72.0%) spent 2–5 h daily on social media sites and followed social media 1–10 times 
per day (54.9%). The majority of them wished to use social media for academic purposes (94.9%), and 
the most preferred site for academic work was WhatsApp (65.1%). Most undergraduates’ self‑reported 
Grade  Point Average  (GPA)  (46.3%) was  <2.9. There was a statistically significant association
between the mean GPA and frequencies of using social media (P = 0.02) (not daily [3.3 ± 0.3], 
1–10 times a day [2.9 ± 0.4], and more than 10 times a day [3 ± 0.4]). Perceived social media addiction 
and duration of sleep (P = 0.02), activities of daily living (P = 0.004), and study time (P = 0.02) were 
found to be significantly associated.
CONCLUSIONS: Despite the undergraduates’ willingness to use social media for academic purposes, 
the frequency of using social media had a significant influence on their academic performance. This
highlights the importance of guidance on effective use of social media and social media addiction 
to improve undergraduates’ academic performance, well‑being, and interpersonal relationships.

Abstract BACKGROUND: The use of social networks in the field of education has also accelerated and
has become a powerful source of learning for transformation and empowerment in various fields.
This study aimed to test the adaptation and psychometric properties of an instrument for students’
prospective on e‑professionalism in the use of social media in Iranian medical science students.
MATERIALS AND METHODS: In this questionnaire, with the aim of psychometric properties of the
perception toward social media in Iranian students, this survey instrument developed by (Ness et al.)
in five fields in 2nd‑year pharmacology students in Purdue University The fields include accountability,
hiring decisions, profile editing, professionalism, and privacy settings. In this study, first, a cultural
adaptation was done by an expert panel. Then, psychometric properties of an instrument by content
validity and construct validity using explanatory factor analysis were performed. Reliability was
assessed by test–retest and internal consistency of items. The reliability of the survey instrument
with three factors was 0.82 using the test–retest, and the internal consistency was good (r = 0.94).
RESULTS: The result of psychometric properties using the principal component method extracted
three factors (accountability, hiring decision, and professionalism) to assessment of students’ attitude
to professionalism using social media in Iranian students.
CONCLUSION: The adapted and psychometric properties of the instrument developed by Ness
et al., 2013, with three dimensions and ten items proved to be a valid, reliable instrument for use
for assessing perspectives on e‑professionalism and social media in Iranian medical students. This
questioner may be suitable for Iranian researches in medical education.

Abstract BACKGROUND: With so much content on social media platforms about COVID‑19, determining
which information is reliable can be a daunting task. Hence, this study is aimed to analyze various
posts with regard to COVID‑19 on various social media platforms for their reliability and also examined
various factors that influence information reliability.
MATERIALS AND METHODS: A cross‑sectional study was conducted, with 934 samples related
to coronavirus pandemic published on Twitter, Instagram, and Facebook using systematic random
sampling. We adopted the criteria given by Paul Bradshaw and modified to assess the characteristics
of the samples. Training and calibration of the investigators were carried out for 3 consecutive days
before beginning the study. The data were analyzed using the Chi‑square test and multinomial logistic
regression to estimate the odds ratios.
RESULTS: Out of 934 samples studied, only 570 (61%) were found to be reliable of which
243 (42.6%) were from Twitter, 117 (20.6%) from Instagram, and 210 (36.8%) from Facebook.
We found that the reliability of the information on social media platforms is significantly influenced
by network (odds: 1.32; 95% confidence interval [CI]: 1.16–1.52; P = 0.036), content (odds: 1.83;
95% CI: 1.69–1.92; P = 0.009), contextual update (odds: 1.41; 95% CI: 1.24–1.53) and age of the
account (odds: 1.92; 95% CI: 1.64–2.09; P = 0.002).
CONCLUSION: Our study shows that the reliability of the social media posts significantly depends
on the network, contextual update, and age of the account. Hence, cross verifying the information
from a reliable source is the need of the hour to prevent panic and mental distress.

