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Is Open Access

Predictors of Facebook User Engagement With Health-Related Content for Gay, Bisexual, and Other Men Who Have Sex With Men: Content Analysis

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      Social media is used by community-based organizations (CBOs) to promote the well-being of gay and bisexual men (GBM). However, few studies have quantified which factors facilitate the diffusion of health content tailored for sexual minorities.


      The aim of this study was to identify post characteristics that can be leveraged to optimize the health promotion efforts of CBOs on Facebook.


      The Facebook application programming interface was used to collect 5 years’ of posts shared across 10 Facebook pages administered by Vancouver-based CBOs promoting GBM health. Network analysis assessed basic indicators of network structure. Content analyses were conducted using informatics-based approaches. Hierarchical negative binomial regression of post engagement data was used to identify meaningful covariates of engagement.


      In total, 14,071 posts were shared and 21,537 users engaged with these posts. Most users (n=13,315) engaged only once. There was moderate correlation between the number of posts and the number of CBOs users engaged with ( r=.53, P<.001). Higher user engagement was positively associated with positive sentiment, sharing multimedia, and posting about pre-exposure prophylaxis, stigma, and mental health. Engagement was negatively associated with asking questions, posting about dating, and sharing posts during or after work (versus before).


      Results highlight the existence of a core group of Facebook users who facilitate diffusion. Factors associated with greater user engagement present CBOs with a number of strategies for improving the diffusion of health content.

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      Most cited references 34

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            Author and article information

            1 Faculty of Health Science Simon Fraser University Burnaby, BC Canada
            2 British Columbia Centre for Excellence in HIV/AIDS Vancouver, BC Canada
            3 School of Public Health and Social Policy University of Victoria Victoria, BC Canada
            4 Interdisciplinary Studies Graduate Program University of British Columbia Vancouver, BC Canada
            5 Community-Based Research Centre for Gay Men's Health Vancouver, BC Canada
            6 YouthCO HIV & Hep C Society Vancouver, BC Canada
            Author notes
            Corresponding Author: Kiffer George Card kiffercard@
            , ORCID:
            JMIR Public Health Surveill
            JMIR Public Health Surveill
            JMIR Public Health and Surveillance
            JMIR Publications (Toronto, Canada )
            Apr-Jun 2018
            06 April 2018
            : 4
            : 2
            29625953 5910534 v4i2e38 10.2196/publichealth.8145
            (Reviewer), (Reviewer), (Reviewer), (Reviewer),
            ©Kiffer George Card, Nathan Lachowsky, Blake W Hawkins, Jody Jollimore, Fahmy Baharuddin, Robert S Hogg. Originally published in JMIR Public Health and Surveillance (, 06.04.2018.

            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 work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.

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