Traditional, Complementary, and Integrative Medicine on X (Formerly Twitter) From 2015 to 2024 Across English, Spanish, and French: Retrospective Observational Study.

Abstract

Social media platforms have become important spaces for the circulation and discussion of health information. X (formerly Twitter) is one such space where traditional, complementary, and integrative medicine (TCIM)-related terms circulate in public health discourse. However, longitudinal TCIM-related mention patterns on social media, particularly during the COVID-19 pandemic period, remain poorly documented. The study aimed to characterize temporal mention patterns of TCIM-related terms on X across English, Spanish, and French between 2015 and 2024, including the COVID-19 pandemic period. We conducted a retrospective observational infodemiology study using raw, nonnormalized annual mention counts from Brandwatch-indexed public X content in English, Spanish, and French that contained 39 predefined TCIM-related terms from 2015 to 2024. Descriptive analyses summarized cumulative mentions and annual mention counts. Exploratory trend analyses were restricted to the 2015 to 2019 prepandemic period. For each term-language combination, ordinary least squares regression was fitted with annual mention count as the dependent variable and calendar year as the independent variable. Exploratory linear trend signals were retained when R²≥0.70 and an exact permutation test on the slope yielded P≤.05 (120 permutations). Cumulative mentions of the 39 TCIM-related terms totaled 191,994,848 over 2015 to 2024. The most frequently mentioned terms were "yoga" (79,618,183), "meditation" (55,560,372), and "mindfulness" (18,915,377), together accounting for 80.3% (154,093,932/191,994,848) of all mentions. Raw cumulative mentions were predominantly indexed in English (170,100,867/191,994,848, 88.6%) compared with Spanish (17,171,541/191,994,848, 8.9%) and French (4,722,440/191,994,848, 2.5%). Between 2019 and 2020, "meditation" showed the largest absolute increase in raw mention counts (1,935,949/3,627,557, 53.4%), whereas "ayurveda" showed the largest relative increase (400,624/214,901, 186.4%). Exploratory 2015 to 2019 trend analyses identified 14 linear trend signals in English (n=13, 92.9% decreasing; n=1, 7.1% increasing: "intermittent fasting," 161,584/70,496, 229%), 11 in French (n=5, 45.5% increasing), and 8 in Spanish (3 increasing). "Reiki" and "reflexology" decreased in all 3 languages. Between 2015 and 2024, raw TCIM-related mention counts on X were highly concentrated in a small set of wellness and mind-body labels and were predominantly in English compared with Spanish and French. No sustained aggregate surge was evident in the raw descriptive data during the COVID-19 pandemic period, although some terms such as "ayurveda" showed short-term fluctuations. These findings should be interpreted as platform-specific raw mention patterns, not as evidence of normalized public interest, sentiment, user attitudes, professional practice, or actual TCIM use.