Abstract BACKGROUND: Several preventive measures were used by governments around the world to
suppress the transmission of SARS‑CoV‑2, including quarantine. During quarantine more people
are at risk of developing mental health problems as social media exposure was increasing.
OBJECTIVES: The objective is to investigate the impact of social media exposure during coronavirus
disease 2019 (COVID‑19) pandemic on depression, anxiety, and stress.
MATERIALS AND METHODS: A cross‑sectional study was conducted between April and May 2020
during the large scale social restriction in Indonesia using online questionnaire Indonesian citizens
over 18 years of age were invited to take part by answering online questionnaire through Google
forms (http://bit.ly/duniamayaCOVID). Data gathered were demographic data, depression, anxiety,
and stress that were assessed using Depression Anxiety Stress Scale‑21, duration of social media
usage, and social media platforms used during COVID‑19 pandemic. Data was analysed using
Pearson Chi‑square and ANOVA. Statistically significant variables and additional risk factors was
analyzed using multinomial logistic regression.
RESULTS: The median age was 24 years (range 17–56 years), 121 (55,0%) samples were female.
The three most frequent social media platforms used by participants were Instagram, WhatsApp, and
YouTube. Female were more likely to suffer from mild‑moderate depression compared to male (odds
ratio [OR]: 2.344; 95% confidence interval [CI]: 1.105–4.972; P = 0.026) and more likely to suffer
from severe‑extremely severe anxiety (OR: 2.066; 95% CI: 1.019–4.187; P = 0.044). Social media
exposure was associated with less likelihood to suffer from severe‑extremely severe depression,
mild‑moderate, and severe‑extremely severe anxiety, mild‑moderate stress.
CONCLUSION: Social media exposure was associated with less depression, anxiety, and stress in
the COVID‑19 pandemic era. Medical professionals and government officials could use social media
to disseminate knowledge about COIVD‑19 to bring positive psychological effect.

Abstract BACKGROUND: Social media addiction (SMA) led to the formation of health‑threatening behaviors
that can have a negative impact on the quality of life and well‑being. Many factors can develop an
exaggerated tendency to use social media (SM), which can be prevented in most cases. This study
aimed to explore the reasons for SMA.
MATERIALS AND METHODS: This qualitative study was conducted using content analysis. A
total of 18 SM addicted subjects were included through purposive sampling. Data were collected
through semi‑structured interviews and analyzed using the Lundman and Graneheim qualitative
content analysis method.
RESULTS: The main category of “weakness in acquiring life skills” was extracted with three themes: “problems
in socializing” (including communicating and escaping loneliness), “problems in resiliency” (including
devastation in harsh conditions and inability to recover oneself and “lack of problem‑solving skills”(including
weaknesses in analysis and decision making and disorganization in planning).
CONCLUSIONS: Weakness in life skills plays an important role in individuals’ addiction to SM and
formation of the health‑threatening behaviors. Since SMA can affect behavioral health, policymakers
must adopt educational and preventive programs to increase the knowledge and skills of individuals
in different societies in the modern world.

Abstract BACKGROUND: COVID‑19 virus has resulted in significant psychological distress for many
individuals, particularly, those in underserved communities. Social media have the potential to be
one of the most effective tools for mental health campaigns, reaching wide audiences in the shortest
amount of time. In this paper, the potential of harnessing social media platforms to address mental
health needs in underserved populations is presented. In addition, description of the preliminary
implementation of a social media mental health campaign, the 5 × 5 campaign, is described
as an example of the feasibility and benefits of such efforts. Key implications gleaned from the
implementation process are also presented.
MATERIALS AND METHODS: Utilizing a participatory approach, the 5 × 5 campaign aimed to
improve recognition of mental health symptoms, promote help seeking, and provide immediate
strategies for self‑care for individuals experiencing psychological distress related to the COVID‑19
pandemic in low‑income, high‑risk communities in and around Guatemala City. Campaign content
was promoted on Facebook, Instagram, and WhatsApp from April 2020 to June 2020.
RESULTS: Preliminary analysis of the 5 × 5 campaign demonstrated feasibility and substantial
impact with over 84,000 individuals reached by the campaigns through initial messaging and shares.
CONCLUSION: The 5 × 5 highlights the feasibility of using social media campaigns for mental health
promotion and key factors that should be incorporated in the planning of social media mental health
campaigns aimed at promoting awareness, engaging underserved communities, and encouraging
help seeking.

