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The lack of organ donors has become a barrier for the development of organ transplantation programs, and many countries are currently facing a severe shortage of deceased organs. Media campaigns on social media have the potential to promote organ donation. However, little is known about what kind of media content is the most appropriate for this purpose.
This study aimed to analyze media posts regarding organ donation on Weibo, a social media platform, and to identify the media themes that are most advantageous in promoting public awareness and attitudes concerning organ donation.
Based on 16 million social media users’ posts randomly extracted from January 1 to December 31, 2017, 1507 reposts of 141 distinct media posts relevant to organ donation were found. We analyzed the media posts’ themes and examined their effects in promoting public awareness about organ donation by comparing the number of reposts and comments they prompted. The themes’ impact on attitude toward organ donation was gauged using the comments indicating support and intentions for organ donation.
Overall, 5 major themes were identified from the media posts, among which “organ donation behaviors” constituted the highest proportion (58/141, 41.13%). However, themes of “statistical descriptions of organ donation” and “meaningfulness of donation” were the most influential in promoting awareness on organ donation: approximately 3 of 10 commenters for the former theme and 2 of 10 commenters for the latter expressed intentions to become organ donors. These two themes, along with “meaningfulness of organ donation for society,” a subtheme of “meaningfulness of donation,” were the most effective for evoking support and intentions for donation.
A discrepancy was revealed between the media themes that were the most salient on the media agenda and those that were the most effective in increasing organ donation awareness and intentions on social media. These findings provide guidance for campaigns on organ donation. The results also suggest the potential of campaigns on social media for promoting prosocial health behaviors and highlight the importance of strategic message design for serving this goal.
Organ transplantation has brought hope to people with illness previously considered incurable [
Social media plays an indispensable role in the public health landscape [
Despite functioning as a venue for information exchange among peers, social media is a platform for promoting health regimens [
In the context of organ donation, the public tends to resort to the media and social media sites for information, indicating the plausibility of promoting this health behavior via media campaigns on social media. A thematic analysis of family dyads’ discussion on organ donation exemplified this predilection by revealing that the media was the most important source of information for decision making in family dyads [
Besides the media’s active role in promoting organ donation, the social media is an important arena for this purpose; for instance, health educators have been communicating about organ transplantation on social media sites [
Despite the plausibility, the media’s actual effects of organ donation campaigns on social media sites remain unknown. Additionally, effective media campaigns require careful selection of media contents; however, existing knowledge about what kind of media posts are most suitable for organ donation is inadequate. Organ donation cannot be increased by merely distributing media posts, as the effect of persuasive messages may not always meet the message designers’ expectations, and some messages might even induce backfire effects [
Therefore, careful selection of media contents is crucial for organ donation campaigns, and identifying the most appropriate media contents is a critical step for this purpose. Previous studies have yielded informative findings; for example, gain rather than loss frames [
This study addressed two research questions:
What are the themes of the media contents regarding organ donation on social media?
What effects do different media themes have on people’s attitudes toward organ donation, and which themes are the most effective in promoting organ donation?
A total of 16 million Weibo users’ posts were randomly extracted from January 1 to December 31, 2017, through Weibo’s application programming interface. Weibo is the Chinese equivalent of Twitter, with an enormous amount of media posts and 37.6 million monthly active users in 2017 [
Primarily, we identified major themes in the media posts. The 1507 reposts were attributed to 141 distinct media posts. In line with previous research, a direct content-analysis approach was adopted to analyze these posts [
When browsing media posts, social media users can repost with a click and sometimes add comments along with the reposts. Adopting the methodology of a previous study [
In addition, the extent to which a media theme motivated organ donation was assessed based on the number of its comments that expressed prodonation attitudes and stated donation intentions. Using a similar procedure for the media content analysis, the comments that indicated support and intention for organ donation were coded and counted for each theme. The number of comments pertaining to a theme that showed prodonation attitudes and intentions was divided by the total number of comments pertaining to the theme, yielding a prodonation/comment ratio and intention/comment ratio, respectively. For instance, the media posts under the theme of “organ donation behavior” received 37 comments, of which 7 contained prodonation attitudes and 3 showed donation intentions, which makes the prodonation/comment ratio 7/37 and the donation/comment ratio 3/37. The results indicate that 18.92% comments pertaining to this theme expressed support for organ donation and 8.11% showed donation intentions. Finally, the media themes’ effectiveness in promoting organ donation was assessed and compared based on these indicators.
