The Potential of Instagram to Reduce Stigmatization of People with Psoriasis: A Randomized Controlled Pilot Study
Intervention against Stigmatisation of Psoriasis
DOI:
https://doi.org/10.2340/actadv.v103.3513Keywords:
Psoriasis, social media, social stigma, skin diseases, randomised controlled trialAbstract
Psoriasis is a stigmatized skin disease. This randomized controlled trial aimed to evaluate an Instagram based stigma-reduction intervention targeting daily Instagram users aged 18 to 49 years without psoriasis. After stratification for baseline characteristics (t0), stigmatization of psoriasis was assessed using a questionnaire and a photo-rating task immediately before (t1) and after (t2) the intervention and two weeks post-intervention (t3). Data from 54 participants, recruited in a university setting and via Instagram, were analysed. For 10 min between t1 and t2, the intervention group (n = 26) and the control group (n = 28) scrolled through two different Instagram accounts. Psoriasis-sensitizing content was displayed to the intervention group while beauty-glorifying posts were shown to the control group. Results indicated significantly less Disease-related Misconceptions in the intervention group in comparison to the control group at t2 (U = 145.50, Z = –3.79, p < 0.001) and at t3 (U = 177.00, Z = –3.25, p = 0.003). Moreover, the intervention group showed a significant reduction over time in Stereotype Endorsement (F(2, 50) = 13.40, p < 0.001, partial η² = 0.35) and Disease-related Misconceptions (χ2(2) = 12.64, p = 0.002). These findings suggest that addressing psoriasis on Instagram has the potential to effectively reduce the related stigmatization. Further studies are necessary to assess the impact of social media on stigmatization concerning psoriasis in more depth.
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References
Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 2020; 369: m1590.
https://doi.org/10.1136/bmj.m1590 DOI: https://doi.org/10.1136/bmj.m1590
Dalgard FJ, Gieler U, Tomas-Aragones L, Lien L, Poot F, Jemec GBE, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol 2015; 135: 984-991.
https://doi.org/10.1038/jid.2014.530 DOI: https://doi.org/10.1038/jid.2014.530
World Health Organization (WHO). Global report on psoriasis. [accessed 2021 Apr 05]. Available from: https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189_eng.pdf.psoriasis?sequence=1.
Jankowiak B, Kowalewska B, Krajewska-Kułak E, Khvorik DF. Stigmatization and quality of life in patients with psoriasis. Dermatol Ther (Heidelb) 2020; 10: 285-296.
https://doi.org/10.1007/s13555-020-00363-1 DOI: https://doi.org/10.1007/s13555-020-00363-1
Sommer R, Augustin M, Mrowietz U, Topp J, Schäfer I, von Spreckelsen R. Stigmatisierungserleben bei Psoriasis - qualitative Analyse aus Sicht von Betroffenen, Angehörigen und Versorgern. Hautarzt 2019; 70: 520-526.
https://doi.org/10.1007/s00105-019-4411-y DOI: https://doi.org/10.1007/s00105-019-4411-y
Sommer R, Topp J, Mrowietz U, Zander N, Augustin M. Perception and determinants of stigmatization of people with psoriasis in the German population. J Eur Acad Dermatol Venereol 2020; 34: 2846-2855.
https://doi.org/10.1111/jdv.16436 DOI: https://doi.org/10.1111/jdv.16436
World Health Assembly. Sixty-Seventh World Health Assembly: Psoriasis. 2014. [accessed 2021 Jan 21]. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R9-en.pdf.