Abstract BACKGROUND: Considering the importance of virtual professionalism and professional ethics
in medical sciences, and the necessity to pay attention to this issue and its impact on medical
professionalism, this study aimed to build a professional culture questionnaire in a virtual environment
for students of medical sciences in Iran.
MATERIALS AND METHODS: This is an exploratory, sequential, mixed‑methods research which
was conducted in three sections. In the first section, the concept of e‑professionalism in medical
sciences was analyzed using the hybrid concept analysis in the theoretical work, field work, and final
analysis stages in order to extract information related to the concept. In the second section, an item
of the questionnaire was designed based on the concept, reviewed texts, and related questionnaires,
in the third section, psychometric properties of a questionnaires were evaluated.
RESULTS: Totally, 39 items were included in the initial pool, which reduced to 33 items in the final
questionnaire after reviewing the psychometric properties. Factor analyses led to extraction of five
factors including appraisal of e‑professionalism compliance with the laws and regulations governing
cyberspace, individual professionalism, knowledge management, respect for professionalism in
interpersonal and group rules, and complying with ethics in the use of cyberspace. The internal
consistency of questionnaire was also confirmed by Cronbach’s alpha coefficient of 0.78, also all
factor correlations absed stability were significant (P < 0.05).
CONCLUSION: An exploratory sequential study in this study led to the extraction of five factors
and development of a 33‑item questionnaire in e‑professionalism. As results and analysis of the
psychometric properties and validation of each item, this questionnaire is valid and reliable for the
assessment of levels of e‑professionalism in medical sciences in Iran.

Abstract BACKGROUND: Lockdown was imposed as a preventive measure for coronavirus disease
pandemic. Social media was the most common tool available for the masses, including the 1st
year medical students during the lockdown. The objectives of the present study were to determine
the extent of use of social media and the effects on mind‑body and social distancing.
MATERIALS AND METHODS: It was mixed research conducted on 1st‑year medical students
using convenience sampling. The quantitative aspect of E‑survey was administered through Google
forms sent via E‑mail, and structured telephonic interview was conducted as a qualitative aspect on
randomly selected 10 students based on predecided interview questions. This study was reported
as per the Checklist for Reporting Results of Internet E‑Surveys. The analysis was performed using
percentages and paired t‑test with significance at P < 0.05, Chi‑square test with Yate’s correction.
Qualitative responses were analyzed using coding and categorization.
RESULTS: The response rate was 88%. Time spent on social media for >4 h increased from 1.1% to
47.72% during lockdown. Forty three (48.86%) of the students reported increased mood fluctuations.
The relation between mood fluctuations and time spent on social media of >4 h was significant
𝜒2 = 6.41 with P < 0.05. Average hours of sleep after using social media before lockdown increased
significantly from 6.68 h to 8.10 h during lockdown using paired t‑test, where “t” was 6.84. There
was a positive impact on communication with friends and family.
CONCLUSION: Due to the increased extent of use of social media during lockdown, negative
mind‑body effects have surfaced but emerged as boon in terms of communication .

