Social Media Reactions to Sex Toy Criminalization in Ghana: Cross-Sectional Sentiment and Text Network Analysis.

Retinoblastoma is the most common intraocular childhood cancer, but treatment outcomes can be good especially with early management []. Although enucleation results in total vision loss and cosmetic concerns [], it remains life-saving for patients at stage E under the Intraocular Classification of Retinoblastoma scheme [,]. With advancements in treatment techniques, especially globe salvage (GS) treatments, the overall survival (OS) and GS rates have increased over the past 4 decades globally [,]. Unfortunately, significant disparities persist between higher-income and lower-income countries, with some regions having significant survival gaps []. While access to health care services, late disease detection, and poor health care system performance has been recognized as critical barriers to improving survival rates [,], social and cultural factors can weaken disease understanding and acceptance of treatment options, resulting in late disease presentation and high default rates in certain regions [,-]. A comprehensive understanding of the underlying barriers is necessary for targeted education and improvement in these regions [-]. Social media offers a significant bidirectional impact on public health care understanding []. On the one hand, it effectively drives public discourse and sentiments concerning health care interventions and modeling social beliefs. Posts on treatment access construct the perceived treatment barrier, and educational posts on disease management and progression without treatment shed light on perceived severity. By emphasizing the early signs and promoting early diagnosis, the prevention of global and life-threatening complications through early diagnosis underlies perceived benefits. Social media may influence health decisions as per the health belief model [-]. On the other hand, it provides a proxy for clinicians and researchers to systematically understand the health-seeking behavior and beliefs of patients [,-]. Public sentiments may alter patients’ choices, and it would be strategic to use social media to disseminate accurate information that enhances health care outcomes [-]. Following the diffusion of innovation theory, key components of effective communications are determined by innovation, communication channels, time, and social systems. By forming highly connected, real-time focused networks around retinoblastoma and general pediatric eye care, social media usage entails both significant benefits and potential threats to the spread of legitimate medical information []. While this impact has been intensively studied in relation to COVID-19 vaccine hesitancy and misinformation, it is also relevant in noncommunicable diseases, including malignancies [-,,,,]. Existing applications of social media for oncology include patient support and patient-driven research. For example, patients with lung cancer have been using platforms such as Twitter (subsequently rebranded X) to offer and receive social and psychological support []. Twitter has also been used to evaluate patients’ adherence to treatment and recovery from urological diseases and prostate cancer []. The extensive use of social media has also been described for pediatric cancer and rare diseases, extending from emotional expression by survivors, information seeking by parents, and key information dissemination to the public. A summary of recent work focusing on the pediatric population has been provided in Table S1 in . To improve global awareness and acceptance of retinoblastoma treatment, it is essential to resolve underlying concerns and beliefs that hinder the understanding of retinoblastoma and its treatments. Perceived barriers to retinoblastoma treatment, such as cultural differences and gender inequality, are not well studied worldwide. We conducted this study to evaluate the use of social media’s power in characterizing global differences in retinoblastoma disease perception and to assess the impact on treatment choices and, subsequently, survival outcomes [].