Association Between Social Media Use and Burnout Among Primary Health Care Workers During the COVID-19 Pandemic in China: Nationwide Cross-Sectional Survey

Abstract

Background: The COVID-19 pandemic has intensified health care worker burnout and increased their engagement with social media. However, it remains unclear whether social media is beneficial in mitigating burnout among primary health care workers (PHWs).

Objective: This study aims to report the prevalence of burnout among Chinese PHWs and investigate the relationship between social media use, specifically WeChat Moments usage, and burnout, with a focus on urban-rural differences.

Methods: Our nationwide cross-sectional survey was conducted between May and October 2022 and included 3769 PHWs. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey, and WeChat Moments usage was self-evaluated. Weighted data were used to report the prevalence of burnout nationwide and in urban and rural areas. Multivariate logistic regression and subgroup analyses were used to examine the association between burnout and WeChat Moments usage frequency, highlighting differences between urban and rural PHWs.

Results: Urban PHWs reported a higher prevalence of burnout compared with their rural counterparts (212/1200, 17.6% vs 351/2569, 13.7%; P=.004). Overall, the frequency of social media use was negatively associated with the prevalence of burnout. With the inclusion of covariates, those who sometimes used WeChat Moments experienced a statistically significant protective effect compared with those who never used WeChat Moments in the fully adjusted model (odds ratio 0.570, 95% CI 0.348-0.933; P=.03). The association between social media use and burnout was more statistically significant in urban settings than in rural settings (urban: all odds ratios and 95% CIs <1, and all P<.05; rural: all P>.05).

Conclusions: Urban and rural differences in burnout prevalence were observed among PHWs, with urban practitioners experiencing significantly higher prevalence. This study also found that increased social media use was associated with a lower likelihood of experiencing burnout, but the association did not always exist. In terms of overall burnout, the relationship between social media use and burnout was statistically significant only in urban areas. Our findings underscore the urgent need for policy makers and health care institutions to prioritize interventions addressing burnout among PHWs, particularly in underresourced and high-stress settings. Local governments could pilot platforms with moderation, allowing PHWs to showcase their work progress to the communities they serve, thereby strengthening trust and reducing emotional exhaustion. Our research also suggests that social media interventions may be particularly effective in urban settings. These findings offer actionable insights for other low- and middle-income countries navigating similar challenges. International bodies (eg, the World Health Organization) should develop digital health guidelines specific to low- and middle-income countries to help policy makers balance the benefits and risks of social media.

Keywords: China; burnout; primary health care workers; social media; urban-rural difference.

Figure 1.. Relations between WeChat Moments usage and burnout among rural and urban areas. DP: depersonalization; EE: emotional exhaustion; PA: personal accomplishment.