Abstract INTRODUCTION: Use of technology and ICT tools is ubiquitous among college students including
medical students. However overuse or misuse may lead to many physical and psychological problems
including the risk of harming professional standing in the long term. The purpose of this study was
to explore techno stress among freshmen at a medical institute and to suggest measures to reduce
problematic use of technology pertaining to internet.
OBJECTIVES: (i) To explore the extent of technology use including internet among medical
freshmen, (ii) To identify the content of usage (iii) To quantify the extent of techno stress and iv. To
suggest measures to reduce problematic use of technology.
MATERIALS AND METHODS: The sample comprised all the freshmen at a medical institute (n = 61).
A semi structured questionnaire was used to collect socio demographic details of students and their
patterns of technology usage. Perceived Stress Scale was used to measure stress.
RESULTS: The mean age of the sample was 18.34 (±0.58) years comprising 68% males and 32%
females. Students spent a mean time of 3.96 h/day on the technology tools (standard deviation = 4.99).
Ninety-two percent of the students used technology for educational purposes followed by
entertainment (89%), social networking (77.78%), watching films (70.37%), communication (66.67%)
and watching pornography (46.3%). 11.47% had symptoms suggestive of problematic internet use.
One percent had craving suggestive of addiction. All these had stress out of which 43% had high
and 57% had moderate levels of stress.
DISCUSSION: Considering the students’ present usage of social media, it can serve as a potent
academic tool. However, awareness is required to be raised with regard to its use as a medical
professional.
CONCLUSION: Use of technology is crucial in the current academic world and restrictions on usage
may neither be practical nor feasible. However, understanding patterns of usage among students is a
preliminary step that can enable educators and administrators to formulate guidelines to channelise
their usage in more productive ways.

Abstract INTRODUCTION: Social media is becoming a new tool for developing health knowledge management.
However, despite the rapid growth of research in this area, few attempts have been made to review
previous research. This study tried to summarize the opportunities and challenges of using social
media to managing health knowledge.
METHODOLOGY: This article used a narrative approach to collect and review studies. In this
review, published documents during 2010–2019 were retrieved by search in the following three
electronic scientific databases: Web of Knowledge, PubMed, and Google Scholar search engine
using keywords including social media, public health, health knowledge, knowledge management,
and health promotion.
RESULTS: Social media by overcoming geographical barriers, developing health promotion,
facilitating decision‑making, and providing public health education has been able to enhancing health
awareness and improving health behavior. Doctors’ unwillingness to interact with the public, lack of
compliance with the principles of medical ethics, users’ privacy concerns, and difficulty of managing
negative comments are the four challenges to health knowledge management in social media.
CONCLUSION: Social media can be a suitable tool for developing health knowledge management
processes if medical professional ethics and users’ privacy managed properly.

Abstract BACKGROUND: Social media platforms are progressively developing as a rich source of mass
communication. Increasing mental health awareness with the help of social media can be a good
initiative to reach out to a large number of people in a short time frame. This study was conducted
to understand the usefulness of social media platforms for health promotion.
MATERIALS AND METHODS: It was a qualitative study to evaluate the effectiveness of social
media platforms in hosting health promotion campaigns in the field of mental health, which was
observed over 5 months from May to September 2019 to reach more people for effective information
dissemination. The campaigns were as follows (1) The Buddies for Suicide Prevention: an online
campaign to create awareness about suicide prevention. The campaign included script writing,
slogan writing, poster making, and short films making, organized for the general public who were
interested to take part; (2) The #Iquitobacco was a 21‑day campaign with an idea of tobacco cessation
in the community, conducted among social media viewers who were willing to participate; and (3)
#Migrainethepainfultruth was yet another campaign conducted among the social media viewers who
were interested to participate. All the campaigns were conducted using two famous social media
platforms commonly used by young adults. Descriptive statistics such as frequency and proportions
were computed for the number of likes and shares.
RESULTS: The Facebook and Instagram posts concerning all the campaigns brought about a
considerable amount of reach to the targeted population. After the campaigns, the page reached to
around 10.3 k people (both fans and nonfans).
CONCLUSIONS: Use of social media to conduct mental health campaigns is an effective initiative
as one can reach out to several people over a short time period. There is an increasing trend in the
awareness of mental health with the effective use of digital media as a platform for disseminating
information.

