Analyzing Public Conversations of Heart Disease and Heart Health on Facebook from 2016 to 2021: A Retrospective Observational Study (Preprint)

BACKGROUND Heart disease continues to be the leading cause of death for men and women in the United States. The COVID-19 pandemic has further led to increases in various long-term cardiovascular complications. OBJECTIVE This study analyzes public conversations related to heart disease and heart health on Facebook in terms of their thematic topics and sentiments. In addition, it provides in-depth analyses of two sub-topics with important practical implications: heart health for women and heart health during the COVID-19 pandemic. METHODS We collected 34,885 posts and 51,835 comments spanning June 2016 to June 2021 that are related to heart disease and health from public Facebook pages and groups. We used Latent Dirichlet Allocation (LDA) topic modeling to extract discussion topics illuminating the public's interests and concerns regarding heart disease and heart health. We also used Linguistic Inquiry and Word Count (LIWC) to identify the public sentiments on heart health. RESULTS We observed an increase in discussions related to heart health on Facebook. Posts and comments increased from 3,102 and 3,632 in 2016 to 8,550 (176% increase) and 14,617 (302% increase) in 2021. Overall, 35.4% of posts were created after January 2020, the start of the COVID-19 outbreak. In total, 13,677 posts (39.21%) were contributed by non-profit health organizations. We identified 6 topics in posts (heart health promotion, personal experiences, risk reduction education, heart health promotion for women, educational information, and doctor's live discussion sessions). We identified 6 topics in the comments (personal experiences, survivor stories, risk reduction, religion, medical questions, and appreciation of doctors and information on heart health). During the pandemic (January 2020 to June 2021), risk reduction was a major topic in both posts and comments. Unverified information on alternative treatments and promotional content (33.4%) were also prevalent. Among all posts, 14.9% were specifically about heart health for women centering on local event promotion and distinctive symptoms of heart diseases for women. CONCLUSIONS Our results tracked the public's ongoing discussions about heart disease and heart health on one prominent social media platform, Facebook. The public's discussions and information sharing on heart health increased over time, especially since the start of the COVID-19 pandemic. Various levels of health organizations on Facebook actively promoted heart health information and engaged a large number of users. Facebook presents opportunities for more targeted heart health interventions that can reach and engage diverse populations. CLINICALTRIAL