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media studies research paper

Special Issue: Propaganda

This essay was published as part of the Special Issue “Propaganda Analysis Revisited”, guest-edited by Dr. A. J. Bauer (Assistant Professor, Department of Journalism and Creative Media, University of Alabama) and Dr. Anthony Nadler (Associate Professor, Department of Communication and Media Studies, Ursinus College).

Propaganda, misinformation, and histories of media techniques

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This essay argues that the recent scholarship on misinformation and fake news suffers from a lack of historical contextualization. The fact that misinformation scholarship has, by and large, failed to engage with the history of propaganda and with how propaganda has been studied by media and communication researchers is an empirical detriment to it, and serves to make the solutions and remedies to misinformation harder to articulate because the actual problem they are trying to solve is unclear.

School of Media and Communication, University of Leeds, UK

media studies research paper

Introduction

Propaganda has a history and so does research on it. In other words, the mechanisms and methods through which media scholars have sought to understand propaganda—or misinformation, or disinformation, or fake news, or whatever you would like to call it—are themselves historically embedded and carry with them underlying notions of power and causality. To summarize the already quite truncated argument below, the larger conceptual frameworks for understanding information that is understood as “pernicious” in some way can be grouped into four large categories: studies of propaganda, the analysis of ideology and its relationship to culture, notions of conspiracy theory, and finally, concepts of misinformation and its impact. The fact that misinformation scholarship generally proceeds without acknowledging these theoretical frameworks is an empirical detriment to it and serves to make the solutions and remedies to misinformation harder to articulate because the actual problem to be solved is unclear. 

The following pages discuss each of these frameworks—propaganda, ideology, conspiracy, and misinformation—before returning to the stakes and implications of these arguments for future research on pernicious media content.

Propaganda and applied research

The most salient aspect of propaganda research is the fact that it is powerful in terms of resources while at the same time it is often intellectually derided, or at least regularly dismissed. Although there has been a left-wing tradition of propaganda research housed uneasily within the academy (Herman & Chomsky, 1988; Seldes & Seldes, 1943), this is not the primary way in which journalism or media messaging has been understood in many journalism schools or mainstream communications departments. This relates, of course, to the institutionalization of journalism and communication studies within the academic enterprise. Within this paradox, we see the greater paradox of communication research as both an applied and a disciplinary field. Propaganda is taken quite seriously by governments, the military, and the foreign service apparatus (Simpson, 1994); at the same time, it has occupied a tenuous conceptual place in most media studies and communications departments, with the dominant intellectual traditions embracing either a “limited effects” notion of what communication “does” or else more concerned with the more slippery concept of ideology (and on that, see more below). There is little doubt that the practical study of the power of messages and the field of communication research grew up together. Summarizing an initially revisionist line of research that has now become accepted within the historiography of the field, Nietzel notes that “from the very beginning, communication research was at least in part designed as an applied science, intended to deliver systematic knowledge that could be used for the business of government to the political authorities.” He adds, however, that

“this context also had its limits, for by the end of the decade, communication research had become established at American universities and lost much of its dependence on state funds. Furthermore, it had become increasingly clear that communication scientists could not necessarily deliver knowledge to the political authorities that could serve as a pattern for political acting (Simpson, 1994 pp. 88–89). From then on, politics and communication science parted ways. Many of the approaches and techniques which seemed innovative and even revolutionary in the 1940s and early 1950s, promising a magic key to managing propaganda activities and controlling public opinion, became routine fields of work, and institutions like the USIA carried out much of this kind of research themselves.” (Nietzel, 2016, p. 66)

It is important to note that this parting of ways did  not  mean that no one in the United States and the Soviet Union was studying propaganda. American government records document that, in inflation-adjusted terms, total funding for the United States Information Agency (USIA) rose from $1.2 billion in 1955 to $1.7 billion in 1999, shortly before its functions were absorbed into the United States Department of State. And this was dwarfed by Soviet spending, which spent more money jamming Western Radio transmissions alone than the United States did in its entire propaganda budget. Media effects research in the form of propaganda studies was a big and well-funded business. It was simply not treated as such within the traditional academy (Zollman, 2019). It is also important to note that this does not mean that no one in academia studies propaganda or the effect of government messages on willing or unwilling recipients, particularly in fields like health communication (also quite well-funded). These more academic studies, however, were tempered by the generally accepted fact that there existed no decontextualized, universal laws of communication that could render media messages easily useable by interested actors.

Ideology, economics, and false consciousness

If academics have been less interested than governments and health scientists in analyzing the role played by propaganda in the formation of public opinion, what has the academy worried about instead when it comes to the study of pernicious messages and their role in public life? Open dominant, deeply contested line of study has revolved around the concept of  ideology.  As defined by Raymond Williams in his wonderful  Keywords , ideology refers to an interlocking set of ideas, beliefs, concepts, or philosophical principles that are naturalized, taken for granted, or regarded as self-evident by various segments of society. Three controversial and interrelated principles then follow. First, ideology—particularly in its Marxist version—carries with it the implication that these ideas are somehow deceptive or disassociated from what actually exists. “Ideology is then abstract and false thought, in a sense directly related to the original conservative use but with the alternative—knowledge of real material conditions and relationships—differently stated” (Williams, 1976). Second, in all versions of Marxism, ideology is related to economic conditions in some fashion, with material reality, the economics of a situation, usually dominant and helping give birth to ideological precepts. In common Marxist terminology, this is usually described as the relationship between the base (economics and material conditions) and the superstructure (the realm of concepts, culture, and ideas). Third and finally, it is possible that different segments of society will have  different  ideologies, differences that are based in part on their position within the class structure of that society. 

Western Marxism in general (Anderson, 1976) and Antonio Gramsci in particular helped take these concepts and put them on the agenda of media and communications scholars by attaching more importance to “the superstructure” (and within it, media messages and cultural industries) than was the case in earlier Marxist thought. Journalism and “the media” thus play a major role in creating and maintaining ideology and thus perpetuating the deception that underlies ideological operations. In the study of the relationship between the media and ideology, “pernicious messages” obviously mean something different than they do in research on propaganda—a more structural, subtle, reinforcing, invisible, and materially dependent set of messages than is usually the case in propaganda analysis.  Perhaps most importantly, little research on media and communication understands ideology in terms of “discrete falsehoods and erroneous belief,” preferring to focus on processes of deep structural  misrecognition  that serves dominant economic interests (Corner, 2001, p. 526). This obviously marks a difference in emphasis as compared to most propaganda research. 

Much like in the study of propaganda, real-world developments have also had an impact on the academic analysis of media ideology. The collapse of communism in the 1980s and 1990s and the rise of neoliberal governance obviously has played a major role in these changes. Although only one amongst a great many debates about the status of ideology in a post-Marxist communications context, the exchange between Corner (2001, 2016) and Downey (2008; Downey et al., 2014) is useful for understanding how scholars have dealt with the relationship between large macro-economic and geopolitical changes in the world and fashions of research within the academy. Regardless of whether concepts of ideology are likely to return to fashion, any analysis of misinformation that is consonant with this tradition must keep in mind the relationship between class and culture, the outstanding and open question of “false consciousness,” and the key scholarly insight that ideological analysis is less concerned with false messages than it is with questions of structural misrecognition and the implications this might have for the maintenance of hegemony.

Postmodern conspiracy

Theorizing pernicious media content as a “conspiracy” theory is less common than either of the two perspectives discussed above. Certainly, conspiratorial media as an explanatory factor for political pathology has something of a post-Marxist (and indeed, postmodern) aura. Nevertheless, there was a period in the 1990s and early 2000s when some of the most interesting notions of conspiracy theories were analyzed in academic work, and it seems hard to deny that much of this literature would be relevant to the current emergence of the “QAnon” cult, the misinformation that is said to drive it, and other even more exotic notions of elites conspiring against the public. 

Frederic Jameson has penned remarks on conspiracy theory that represent the starting point for much current writing on the conspiratorial mindset, although an earlier and interrelated vein of scholarship can be found in the work of American writers such as Hofstadter (1964) and Rogin (1986). “Conspiracy is the poor person’s cognitive mapping in the postmodern age,” Jameson writes, “it is a degraded figure of the total logic of late capital, a desperate attempt to represent the latter’s system” (Jameson, 1991). If “postmodernism,” in Jameson’s terms, is marked by a skepticism toward metanarratives, then conspiracy theory is the only narrative system available to explain the various deformations of the capitalist system. As Horn and Rabinach put it:

“The broad interest taken by cultural studies in popular conspiracy theories mostly adopted Jameson’s view and regards them as the wrong answers to the right questions. Showing the symptoms of disorientation and loss of social transparency, conspiracy theorists are seen as the disenfranchised “poor in spirit,” who, for lack of a real understanding of the world they live in, come up with paranoid systems of world explanation.” (Horn & Rabinach, 2008)

Other thinkers, many of them operating from a perch within media studies and communications departments, have tried to take conspiracy theories more seriously (Bratich, 2008; Fenster, 2008; Pratt, 2003; Melley, 2008). The key question for all of these thinkers lies within the debate discussed in the previous section, the degree to which “real material interests” lie behind systems of ideological mystification and whether audiences themselves bear any responsibility for their own predicament. In general, writers sympathetic to Jameson have tended to maintain a Marxist perspective in which conspiracy represents a pastiche of hegemonic overthrow, thus rendering it just another form of ideological false consciousness. Theorists less taken with Marxist categories see conspiracy as an entirely rational (though incorrect) response to conditions of late modernity or even as potentially liberatory. Writers emphasizing that pernicious media content tends to fuel a conspiratorial mindset often emphasize the mediated aspects of information rather than the economics that lie behind these mediations. Both ideological analysis and academic writings on conspiracy theory argue that there is a gap between “what seems to be going on” and “what is actually going on,” and that this gap is maintained and widened by pernicious media messages. Research on ideology tends to see the purpose of pernicious media content as having an ultimately material source that is rooted in “real interests,” while research on conspiracies plays down these class aspects and questions whether any real interests exist that go beyond the exercise of political power.

The needs of informationally ill communities

The current thinking in misinformation studies owes something to all these approaches. But it owes an even more profound debt to two perspectives on information and journalism that emerged in the early 2000s, both of which are indebted to an “ecosystemic” perspective on information flows. One perspective sees information organizations and their audiences as approximating a natural ecosystem, in which different media providers contribute equally to the health of an information environment, which then leads to healthy citizens. The second perspective analyzes the flows of messages as they travel across an information environment, with messages becoming reshaped and distorted as they travel across an information network. 

Both of these perspectives owe a debt to the notion of the “informational citizen” that was popular around the turn of the century and that is best represented by the 2009 Knight Foundation report  The Information Needs of Communities  (Knight Foundation, 2009). This report pioneered the idea that communities were informational communities whose political health depended in large part on the quality of information these communities ingested. Additional reports by The Knight Foundation, the Pew Foundation, and this author (Anderson, 2010) looked at how messages circulated across these communities, and how their transformation impacted community health. 

It is a short step from these ecosystemic notions to a view of misinformation that sees it as a pollutant or even a virus (Anderson, 2020), one whose presence in a community turns it toward sickness or even political derangement. My argument here is that the current misinformation perspective owes less to its predecessors (with one key exception that I will discuss below) and more to concepts of information that were common at the turn of the century. The major difference between the concept of misinformation and earlier notions of informationally healthy citizens lies in the fact that the normative standard by which health is understood within information studies is crypto-normative. Where writings about journalism and ecosystemic health were openly liberal in nature and embraced notions of a rational, autonomous citizenry who just needed the right inputs in order to produce the right outputs, misinformation studies has a tendency to embrace liberal behavioralism without embracing a liberal political theory. What the political theory of misinformation studies is, in the end, deeply unclear.

I wrote earlier that misinformation studies owed more to notions of journalism from the turn of the century than it did to earlier traditions of theorizing. There is one exception to this, however. Misinformation studies, like propaganda analysis, is a radically de-structured notion of what information does. Buried within analysis of pernicious information there is

“A powerful cultural contradiction—the need to understand and explain social influence versus a rigid intolerance of the sociological and Marxist perspectives that could provide the theoretical basis for such an understanding. Brainwashing, after all, is ultimately a theory of ideology in the crude Marxian sense of “false consciousness.” Yet the concept of brainwashing was the brainchild of thinkers profoundly hostile to Marxism not only to its economic assumptions but also to its emphasis on structural, rather than individual, causality.” (Melley, 2008, p. 149)

For misinformation studies to grow in such a way that allows it to take its place among important academic theories of media and communication, several things must be done. The field needs to be more conscious of its own history, particularly its historical conceptual predecessors. It needs to more deeply interrogate its  informational-agentic  concept of what pernicious media content does, and perhaps find room in its arsenal for Marxist notions of hegemony or poststructuralist concepts of conspiracy. Finally, it needs to more openly advance its normative agenda, and indeed, take a normative position on what a good information environment would look like from the point of view of political theory. If this environment is a liberal one, so be it. But this position needs to be stated clearly.

Of course, misinformation studies need not worry about its academic bona fides at all. As the opening pages of this Commentary have shown, propaganda research was only briefly taken seriously as an important academic field. This did not stop it from being funded by the U.S. government to the tune of 1.5 billion dollars a year. While it is unlikely that media research will ever see that kind of investment again, at least by an American government, let’s not forget that geopolitical Great Power conflict has not disappeared in the four years that Donald Trump was the American president. Powerful state forces in Western society will have their own needs, and their own demands, for misinformation research. It is up to the scholarly community to decide how they will react to these temptations. 

  • Mainstream Media
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Cite this Essay

Anderson, C. W. (2021). Propaganda, misinformation, and histories of media techniques. Harvard Kennedy School (HKS) Misinformation Review . https://doi.org/10.37016/mr-2020-64

Bibliography

Anderson, C. W. (2010). Journalistic networks and the diffusion of local news: The brief, happy news life of the Francisville Four. Political Communication , 27 (3), 289–309. https://doi.org/10.1080/10584609.2010.496710

Anderson, C. W. (2020, August 10). Fake news is not a virus: On platforms and their effects. Communication Theory , 31 (1), 42–61. https://doi.org/10.1093/ct/qtaa008

Anderson, P. (1976). Considerations on Western Marxism . Verso.

Bratich, J. Z. (2008). Conspiracy panics: Political rationality and popular culture. State University of New York Press.