Five major themes were derived from the 141 media posts: organ donation behaviors, issues and policies regarding organ donation, meaningfulness of organ donation, statistical descriptions of organ donation, and organ donation practice (
Coded themes or subthemes of media posts for organ donation.
Theme and subtheme | Number of posts | Definition | Example | |
Organ donation behaviors | 58 | The text pertains to individual donors’ or their families’ behavior related to donation or the donation process | A father donated his beloved son’s organ after the son’s death in a car accident | |
28 | The text pertains to the meaningfulness generated by organ donation | A mother heard her deceased son’s heartbeat when she met her son’s organ recipient | ||
Meaningfulness for donors | 10 | The text pertains to the meaningfulness of organ donations for the donors | A mother heard her deceased son’s heartbeat when she met her son’s organ recipient | |
Meaningfulness for recipients | 4 | The text pertains to the meaningfulness of organ donations for the recipients | An organ recipient was grateful to the donor’s families and called them “mom and dad” | |
Meaningfulness for society | 14 | The text pertains to the meaningfulness of organ donations for society | Organ donation extends our lives | |
Issues and policies regarding organ donation | 28 | The text pertains to the state and the problems facing organ donation or policies that address these problems | The “organ donation coordinator” was employed to help alleviate the organ donation shortage | |
Statistical descriptions of organ donation | 21 | The text pertains to the statistics of registered organ donors | In 2016, the number of registered organ donation volunteers reached 104,528 in China | |
Organ donation practice | 6 | The text pertains to the implementation and procedure of organ donation | A well-known medical professional performed an organ donation transplantation for a patient while on a visit to Beijing for a major conference |
Among them, the largest proportion of the posts addressed “organ donation behaviors” (58/141, 41.13%). This theme refers to an individual donor or his family’s engagement with organ donation (eg, “The father donated his beloved son’s organ after the son passed away in a car accident”). “Issues and policies regarding organ donation” and “meaningfulness of organ donation,” each constituted 19.86% (28) of the posts. Upon close analysis, we found that three subthemes of “meaningfulness of organ donation” were observed, based on the subjects involved in organ donation: the meaningfulness of donation for the donors, recipients, and society. The remaining two themes pertained to “statistical descriptions of organ donation” (21, 14.89%) and “organ donation practice” (6, 4.26%).
Sources of the media posts were also identified and classified according to three commonly recognized media source categories in China: official media, which was responsible to the government institutions; market-oriented media, which is largely influenced by market competition; and self-media, which is initiated by individual persons or organizations [
Of the five themes, “statistical descriptions of organ donation” had the highest repost/post ratio of 37.24%, indicating that the media posts in this theme triggered 37.24 reposts on an average, followed by “meaningfulness of organ donation,” with a repost/post ratio of 14.04%. It is also noteworthy that among its three subthemes, “meaningfulness for recipients” induced a high repost/post ratio of 27.75%. By contrast, the ratios for “organ donation practice” and “issues and policies regarding organ donation” ranked low at 1.33% and 1.04%, respectively. Regarding the comment/post ratio, “statistical descriptions of organ donation” had a value of 7.71%, which was the highest, and “organ donation behaviors” had the lowest ratio of 0.64% (
Posts, reposts, and comments across media themes.
Media themes and subthemes | Number of posts | Number of reposts | Number of comments | Repost/post ratio (%) | Comment/post ratio (%) | |
Organ donation behaviors | 58 | 295 | 37 | 5.09 | 0.64 | |
28 | 393 | 42 | 14.04 | 1.5 | ||
Meaningfulness for donors | 10 | 198 | 24 | 19.80 | 2.4 | |
Meaningfulness for recipients | 4 | 111 | 11 | 27.75 | 2.75 | |
Meaningfulness for society | 14 | 84 | 7 | 6.00 | 0.5 | |
Issues and policies regarding organ donation | 28 | 29 | 4 | 1.04 | 0.14 | |
Statistical descriptions of organ donation | 21 | 782 | 162 | 37.24 | 7.71 | |
Organ donation practice | 6 | 8 | 0 | 1.33 | 0 |
Prodonation attitudes and donation intentions expressed across media themes.
