Promoting Public Engagement in Palliative and End-of-Life Care Discussions on Chinese Social Media: Model Development and Analysis

Abstract

Background: In Chinese traditional culture, discussions surrounding death are often considered taboo, leading to a poor quality of death, and limited public awareness and knowledge about palliative and end-of-life care (PEoLC). However, the increasing prevalence of social media in health communication in China presents an opportunity to promote and educate the public about PEoLC through online discussions. Objective: This study aimed to examine the factors influencing public engagement in PEoLC discussions on a Chinese social media platform and develop practice recommendations to promote such engagement. Methods: We gathered 30,811 PEoLC-related posts on Weibo, the largest social media platform in China. Guided by the elaboration likelihood model, our study examined factors across 4 dimensions: content theme, mood, information richness, and source credibility. Content theme was examined using thematic analysis, while sentiment analysis was used to determine the mood of the posts. The impact of potential factors on post engagement was quantified using negative binomial regression. Results: Organizational accounts exhibited lower engagement compared to individual accounts (incidence rate ratio [IRR]<1; P