Corner, J. (2001). ‘Ideology’: A note on conceptual salvage. Media, Culture & Society , 23 (4), 525–533. https://doi.org/10.1177/016344301023004006

Corner, J. (2016). ‘Ideology’ and media research. Media, Culture & Society , 38 (2), 265 – 273. https://doi.org/10.1177/0163443715610923

Downey, J. (2008). Recognition and renewal of ideology critique. In D. Hesmondhaigh & J. Toynbee (Eds.), The media and social theory (pp. 59–74). Routledge.

Downey, J., Titley, G., & Toynbee, J. (2014). Ideology critique: The challenge for media studies. Media, Culture & Society , 36 (6), 878–887. https://doi.org/10.1177/0163443714536113

Fenster (2008). Conspiracy theories: Secrecy and power in American culture (Rev. ed.). University of Minnesota Press.

Herman, E., & Chomsky, N. (1988). Manufacturing consent: The political economy of the mass media. Pantheon Books. 

Hofstadter, R. (1964, November). The paranoid style in American politics. Harper’s Magazine.

Horn, E., & Rabinach, A. (2008). Introduction. In E. Horn (Ed.), Dark powers: Conspiracies and conspiracy theory in history and literature (pp. 1–8), New German Critique , 35 (1). https://doi.org/10.1215/0094033x-2007-015

Jameson, F. (1991). Postmodernism, or, the cultural logic of late capitalism . Duke University Press.

The Knight Foundation. (2009). Informing communities: Sustaining democracy in the digital age. https://knightfoundation.org/wp-content/uploads/2019/06/Knight_Commission_Report_-_Informing_Communities.pdf

Melley, T. (2008). Brainwashed! Conspiracy theory and ideology in postwar United States. New German Critique , 35 (1), 145–164. https://doi.org/10.1215/0094033X-2007-023

Nietzel, B. (2016). Propaganda, psychological warfare and communication research in the USA and the Soviet Union during the Cold War. History of the Human Sciences , 29 (4 – 5), 59–76. https://doi.org/10.1177/0952695116667881

Pratt, R. (2003). Theorizing conspiracy. Theory and Society , 32 , 255–271. https://doi.org/10.1023/A:1023996501425

Rogin, M. P. (1986). The countersubversive tradition in American politics.  Berkeley Journal of Sociology,   31 , 1 –33. https://www.jstor.org/stable/41035372

Seldes, G., & Seldes, H. (1943). Facts and fascism. In Fact.

Simpson, C. (1994). Science of coercion: Communication research and psychological warfare, 1945–1960. Oxford University Press.

Williams, R. (1976).  Keywords: A vocabulary of culture and society . Oxford University Press.

Zollmann, F. (2019). Bringing propaganda back into news media studies. Critical Sociology , 45 (3), 329–345. https://doi.org/10.1177/0896920517731134

This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided that the original author and source are properly credited.

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2.3 Methods of Researching Media Effects

Learning objectives.

  • Identify the prominent media research methods.
  • Explain the uses of media research methods in a research project.

Media theories provide the framework for approaching questions about media effects ranging from as simple as how 10-year-old boys react to cereal advertisements to as broad as how Internet use affects literacy. Once researchers visualize a project and determine a theoretical framework, they must choose actual research methods. Contemporary research methods are greatly varied and can range from analyzing old newspapers to performing controlled experiments.

Content Analysis

Content analysis is a research technique that involves analyzing the content of various forms of media. Through content analysis, researchers hope to understand both the people who created the content and the people who consumed it. A typical content analysis project does not require elaborate experiments. Instead, it simply requires access to the appropriate media to analyze, making this type of research an easier and inexpensive alternative to other forms of research involving complex surveys or human subjects.

Content analysis studies require researchers to define what types of media to study. For example, researchers studying violence in the media would need to decide which types of media to analyze, such as television, and the types of formats to examine, such as children’s cartoons. The researchers would then need to define the terms used in the study; media violence can be classified according to the characters involved in the violence (strangers, family members, or racial groups), the type of violence (self-inflicted, slapstick, or against others), or the context of the violence (revenge, random, or duty-related). These are just a few of the ways that media violence could be studied with content-analysis techniques (Berger, 1998).

Archival Research

Any study that analyzes older media must employ archival research, which is a type of research that focuses on reviewing historical documents such as old newspapers and past publications. Old local newspapers are often available on microfilm at local libraries or at the newspaper offices. University libraries generally provide access to archives of national publications such as The New York Times or Time ; publications can also increasingly be found in online databases or on websites.

Older radio programs are available for free or by paid download through a number of online sources. Many television programs and films have also been made available for free download, or for rent or sale through online distributors. Performing an online search for a particular title will reveal the options available.

Resources such as the Internet Archive ( www.archive.org ) work to archive a number of media sources. One important role of the Internet Archive is website archiving. Internet archives are invaluable for a study of online media because they store websites that have been deleted or changed. These archives have made it possible for Internet content analyses that would have otherwise been impossible.

Surveys are ubiquitous in modern life. Questionaires record data on anything from political preferences to personal hygiene habits. Media surveys generally take one of the following two forms.

A descriptive survey aims to find the current state of things, such as public opinion or consumer preferences. In media, descriptive surveys establish television and radio ratings by finding the number of people who watch or listen to particular programs. An analytical survey, however, does more than simply document a current situation. Instead, it attempts to find out why a particular situation exists. Researchers pose questions or hypotheses about media, and then conduct analytical surveys to answer these questions. Analytical surveys can determine the relationship between different forms of media consumption and the lifestyles and habits of media consumers.

Surveys can employ either open-ended or closed-ended questions. Open-ended questions require the participant to generate answers in their own words, while closed-ended questions force the participant to select an answer from a list. Although open-ended questions allow for a greater variety of answers, the results of closed-ended questions are easier to tabulate. Although surveys are useful in media studies, effective use requires keeping their limitations in mind.

Social Role Analysis

As part of child rearing, parents teach their children about social roles. When parents prepare children to attend school for example, they explain the basics of school rules and what is expected of a student to help the youngsters understand the role of students. Like the role of a character in a play, this role carries specific expectations that differentiate school from home. Adults often play a number of different roles as they navigate between their responsibilities as parents, employees, friends, and citizens. Any individual may play a number of roles depending on his or her specific life choices.

Social role analysis of the media involves examining various individuals in the media and analyzing the type of role that each plays. Role analysis research can consider the roles of men, women, children, members of a racial minority, or members of any other social group in specific types of media. For example, if the role children play in cartoons is consistently different from the role they play in sitcoms, then certain conclusions might be drawn about both of these formats. Analyzing roles used in media allows researchers to gain a better understanding of the messages that the mass media sends (Berger, 1998).

Depth Interviews

The depth interview is an anthropological research tool that is also useful in media studies. Depth interviews take surveys one step further by allowing researchers to directly ask a study participant specific questions to gain a fuller understanding of the participant’s perceptions and experiences. Depth interviews have been used in research projects that follow newspaper reporters to find out their reasons for reporting certain stories and in projects that attempt to understand the motivations for reading romance novels. Depth interviews can provide a deeper understanding of the media consumption habits of particular groups of people (Priest, 2010).

Rhetorical Analysis

Rhetorical analysis involves examining the styles used in media and attempting to understand the kinds of messages those styles convey. Media styles include form, presentation, composition, use of metaphors, and reasoning structure. Rhetorical analysis reveals the messages not apparent in a strict reading of content. Studies involving rhetorical analysis have focused on media such as advertising to better understand the roles of style and rhetorical devices in media messages (Gunter, 2000).

Focus Groups

Like depth interviews, focus groups allow researchers to better understand public responses to media. Unlike a depth interview, however, a focus group allows the participants to establish a group dynamic that more closely resembles that of normal media consumption. In media studies, researchers can employ focus groups to judge the reactions of a group to specific media styles and to content. This can be a valuable means of understanding the reasons for consuming specific types of media.

2.3.0

Focus groups are effective ways to obtain a group opinion on media.

Wikimedia Commons – CC BY-SA 3.0.

Experiments

Media research studies also sometimes use controlled experiments that expose a test group to an experience involving media and measure the effects of that experience. Researchers then compare these measurements to those of a control group that had key elements of the experience removed. For example, researchers may show one group of children a program with three incidents of cartoon violence and another control group of similar children the same program without the violent incidents. Researchers then ask the children from both groups the same sets of questions, and the results are compared.

Participant Observation

In participant observation , researchers try to become part of the group they are studying. Although this technique is typically associated with anthropological studies in which a researcher lives with members of a particular culture to gain a deeper understanding of their values and lives, it is also used in media research.

Media consumption often takes place in groups. Families or friends gather to watch favorite programs, children may watch Saturday morning cartoons with a group of their peers, and adults may host viewing parties for televised sporting events or awards shows. These groups reveal insights into the role of media in the lives of the public. A researcher might join a group that watches football together and stay with the group for an entire season. By becoming a part of the group, the researcher becomes part of the experiment and can reveal important influences of media on culture (Priest).

Researchers have studied online role-playing games, such as World of Warcraft , in this manner. These games reveal an interesting aspect of group dynamics: Although participants are not in physical proximity, they function as a group within the game. Researchers are able to study these games by playing them. In the book Digital Culture, Play, and Identity: A World of Warcraft Reader , a group of researchers discussed the results of their participant observation studies. The studies reveal the surprising depth of culture and unwritten rules that exist in the World of Warcraft universe and give important interpretations of why players pursue the game with such dedication (Corneliussen & Rettberg, 2008).

Key Takeaways

  • Media research methods are the practical procedures for carrying out a research project. These methods include content analysis, surveys, focus groups, experiments, and participant observation.
  • Research methods generally involve either test subjects or analysis of media. Methods involving test subjects include surveys, depth interviews, focus groups, and experiments. Analysis of media can include content, style, format, social roles, and archival analysis.

Media research methods offer a variety of procedures for performing a media study. Each of these methods varies in cost; thus, a project with a lower budget would be prohibited from using some of the more costly methods. Consider a project on teen violence and video game use. Then answer the following short-response questions. Each response should be a minimum of one paragraph.

  • Which methods would a research organization with a low budget favor for this project? Why?
  • How might the results of the project differ from those of one with a higher budget?

Berger, Arthur Asa. Media Research Techniques (Thousand Oaks, CA: Sage, 1998), 23–24.

Corneliussen, Hilde and Jill Walker Rettberg, “Introduction: ‘Orc ProfessorLFG,’ or Researching in Azeroth,” in Digital Culture, Play, and Identity: A World of Warcraft Reader , ed. Hilde Corneliussen and Jill Walker Rettberg (Cambridge, MA: Massachusetts Institute of Technology, 2008), 6–7.

Gunter, Barrie. Media Research Methods: Measuring Audiences, Reactions and Impact (Thousand Oaks, CA: Sage, 2000), 89.

Priest, Susanna Hornig Doing Media Research: An Introduction (Thousand Oaks, CA: Sage, 2010), 16–22.

Priest, Susanna Hornig Doing Media Research , 96–98.

Understanding Media and Culture Copyright © 2016 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Social media research: We are publishing more but with weak influence

Affiliations.

  • 1 Department of Marketing, National University of Singapore, Singapore, Singapore.
  • 2 Department of Business Administration, Holy Spirit University of Kaslik, Jounieh, Lebanon.
  • PMID: 38330028
  • PMCID: PMC10852228
  • DOI: 10.1371/journal.pone.0297241

The purpose of this paper is to address the chasm between academic research on social media as an expanding academic discipline and at the same time a growing marketing function. A bibliometric analysis indicated the evolution of academic research on social media. The results of a survey of 280 social media practitioners shed the light on the gap between academic social media research and the practice of professionals. A qualitative study also offered novel insights and recommendations for future developments in academic research on social media. The findings of this paper showed that academic research on social media is growing in terms of the number of publications but is struggling in three areas: visibility, relevance, and influence on practitioners. This study contributes to the body of knowledge on social media. The implications of our study are derived from the importance of our findings on the directions to publish more relevant and timely academic research on social media. While extensive studies exist on social media, their influence on practitioners is still limited.

Copyright: © 2024 Elhajjar, Yacoub. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Bibliometrics
  • Qualitative Research
  • Social Media*

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Media Research Paper

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The term media refers broadly to the range of tools that humans have used throughout history to communicate with each other about a shared reality. The most common reference is to the set of modern technologies – from the printing press to the Internet – which facilitate communication across space, time, and social collectives.

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Get 10% off with 24start discount code, history of the concept of media.

The Oxford English Dictionary Online (OED) notes that while classical Latin medium referred to some middle entity or state, in postclassical Latin and in British sources from the twelfth century onward, medium and media also came to denote the means of doing something. On the one hand, a medium could be understood as a more or less incidental presence, linking natural phenomena of this world and some metaphysical realm. On the other hand, a medium can serve as an intentional instrument of human action in a modern sense. In the latter respect, the OED distinguishes two conceptions – medium as an artistic modality, material, or technique; and medium as a channel of mass communication – both of them from the mid-nineteenth century. This was the period when a general idea of communication took hold (Peters 1999), partly in response to new technological means of communication with important social and aesthetic implications, from telegraph and telephone, to film, radio and, later, television. It was not until the 1960s, however, that media came into general use as a term covering diverse technologies and institutions, most commonly in the sense of mass media, communicating from one center to a mass of dispersed and anonymous receivers.

Media Research Paper

Three Disciplinary Roots of Concepts

Each media concept implies a particular understanding of the basic communication model of sender, message, and receiver. The first concept, articulated in Lasswell’s paradigm (Lasswell 1948) – who says what, in which channel, to whom, with what effect – approached the medium as a neutral conduit for the dissemination of information of all kinds. In order to assess the effects and implications of a given medium, such as a newspaper or a radio station, scholars might focus their attention on the strategies of the sender, the selectivity of the communicated message, the reach of the medium in question, or the susceptibility of the receivers to particular ideas. A great deal of subsequent work has questioned Lasswell’s focus on separate stages of communication, as associated with separate forms of media analysis. In fairness, Lasswell further emphasized the function of media as mechanisms of surveillance at a macro-level. Media are means of monitoring a society as well as its surroundings with a view to self-protection, self-regulation, and long-term stability. In this regard, media can be understood in social scientific terms as a particular set of institutions in society.

The second variant was stated in the mathematical theory of communication. Its basis was Claude Shannon’s research and development regarding the physical and technological conditions for the transfer of signals in telephone systems. A number of the insights were presented in a joint publication with Warren Weaver (Shannon & Weaver 1949), and it was this volume that influenced a good deal of theory development on media. In fact, Shannon was addressing the material aspects of how to design a communication system. In its popularized form, however, the underlying model of engineering was applied to humans as a description of social interaction. Although such applications have regularly been criticized as metaphorical and imprecise, the model has remained an important part of the heritage of communication theory. This may be due, in part, to the obvious point that media are concrete vehicles whose affordances and constraints condition their potential role in human communication. The attempt to account for media as material technologies with social implications has continued to occupy communication researchers.

