Examining Social Media User Types and the Impact on a Reproductive Health Web-Based Intervention for Young People in Francophone West Africa: Randomized Factorial Design Using Latent Class Analysis.

内容摘要

Web-based interventions present an opportunity for addressing reproductive health outcomes among young Francophone West Africans, but little is known about how social media use impacts such interventions. This study aimed to identify social media use patterns among young French-speaking West Africans and assess the impact on a reproductive health intervention delivered on Facebook. French-speaking social media users (aged 15-24 years) were recruited from Senegal, C&#xf4;te d'Ivoire, and Burkina Faso via social media advertisements. Using a factorial design for a multiarm parallel study, participants were randomly assigned via block randomization to 4 conditions: comparison (standard content), peer role models (personal narratives from similarly aged peers), online influencers (popular online figures), and a mixed peer role model and online influencer strategy. Participant blinding was implemented. Respondents completed pre- and post- self-administered online surveys between December 2023 and February 2024. Latent class analysis using maximum likelihood estimation was used to examine social media use patterns and related outcomes: contraceptive knowledge, provider awareness, and online service use. In total, 353 participants were randomized to each group, with a final analytic sample of 262 participants. Two social media user types were identified from the completed study: selective users (daily use of WhatsApp and Facebook) and multiplatform users (daily use of WhatsApp, Facebook, Instagram, YouTube, and TikTok). Being 20-24 years old, compared with 15-19 years, was associated with increased odds of multiplatform use (odds ratio [OR] 3.61, 95% CI 1.46-9.36; P=.008). Furthermore, residing in Senegal was associated with a greater likelihood of multiplatform use, compared with C&#xf4;te d'Ivoire (OR 0.27, 95% CI 0.08-0.88; P=.03) and Burkina Faso (OR 0.23, 95% CI 0.07-0.76; P=.02). Among selective users (daily users of WhatsApp and Facebook), the peer role model approach demonstrated a 1.84-unit increase in contraceptive knowledge (OR 1.84, 95% CI 0.27-3.41; P=.02), a 1.81-unit increase in provider awareness (OR 1.81, 95% CI 1.15-2.47; P<.001), and a 1.49-unit increase in service use (OR 1.49, 95% CI 0.06-2.93; P=.04), compared with the comparison group. For multiplatform users, the peer role model approachwas associated with a decrease in provider awareness (OR 0.33, 95% CI -0.64 to -0.01; P=.04). Unlike the peer role model approach (n=70), generally, online influencer (n=63) and mixed approaches (n=57) did not yield significant outcomes, relative to the comparison group (n= 72). There were no adverse events reported. This study applies latent class analysis in a novel way for this population: examining how a comprehensive measure of social media use moderates digital interventions. This approach is underused in other social media studies in sub-Saharan Africa. Findings suggest that a one-size-fits-all approach in web-based interventions is not ideal, and online peer-to-peer communication is still an important strategy for certain social media users.