Media themes and subthemes | Number of prodonations | Prodonation/comment ratio (%) | Number of donation intentions | Donation/comment ratio (%) | |
Organ donation behaviors | 7 | 18.92 | 3 | 8.11 | |
16 | 38.10 | 9 | 21.43 | ||
Meaningfulness for donors | 7 | 29.17 | 4 | 16.67 | |
Meaningfulness for recipients | 4 | 36.36 | 1 | 9.10 | |
Meaningfulness for society | 5 | 71.43 | 4 | 57.14 | |
Issues and policies regarding organ donation | 1 | 25.00 | 0 | 0.00 | |
Statistical descriptions of organ donation | 85 | 52.47 | 50 | 30.86 | |
Organ donation practice | N/Aa | N/A | N/A | N/A |
aN/A: not applicable.
Among the 1507 reposts, 245 contained comments, of which 109 expressed prodonation attitudes and 62 comments contained clear donation intentions. These social media users showed positive attitudes toward organ donations with both straightforward claims such as “I support organ donation” and more nuanced tones such as “It shows the advancement of our society.” There were typical comments regarding organ donation intentions, such as “If I meet the requirements, I would like to donate my organs.” The media themes were compared based on the two indicators for prodonation attitudes and donation intentions. The analysis showed that “statistical descriptions of organ donation” generated the highest prodonation/comment ratio of 52.47% and intention/comment ratio of 30.86%, suggesting that 52.47% of the comments under this theme contained prodonation sentiments and 30.86% included donation intentions. “Meaningfulness of donation” had the second highest prodonation/comment ratio of 38.10% and a donation/comment ratio of 21.43%. In addition, one subtheme of “meaningfulness of donation”—“meaningfulness for society”—had a prodonation/comment ratio of 71.43% and a donation/comment ratio of 57.14%. In comparison, organ donation behaviors had both the lowest prodonation/comment ratio of 18.92% and the lowest donation/comment ratio of 8.11% (
The effectiveness of campaigns would be further enhanced if the target audience could be profiled. Specifically, it would be informative to acknowledge people with characteristics that are more likely to transmit the organ donation posts and who are more inclined to develop prodonation attitudes after media exposure. Therefore, we took a further step to characterize the people who reposted, commenters, donation supporters, and self-reported donor volunteers by retrieving and analyzing information on their sex and age. The social media users’ characteristics in our sample were compared with those of the original 16 million social media users to ensure that the observed difference in the dataset of organ donation (ie, more young people supported organ donation than the old) was not derived from overrepresentation or underrepresentation of certain groups. The analysis showed that female individuals were more likely to comment about organ donation than male individuals and that the sex distribution of commenters in the datasets of organ donation and the dataset of 16 million users was significantly different (χ21=23.0;
With social media and media, in general, taking increasingly active roles in the public health arena [
With respect to evoking the public’s donation intentions, “statistical descriptions of organ donation” was found to have a dominant advantage: 3 of 10 commenters were motivated to become donors. “Meaningfulness of organ donation” and one of its subthemes, “meaningfulness for society,” also generated a significant amount of donation intentions. These two major themes were observed in the other aspects as well (eg, prodonation attitudes). Their particular effectiveness in provoking donation intentions may stem from social norms, which could be promoted by the media, and influence people’s behavioral intentions [
In sharp contrast with these two themes’ impacts, “organ donation behaviors” had the weakest effect on promoting organ donation intentions. This result is consistent with previous experimental findings: As compared to identifying information regarding the organ recipient, presenting information of the deceased donors helped less in motivating people to register for donations, as it may induce thoughts of death rather than saving lives [
Combining the findings regarding the salience and effects of the media themes, a gap was observed between the media themes that received the most media attention and those that were the most advantageous in promoting organ donation. This discrepancy indicates an unrealized potential for the media to increase organ donations; media campaigns might fulfill this goal by emphasizing donation trends and meaningfulness while curtailing the number of reports on ordinary individuals’ donation behaviors. Furthermore, the themes that are advantageous in promoting organ donation awareness, attitudes, and intentions also provide templates for message designs for future media campaigns.
An exploratory analysis was also conducted to characterize social media users who were actively involved in the issue of organ donation after exposure to the relevant media contents. The analysis of characteristics of commenters revealed patterns including one showing that female individuals more actively commented on organ donation than male individuals. This finding is consistent with previous insights that female individuals had higher level of engagement with social media [
Overall, this study examined the media effects of a health issue on social media. Previous researchers pointed out that social media has become an increasingly influential platform for health-related campaigns and a rich mine for research on health-related behaviors [
The quantity of the data for this analysis was not large, partly due to general insufficient awareness about organ donation [
This work was partially supported by the Major Project of the National Social Science Foundation of China (Award #18ZDA165).
None declared.