The third concept derives from humanistic perspectives on media as aesthetic means of expression and as carriers of cultural and historical meaning. Rooted in centuries of rhetorical and hermeneutic scholarship, this discursive media concept received an influential formulation in Roman Jakobson’s (1960) model of communication. While carrying an outward resemblance to the models of Lasswell and Shannon and Weaver, Jakobson’s model grew out of literary theory, highlighting the various communicative functions of different linguistic and aesthetic choices by authors. Jakobson further made a distinction between the channel (what he termed contact – the material relation, such as book, newspaper, or Internet) and the code (the modalities or forms of expression, such as speech, writing, music, moving images, etc.). Compared to both Lasswell and Shannon and Weaver, however, Jakobson stayed entirely within the boundaries of the text or message, calling for an immanent analysis of how communicative functions manifest themselves in concrete textual structures, and bracketing the social contexts and uses of, for instance, literature or advertising. Much humanistic scholarship, accordingly, has approached media as forms of expression that are externalized and available for study in the form of discourses.

An Interdisciplinary Concept of Media

Particularly since the 1980s, much media research has been characterized by efforts at combining and integrating these concepts as dimensions within some form of theoretical systematic. A common position is that all three perspectives are necessary, and none of them sufficient, for a scientifically valid and socially relevant field of media studies. Interdisciplinary research and debate has explored not least the relationship between social sciences (media as institutions) and humanities (media as discourses) (for overview, see Jensen 2002b). Until recently, there appears to have been relatively less theory development devoted specifically to the interrelations between media as material technologies and media as institutions and discourses – despite the wealth of research on new media technologies as well as a growing interest in the distinctive affordances of different media technologies and their historical uses. Digitization has provided an impetus for reconsidering how, concretely, the materiality of media shapes, and is shaped by, culture and society.

The individual media can be understood as characteristic configurations of the human potential for communication at a given historical time. These configurations are organized along three dimensions – materials, modalities, and institutions – as identified in the three conceptions of a medium.

Media are physical materials which – in a particular cultural shape – enable forms of communication that previously had not been possible. Sound recordings, from the late 1800s, made possible the preservation of parts of the cultural heritage that until then had disappeared into the air. From the 1910s, recorded sound became mobile with the introduction of portable gramophones. And, from 1979, media users wearing a Walkman were able to create soundscapes that were at once mobile and private.

It is through specific forms of expression and experience that media enable human communication – language, music, moving images, etc. These modalities, on the one hand, are grounded biologically in the human senses. On the other hand, modalities have been subject to millennia of differentiation and cultivation. In modern media technologies, the modalities have entered into shifting and evolving genres – from novels and radio serials, to music videos and virtual worlds.

Institutions

Media, finally, constitute distinctive institutions in society: through media, individuals and collectives can describe and reflect upon themselves as well as the rest of society. Media and other social institutions have jointly reproduced each other under changing technological and cultural circumstances. Print and electronic media extended cultures in space and sustained nation-states over time; nation-states and international treaties regulate the legal limits of public communication and the economic bases of each new medium. Television, for example, was developed as a consumer good for the home, financed by advertising or license fees, even though the material technology might have been framed socially on the model of cinema as a public or community activity.

In comparison with other meaningful cultural artifacts and social arrangements – from interior decorating to business transactions – the media that constitute the objects of analysis in media and communication research, are distinguished by their programmability, being uniquely flexible resources for the articulation of information and communicative interaction as part of an ongoing social structuration (Giddens 1984).

Whereas programmability is most commonly associated with the various levels of the digital computer, other communication platforms also lend themselves to combinatorial configurations. First, the modalities of media amount to semiotic registers of language, music, images, etc., allowing for an immense repertoire of genres and discourses, and engaging the human senses in selective and culturally conventional ways. Thus, media make possible the rendering of and interaction with worlds past and present, real and imagined. Second, the technologies of media provide the material substratum of such representations, not as fixed conduits, but as resources for accomplishing particular social and aesthetic ends. Third, media communicate to, about, and on behalf of social institutions, which, again, are shaped and reshaped through communication. As combinatorial systems, media and societies can be said to mutually program each other – a notion that, for example, systems theory has elaborated and formalized. The degrees of freedom that condition this entire process, in three dimensions, help to account for the relative indetermination of the structures and outcomes of mediated communication, and continue to challenge research on the question of what difference the media make.

Media of Three Degrees

The coming of digital media has stimulated renewed research interest in the duality of mediated and nonmediated communication. For one thing, ordinary human conversation, while nonmediated by technologies, is mediated by aural–oral modalities, in addition to body language, broadly speaking. For another thing, computer-mediated communication – email, chat, online gaming – often carries a stronger resemblance to interpersonal than to mass communication. In order to assess the implications of digital media as emerging social and cultural institutions, much ongoing work has begun to address the interrelations between different media types (Bolter & Grusin 1999; Manovich 2001; Lievrouw & Livingstone 2002). One explanatory framework would distinguish between media of three degrees (Jensen 2002a).

Media of the first degree can be defined as the biologically based, socially formed resources that enable humans to articulate an understanding of reality, for a particular purpose, and to engage in communication about it with others. The central example is verbal language, or speech, as constitutive of oral cultures and subcultures – additional examples include song and other musical expression, dance, drama, painting, and creative arts generally, often relying on mechanical techniques such as musical instruments and artistic or writing utensils as necessary elements. Importantly, such media depend on the presence of the human body in local time–space. While one might identify (spoken) language, or the human voice, as the medium, it is helpful to differentiate between, for instance, speech and song as media with reference to their different modalities, sharing the same material substratum, but commonly addressing different social institutions, contexts, and practices.

Media of the second degree come under the classic definition by Walter Benjamin (1936/1977) of the technically reproduced and enhanced forms of representation and interaction which support communication across space and time, irrespective of the presence and number of participants. Whereas Benjamin emphasized photography, film, and radio, media of the second degree range from early modern examples, including the standardized reproduction of religious and political texts by the printing press, to television and video. The common features are, first, one-to-one reproduction, storage, and presentation of a particular content and, second, radically extended possibilities for dissemination across time and space. These technologies had important consequences for major social institutions – from the breakup of the Catholic church to the rise of the nation-state. Also, modalities from media of the first degree were refashioned. In radio talk shows, conversation took on new conventions, just as acting styles were adapted from the theater stage to cinema and television.

It is debatable whether manuscripts, which fix speech, drawing, music, and other human communication in a stable format, should be considered a separate media category, partly in view of their epochal significance. In historical perspective, Meyrowitz (1994, 54) suggested that its comparatively inefficient forms of reproduction and distribution made handwriting a transitional cultural form. For a systematics of media, and from the perspective of media and communication research as a field, it can be argued that the production of manuscripts, like other media of the first degree, is embodied and local, laborious and error-prone; that their distribution is commonly selective rather than public, within established institutions, as supported by oral commentary; and that the constitutive role of handwriting in the reproduction of cultural tradition and social institutions has been taken over by media of the second degree.

Media of the third degree are the digitally processed forms of representation and interaction. Digital technology enables reproduction and recombination of all media of the second degree on a single platform: computers, thus, can be understood as metamedia (Kay & Goldberg 1977/1999). The central current example is the networked personal computer, although this interface, like that of mobile telephones, is likely to change substantially as technologies are adapted further to the human senses, and integrated into both common objects and social arrangements. Whereas classic mass media, such as illustrated magazines and television, combined modalities to a considerable degree, the scale and speed with which digitalization facilitates their incorporation and reconfiguration suggests that digital media may represent a qualitative shift from media of the second degree that is comparable to the shift from first-degree to second-degree media. The media types have not replaced each other – they recirculate the forms and contents of shifting cultural traditions in social contexts. They do, however, offer distinctive and ascending degrees of programmability in terms of adaptable technologies, differentiated modalities, and institutions transcending time, space, and social collectives.

The Double Hermeneutics

The development both of the concept of media and of media studies indicates that media are understood in historical context. The modern, general concept of communication was, in part, a response to nineteenth-century analog technologies (Peters 1999); current debates about the concept of media may be a response to twentieth-century digital technologies. This interplay of social and conceptual changes has been called a double hermeneutics (Giddens 1984): changing social realities challenge research to deliver new interpretations and explanations – which, in turn, may change society, for example, through the design and regulation of media.

Bibliography:

  • Benjamin, W. (1977). The work of art in the age of mechanical reproduction. In J. Curran, M. Gurevitch, & J. Woollacott (eds.), Mass communication and society. London: Edward Arnold. (Original work published 1936).
  • Bolter, J. D., & Grusin, R. (1999). Remediation: Understanding new media. Cambridge, MA: MIT Press.
  • Giddens, A. (1984). The constitution of society. Berkeley, CA: University of California Press.
  • Jakobson, R. (1960). Closing statement: Linguistics and poetics. In T. A. Sebeok (ed.), Style in language. Cambridge, MA: MIT Press.
  • Jensen, K. B. (2002a). Introduction: The state of convergence in media and communication research. In K. B. Jensen (ed.), A handbook of media and communication research: Qualitative and quantitative methodologies. London: Routledge.
  • Jensen, K. B. (ed.) (2002b). A handbook of media and communication research: Qualitative and quantitative methodologies. London: Routledge.
  • Kay, A., & Goldberg, A. (1999). Personal dynamic media. In P. A. Mayer (ed.), Computer media and communication: A reader. Oxford: Oxford University Press, pp. 111–119. (Original work published 1977).
  • Lasswell, H. D. (1948). The structure and function of communication in society. In L. Bryson (ed.), The communication of ideas. New York: Harper, pp. 32 –51.
  • Lievrouw, L., & Livingstone, S. (eds.) (2002). Handbook of new media: Social shaping and social consequences. London: Sage.
  • Manovich, L. (2001). The language of new media. Cambridge, MA: MIT Press.
  • Meyrowitz, J. (1994). Medium theory. In D. Crowley & D. Mitchell (eds.), Communication theory today. Cambridge: Polity Press.
  • Peters, J. D. (1999). Speaking into the air: A history of the idea of communication. Chicago, IL: University of Chicago Press.
  • Shannon, C., & Weaver, W. (1949). The mathematical theory of communication. Urbana, IL: University of Illinois Press.

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Visual media symposium 2024, state of visual evidence symposium.

We invite experts in the field of visual communication to discuss the current challenges and opportunities that synthetic media pose for the contemporary media environment, and how we can utilize visuals as data to answer social scientific questions.

Date: Monday, April 8, 3-6:30 p.m. (central time USA)

Conference Mode: Zoom  

Opening Remarks: 3-3:15 p.m.

Melissa Tully, Sang Jung Kim, Alex Scott and Bingbing Zhang

Keynote 1: 3:15-4:15 p.m.

Speaker: Bryce Dietrich  

Moderator: Sang Jung Kim

Topic: Video-as-data; Seeing Racial Avoidance on Virtual Streets

Speaker Bio: Dietrich is an Associate Professor of Political Science at Purdue University. He is also a Research Scholar at the Center for C-SPAN Scholarship & Engagement. Previously, he was an Assistant Professor of Social Science Informatics at the University of Iowa and a postdoctoral research fellow at Harvard's Kennedy School and Northeastern University.

Dietrich's research uses novel quantitative, automated, and machine learning methods to analyze non-traditional data sources such as audio (or speech) data and video data. He uses these to understand the causes and consequences of non-verbal political behavior, such as vocal inflections and walking trajectories, especially in relation to descriptive representation and implicit gender/racial bias. Underlying this research is a love for high-performance computing and a genuine desire to make "big data" more accessible, while his substantive interests are firmly grounded in American political behavior at both the mass- and elite-level.

Keynote 2: 4:15-5:15 p.m

Speaker: Cindy Shen  

Moderator: Bingbing Zhang

Topic: Perception, mechanism, and intervention of visual misinformation 

Speaker Bio: Cuihua (Cindy) Shen is a professor of communication at UC Davis and the co-director of the Computational Communication Research lab. Her recent research focuses on computational social science and multimodal (mis)information in AI-mediated environments. She is the past chair of the Computational Methods Division of the International Communication Association, and the founding associate editor of the journal Computational Communication Research , as well as the associate editor of Journal of Computer-Mediated Communication . Her research has been funded by the National Science Foundation and Facebook. She is a recipient of numerous top paper awards from ICA as well as a Fulbright US Scholar Award. 

Keynote 3: 5:15-6:15 p.m.

Q & A with  T. J. Thomson  

Moderator: Alex Scott

Topic: Impact of AI generated images & visual misinformation 

Speaker Bio:   A majority of Thomson's research centers on the visual aspects of news and journalism and on the concerns and processes relevant to those who make, edit, and present visual news. He has broader interests in digital media, journalism studies, and visual culture and often focuses on under-represented identities, attributes, and environments in his research. Thomson is committed to not only studying visual communication phenomena but also working to increase the visibility, innovation, and quality of how research findings are presented, accessed, and understood.

Thomson has obtained more than $1.32 million in external research funding from a number of organizations, including the Australian Academy of the Humanities, the Australian Research Council, the Office of the Queensland Chief Scientist, the University of Nottingham Ningbo China, and the International Visual Literacy Association. He has also been awarded research fellowships in China and Germany.

Closing Remarks: 6:15-6:30 p.m.

Sang Jung Kim, Alex Scott and Bingbing Zhang

Symposium Co-Sponsors

The School of Journalism and Mass Communication and Visual Media Lab would like to thank the symposium co-sponsors for their support of this event:

  • College of Liberal Arts and Sciences
  • Department of Communication Studies
  • Department of Cinematic Arts
  • SPARTA Lab - Department of Computer Science
  • Department of Political Science
  • Public Policy Center

NOTICE: The University of Iowa Center for Advancement is an operational name for the State University of Iowa Foundation, an independent, Iowa nonprofit corporation organized as a 501(c)(3) tax-exempt, publicly supported charitable entity working to advance the University of Iowa. Please review its full disclosure statement.

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Americans’ social media use, youtube and facebook are by far the most used online platforms among u.s. adults; tiktok’s user base has grown since 2021.