Augustin M, Mrowietz U, Luck-Sikorski C, von Kiedrowski R, Schlette S, Radtke MA, et al. Translating the WHA resolution in a member state: towards a German programme on 'Destigmatization' for individuals with visible chronic skin diseases. J Eur Acad Dermatol Venereol 2019; 33: 2202-2208.
https://doi.org/10.1111/jdv.15682 DOI: https://doi.org/10.1111/jdv.15682
Sommer R, Weinberger NA, Von Spreckelsen R, Mrowietz U, Schielein MC, Luck-Sikorski C, et al. A structured intervention for medical students significantly improves awareness for stigmatisation in visible chronic skin diseases: a randomised controlled trial. Acta Derm Venereol 2021; 102: adv00641.
https://doi.org/10.2340/actadv.v101.894 DOI: https://doi.org/10.2340/actadv.v101.894
Weinberger NA, Mrowietz S, Luck-Sikorski C, von Spreckelsen R, John SM, Sommer R, et al. Effectiveness of a structured short intervention against stigmatisation in chronic visible skin diseases: results of a controlled trial in future educators. Health Expect 2021; 24: 1790-1800.
https://doi.org/10.1111/hex.13319 DOI: https://doi.org/10.1111/hex.13319
Shahbaznezhad H, Dolan R, Rashidirad M. The role of social media content format and platform in users' engagement behavior. J Interact Market 2021; 53: 47-65.
https://doi.org/10.1016/j.intmar.2020.05.001 DOI: https://doi.org/10.1016/j.intmar.2020.05.001
Dolan R, Conduit J, Bentham C, Fahy J, Goodman S. Social media engagement behavior: a framework for engaging customers through social media content. Eur J Market 2019; 53: 2213-2243.
https://doi.org/10.1108/EJM-03-2017-0182 DOI: https://doi.org/10.1108/EJM-03-2017-0182
Evans JS. In two minds: dual-process accounts of reasoning. Trends Cogn Sci 2003; 7: 454-459.
https://doi.org/10.1016/j.tics.2003.08.012 DOI: https://doi.org/10.1016/j.tics.2003.08.012
Evans JS, Stanovich KE. Dual-process theories of higher cognition: advancing the debate. Perspect Psychol Sci 2013; 8: 223-241.
https://doi.org/10.1177/1745691612460685 DOI: https://doi.org/10.1177/1745691612460685
Reeder GD, Pryor JB. Dual psychological processes underlying public stigma and the implications for reducing stigma. Mens Sana Monogr 2008; 6: 175-186.
https://doi.org/10.4103/0973-1229.36546 DOI: https://doi.org/10.4103/0973-1229.36546
McClure KJ, Puhl RM, Heuer CA. Obesity in the news: do photographic images of obese persons influence antifat attitudes? J Health Commun 2011; 16: 359-371.
https://doi.org/10.1080/10810730.2010.535108 DOI: https://doi.org/10.1080/10810730.2010.535108
Puhl RM, Luedicke J, Heuer CA. The stigmatizing effect of visual media portrayals of obese persons on public attitudes: does race or gender matter? J Health Commun 2013; 18: 805-826.
https://doi.org/10.1080/10810730.2012.757393 DOI: https://doi.org/10.1080/10810730.2012.757393
Beisch N, Koch W. 25 Jahre ARD/ZDF-Onlinestudie: Unterwegsnutzung steigt wieder und Streaming/Mediatheken sind weiterhin Treiber des medialen Internets. [accessed 2022 Mar 06]. Available from: https://www.ard-media.de/fileadmin/user_upload/media-perspektiven/ARD-ZDF-Onlinestudie/25_Jahre_ARD-ZDF-Onlinestudie.pdf.
Fung IC, Blankenship EB, Ahweyevu JO, Cooper LK, Duke CH, Carswell SL, et al. Public health implications of image-based social media: a systematic review of Instagram, Pinterest, Tumblr, and Flickr. Perm J 2020; 24: 18.307.
https://doi.org/10.7812/TPP/18.307 DOI: https://doi.org/10.7812/TPP/18.307
Die Medienanstalten. Average time spent using social networks per person in Germany in December 2017, by platform. [accessed 2022 Mar 06]. Available from: https://www.die-medienanstalten.de/fileadmin/user_upload/die_medienanstalten/Themen/Forschung/Internetnutzung/Nielsen_Jahresbericht_2017.pdf.
Instagram. Celebrating one year of Instagram stories. [accessed 2022 Mar 06]. Available from: https://about.instagram.com/blog/announcements/celebrating-one-year-of-instagram-stories.