Abstract CONTEXT: In the era of technology, social networking has become a platform for the teaching–
learning process. Exploring international students’ perspective on using Twitter would reveal the
barriers and potential for its use in higher educational activities.
AIMS: This study aimed to explore the postgraduate students’ perspective on using Twitter as a
learning resource.
SUBJECTS AND METHODS: This qualitative study was conducted as part of a postgraduate program
at a university in the United Kingdom. A focus group discussion and five in‑depth interviews were
conducted after receiving the informed consent. The qualitative data were analyzed by R package
for Qualitative Data Analysis software.
ANALYSIS USED: Deductive content analysis was used in this study.
RESULTS: Qualitative analysis revealed four salient themes, which were (1) background knowledge
about Twitter, (2) factors influencing the usage of Twitter, (3) master’s students’ experiences on
using Twitter for education, and (4) potential of using Twitter in the postgraduate study. The students
preferred to use Twitter for sharing links and appreciated the benefit on immediate dissemination
of information. Meanwhile, privacy concern, unfamiliarity, and hesitation to participate in discussion
discouraged the students from using Twitter as a learning platform.
CONCLUSIONS: Using social media platforms in education could be challenging for both
the learners and the educators. Our study revealed that Twitter was mainly used for social
communication among postgraduate students however most could see a benefit of using Twitter
for their learning if they received adequate guidance on how to use the platform. The multiple
barriers to using Twitter were mainly related to unfamiliarity which should be addressed early in
the learning process.

Abstract INTRODUCTION: The use of social media to disseminate major communications, particularly for
campaigns related to days of health importance, is becoming much popular. The use of Twitter,
Instagram, and Facebook is gaining an integral place in public life online with hashtag campaigns.
OBJECTIVES: The objectives of this study were to assess the characteristics of hashtag campaigns
related to health in social media and to compare three different campaigns in three commonly used
social media platforms, namely, Twitter, Instagram, and Facebook.
METHODOLOGY: This was a cross‑sectional study which analyzed contents of three health‑related
campaigns in Instagram, Facebook, and Twitter. The campaigns were #let’s talk (World Health day
2017), Hands up #HIV prevention (World AIDS day 2016), and #No tobacco (World No Tobacco Day
2017). Public posts related to each were searched from three platforms and assessed separately.
Source, publicity, credibility, reach outs, and other characteristics were assessed among each
campaign and comparison was also done among the three social media.
RESULTS: Out of 812 posts, 507 (62.4%) were related to the study. Facebook posts were more
related (67.33%), popular (45.05%), and authenticated (28.22%). Among the campaigns, # let’s talk
was more credible (96.33%) and authenticated (33.94%). Also in that, 57.79% from individual source
and 79.82% were awareness related.
CONCLUSION: Posts in social media related to hashtag campaigns are more credible, related, and
less popular. These factors have to be considered for the campaigns to become an effective tool.

Abstract BACKGROUND AND AIM: Twitter® use among paramedics and other prehospital care clinicians is
on the rise and is increasingly being used as a platform for continuing education and international
collaboration. In 2014, the hashtag #FOAMems was registered. It is used for the sharing of emergency
medical services, paramedicine, and prehospital care‑related content. It is a component of the ‘free
open‑access meducation’ (FOAM) movement. The aim of this study was to characterize and evaluate
the content of #FOAMems tweets since registration.
MATERIALS AND METHODS: An analytical report for #FOAMems was generated on symplur.com
from February 4, 2014, to April 30, 2017. A transcript of all #FOAMems tweets for a randomly selected
1 month period (October 2015) was generated, and quantitative content analysis was performed by
two reviewers. Tweets were categorized according to source (original tweet/retweet) and whether
referenced. The top 92 tweeters were analyzed for professional identity.
RESULTS: During the study period, there were over 99,000 tweets containing #FOAMems, by
over 9,200 participants. These resulted in almost 144 million impressions. Of the top 92 tweeters,
50 were paramedics (54%). Tweets were mainly related to cardiac (23%), leadership (19%), and
trauma (14%). The 1‑month period resulted in 649 original tweets, with 2110 retweets; 1070 of these
were referenced.
CONCLUSION: Paramedics are engaging with both clinical and nonclinical content on Twitter® using
#FOAMems. Social media resources are widely shared, which is in line with the FOAM movement’s
philosophy. However, opportunities exist for paramedics to share further diverse resources supported
by referenced material.