To better understand Americans’ social media use, Pew Research Center surveyed 5,733 U.S. adults from May 19 to Sept. 5, 2023. Ipsos conducted this National Public Opinion Reference Survey (NPORS) for the Center using address-based sampling and a multimode protocol that included both web and mail. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race and ethnicity, education and other categories.

Polls from 2000 to 2021 were conducted via phone. For more on this mode shift, read our Q&A .

Here are the questions used for this analysis , along with responses, and  its methodology ­­­.

A note on terminology: Our May-September 2023 survey was already in the field when Twitter changed its name to “X.” The terms  Twitter  and  X  are both used in this report to refer to the same platform.

Social media platforms faced a range of controversies in recent years, including concerns over misinformation and data privacy . Even so, U.S. adults use a wide range of sites and apps, especially YouTube and Facebook. And TikTok – which some Congress members previously called to ban – saw growth in its user base.

These findings come from a Pew Research Center survey of 5,733 U.S. adults conducted May 19-Sept. 5, 2023.

Which social media sites do Americans use most?

A horizontal bar chart showing that most U.S. adults use YouTube and Facebook; about half use Instagram.

YouTube by and large is the most widely used online platform measured in our survey. Roughly eight-in-ten U.S. adults (83%) report ever using the video-based platform.

While a somewhat lower share reports using it, Facebook is also a dominant player in the online landscape. Most Americans (68%) report using the social media platform.

Additionally, roughly half of U.S. adults (47%) say they use Instagram .

The other sites and apps asked about are not as widely used , but a fair portion of Americans still use them:

  • 27% to 35% of U.S. adults use Pinterest, TikTok, LinkedIn, WhatsApp and Snapchat.
  • About one-in-five say they use Twitter (recently renamed “X”) and Reddit.  

This year is the first time we asked about BeReal, a photo-based platform launched in 2020. Just 3% of U.S. adults report using it.

Recent Center findings show that YouTube also dominates the social media landscape among U.S. teens .

TikTok sees growth since 2021

One platform – TikTok – stands out for growth of its user base. A third of U.S. adults (33%) say they use the video-based platform, up 12 percentage points from 2021 (21%).

A line chart showing that a third of U.S. adults say they use TikTok, up from 21% in 2021.

The other sites asked about had more modest or no growth over the past couple of years. For instance, while YouTube and Facebook dominate the social media landscape, the shares of adults who use these platforms has remained stable since 2021.

The Center has been tracking use of online platforms for many years. Recently, we shifted from gathering responses via telephone to the web and mail. Mode changes can affect study results in a number of ways, therefore we have to take a cautious approach when examining how things have – or have not – changed since our last study on these topics in 2021. For more details on this shift, please read our Q&A .

Stark age differences in who uses each app or site

Adults under 30 are far more likely than their older counterparts to use many of the online platforms. These findings are consistent with previous Center data .

A dot plot showing that the youngest U.S. adults are far more likely to use Instagram, Snapchat and TikTok; age differences are less pronounced for Facebook.

Age gaps are especially large for Instagram, Snapchat and TikTok – platforms that are used by majorities of adults under 30. For example:

  • 78% of 18- to 29-year-olds say they use Instagram, far higher than the share among those 65 and older (15%).
  • 65% of U.S. adults under 30 report using Snapchat, compared with just 4% of the oldest age cohort.
  • 62% of 18- to 29-year-olds say they use TikTok, much higher than the share among adults ages 65 years and older (10%).
  • Americans ages 30 to 49 and 50 to 64 fall somewhere in between for all three platforms.

YouTube and Facebook are the only two platforms that majorities of all age groups use. That said, there is still a large age gap between the youngest and oldest adults when it comes to use of YouTube. The age gap for Facebook, though, is much smaller.

Americans ages 30 to 49 stand out for using three of the platforms – LinkedIn, WhatsApp and Facebook – at higher rates. For instance, 40% of this age group uses LinkedIn, higher than the roughly three-in-ten among those ages 18 to 29 and 50 to 64. And just 12% of those 65 and older say the same. 

Overall, a large majority of the youngest adults use multiple sites and apps. About three-quarters of adults under 30 (74%) use at least five of the platforms asked about. This is far higher than the shares of those ages 30 to 49 (53%), 50 to 64 (30%), and ages 65 and older (8%) who say the same.  

Refer to our social media fact sheet for more detailed data by age for each site and app.

Other demographic differences in use of online platforms

A number of demographic differences emerge in who uses each platform. Some of these include the following:

  • Race and ethnicity: Roughly six-in-ten Hispanic (58%) and Asian (57%) adults report using Instagram, somewhat higher than the shares among Black (46%) and White (43%) adults. 1
  • Gender: Women are more likely than their male counterparts to say they use the platform.
  • Education: Those with some college education and those with a college degree report using it at somewhat higher rates than those who have a high school degree or less education.
  • Race and ethnicity: Hispanic adults are particularly likely to use TikTok, with 49% saying they use it, higher than Black adults (39%). Even smaller shares of Asian (29%) and White (28%) adults say the same.
  • Gender: Women use the platform at higher rates than men (40% vs. 25%).
  • Education: Americans with higher levels of formal education are especially likely to use LinkedIn. For instance, 53% of Americans with at least a bachelor’s degree report using the platform, far higher than among those who have some college education (28%) and those who have a high school degree or less education (10%). This is the largest educational difference measured across any of the platforms asked about.

Twitter (renamed “X”)

  • Household income: Adults with higher household incomes use Twitter at somewhat higher rates. For instance, 29% of U.S. adults who have an annual household income of at least $100,000 say they use the platform. This compares with one-in-five among those with annual household incomes of $70,000 to $99,999, and around one-in-five among those with annual incomes of less than $30,000 and those between $30,000 and $69,999.
  • Gender: Women are far more likely to use Pinterest than men (50% vs. 19%).
  • Race and ethnicity: 54% of Hispanic adults and 51% of Asian adults report using WhatsApp. This compares with 31% of Black adults and even smaller shares of those who are White (20%).

A heat map showing how use of online platforms – such as Facebook, Instagram or TikTok – differs among some U.S. demographic groups.

  • Estimates for Asian adults are representative of English speakers only. ↩

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Table of contents, q&a: how – and why – we’re changing the way we study tech adoption, americans’ use of mobile technology and home broadband, social media fact sheet, internet/broadband fact sheet, mobile fact sheet, most popular.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

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Title: immediate generalisation in humans but a generalisation lag in deep neural networks$\unicode{x2014}$evidence for representational divergence.

Abstract: Recent research has seen many behavioral comparisons between humans and deep neural networks (DNNs) in the domain of image classification. Often, comparison studies focus on the end-result of the learning process by measuring and comparing the similarities in the representations of object categories once they have been formed. However, the process of how these representations emerge$\unicode{x2014}$that is, the behavioral changes and intermediate stages observed during the acquisition$\unicode{x2014}$is less often directly and empirically compared. Here we report a detailed investigation of how transferable representations are acquired in human observers and various classic and state-of-the-art DNNs. We develop a constrained supervised learning environment in which we align learning-relevant parameters such as starting point, input modality, available input data and the feedback provided. Across the whole learning process we evaluate and compare how well learned representations can be generalized to previously unseen test data. Our findings indicate that in terms of absolute classification performance DNNs demonstrate a level of data efficiency comparable to$\unicode{x2014}$and sometimes even exceeding that$\unicode{x2014}$of human learners, challenging some prevailing assumptions in the field. However, comparisons across the entire learning process reveal significant representational differences: while DNNs' learning is characterized by a pronounced generalisation lag, humans appear to immediately acquire generalizable representations without a preliminary phase of learning training set-specific information that is only later transferred to novel data.

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Authors of this article:

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  • Rupal Trivedi 1 , RDN, MS, PhD   ; 
  • Shaimaa Elshafie 1 , BPharm, MS   ; 
  • Randall Tackett 1 , PhD   ; 
  • Henry Young 1 , PhD   ; 
  • Elisabeth Lilian Pia Sattler 1, 2 , RPh, PhD  

1 Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA, United States

2 Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA, United States

Corresponding Author:

Elisabeth Lilian Pia Sattler, RPh, PhD

Department of Clinical and Administrative Pharmacy

College of Pharmacy

University of Georgia

250 W Green St

United States

Phone: 1 7065421040

Email: [email protected]

Background: Telehealth-based dietary interventions were recommended for cardiovascular disease (CVD) management during the COVID-19 pandemic; however, data regarding their effectiveness and feasibility are limited.

Objective: We aimed to examine (1) the effectiveness of telehealth-based dietary interventions in improving clinical CVD risk factors and (2) the feasibility of these interventions among individuals with CVD.

Methods: To conduct this systematic review and meta-analysis of randomized controlled trials (RCTs), 2 investigators searched PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov databases based on predetermined search terms and included English-language RCTs published between January 2000 and July 2022. The Cochrane Risk of Bias tool was used to assess RCT quality. To evaluate intervention effectiveness, weight, BMI, systolic and diastolic blood pressure, and levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, or blood glucose were compared postintervention in telehealth and usual care (UC) groups. Feasibility was determined through the number of participants retained in intervention and UC groups. Pooled data for each CVD outcome were analyzed using a random effects model. Mean difference (MD), standardized MD, or risk ratio were calculated using R software.

Results: A total of 13 RCTs with 3013 participants were included in the analysis to assess the effectiveness and feasibility of telehealth-based dietary interventions among individuals with CVD. Participants had a mean age of 61.0 (SD 3.7) years, and 18.5% (n=559) were women. Approximately one-third of RCTs were conducted in the United States (n=4, 31%). Included studies used telephone, app, text, audio-visual media, or website-based interventions. Of the 13 included studies, 3 were of high quality, 9 were of moderate quality, and only 1 was of low quality. Pooled estimates showed systolic blood pressure (MD –2.74, 95% CI –4.93 to –0.56) and low-density lipoprotein cholesterol (standardized MD –0.11, 95% CI –0.19 to –0.03) to be significantly improved among individuals with CVD as a result of telehealth-based dietary interventions compared to UC. No significant difference in effectiveness was detected for weight, BMI, and levels of diastolic blood pressure, total cholesterol, high-density lipoprotein, and triglycerides between telehealth-based dietary interventions and UC among those with CVD. There was no significant difference between the feasibility of telehealth-based dietary interventions versus UC. Significant I 2 indicated moderate to considerable heterogeneity.

Conclusions: Telehealth-based dietary interventions show promise in addressing CVD risk factors.

Introduction

Cardiovascular diseases (CVDs) impact 126.9 million American adults and are associated with 5.0 million annual hospitalizations, 874,613 annual deaths, and US $378 billion in medical expenditures in the United States [ 1 ]. CVD diagnoses are adversely impacted by lifestyle-related CVD risk factors [ 2 ]. About 80% of CVD risk in the United States can be attributed to lifestyle factors, including the consumption of an unhealthy diet, smoking, physical inactivity, alcohol use, obesity, uncontrolled levels of blood pressure, total cholesterol, and blood glucose [ 2 ]. Out of these lifestyle-related factors, the consumption of an unhealthy diet contributes to the largest proportion of CVD risk among Americans [ 2 ].

For primary and secondary CVD prevention, clinical guidelines endorse the maintenance of a healthy body weight, engagement in physical activity, smoking cessation, limited alcohol consumption, and a healthy diet [ 3 - 6 ]. Registered dietitian nutritionist (RDN)-led medical nutrition therapy has been shown to successfully improve dietary consumption among individuals with CVD [ 3 , 5 , 6 ]; however, limited access to health care services due to long travel distances and lack of adequate transportation to health care facilities presents significant barriers to obtaining effective medical nutrition therapy, particularly in rural communities [ 7 - 11 ].

Telehealth technologies provide a solution for overcoming these barriers by administering and supporting clinical health care over a long distance [ 12 , 13 ]. Through the use of the internet, videoconferencing, streaming media, electronic health records, and terrestrial and wireless communication tools, a variety of medical conditions have been successfully managed, including CVD [ 14 , 15 ]. Furthermore, the American Society for Preventative Cardiology recommended telehealth technologies for the dissemination of RDN-led medical nutrition therapy among those diagnosed with CVD during the COVID-19 pandemic [ 16 ]. While RDN-led telehealth-based medical nutrition therapy showed great promise in expanding patient care infrastructure during the pandemic, data regarding the effectiveness and feasibility of telehealth services among individuals with CVD are limited [ 16 ]. Previous research used small sample sizes, lacked inclusion of individuals with CVD as the target population, and did not assess telehealth-based dietary interventions [ 17 ]. Therefore, the objective of this study was to determine the effectiveness and feasibility of telehealth-based dietary interventions among individuals with CVD.

Study Design

We conducted a systematic review and meta-analysis, guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 [ 18 ].

Inclusion Criteria

Randomized controlled trials (RCTs) published in the English language between January 2000 and July 31, 2022, that compared telehealth-based dietary interventions and usual care (UC) among adults aged ≥18 years with CVD were included in this study. Eligible RCTs involved participants with CVDs, including coronary heart disease, heart failure, hypertension, individuals with CVD with a history of cardiac events (myocardial infarction, acute coronary syndromes, angina, and revascularization), and individuals with CVD with a history of cardiac procedures (percutaneous coronary intervention and coronary artery bypass graft surgery) [ 19 , 20 ]. Interventions were considered as telehealth-based dietary interventions if diet-related information was conveyed through synchronous or asynchronous points-of-contacts between a patient and a health care professional via medical education systems or information and communications technologies, such as telephones, cellular phones, web-based systems, and video technologies [ 21 , 22 ]. Participants in UC groups received some form of in-person nutritional care as a part of CVD management. If the involvement of nutritional care in UC was not clearly stated in the RCTs’ papers, authors R Trivedi and ELPS contacted the study authors to gain clarity. In the case where authors did not reply with clarification, the corresponding RCT was excluded from this systematic review and meta-analysis. To determine the effectiveness of telehealth-based dietary interventions, clinical CVD risk factors (weight, BMI, systolic and diastolic blood pressures, and levels of total cholesterol, low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol, triglycerides, or blood glucose) were assessed in postintervention in telehealth, and compared to UC groups. To determine patient feasibility toward the telehealth-based dietary interventions, the included studies reported the number of participants retained by the RCT in both intervention and UC groups.

