New Publication! Ethics and Privacy Implications of Using the Internet and Social Media to Recruit Participants for Health Research: A Privacy-by-Design Framework for Online Recruitment

I am so happy to announce I have a new paper published in JMIR, an open-access journal on medicine and the internet. Read the abstract below, and click the links to read the full article.

Ethics and Privacy Implications of Using the Internet and Social Media to Recruit Participants for Health Research: A Privacy-by-Design Framework for Online Recruitment

Authors: JL Bender, AB Cyr, L Arbuckle, LE Ferris


Background: The Internet and social media offer promising ways to improve the reach, efficiency, and effectiveness of recruitment efforts at a reasonable cost, but raise unique ethical dilemmas. We describe how we used social media to recruit cancer patients and family caregivers for a research study, the ethical issues we encountered, and the strategies we developed to address them.

Objective: Drawing on the principles of Privacy by Design (PbD), a globally recognized standard for privacy protection, we aimed to develop a PbD framework for online health research recruitment.

Methods: We proposed a focus group study on the dietary behaviors of cancer patients and their families, and the role of Web-based dietary self-management tools. Using an established blog on our hospital website, we proposed publishing a recruitment post and sharing the link on our Twitter and Facebook pages. The Research Ethics Board (REB) raised concern about the privacy risks associated with our recruitment strategy; by clicking on a recruitment post, an individual could inadvertently disclose personal health information to third-party companies engaged in tracking online behavior. The REB asked us to revise our social media recruitment strategy with the following questions in mind: (1) How will you inform users about the potential for privacy breaches and their implications? and (2) How will you protect users from privacy breaches or inadvertently sharing potentially identifying information about themselves?

Results: Ethical guidelines recommend a proportionate approach to ethics assessment, which advocates for risk mitigation strategies that are proportional to the magnitude and probability of risks. We revised our social media recruitment strategy to inform users about privacy risks and to protect their privacy, while at the same time meeting our recruitment objectives. We provide a critical reflection of the perceived privacy risks associated with our social media recruitment strategy and the appropriateness of the risk mitigation strategies that we employed by assessing their alignment with PbD and by discussing the following: (1) What are the potential risks and who is at risk? (2) Is cancer considered “sensitive” personal information? (3) What is the probability of online disclosure of a cancer diagnosis in everyday life? and (4) What are the public’s expectations for privacy online and their views about online tracking, profiling, and targeting? We conclude with a PbD framework for online health research recruitment.

Conclusions: Researchers, REBs, ethicists, students, and potential study participants are often unaware of the privacy risks of social media research recruitment and there is no official guidance. Our PbD framework for online health research recruitment is a resource for these wide audiences.

Read the full article

What does all this tweeting about health really mean? Expanding our understanding of Twitter & disease [research study]

I want to help build our understanding of how Twitter is used in health, particularly around healing. Will you help me by sharing this post?

With more than 560 disease-related hashtags registered on Symplur’s Health Care Hashtag Project, it’s clear that people are using Twitter to talk about health. The academic world has recognized this and has gradually been building scientific proof since Twitter launched in 2006. At the end of 2014, I searched published academic literature for papers on Twitter and consumer health and found studies on cancer, drugs, medication, communicable diseases, smoking (including e-cigarettes), mental health, exercise, pain, cardiac arrest, childhood obesity, concussion, dementia, epilepsy, orthodontics, palliative care, vaccines, and weight loss. I’m sure that list comes as no surprise to seasoned Twitter users – people seem to talk about everything on Twitter!

So while academics have shown that people tweet about health, we haven’t really got too far in exploring how it all connects to the daily lives of Twitter users. It’s an area worth exploring. The new online social tools of the last decade have become so ingrained in our daily lives, yet we don’t have a lot of research to show how it has shaped our “offline” lives. As Marie Hardin wrote in 2014,

“The next logical step after we have a good sense about [what Twitter is, how people use it, and for what purpose they use it] is to pursue studies that put a much higher priority on the wider sociocultural context and on theory. In other words, providing much more substance about what all this tweeting really means and its implications for what we already know. What is consequential and how so?”

It’s a huge topic that will take many researchers and even more studies, but I hope to tackle just a small sliver of it through my thesis.

One of the first published papers on medical anthropology ends with an idea that may explain why so many people turn to Twitter to talk about their health:

“… the increasing technical control [in medicine] has been accompanied by the separation of efficacy from meaning, progressive dehumanization of the healing function, so much so that we are seeing traditional healing activities surface in the wider social structure just as they are disappearing from clinical practices. ” (Arthur M Kleinman Inquiry, 16 (1973), 206-213)

What Kleinman is suggesting is that as we get better at treating the biological parts of disease through the development of modern medicine, the social connection of healing, common in traditional healing activities, disappears from the clinical encounter and instead happens in other social contexts. It made me wonder: is Twitter one of these other social contexts?

Update: Data collection has ended for this project and I am now finishing my analysis. Please contact me at if you are interested in learning more about this study or if you’d like to be contacted when the final analysis is complete.

This research study was reviewed and approved by the Research Ethics Board at the University of Toronto.

To prevent disclosure of personal information, please note that comments must be approved before they appear below.

Alaina’s Not Here, Man

Just a quick update for my followers:

Although I have been neglecting this blog, I haven’t stopped blogging. Oh, no! I am now regularly blogging on two additional websites. So if you’ve been missing me lately, check out some of my latest posts:

Oh, and don’t worry. This blog isn’t going anywhere. I’ll still be writing every now and then 😉

#hcsmca’s 2-year report card – Infographic

Last week I wrote a guest post on Colleen Young’s blog about the evolution of the #hcsmca community over the past 2 years. Here is the post and the infograph I created to show off our growth.

Colleen Young

Presenting #hcsmca’s 2-year report card. Thank you Alaina Cyr for creating yet another beautiful infographic. And don’t forget to read her commentary below and add your thoughts and interpretations. What a community!

2 year infographic

By Alaina Cyr (@AlainaBCyr) 

It’s my pleasure to share with you #hcsmca’s 2-year report card!

Like the 6-month and 18-month report cards that came before, this infograph shows how the #hcsmca community has grown since September 29, 2010. But what I find most meaningful in this report card is how the history and identity of our community shines through between the graphs and numbers.

As I look over the familiar faces of those daring souls who’ve moderated a chat, I see representation from throughout the spectrum of healthcare. Like our community as a whole, the moderators are patients, caregivers, students, researchers, communicators, developers, nurses, doctors, representatives from medical practices, non-profit organizations and, often times, several of these at once…

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