The Effect of Monetary Incentives on Health Care Social Media Content: Study Based on Topic Modeling and Sentiment Analysis

Background: While there is high-quality online health information, a lot of recent work has unfortunately highlighted significant issues with the health content on social media platforms (eg, fake news and misinformation), the consequences of which are severe in health care. One solution is to investigate methods that encourage users to post high-quality content. Objective: Incentives have been shown to work in many domains, but until recently, there was no method to provide financial incentives easily on social media for users to generate high-quality content. This study investigates the following question: What effect does the provision of incentives have on the creation of social media health care content? Methods: We analyzed 8328 health-related posts from an incentive-based platform (Steemit) and 1682 health-related posts from a traditional platform (Reddit). Using topic modeling and sentiment analysis-based methods in machine learning, we analyzed these posts across the following 3 dimensions: (1) emotion and language style using the IBM Watson Tone Analyzer service, (2) topic similarity and difference from contrastive topic modeling, and (3) the extent to which posts resemble clickbait. We also conducted a survey using 276 Amazon Mechanical Turk (MTurk) users and asked them to score the quality of Steemit and Reddit posts. Results: Using the Watson Tone Analyzer in a sample of 2000 posts from Steemit and Reddit, we found that more than double the number of Steemit posts had a confident language style compared with Reddit posts (77 vs 30). Moreover, 50% more Steemit posts had analytical content and 33% less Steemit posts had a tentative language style compared with Reddit posts (619 vs 430 and 416 vs 627, respectively). Furthermore, more than double the number of Steemit posts were considered joyful compared with Reddit posts (435 vs 200), whereas negative posts (eg, sadness, fear, and anger) were 33% less on Steemit than on Reddit (384 vs 569). Contrastive topic discovery showed that only 20% (2/10) of topics were common, and Steemit had more unique topics than Reddit (5 vs 3). Qualitatively, Steemit topics were more informational, while Reddit topics involved discussions, which may explain some of the quantitative differences. Manual labeling marked more Steemit headlines as clickbait than Reddit headlines (66 vs 26), and machine learning model labeling consistently identified a higher percentage of Steemit headlines as clickbait than Reddit headlines. In the survey, MTurk users said that at least 57% of Steemit posts had better quality than Reddit posts, and they were at least 52% more likely to like and comment on Steemit posts than Reddit posts. Conclusions: It is becoming increasingly important to ensure high-quality health content on social media; therefore, incentive-based social media could be important in the design of next-generation social platforms for health information.