Search Strategy

PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov databases were searched using the following key terms and Medical Subject Headings terms: (“diet” or “nutrition” or “nutrition status” or “status, nutrition” or “nutritional science” or “science, nutritional” or “nutrition science” or “science, nutrition”) and (“telehealth” or “telemedicine” or “mobile health” or “health, mobile” or “mhealth” or “telehealth” or “ehealth”) and (“cardiovascular disease” or “cardiovascular diseases” or “disease, cardiovascular” or “diseases, cardiovascular” or “heart disease” or “cardiac disease” or “cardiac disorder” or “heart disorder” or “vascular disease” or “disease, vascular”) and (“rand*”). An experienced librarian reviewed and confirmed this search strategy ( Multimedia Appendix 1 ).

Using the predetermined search string, 2 investigators (R Trivedi and SE) first screened titles and abstracts to determine eligibility independently. Further scrutiny was given to the full text of the selected papers to determine whether eligibility was sustained. The included and excluded records were compared between the 2 investigators, and no unresolved disagreements needed to be reconciled through the input of a third investigator (ELPS).

Data Extraction

Study characteristics manually extracted from each RCT included National Clinical Trial identifier number, first author’s last name, year of publication, cardiovascular condition, interventions and their duration, follow-up durations after intervention initiation, country in which the study took place, location type (urban or rural), and total number of randomized participants. Participant characteristics extracted from each RCT included age, gender, race or ethnicity, and education and income levels. Continuous clinical outcome data included postintervention weight (kg or lbs), BMI (kg/m 2 ), systolic and diastolic blood pressure (mmHg), and levels of total cholesterol (mg/dL or mmol/L), LDL cholesterol (mg/dL or mmol/L), HDL cholesterol (mg/dL or mmol/L), triglycerides (mg/dL or mmol/L), or blood glucose (mg/dL or mmol/L) from intervention and UC groups, respectively. The dichotomous feasibility outcome data included the number of participants retained in intervention and UC groups [ 23 - 28 ].

Risk of Bias

Study quality was determined independently by R Trivedi and SE through the Cochrane risk of bias tool, assessing randomization, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete or selective reporting, and external sources of bias [ 29 ]. The decision on the RCTs’ overall quality was based on the number of unmet or insufficiently described criteria and the following thresholds: more than 3 (low quality), 2-3 (moderate quality), and less than 2 (high quality). All conflicts were resolved through discussion by the 2 investigators, and no further input was required by ELPS as a third investigator.

Analytic Plan

Pooled data for each outcome was assessed using a random effects model. Data for continuous variables were assessed either as weighted mean difference (MD) or standardized mean difference (SMD) using the inverse-variance model while our dichotomous variable was assessed as a risk ratio using the Mantel-Haenszel (DerSimonian-Laird method) model to account for the variations among studies. An MD was calculated when outcomes were reported in a uniform measurement scale and SMD was calculated when nonuniform measurement scales were used. Since participants from the included studies were assigned to intervention and UC groups at random, baseline characteristics of participants between groups of each study were assumed to be similar. Therefore, no analysis was conducted to detect differences between the intervention and the UC groups at baseline. Visual inspection of the forest plots and the statistically measured I 2 determined the heterogeneity among the analyzed studies. The level of heterogeneity was based on the following I 2 thresholds: up to 29.99% (low), 30%-59.99% (moderate), 60%-74.99% (substantial), and 75%-100% (considerable). A sensitivity analysis was performed if significant heterogeneity was detected through analysis and the outcome involved more than 7 RCTs, ensuring that the I 2 estimate was reliable and not overestimated by a small number of studies analyzed [ 30 ]. The sensitivity analysis was performed based on the type of telehealth intervention and the follow-up duration after intervention initiation. Further assessment to determine the source of heterogeneity included influence analysis. Influence analysis, or “leave-one-out” approach, assesses between-study heterogeneity by quantifying the influence of any one RCT on the overall summary estimate that is calculated in a meta-analysis, which is beneficial in identifying potential sources of error or bias introduced by an RCT [ 31 - 33 ]. Visual inspection of the funnel plot and the statistical Egger test were used to assess publication bias for outcomes with more than 10 RCTs to ensure adequate power for the test [ 29 ]. All analyses were conducted using the meta and metafor packages in R (version 4.2.2; R Foundation for Statistical Computing) with a P ≤.05 (95% CI) set as a statistically significant level.

Literature Search Results

Our search string initially returned 230 records from PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov databases. Out of the 230 records, 61 were duplicates and the remaining 169 records’ titles and abstracts were initially screened. After applying the inclusion and exclusion criteria, 145 records were excluded from this study. A total of 24 RCTs’ reports were further assessed for eligibility, out of which 11 RCTs were excluded in secondary screening. Of these excluded RCTs, 4 included non-CVD participants, 5 did not report any primary outcomes of interest, and 2 did not incorporate an eligible UC. Based on the screening completed, a total of 13 RCTs were included in this study ( Figure 1 ).

media studies research paper

Study Characteristics

A summary of the study and participant characteristics of the included 13 RCTs [ 34 - 46 ] are shown in Multimedia Appendix 2 [ 34 - 46 ]. A total of 3013 participants were analyzed in this study. The mean age was 61.0 (SD 3.7) years and 18.5% (n=559) were women. Cardiovascular conditions in the included studies were a “general CVD diagnosis” (n=3), hypertension (n=3), individuals with CVD who experienced cardiac events (ie, myocardial infarction, acute coronary syndromes, angina, and revascularization, n=3), individuals with CVD who underwent cardiac procedures (ie, percutaneous coronary intervention and coronary artery bypass graft surgery, n=2), heart failure (n=1), and coronary heart disease (n=1). The trial locations included United States (n=4), Europe (n=4: Netherlands, United Kingdom, Spain, and Sweden), New Zealand (n=2), Australia (n=1), Korea (n=1), and Japan (n=1). Except for 1 trial [ 38 ], all RCTs took place in an urban setting. Intervention durations ranged from 4 weeks to 48 weeks. Follow-up durations after intervention initiation varied from 4 weeks (n=1), 6 weeks (n=1), 8 weeks (n=1), 12 weeks (n=2), 16 weeks (n=1), 24 weeks (n=4), 40 weeks (n=1), 48 weeks (n=1), to 48-56 weeks (n=1). The types of telehealth-based dietary interventions were based on apps (n=7), text messaging (n=3), telephone calls (n=1), web interaction (n=1), and an audio-visual media device (n=1). Of note, few RCTs included in this study involved RDNs in the dissemination of the telehealth-based dietary interventions (n=4) and UC (n=1).

The quality of the included RCTs, assessed based on the Cochrane risk of bias tool [ 29 ], is presented in Table 1 . Out of the 13 included studies, 3 were assessed to be of high overall quality, while 9 were of moderate quality, and only 1 was of low quality. The majority of RCTs did not mask their participants; however, the absence of masking outcome assessors and unclear description of allocation concealment additionally contributed to the moderate and low assessments of overall quality.

a Low risk of bias.

b High risk of bias.

c Moderate risk of bias.

Meta-Analysis

A summary of the pooled estimates for all outcomes is reported in Table 2 . Telehealth-based dietary interventions significantly reduced systolic blood pressure (MD –2.74, 95% CI –4.93 to –0.56) and LDL cholesterol (SMD –0.11, 95% CI –0.19 to –0.03) when compared to UC among individuals with CVD. The pooled estimates for weight (SMD –0.15, 95% CI –0.34 to 0.04), BMI (MD –0.01, 95% CI –1.70 to 1.68), diastolic blood pressure (MD –1.29, 95% CI –2.85 to 0.28), and levels for total cholesterol (SMD –0.10, 95% CI –0.28 to 0.08), HDL (SMD –0.10, 95% CI –0.22 to 0.01), and triglycerides (SMD –0.07, 95% CI –0.32 to 0.18) showed no significant difference among individuals with CVD who received telehealth-based dietary interventions versus UC. The forest plots and pooled estimate results for individual clinical outcomes are presented in Figures 2 - 9 . The feasibility of intervention groups of the included RCTs did not significantly differ from UC groups (risk ratio 0.99, 95% CI 0.95 to 1.02), as shown in Figure 10 , indicating similar feasibility between the 2 groups.

a Values for n not provided for I 2 percentages.

b SMD: standardized mean difference.

c IV: inverse-variance model.

d MD: mean difference.

e LDL: low-density lipoprotein.

f HDL: high-density lipoprotein.

g RR: risk ratio.

h M-H: Mantel-Haenszel model.

media studies research paper

Funnel plot and the Egger statistic were assessed only for the feasibility outcome because its analysis included more than 10 RCTs, which ensured adequate power to test for publication bias [ 29 ]. Visual symmetry was noted in the funnel plot for the outcome, indicating no significant evidence for publication bias, as shown in Multimedia Appendix 3 . This result was confirmed by the 1-tailed Egger regression test estimate for the feasibility outcome (t 11 =0.51, P =.62).

Sensitivity Analyses

Sensitivity analyses were conducted for the systolic blood pressure and the feasibility (ie, feasibility) outcomes to investigate the significant heterogeneity detected. These outcomes were deemed appropriate for further assessment because they involved more than 7 RCTs, ensuring that the I 2 estimate was reliable and unbiased by the small number of studies analyzed [ 30 ]. The results for the sensitivity analyses on intervention type and follow-up duration after intervention initiation are shown in Multimedia Appendix 4 [ 34 - 37 , 39 - 43 , 45 ], Multimedia Appendix 5 [ 34 - 37 , 39 - 43 , 45 ], Multimedia Appendix 6 [ 34 - 46 ], and Multimedia Appendix 7 [ 34 - 46 ]. App-based (MD –1.33, 95% CI –4.41 to 1.74) and text-based (MD –3.44, 95% CI –8.61 to 1.72) interventions did not show any significant difference between telehealth-based dietary interventions and UC for systolic blood pressure ( Multimedia Appendix 4 [ 34 - 37 , 39 - 43 , 45 ]). The RCTs that involved app-based interventions were nonsignificantly homogeneous ( I 2 =0%, P =.91); however, RCTs with text-based interventions had significant and considerable heterogeneity ( I 2 =89%, P <.01; Multimedia Appendix 4 [ 34 - 37 , 39 - 43 , 45 ]). The RCTs with a 24-week follow-up duration after intervention initiation showed a significant reduction in systolic blood pressure when compared to UC (MD –3.53, 95% CI –7.05 to –0.01) but they had significant and considerable heterogeneity ( I 2 =85%, P <.01; Multimedia Appendix 5 [ 34 - 37 , 39 - 43 , 45 ]).

The sensitivity analyses for the feasibility outcome consistently showed no significant difference between telehealth-based dietary interventions and UC groups ( Multimedia Appendices 6 [ 34 - 46 ] and 7 [ 34 - 46 ]). The RCTs involving app-based interventions had insignificant and low heterogeneity ( I 2 =14%, P =.33), while RCTs with text-based interventions demonstrated significant and considerable heterogeneity ( I 2 =78%, P =.01; Multimedia Appendix 6 [ 34 - 46 ]). Within the feasibility outcome, RCTs with a 12-week follow-up duration after intervention initiation were insignificantly homogeneous ( I 2 =0%, P =.86), while RCTs with a 24-week follow-up duration showed significant and considerable heterogeneity ( I 2 =74%, P <.01; Multimedia Appendix 7 [ 34 - 46 ]).

Influence Analysis

An influence analysis was conducted to determine whether any particular RCT impacted the heterogeneity for the systolic blood pressure and the feasibility outcomes, as shown in Multimedia Appendices 8 [ 34 - 37 , 39 - 43 , 45 ] and 9 [ 34 - 46 ]. The results for the systolic blood pressure outcome confirmed that the RCT by Chow et al [ 35 ] was the main source of heterogeneity. After omitting this RCT from the analysis, the MD summary estimate still showed telehealth-based dietary interventions to reduce systolic blood pressure significantly more than UC (MD –1.94, 95% CI –3.31 to –0.58); however, the I 2 percent of this outcome dropped from 64.4% (substantial heterogeneity) to 0% (low heterogeneity; Multimedia Appendix 8 [ 34 - 37 , 39 - 43 , 45 ]).

For the feasibility outcome, no single RCT was determined to be drastically different from the others in that its omission from analysis would reduce the outcome’s moderate heterogeneity to the low category ( Multimedia Appendix 9 [ 34 - 46 ]).

Principal Findings

To the best of our knowledge, this study is the first to assess the effectiveness and feasibility of telehealth-based dietary interventions among individuals with CVD. Our study showed that telehealth-based dietary interventions improved levels of systolic blood pressure and LDL cholesterol when compared to UC. We further found no significant difference between telehealth-based dietary interventions and UC in improving weight, BMI, levels of diastolic blood pressure, total and HDL cholesterol, and triglycerides among individuals with CVD. There was no significant difference in feasibility between telehealth-based dietary interventions and UC.

Our finding of a positive clinical effect of telehealth-based dietary interventions on LDL cholesterol levels was in contrast to a previous meta-analysis conducted by Kelly et al [ 47 ] that found no significant differences in LDL cholesterol when comparing the effectiveness of telehealth-based dietary interventions to UC in changing dietary habits among chronic disease patients. However, our results of telehealth interventions improving systolic blood pressure compared to UC were confirmed by a meta-analysis by Kelly et al [ 47 ]. Plausible explanations for the clinical effectiveness of telehealth-based dietary interventions observed in our study are rooted in the unique benefits that telehealth-based technologies provide in modifying health behaviors. Telephone-based dietary telehealth interventions likely motivated participants through easily accessible, monthly scheduled, individually tailored counseling sessions, aimed to improve multiple components of their diet (ie, the intake of sodium, fat, fruit, and vegetables) [ 34 ]. According to Bandura’s social cognitive theory (SCT), a motivated attitude can lead an individual to carry out healthy behaviors [ 48 ]. Telehealth-based dietary interventions that involved text messages were significantly more effective than UC in improving systolic blood pressure levels, possibly as a result of increasing and reinforcing participants’ knowledge of healthy behaviors through receipt of regular messages, which may impact an individual’s self-efficacy, and thereby leading to healthy behaviors per the SCT [ 36 , 48 ]. An RCT by Dale et al [ 36 ], which was included in our analysis, aimed to determine the effectiveness of a text message-based cardiac rehabilitation intervention among adults with coronary heart disease. Through the intervention in this trial, participants received recommendations to improve lifestyle behaviors, including diet [ 36 ]. Adherence to the recommendations and clinical biomarkers were measured as the primary and secondary outcomes, respectively [ 36 ]. The number of text messages sent to participants in the RCT’s intervention arm was reduced from the first 12 weeks (7 messages per week) to the last 12 weeks (5 messages per week) of the study period [ 36 ]. As the number of text messages from the study team decreased per week, participants may have relapsed into unhealthy dietary behaviors [ 36 ]. This suggests a need for sustained implementation of telehealth-based dietary interventions as a continued source of knowledge and support of self-efficacy for participants’ healthy behaviors and their clinical benefits. However, future research should confirm whether effectiveness is sustained if intervention durations are prolonged. Furthermore, findings from an RCT included in our study assessed the effectiveness and feasibility of a telehealth-based weight management intervention with cardiac rehabilitation in reducing the weight of overweight and obese individuals with CVD postcardiac procedure when compared to those who only received cardiac rehabilitation [ 38 ]. This RCT showed that participants who received nutritional intervention through an audio-visual media device in addition to cardiac rehabilitation had higher scores of perceived self-efficacy, knowledge, and skills in CVD self-management during follow-up than those who only received cardiac rehabilitation [ 38 ]. Greater self-efficacy, knowledge, and skill are all known constructs of the SCT, shown to help participants improve their health behaviors [ 48 ]. Lastly, a telehealth-based dietary intervention that involved smartphone apps provided notifications on heart-healthy alternatives to participants at the time of eating in a restaurant or purchasing food at a grocery store [ 41 ]. Such real-time app notifications provided participants with tailored nutritional information during critical decision-making time, which may be a key to the clinical benefits of telehealth-based dietary interventions observed in our study [ 41 ]. Various types of app-based interventions have been implemented through telehealth in the included RCTs that engage participants in different frequencies and timings during the day and target different constructs of behaviors, all aiming to improve cardiovascular health outcomes. For example, some app-based telehealth interventions may provide clinical benefits among individuals with CVD because they require participants to enter their food consumption into the app daily, which may improve motivation toward adhering to a heart-healthy diet [ 44 , 48 ]. According to the SCT, improved motivation can increase skills toward health behaviors by increasing participants’ capacity for forethought and goal setting [ 48 ].