Murmuras. Tägliche Nutzungsdauer der WhatsApp-, Instagram-, und YouTube-App durch Nutzer in Deutschland von Januar bis Juli 2020. [accessed 2022 Mar 06]. Available from: https://de.statista.com/statistik/daten/studie/1175958/umfrage/taegliche-nutzungsdauer-von-apps/#professional.
Yellow. Umfrage zur Nutzungsdauer pro Besuch von sozialen Netzwerken in Australien 2016. [accessed 2022 Mar 06]. Available from: https://irp-cdn.multiscreensite.com/535ef142/files/uploaded/Sensis_Social_Media_Report_2016.pdf.
Facebook IQ. How to connect with new audiences on Instagram. [accessed 2022 Mar 06]. Available from: https://en-gb.facebook.com/business/news/insights/how-to-connect-with-new-audiences-on-instagram.
Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175-191.
https://doi.org/10.3758/BF03193146 DOI: https://doi.org/10.3758/BF03193146
Karras T, Laine S, Aila T. A style-based generator architecture for generative adversarial networks. IEEE Trans Pattern Anal Mach Intell 2021; 43: 4217-4228.
https://doi.org/10.1109/TPAMI.2020.2970919 DOI: https://doi.org/10.1109/TPAMI.2020.2970919
Pryor JB, Reeder GD, Yeadon C, Hesson-McLnnis M. A dual-process model of reactions to perceived stigma. J Pers Soc Psychol 2004; 87: 436-452.
https://doi.org/10.1037/0022-3514.87.4.436 DOI: https://doi.org/10.1037/0022-3514.87.4.436
Jaeger B, Wagemans FMA, Evans AM, van Beest I. Effects of facial skin smoothness and blemishes on trait impressions. Perception 2018; 47: 608-625.
https://doi.org/10.1177/0301006618767258 DOI: https://doi.org/10.1177/0301006618767258
Tsankova E, Kappas A. Facial skin smoothness as an indicator of perceived trustworthiness and related traits. Perception 2016; 45: 400-408.
https://doi.org/10.1177/0301006615616748 DOI: https://doi.org/10.1177/0301006615616748
Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 2012; 63: 963-973.
https://doi.org/10.1176/appi.ps.201100529 DOI: https://doi.org/10.1176/appi.ps.201100529
Lieberman MD, Jarcho JM, Satpute AB. Evidence-based and intuition-based self-knowledge: an FMRI study. J Pers Soc Psychol 2004; 87: 421-435.
https://doi.org/10.1037/0022-3514.87.4.421 DOI: https://doi.org/10.1037/0022-3514.87.4.421
Pearl RL, Wan MT, Takeshita J, Gelfand JM. Stigmatizing attitudes toward persons with psoriasis among laypersons and medical students. J Am Acad Dermatol 2019; 80: 1556-1563.
https://doi.org/10.1016/j.jaad.2018.08.014 DOI: https://doi.org/10.1016/j.jaad.2018.08.014
Faktenkontor. Anteil der befragten Internetnutzer, die Instagram nutzen, nach Bildungsgrad in Deutschland im Jahr 2017. [accessed 2022 Jan 02]. Available from: https://www.faktenkontor.de/studien/social-media-atlas-2017-2018/
Jonkisz E, Moosbrugger H, Brandt H. Planung und Entwicklung von Tests und Fragebogen. In: Moosbrugger H, Kelava A, editors. Testtheorie und Fragebogenkonstruktion. Berlin, Heidelberg: Springer Berlin Heidelberg; 2012. p. 27-74.
https://doi.org/10.1007/978-3-642-20072-4_3 DOI: https://doi.org/10.1007/978-3-642-20072-4_3
Short C-E, DeSmet A, Woods C, Williams S-L, Maher C, Middelweerd A, et al. Measuring engagement in ehealth and mhealth behavior change interventions: viewpoint of methodologies. J Med Internet Res 2018; 20: e292.
https://doi.org/10.2196/jmir.9397 DOI: https://doi.org/10.2196/jmir.9397
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