Mpox on Instagram: Content Analytic Study

Abstract Background Mpox was declared a public health emergency of international concern in 2022. Instagram is widely used by age groups and communities disproportionately affected by mpox; yet platform-specific evidence on mpox information characteristics and engagement remains limited. Objective The aim of this study is to characterize sources, content, and engagement features of mpox-related Instagram posts, to describe prevention and treatment framing, and to compare the top 10% most-liked posts with the remaining corpus. Methods We retrieved English-language public Instagram posts via CrowdTangle containing “mpox” or “monkeypox” dated May 5, 2022, to January 17, 2023 (initial N=18,616). Using a pretested, deductive codebook adapted from prior Instagram health studies, 2 coders completed 2 pilot rounds; variables with low agreement were excluded. A randomized analytic sample of 1000 posts was coded for source type, content features, and prevention/treatment framing. Descriptive statistics were computed. For engagement contrasts, we compared the top 10% most-liked posts with the bottom 90% using tests of differences in independent proportions (mean differences [MD] with P values). Results Most posts originated from organizations (760/1000, 76%) versus individuals (240/1000, 24%). Organizational sources most commonly included businesses (436/760, 57.4%) and news/media outlets (401/760, 52.8%); government (174/760, 22.9%), nonprofits (131/760, 17.3%), and health care organizations (70/760, 9.2%) were less frequent. About one-third of posts cited a source (344/1000, 34.4%), most often the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)/other federal entity. Posts predominantly used illustrated images/infographics (827/1000, 82.7%); photos appeared in 47.3% (473/1000) and videos in 12.4% (124/1000) of posts. Prevention content appeared in 38.4% (384/1000) of posts, most commonly vaccination (684/1000, 68.5% of prevention posts), followed by avoiding close contact (145/1000, 14.5%), avoiding contact with objects (83/1000, 8.3%), abstaining from sexual activity (76/1000, 7.6%), and condom use (13/1000, 1.3%); 28.9% (289/1000) of prevention posts noted barriers. Treatment mentions were uncommon (25/1000, 2.5% traditional biomedical; 2/1000, 0.2% alternative). Compared with the bottom 90%, the top 10% most-liked posts (1) were more likely to originate from public figures/celebrities among individuals (MD=−0.591; P