While all included RCTs provided a nutritional component to participants (UC and telehealth intervention groups), the benefits of the telehealth-based dietary intervention over UC may imply the need for improved access to and standard of nutritional care for individuals diagnosed with CVD [ 34 - 46 ]. Participants enrolled in usual cardiac rehabilitation postcardiac events and procedures were provided with weekly educational sessions for at least 2 weeks, and nutrition was only 1 out of several other topics covered [ 36 , 38 , 44 , 45 ]. Once cardiac rehabilitation was complete, participants were typically not followed up by the rehabilitation unit, which indicates that nutrition was likely a very small component of the overall rehabilitation care given to the participants [ 44 ]. Other forms of UC involved regular outpatient clinic visits where participants received disease-specific pharmacological treatment, evaluation of cardiovascular risk factors, and general feedback on improving their lifestyle habits [ 35 , 37 , 40 , 43 , 46 ]. In some of the included RCTs, UC simply implied that participants received nutritional and disease-specific advice at 1 time point only (baseline) [ 34 ]. In one of the included RCTs, participants in the UC group received only a postal copy of publicly available booklets from the British Heart Foundation focused on reducing salt intake, titled “Cut Down on Salt” or “Taking Control of Salt” [ 42 ]. Apart from 1 RCT, where an RDN provided nutritional counseling to participants in the UC group [ 39 ], nutritionally trained health care professionals may not have been consistently involved in the dissemination of nutritional care in UC groups of the included RCTs.

While most included RCTs did not clearly state that they involved RDNs to disseminate the nutritional component to participants in intervention and UC groups, there is strong evidence suggesting that patients referred to RDNs have significant improvements in their clinical CVD risk factor outcomes [ 49 - 52 ]. According to the Academy of Nutrition and Dietetics, RDNs are increasingly using telehealth services in their clinical practice [ 53 ]. A qualitative study of 200 RDNs reported that medical nutrition therapy delivered through telehealth services positively impacted patient outcomes [ 54 ]. Previous studies suggest that telehealth services enable RDNs to better understand their patients’ nutritional habits since they were able to observe and discuss patients’ home environment more efficiently than in the clinical setting [ 54 , 55 ]. Furthermore, telehealth services may allow RDNs to facilitate group visits with a patient to involve their family members more conveniently during dietary education sessions, which has been shown to improve patient adherence to dietary advice and attendance to medical nutrition therapy appointments with RDNs [ 54 , 55 ].

Despite the benefits of telehealth-based dietary interventions on clinical CVD risk factors, some policy and patient-based barriers may prevent the implementation of telehealth use in clinical practice. First, each state has its own policies and license requirements for telehealth-based dietary practices in the clinical setting [ 53 ]. This may create inconsistencies in nutritional care provided to individuals with CVD nationwide. Therefore, more research showing the clinical benefits of telehealth-based dietary interventions is needed to demonstrate their effectiveness to policymakers in an attempt to standardize policies and strengthen dietetics practices across the United States [ 53 ]. Additionally, RDNs may not be able to use telehealth services to communicate with specific patients who have a limited understanding of communication technologies [ 53 ]. This patient-related barrier must be considered by RDNs on a case-by-case basis before engaging in virtual care.

Limitations

Our study is not without limitations. First, the included RCTs did not consistently provide participant demographic information on race, and levels of education and income, which limits our understanding of participant characteristics and the potential impact they may have on the overall results. Next, a majority of the included RCTs were of moderate overall quality, which may have impacted the overall results of our study. While we did not assess the certainty of evidence through the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach, we were able to assess the quality of each RCT using the Cochrane risk of bias tool, analyze publication bias when appropriate, and evaluate heterogeneity in the meta-analysis results to determine any source of bias. The included RCTs did not provide adequate data to analyze the effectiveness of telehealth-based dietary intervention on improving blood glucose levels or hemoglobin A 1C . While one of the assessed outcomes involved 13 RCTs, most other clinical CVD risk factor outcomes only involved 3-7 RCTs, which limited our analysis of heterogeneity and publication bias. Additionally, our sensitivity analysis was limited by the few number of RCTs available for each type of telehealth-based dietary intervention and the length of follow-up duration after intervention initiation. Therefore, more RCTs are needed to build a stronger evidence base on the effectiveness of different types of telehealth-based dietary interventions and for various follow-up durations to confirm our results. While we were able to determine that the RCT by Chow et al [ 35 ] was the source of heterogeneity for the systolic blood pressure outcome, this was less clear for the feasibility outcome. Nonetheless, our study contributes valuable knowledge on the effectiveness and feasibility of telehealth-based dietary interventions among individuals with CVD using robust meta-analysis techniques.

Conclusions

Telehealth-based dietary interventions significantly improved systolic blood pressure and LDL cholesterol when compared to UC among individuals with CVD. Future updates on this meta-analysis are needed to evaluate data from an increased number of RCTs for each type of telehealth intervention and follow-up duration in individuals with CVD.

Acknowledgments

None declared. No funding was received for this study, and there is no other financial information to disclose.

Data Availability

All data generated or analyzed during this study are included in the tables and figures of this published paper.

Authors' Contributions

R Trivedi and ELPS conceptualized the research questions, designed this study, interpreted the results, and wrote the original version of this paper. R Trivedi extracted the data and SE repeated extraction to confirm the results. R Trivedi managed and analyzed the data. SE, R Tackett, and HY interpreted the results and contributed to the discussion. All authors reviewed and commented on subsequent drafts of this paper, and approved the final version of this paper for publication. No generative AI was used in any portion of this paper.

Conflicts of Interest

None declared.

Search strategy.

Characteristics of the included randomized controlled trials.

Funnel plot of risk ratio for feasibility.

Forest plot of mean differences in systolic blood pressure levels for telehealth-based dietary intervention (Int) and usual care (UC) groups by intervention type.

Forest plot of mean differences in systolic blood pressure levels for telehealth-based dietary intervention (Int) and usual care (UC) groups by follow-up duration after intervention initiation.

Forest plot of risk ratio (RR) for feasibility by intervention type.

Forest plot of risk ratio (RR) for feasibility by follow-up duration after intervention initiation.

Influence analysis of mean differences (MD) for systolic blood pressure levels.

Influence analysis of risk ratio (RR) for feasibility.

PRISMA 2020 checklist.

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Abbreviations

Edited by T de Azevedo Cardoso; submitted 01.06.23; peer-reviewed by M Rozga; comments to author 29.06.23; revised version received 17.08.23; accepted 24.11.23; published 16.02.24

©Rupal Trivedi, Shaimaa Elshafie, Randall Tackett, Henry Young, Elisabeth Lilian Pia Sattler. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.02.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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Research trends in social media addiction and problematic social media use: A bibliometric analysis

Alfonso pellegrino.

1 Sasin School of Management, Chulalongkorn University, Bangkok, Thailand

Alessandro Stasi

2 Business Administration Division, Mahidol University International College, Mahidol University, Nakhon Pathom, Thailand

Veera Bhatiasevi

Associated data.

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.

Despite their increasing ubiquity in people's lives and incredible advantages in instantly interacting with others, social media's impact on subjective well-being is a source of concern worldwide and calls for up-to-date investigations of the role social media plays in mental health. Much research has discovered how habitual social media use may lead to addiction and negatively affect adolescents' school performance, social behavior, and interpersonal relationships. The present study was conducted to review the extant literature in the domain of social media and analyze global research productivity during 2013–2022. Bibliometric analysis was conducted on 501 articles that were extracted from the Scopus database using the keywords social media addiction and problematic social media use. The data were then uploaded to VOSviewer software to analyze citations, co-citations, and keyword co-occurrences. Volume, growth trajectory, geographic distribution of the literature, influential authors, intellectual structure of the literature, and the most prolific publishing sources were analyzed. The bibliometric analysis presented in this paper shows that the US, the UK, and Turkey accounted for 47% of the publications in this field. Most of the studies used quantitative methods in analyzing data and therefore aimed at testing relationships between variables. In addition, the findings in this study show that most analysis were cross-sectional. Studies were performed on undergraduate students between the ages of 19–25 on the use of two social media platforms: Facebook and Instagram. Limitations as well as research directions for future studies are also discussed.

Introduction

Social media generally refers to third-party internet-based platforms that mainly focus on social interactions, community-based inputs, and content sharing among its community of users and only feature content created by their users and not that licensed from third parties ( 1 ). Social networking sites such as Facebook, Instagram, and TikTok are prominent examples of social media that allow people to stay connected in an online world regardless of geographical distance or other obstacles ( 2 , 3 ). Recent evidence suggests that social networking sites have become increasingly popular among adolescents following the strict policies implemented by many countries to counter the COVID-19 pandemic, including social distancing, “lockdowns,” and quarantine measures ( 4 ). In this new context, social media have become an essential part of everyday life, especially for children and adolescents ( 5 ). For them such media are a means of socialization that connect people together. Interestingly, social media are not only used for social communication and entertainment purposes but also for sharing opinions, learning new things, building business networks, and initiate collaborative projects ( 6 ).

Among the 7.91 billion people in the world as of 2022, 4.62 billion active social media users, and the average time individuals spent using the internet was 6 h 58 min per day with an average use of social media platforms of 2 h and 27 min ( 7 ). Despite their increasing ubiquity in people's lives and the incredible advantages they offer to instantly interact with people, an increasing number of studies have linked social media use to negative mental health consequences, such as suicidality, loneliness, and anxiety ( 8 ). Numerous sources have expressed widespread concern about the effects of social media on mental health. A 2011 report by the American Academy of Pediatrics (AAP) identifies a phenomenon known as Facebook depression which may be triggered “when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression” ( 9 ). Similarly, the UK's Royal Society for Public Health (RSPH) claims that there is a clear evidence of the relationship between social media use and mental health issues based on a survey of nearly 1,500 people between the ages of 14–24 ( 10 ). According to some authors, the increase in usage frequency of social media significantly increases the risks of clinical disorders described (and diagnosed) as “Facebook depression,” “fear of missing out” (FOMO), and “social comparison orientation” (SCO) ( 11 ). Other risks include sexting ( 12 ), social media stalking ( 13 ), cyber-bullying ( 14 ), privacy breaches ( 15 ), and improper use of technology. Therefore, social media's impact on subjective well-being is a source of concern worldwide and calls for up-to-date investigations of the role social media plays with regard to mental health ( 8 ). Many studies have found that habitual social media use may lead to addiction and thus negatively affect adolescents' school performance, social behavior, and interpersonal relationships ( 16 – 18 ). As a result of addiction, the user becomes highly engaged with online activities motivated by an uncontrollable desire to browse through social media pages and “devoting so much time and effort to it that it impairs other important life areas” ( 19 ).

Given these considerations, the present study was conducted to review the extant literature in the domain of social media and analyze global research productivity during 2013–2022. The study presents a bibliometric overview of the leading trends with particular regard to “social media addiction” and “problematic social media use.” This is valuable as it allows for a comprehensive overview of the current state of this field of research, as well as identifies any patterns or trends that may be present. Additionally, it provides information on the geographical distribution and prolific authors in this area, which may help to inform future research endeavors.

In terms of bibliometric analysis of social media addiction research, few studies have attempted to review the existing literature in the domain extensively. Most previous bibliometric studies on social media addiction and problematic use have focused mainly on one type of screen time activity such as digital gaming or texting ( 20 ) and have been conducted with a focus on a single platform such as Facebook, Instagram, or Snapchat ( 21 , 22 ). The present study adopts a more comprehensive approach by including all social media platforms and all types of screen time activities in its analysis.

Additionally, this review aims to highlight the major themes around which the research has evolved to date and draws some guidance for future research directions. In order to meet these objectives, this work is oriented toward answering the following research questions:

  • (1) What is the current status of research focusing on social media addiction?
  • (2) What are the key thematic areas in social media addiction and problematic use research?
  • (3) What is the intellectual structure of social media addiction as represented in the academic literature?
  • (4) What are the key findings of social media addiction and problematic social media research?
  • (5) What possible future research gaps can be identified in the field of social media addiction?

These research questions will be answered using bibliometric analysis of the literature on social media addiction and problematic use. This will allow for an overview of the research that has been conducted in this area, including information on the most influential authors, journals, countries of publication, and subject areas of study. Part 2 of the study will provide an examination of the intellectual structure of the extant literature in social media addiction while Part 3 will discuss the research methodology of the paper. Part 4 will discuss the findings of the study followed by a discussion under Part 5 of the paper. Finally, in Part 7, gaps in current knowledge about this field of research will be identified.

Literature review

Social media addiction research context.

