Background

Sexual and gender minority (SGM) persons face a number of physical and mental health disparities closely linked to discrimination, social stigma, and victimization. Despite the acceptability and increasing number of digital health interventions focused on improving health outcomes among SGM people, there is a lack of reviews summarizing whether and how researchers assess engagement with social media–delivered health interventions for this group.

Objective

The objective of this systematic review was to synthesize and critique the evidence on evaluation of engagement with social media–delivered interventions for improving health outcomes among SGM persons.

Methods

We conducted a literature search for studies published between January 2003 and June 2020 using 4 electronic databases. Articles were included if they were peer-reviewed, in English language, assessed engagement with a social media–delivered health intervention for improving health outcomes among sexual and gender minorities. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed quality of data reporting using the CONSORT extension for pilot and feasibility studies and CONSORT statement parallel group randomized trials.

Results

We included 18 articles in the review; 15 were feasibility studies and 3 were efficacy or effectiveness randomized trials. The quality of data reporting varied considerably. The vast majority of articles focused on improving HIV-related outcomes among men who have sex with men. Only three studies recruited cisgender women and/or transgender persons. We found heterogeneity in how engagement was defined and assessed. Intervention usage from social media data was the most frequently used engagement measure.

Conclusion

In addition to the heterogeneity in defining and assessing engagement, we found that the focus of assessment was often on measures of intervention usage only. More purposeful recruitment is needed to learn about whether, how, and why different SGM groups engage with social media-interventions. This leaves significant room for future research to expand evaluation criteria for cognitive and emotional aspects of intervention engagement in order to develop effective and tailored social media-delivered interventions for SGM people. Our findings also support the need for developing and testing social media-delivered interventions that focus on improving mental health and outcomes related to chronic health conditions among SGM persons.

中文翻译：

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对社交媒体参与改善性和性别少数群体健康结果的干预措施的系统评价

背景

性和性别少数群体 (SGM) 面临着许多与歧视、社会污名和受害密切相关的身心健康差异。尽管专注于改善 SGM 人群健康结果的数字健康干预措施的可接受性和数量不断增加，但缺乏总结研究人员是否以及如何评估该群体参与社交媒体提供的健康干预措施的评论。

客观的

本系统评价的目的是综合和评论评估参与社交媒体提供的干预措施以改善 SGM 人员健康结果的证据。

方法

我们使用 4 个电子数据库对 2003 年 1 月至 2020 年 6 月期间发表的研究进行了文献检索。如果文章经过同行评审，以英语语言进行，评估参与社交媒体提供的健康干预措施以改善性少数群体和性别少数群体的健康结果，则文章将被纳入。至少有两名作者使用先验开发的抽象形式从每项研究中独立提取数据。我们使用 CONSORT 扩展进行试点和可行性研究以及 CONSORT 声明平行组随机试验评估数据报告的质量。

结果

我们在评论中纳入了 18 篇文章；15 项为可行性研究，3 项为疗效或有效性随机试验。数据报告的质量差异很大。绝大多数文章的重点是改善男男性行为者的 HIV 相关结果。只有三项研究招募了顺性别女性和/或跨性别者。我们发现参与度的定义和评估方式存在异质性。来自社交媒体数据的干预使用是最常用的参与度量。

结论

除了定义和评估参与度的异质性外，我们发现评估的重点通常仅放在干预使用的测量上。需要更有针对性的招聘来了解不同的 SGM 团体是否、如何以及为什么参与社交媒体干预。这为未来的研究留下了很大的空间，以扩展干预参与的认知和情感方面的评估标准，以便为 SGM 人开发有效且量身定制的社交媒体提供的干预措施。我们的研究结果还支持开发和测试社交媒体提供的干预措施的必要性，这些干预措施的重点是改善 SGM 人的心理健康和与慢性健康状况相关的结果。