Previous studies on behavioral addictions have looked at a lot of different factors that affect social media addiction focusing on personality traits. Although there is some inconsistency in the literature, numerous studies have focused on three main personality traits that may be associated with social media addiction, namely anxiety, depression, and extraversion ( 23 , 24 ).

It has been found that extraversion scores are strongly associated with increased use of social media and addiction to it ( 25 , 26 ). People with social anxiety as well as people who have psychiatric disorders often find online interactions extremely appealing ( 27 ). The available literature also reveals that the use of social media is positively associated with being female, single, and having attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), or anxiety ( 28 ).

In a study by Seidman ( 29 ), the Big Five personality traits were assessed using Saucier's ( 30 ) Mini-Markers Scale. Results indicated that neurotic individuals use social media as a safe place for expressing their personality and meet belongingness needs. People affected by neurosis tend to use online social media to stay in touch with other people and feel better about their social lives ( 31 ). Narcissism is another factor that has been examined extensively when it comes to social media, and it has been found that people who are narcissistic are more likely to become addicted to social media ( 32 ). In this case users want to be seen and get “likes” from lots of other users. Longstreet and Brooks ( 33 ) did a study on how life satisfaction depends on how much money people make. Life satisfaction was found to be negatively linked to social media addiction, according to the results. When social media addiction decreases, the level of life satisfaction rises. But results show that in lieu of true-life satisfaction people use social media as a substitute (for temporary pleasure vs. longer term happiness).

Researchers have discovered similar patterns in students who tend to rank high in shyness: they find it easier to express themselves online rather than in person ( 34 , 35 ). With the use of social media, shy individuals have the opportunity to foster better quality relationships since many of their anxiety-related concerns (e.g., social avoidance and fear of social devaluation) are significantly reduced ( 36 , 37 ).

Problematic use of social media

The amount of research on problematic use of social media has dramatically increased since the last decade. But using social media in an unhealthy manner may not be considered an addiction or a disorder as this behavior has not yet been formally categorized as such ( 38 ). Although research has shown that people who use social media in a negative way often report negative health-related conditions, most of the data that have led to such results and conclusions comprise self-reported data ( 39 ). The dimensions of excessive social media usage are not exactly known because there are not enough diagnostic criteria and not enough high-quality long-term studies available yet. This is what Zendle and Bowden-Jones ( 40 ) noted in their own research. And this is why terms like “problematic social media use” have been used to describe people who use social media in a negative way. Furthermore, if a lot of time is spent on social media, it can be hard to figure out just when it is being used in a harmful way. For instance, people easily compare their appearance to what they see on social media, and this might lead to low self-esteem if they feel they do not look as good as the people they are following. According to research in this domain, the extent to which an individual engages in photo-related activities (e.g., taking selfies, editing photos, checking other people's photos) on social media is associated with negative body image concerns. Through curated online images of peers, adolescents face challenges to their self-esteem and sense of self-worth and are increasingly isolated from face-to-face interaction.

To address this problem the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has been used by some scholars ( 41 , 42 ). These scholars have used criteria from the DSM-V to describe one problematic social media use, internet gaming disorder, but such criteria could also be used to describe other types of social media disorders. Franchina et al. ( 43 ) and Scott and Woods ( 44 ), for example, focus their attention on individual-level factors (like fear of missing out) and family-level factors (like childhood abuse) that have been used to explain why people use social media in a harmful way. Friends-level factors have also been explored as a social well-being measurement to explain why people use social media in a malevolent way and demonstrated significant positive correlations with lower levels of friend support ( 45 ). Macro-level factors have also been suggested, such as the normalization of surveillance ( 46 ) and the ability to see what people are doing online ( 47 ). Gender and age seem to be highly associated to the ways people use social media negatively. Particularly among girls, social media use is consistently associated with mental health issues ( 41 , 48 , 49 ), an association more common among older girls than younger girls ( 46 , 48 ).

Most studies have looked at the connection between social media use and its effects (such as social media addiction) and a number of different psychosomatic disorders. In a recent study conducted by Vannucci and Ohannessian ( 50 ), the use of social media appears to have a variety of effects “on psychosocial adjustment during early adolescence, with high social media use being the most problematic.” It has been found that people who use social media in a harmful way are more likely to be depressed, anxious, have low self-esteem, be more socially isolated, have poorer sleep quality, and have more body image dissatisfaction. Furthermore, harmful social media use has been associated with unhealthy lifestyle patterns (for example, not getting enough exercise or having trouble managing daily obligations) as well as life threatening behaviors such as illicit drug use, excessive alcohol consumption and unsafe sexual practices ( 51 , 52 ).

A growing body of research investigating social media use has revealed that the extensive use of social media platforms is correlated with a reduced performance on cognitive tasks and in mental effort ( 53 ). Overall, it appears that individuals who have a problematic relationship with social media or those who use social media more frequently are more likely to develop negative health conditions.

Social media addiction and problematic use systematic reviews

Previous studies have revealed the detrimental impacts of social media addiction on users' health. A systematic review by Khan and Khan ( 20 ) has pointed out that social media addiction has a negative impact on users' mental health. For example, social media addiction can lead to stress levels rise, loneliness, and sadness ( 54 ). Anxiety is another common mental health problem associated with social media addiction. Studies have found that young adolescents who are addicted to social media are more likely to suffer from anxiety than people who are not addicted to social media ( 55 ). In addition, social media addiction can also lead to physical health problems, such as obesity and carpal tunnel syndrome a result of spending too much time on the computer ( 22 ).

Apart from the negative impacts of social media addiction on users' mental and physical health, social media addiction can also lead to other problems. For example, social media addiction can lead to financial problems. A study by Sharif and Yeoh ( 56 ) has found that people who are addicted to social media tend to spend more money than those who are not addicted to social media. In addition, social media addiction can also lead to a decline in academic performance. Students who are addicted to social media are more likely to have lower grades than those who are not addicted to social media ( 57 ).

Research methodology

Bibliometric analysis.

Merigo et al. ( 58 ) use bibliometric analysis to examine, organize, and analyze a large body of literature from a quantitative, objective perspective in order to assess patterns of research and emerging trends in a certain field. A bibliometric methodology is used to identify the current state of the academic literature, advance research. and find objective information ( 59 ). This technique allows the researchers to examine previous scientific work, comprehend advancements in prior knowledge, and identify future study opportunities.

To achieve this objective and identify the research trends in social media addiction and problematic social media use, this study employs two bibliometric methodologies: performance analysis and science mapping. Performance analysis uses a series of bibliometric indicators (e.g., number of annual publications, document type, source type, journal impact factor, languages, subject area, h-index, and countries) and aims at evaluating groups of scientific actors on a particular topic of research. VOSviewer software ( 60 ) was used to carry out the science mapping. The software is used to visualize a particular body of literature and map the bibliographic material using the co-occurrence analysis of author, index keywords, nations, and fields of publication ( 61 , 62 ).

Data collection

After picking keywords, designing the search strings, and building up a database, the authors conducted a bibliometric literature search. Scopus was utilized to gather exploration data since it is a widely used database that contains the most comprehensive view of the world's research output and provides one of the most effective search engines. If the research was to be performed using other database such as Web Of Science or Google Scholar the authors may have obtained larger number of articles however they may not have been all particularly relevant as Scopus is known to have the most widest and most relevant scholar search engine in marketing and social science. A keyword search for “social media addiction” OR “problematic social media use” yielded 553 papers, which were downloaded from Scopus. The information was gathered in March 2022, and because the Scopus database is updated on a regular basis, the results may change in the future. Next, the authors examined the titles and abstracts to see whether they were relevant to the topics treated. There were two common grounds for document exclusion. First, while several documents emphasized the negative effects of addiction in relation to the internet and digital media, they did not focus on social networking sites specifically. Similarly, addiction and problematic consumption habits were discussed in relation to social media in several studies, although only in broad terms. This left a total of 511 documents. Articles were then limited only to journal articles, conference papers, reviews, books, and only those published in English. This process excluded 10 additional documents. Then, the relevance of the remaining articles was finally checked by reading the titles, abstracts, and keywords. Documents were excluded if social networking sites were only mentioned as a background topic or very generally. This resulted in a final selection of 501 research papers, which were then subjected to bibliometric analysis (see Figure 1 ).

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Preferred reporting items for systematic reviews and meta-analysis (PRISMA) flowchart showing the search procedures used in the review.

After identifying 501 Scopus files, bibliographic data related to these documents were imported into an Excel sheet where the authors' names, their affiliations, document titles, keywords, abstracts, and citation figures were analyzed. These were subsequently uploaded into VOSViewer software version 1.6.8 to begin the bibliometric review. Descriptive statistics were created to define the whole body of knowledge about social media addiction and problematic social media use. VOSViewer was used to analyze citation, co-citation, and keyword co-occurrences. According to Zupic and Cater ( 63 ), co-citation analysis measures the influence of documents, authors, and journals heavily cited and thus considered influential. Co-citation analysis has the objective of building similarities between authors, journals, and documents and is generally defined as the frequency with which two units are cited together within the reference list of a third article.

The implementation of social media addiction performance analysis was conducted according to the models recently introduced by Karjalainen et al. ( 64 ) and Pattnaik ( 65 ). Throughout the manuscript there are operational definitions of relevant terms and indicators following a standardized bibliometric approach. The cumulative academic impact (CAI) of the documents was measured by the number of times they have been cited in other scholarly works while the fine-grained academic impact (FIA) was computed according to the authors citation analysis and authors co-citation analysis within the reference lists of documents that have been specifically focused on social media addiction and problematic social media use.

Results of the study presented here include the findings on social media addiction and social media problematic use. The results are presented by the foci outlined in the study questions.

Volume, growth trajectory, and geographic distribution of the literature

After performing the Scopus-based investigation of the current literature regarding social media addiction and problematic use of social media, the authors obtained a knowledge base consisting of 501 documents comprising 455 journal articles, 27 conference papers, 15 articles reviews, 3 books and 1 conference review. The included literature was very recent. As shown in Figure 2 , publication rates started very slowly in 2013 but really took off in 2018, after which publications dramatically increased each year until a peak was reached in 2021 with 195 publications. Analyzing the literature published during the past decade reveals an exponential increase in scholarly production on social addiction and its problematic use. This might be due to the increasingly widespread introduction of social media sites in everyday life and the ubiquitous diffusion of mobile devices that have fundamentally impacted human behavior. The dip in the number of publications in 2022 is explained by the fact that by the time the review was carried out the year was not finished yet and therefore there are many articles still in press.

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Annual volume of social media addiction or social media problematic use ( n = 501).

The geographical distribution trends of scholarly publications on social media addiction or problematic use of social media are highlighted in Figure 3 . The articles were assigned to a certain country according to the nationality of the university with whom the first author was affiliated with. The figure shows that the most productive countries are the USA (92), the U.K. (79), and Turkey ( 63 ), which combined produced 236 articles, equal to 47% of the entire scholarly production examined in this bibliometric analysis. Turkey has slowly evolved in various ways with the growth of the internet and social media. Anglo-American scholarly publications on problematic social media consumer behavior represent the largest research output. Yet it is interesting to observe that social networking sites studies are attracting many researchers in Asian countries, particularly China. For many Chinese people, social networking sites are a valuable opportunity to involve people in political activism in addition to simply making purchases ( 66 ).

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Global dispersion of social networking sites in relation to social media addiction or social media problematic use.

Analysis of influential authors

This section analyses the high-impact authors in the Scopus-indexed knowledge base on social networking sites in relation to social media addiction or problematic use of social media. It provides valuable insights for establishing patterns of knowledge generation and dissemination of literature about social networking sites relating to addiction and problematic use.

Table 1 acknowledges the top 10 most highly cited authors with the highest total citations in the database.

Highly cited authors on social media addiction and problematic use ( n = 501).

a Total link strength indicates the number of publications in which an author occurs.

Table 1 shows that MD Griffiths (sixty-five articles), CY Lin (twenty articles), and AH Pakpour (eighteen articles) are the most productive scholars according to the number of Scopus documents examined in the area of social media addiction and its problematic use . If the criteria are changed and authors ranked according to the overall number of citations received in order to determine high-impact authors, the same three authors turn out to be the most highly cited authors. It should be noted that these highly cited authors tend to enlist several disciplines in examining social media addiction and problematic use. Griffiths, for example, focuses on behavioral addiction stemming from not only digital media usage but also from gambling and video games. Lin, on the other hand, focuses on the negative effects that the internet and digital media can have on users' mental health, and Pakpour approaches the issue from a behavioral medicine perspective.

Intellectual structure of the literature

In this part of the paper, the authors illustrate the “intellectual structure” of the social media addiction and the problematic use of social media's literature. An author co-citation analysis (ACA) was performed which is displayed as a figure that depicts the relations between highly co-cited authors. The study of co-citation assumes that strongly co-cited authors carry some form of intellectual similarity ( 67 ). Figure 4 shows the author co-citation map. Nodes represent units of analysis (in this case scholars) and network ties represent similarity connections. Nodes are sized according to the number of co-citations received—the bigger the node, the more co-citations it has. Adjacent nodes are considered intellectually similar.

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Two clusters, representing the intellectual structure of the social media and its problematic use literature.

Scholars belonging to the green cluster (Mental Health and Digital Media Addiction) have extensively published on medical analysis tools and how these can be used to heal users suffering from addiction to digital media, which can range from gambling, to internet, to videogame addictions. Scholars in this school of thought focus on the negative effects on users' mental health, such as depression, anxiety, and personality disturbances. Such studies focus also on the role of screen use in the development of mental health problems and the increasing use of medical treatments to address addiction to digital media. They argue that addiction to digital media should be considered a mental health disorder and treatment options should be made available to users.

In contrast, scholars within the red cluster (Social Media Effects on Well Being and Cyberpsychology) have focused their attention on the effects of social media toward users' well-being and how social media change users' behavior, focusing particular attention on the human-machine interaction and how methods and models can help protect users' well-being. Two hundred and two authors belong to this group, the top co-cited being Andreassen (667 co-citations), Pallasen (555 co-citations), and Valkenburg (215 co-citations). These authors have extensively studied the development of addiction to social media, problem gambling, and internet addiction. They have also focused on the measurement of addiction to social media, cyberbullying, and the dark side of social media.

Most influential source title in the field of social media addiction and its problematic use

To find the preferred periodicals in the field of social media addiction and its problematic use, the authors have selected 501 articles published in 263 journals. Table 2 gives a ranked list of the top 10 journals that constitute the core publishing sources in the field of social media addiction research. In doing so, the authors analyzed the journal's impact factor, Scopus Cite Score, h-index, quartile ranking, and number of publications per year.

Top 10 most cited and more frequently mentioned documents in the field of social media addiction.

The journal Addictive Behaviors topped the list, with 700 citations and 22 publications (4.3%), followed by Computers in Human Behaviors , with 577 citations and 13 publications (2.5%), Journal of Behavioral Addictions , with 562 citations and 17 publications (3.3%), and International Journal of Mental Health and Addiction , with 502 citations and 26 publications (5.1%). Five of the 10 most productive journals in the field of social media addiction research are published by Elsevier (all Q1 rankings) while Springer and Frontiers Media published one journal each.

Documents citation analysis identified the most influential and most frequently mentioned documents in a certain scientific field. Andreassen has received the most citations among the 10 most significant papers on social media addiction, with 405 ( Table 2 ). The main objective of this type of studies was to identify the associations and the roles of different variables as predictors of social media addiction (e.g., ( 19 , 68 , 69 )). According to general addiction models, the excessive and problematic use of digital technologies is described as “being overly concerned about social media, driven by an uncontrollable motivation to log on to or use social media, and devoting so much time and effort to social media that it impairs other important life areas” ( 27 , 70 ). Furthermore, the purpose of several highly cited studies ( 31 , 71 ) was to analyse the connections between young adults' sleep quality and psychological discomfort, depression, self-esteem, and life satisfaction and the severity of internet and problematic social media use, since the health of younger generations and teenagers is of great interest this may help explain the popularity of such papers. Despite being the most recent publication Lin et al.'s work garnered more citations annually. The desire to quantify social media addiction in individuals can also help explain the popularity of studies which try to develop measurement scales ( 42 , 72 ). Some of the highest-ranked publications are devoted to either the presentation of case studies or testing relationships among psychological constructs ( 73 ).

Keyword co-occurrence analysis

The research question, “What are the key thematic areas in social media addiction literature?” was answered using keyword co-occurrence analysis. Keyword co-occurrence analysis is conducted to identify research themes and discover keywords. It mainly examines the relationships between co-occurrence keywords in a wide variety of literature ( 74 ). In this approach, the idea is to explore the frequency of specific keywords being mentioned together.

Utilizing VOSviewer, the authors conducted a keyword co-occurrence analysis to characterize and review the developing trends in the field of social media addiction. The top 10 most frequent keywords are presented in Table 3 . The results indicate that “social media addiction” is the most frequent keyword (178 occurrences), followed by “problematic social media use” (74 occurrences), “internet addiction” (51 occurrences), and “depression” (46 occurrences). As shown in the co-occurrence network ( Figure 5 ), the keywords can be grouped into two major clusters. “Problematic social media use” can be identified as the core theme of the green cluster. In the red cluster, keywords mainly identify a specific aspect of problematic social media use: social media addiction.

Frequency of occurrence of top 10 keywords.

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Keywords co-occurrence map. Threshold: 5 co-occurrences.

The results of the keyword co-occurrence analysis for journal articles provide valuable perspectives and tools for understanding concepts discussed in past studies of social media usage ( 75 ). More precisely, it can be noted that there has been a large body of research on social media addiction together with other types of technological addictions, such as compulsive web surfing, internet gaming disorder, video game addiction and compulsive online shopping ( 76 – 78 ). This field of research has mainly been directed toward teenagers, middle school students, and college students and university students in order to understand the relationship between social media addiction and mental health issues such as depression, disruptions in self-perceptions, impairment of social and emotional activity, anxiety, neuroticism, and stress ( 79 – 81 ).

The findings presented in this paper show that there has been an exponential increase in scholarly publications—from two publications in 2013 to 195 publications in 2021. There were 45 publications in 2022 at the time this study was conducted. It was interesting to observe that the US, the UK, and Turkey accounted for 47% of the publications in this field even though none of these countries are in the top 15 countries in terms of active social media penetration ( 82 ) although the US has the third highest number of social media users ( 83 ). Even though China and India have the highest number of social media users ( 83 ), first and second respectively, they rank fifth and tenth in terms of publications on social media addiction or problematic use of social media. In fact, the US has almost double the number of publications in this field compared to China and almost five times compared to India. Even though East Asia, Southeast Asia, and South Asia make up the top three regions in terms of worldwide social media users ( 84 ), except for China and India there have been only a limited number of publications on social media addiction or problematic use. An explanation for that could be that there is still a lack of awareness on the negative consequences of the use of social media and the impact it has on the mental well-being of users. More research in these regions should perhaps be conducted in order to understand the problematic use and addiction of social media so preventive measures can be undertaken.

From the bibliometric analysis, it was found that most of the studies examined used quantitative methods in analyzing data and therefore aimed at testing relationships between variables. In addition, many studies were empirical, aimed at testing relationships based on direct or indirect observations of social media use. Very few studies used theories and for the most part if they did they used the technology acceptance model and social comparison theories. The findings presented in this paper show that none of the studies attempted to create or test new theories in this field, perhaps due to the lack of maturity of the literature. Moreover, neither have very many qualitative studies been conducted in this field. More qualitative research in this field should perhaps be conducted as it could explore the motivations and rationales from which certain users' behavior may arise.

The authors found that almost all the publications on social media addiction or problematic use relied on samples of undergraduate students between the ages of 19–25. The average daily time spent by users worldwide on social media applications was highest for users between the ages of 40–44, at 59.85 min per day, followed by those between the ages of 35–39, at 59.28 min per day, and those between the ages of 45–49, at 59.23 per day ( 85 ). Therefore, more studies should be conducted exploring different age groups, as users between the ages of 19–25 do not represent the entire population of social media users. Conducting studies on different age groups may yield interesting and valuable insights to the field of social media addiction. For example, it would be interesting to measure the impacts of social media use among older users aged 50 years or older who spend almost the same amount of time on social media as other groups of users (56.43 min per day) ( 85 ).

A majority of the studies tested social media addiction or problematic use based on only two social media platforms: Facebook and Instagram. Although Facebook and Instagram are ranked first and fourth in terms of most popular social networks by number of monthly users, it would be interesting to study other platforms such as YouTube, which is ranked second, and WhatsApp, which is ranked third ( 86 ). Furthermore, TikTok would also be an interesting platform to study as it has grown in popularity in recent years, evident from it being the most downloaded application in 2021, with 656 million downloads ( 87 ), and is ranked second in Q1 of 2022 ( 88 ). Moreover, most of the studies focused only on one social media platform. Comparing different social media platforms would yield interesting results because each platform is different in terms of features, algorithms, as well as recommendation engines. The purpose as well as the user behavior for using each platform is also different, therefore why users are addicted to these platforms could provide a meaningful insight into social media addiction and problematic social media use.

Lastly, most studies were cross-sectional, and not longitudinal, aiming at describing results over a certain point in time and not over a long period of time. A longitudinal study could better describe the long-term effects of social media use.

This study was conducted to review the extant literature in the field of social media and analyze the global research productivity during the period ranging from 2013 to 2022. The study presents a bibliometric overview of the leading trends with particular regard to “social media addiction” and “problematic social media use.” The authors applied science mapping to lay out a knowledge base on social media addiction and its problematic use. This represents the first large-scale analysis in this area of study.

A keyword search of “social media addiction” OR “problematic social media use” yielded 553 papers, which were downloaded from Scopus. After performing the Scopus-based investigation of the current literature regarding social media addiction and problematic use, the authors ended up with a knowledge base consisting of 501 documents comprising 455 journal articles, 27 conference papers, 15 articles reviews, 3 books, and 1 conference review.

The geographical distribution trends of scholarly publications on social media addiction or problematic use indicate that the most productive countries were the USA (92), the U.K. (79), and Turkey ( 63 ), which together produced 236 articles. Griffiths (sixty-five articles), Lin (twenty articles), and Pakpour (eighteen articles) were the most productive scholars according to the number of Scopus documents examined in the area of social media addiction and its problematic use. An author co-citation analysis (ACA) was conducted which generated a layout of social media effects on well-being and cyber psychology as well as mental health and digital media addiction in the form of two research literature clusters representing the intellectual structure of social media and its problematic use.

The preferred periodicals in the field of social media addiction and its problematic use were Addictive Behaviors , with 700 citations and 22 publications, followed by Computers in Human Behavior , with 577 citations and 13 publications, and Journal of Behavioral Addictions , with 562 citations and 17 publications. Keyword co-occurrence analysis was used to investigate the key thematic areas in the social media literature, as represented by the top three keyword phrases in terms of their frequency of occurrence, namely, “social media addiction,” “problematic social media use,” and “social media addiction.”

This research has a few limitations. The authors used science mapping to improve the comprehension of the literature base in this review. First and foremost, the authors want to emphasize that science mapping should not be utilized in place of established review procedures, but rather as a supplement. As a result, this review can be considered the initial stage, followed by substantive research syntheses that examine findings from recent research. Another constraint stems from how 'social media addiction' is defined. The authors overcame this limitation by inserting the phrase “social media addiction” OR “problematic social media use” in the search string. The exclusive focus on SCOPUS-indexed papers creates a third constraint. The SCOPUS database has a larger number of papers than does Web of Science although it does not contain all the publications in a given field.

Although the total body of literature on social media addiction is larger than what is covered in this review, the use of co-citation analyses helped to mitigate this limitation. This form of bibliometric study looks at all the publications listed in the reference list of the extracted SCOPUS database documents. As a result, a far larger dataset than the one extracted from SCOPUS initially has been analyzed.

The interpretation of co-citation maps should be mentioned as a last constraint. The reason is that the procedure is not always clear, so scholars must have a thorough comprehension of the knowledge base in order to make sense of the result of the analysis ( 63 ). This issue was addressed by the authors' expertise, but it remains somewhat subjective.

Implications

The findings of this study have implications mainly for government entities and parents. The need for regulation of social media addiction is evident when considering the various risks associated with habitual social media use. Social media addiction may lead to negative consequences for adolescents' school performance, social behavior, and interpersonal relationships. In addition, social media addiction may also lead to other risks such as sexting, social media stalking, cyber-bullying, privacy breaches, and improper use of technology. Given the seriousness of these risks, it is important to have regulations in place to protect adolescents from the harms of social media addiction.

Regulation of social media platforms

One way that regulation could help protect adolescents from the harms of social media addiction is by limiting their access to certain websites or platforms. For example, governments could restrict adolescents' access to certain websites or platforms during specific hours of the day. This would help ensure that they are not spending too much time on social media and are instead focusing on their schoolwork or other important activities.

Another way that regulation could help protect adolescents from the harms of social media addiction is by requiring companies to put warning labels on their websites or apps. These labels would warn adolescents about the potential risks associated with excessive use of social media.

Finally, regulation could also require companies to provide information about how much time each day is recommended for using their website or app. This would help adolescents make informed decisions about how much time they want to spend on social media each day. These proposed regulations would help to protect children from the dangers of social media, while also ensuring that social media companies are more transparent and accountable to their users.

Parental involvement in adolescents' social media use

Parents should be involved in their children's social media use to ensure that they are using these platforms safely and responsibly. Parents can monitor their children's online activity, set time limits for social media use, and talk to their children about the risks associated with social media addiction.

Education on responsible social media use

Adolescents need to be educated about responsible social media use so that they can enjoy the benefits of these platforms while avoiding the risks associated with addiction. Education on responsible social media use could include topics such as cyber-bullying, sexting, and privacy breaches.

Research directions for future studies

A content analysis was conducted to answer the fifth research questions “What are the potential research directions for addressing social media addiction in the future?” The study reveals that there is a lack of screening instruments and diagnostic criteria to assess social media addiction. Validated DSM-V-based instruments could shed light on the factors behind social media use disorder. Diagnostic research may be useful in order to understand social media behavioral addiction and gain deeper insights into the factors responsible for psychological stress and psychiatric disorders. In addition to cross-sectional studies, researchers should also conduct longitudinal studies and experiments to assess changes in users' behavior over time ( 20 ).

Another important area to examine is the role of engagement-based ranking and recommendation algorithms in online habit formation. More research is required to ascertain how algorithms determine which content type generates higher user engagement. A clear understanding of the way social media platforms gather content from users and amplify their preferences would lead to the development of a standardized conceptualization of social media usage patterns ( 89 ). This may provide a clearer picture of the factors that lead to problematic social media use and addiction. It has been noted that “misinformation, toxicity, and violent content are inordinately prevalent” in material reshared by users and promoted by social media algorithms ( 90 ).

Additionally, an understanding of engagement-based ranking models and recommendation algorithms is essential in order to implement appropriate public policy measures. To address the specific behavioral concerns created by social media, legislatures must craft appropriate statutes. Thus, future qualitative research to assess engagement based ranking frameworks is extremely necessary in order to provide a broader perspective on social media use and tackle key regulatory gaps. Particular emphasis must be placed on consumer awareness, algorithm bias, privacy issues, ethical platform design, and extraction and monetization of personal data ( 91 ).

From a geographical perspective, the authors have identified some main gaps in the existing knowledge base that uncover the need for further research in certain regions of the world. Accordingly, the authors suggest encouraging more studies on internet and social media addiction in underrepresented regions with high social media penetration rates such as Southeast Asia and South America. In order to draw more contributions from these countries, journals with high impact factors could also make specific calls. This would contribute to educating social media users about platform usage and implement policy changes that support the development of healthy social media practices.

The authors hope that the findings gathered here will serve to fuel interest in this topic and encourage other scholars to investigate social media addiction in other contexts on newer platforms and among wide ranges of sample populations. In light of the rising numbers of people experiencing mental health problems (e.g., depression, anxiety, food disorders, and substance addiction) in recent years, it is likely that the number of papers related to social media addiction and the range of countries covered will rise even further.

Data availability statement

Author contributions.

AP took care of bibliometric analysis and drafting the paper. VB took care of proofreading and adding value to the paper. AS took care of the interpretation of the findings. All authors contributed to the article and approved the submitted version.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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    Of the 13 included studies, 3 were of high quality, 9 were of moderate quality, and only 1 was of low quality. Pooled estimates showed systolic blood pressure (MD -2.74, 95% CI -4.93 to -0.56) and low-density lipoprotein cholesterol (standardized MD -0.11, 95% CI -0.19 to -0.03) to be significantly improved among individuals with ...

  25. Research trends in social media addiction and problematic social media

    The present study was conducted to review the extant literature in the domain of social media and analyze global research productivity during 2013-2022. Bibliometric analysis was conducted on 501 articles that were extracted from the Scopus database using the keywords social media addiction and problematic social media use.