Social media and applications to health behavior

https://doi.org/10.1016/j.copsyc.2015.10.021Get rights and content

Highlights

  • Social media presents an unprecedented opportunity to change health through online influence.

  • Of all the platforms available, Facebook features most commonly in health behavior change research.

  • Twitter, online communities and apps are increasingly appearing in health research.

  • Randomized controlled trials investigating the efficacy of social media for health are rare.

  • Continued research is required to refine the application of social media for better health.

Social media is ingrained in daily life, with high usage and apparent ease of engagement making it an attractive tool for health behavior interventions. Approaches have varied widely in terms of target behavior, social networking platforms used, and intervention characteristics. Targeted applications of Facebook, Twitter, online social communities and apps with social features appear to enhance some aspects of health, and offer unique insights into health-related behavior. However, delivery of an intervention that incorporates an established and popular social media platform does not guarantee impact. Online social media is complex, evolving and nuanced. Future challenges for the field will include evaluating interventions in a diverse populace, and designing features that sustain engagement and behavior change.

Section snippets

Social media: an opportunity to change health

With nearly 2 billion active users of Facebook, Twitter and other platforms across the world (http://www.statista.com/), social media is an important part of daily life for many people. Used as an umbrella term, ‘social media’ describes web applications that allow users to generate, share, receive and comment on content via social networks (e.g. Facebook); blogs and microblogs (e.g. WordPress and Twitter); content communities (e.g. YouTube); collaborative projects (e.g. Wikipedia); and virtual

Facebook: forums, groups and games

Facebook has been the most popular social media platform featuring in health behavior change research. Studies have targeted a wide range of health behaviors, including weight loss [5, 6•, 7, 8, 9], physical activity [10, 11, 12, 13, 14, 15], sexual health [16, 17, 18, 19], smoking cessation [14], mental health [20], food safety [21], disease self-management [22], and tobacco chewing [23]. Target populations for these interventions have varied. Some studies have covered the general population [

Twitter: social support and data mining

Although rarely used as a health-change tool on its own, Twitter has been successfully applied as a supplementary aid to increase success of online interventions by enhancing social engagement. Twitter boosted the spread of information and strengthened social networks in an online quit smoking program [28] and enhanced social support for weight loss [29, 30, 31] and the ‘#PlankADay’ exercise challenge [32].

In addition, Twitter has been mined as a source of public and searchable data relating to

Online social networks and free-standing apps: where the numbers are

Many online health and wellbeing sites incorporate social media by allowing users to log in with their Facebook account, and to post their progress to Facebook and Twitter  for example, Dietbet [38] and Daily Challenge [39]. However some sites also incorporate online social networking features within their own platforms, such the provision of ‘friending’ forums and pages for blogging and other in-house content sharing. Such sites have attracted users numbering in the hundreds of thousands (e.g.

Social media for health interventions: a fascinating and evolving field

A growing body of evidence supports the notion that online social platforms can effectuate health behavior change. However  like most tools  social media has its strengths and weaknesses. Nuances of social interactions, user familiarity, privacy, platform cost and usability, and engagement must be considered.

From a social perspective, social media has benefits not offered by offline health programs. For weight loss and exercise support, a built-in social element has been shown to enhance

The future of online social media for health

The use of social media platforms for health applications is a complex and quickly evolving field. To date, a wide variety of health behaviors have been targeted, though physical activity has been particularly popular. Future efforts across a variety of research fronts are warranted. In future, it will be useful to scrutinize which types of interactions most support health behavior change and how to achieve sustained engagement will be critical. Furthermore, working with diverse groups with

Conflict of interest statement

Nothing declared.

References and recommended reading

Papers of particular interest, published within the period of review, have been highlighted as:

  • • of special interest

  • •• of outstanding interest

Acknowledgements

Carol Maher is supported by a Postdoctoral Fellowship from the Australian National Heart Foundation.

References (55)

  • J.E. Chung

    Antismoking campaign videos on YouTUbe and audience response: application of social media assessment metrics

    Comput Hum Behav

    (2015)
  • N.A. Christakis et al.

    Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives

    (2009)
  • C.A. Maher et al.

    Are health behavior change interventions that use online social networks effective? A systematic review

    J Med Internet Res

    (2014)
  • L. Laranjo et al.

    The influence of social networking sites on health behavior change: a systematic review and meta-analysis

    J Am Med Inform Assoc

    (2014)
  • S.B. Hales et al.

    Varying social media post types differentially impacts engagement in a behavioral weight loss intervention

    Transl Behav Med

    (2014)
  • K. Patrick et al.

    Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART)

    Contemp Clin Trials

    (2014)
  • S.J. Woolford et al.

    Let's face it: patient and parent perspectives on incorporating a Facebook group into a multidisciplinary weight management program

    Child Obes

    (2013)
  • R.P. Joseph et al.

    Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial

    BMC Womens Health

    (2015)
  • C.G. Valle et al.

    A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors

    J Cancer Surviv

    (2013)
  • D.N. Cavallo et al.

    A social media-based physical activity intervention: a randomized controlled trial

    Am J Prev Med

    (2012)
  • D. Foster et al.

    Motivating physical activity at work: using persuasive social media for competitive step counting

  • N.H. Durant et al.

    Peer reviewed: recommendations for a culturally relevant Internet-based tool to promote physical activity among overweight young African American women, Alabama, 2010–2011

    Prev Chronic Dis

    (2014)
  • J. Syred et al.

    Would you tell everyone this? Facebook conversations as health promotion interventions

    J Med Internet Res

    (2014)
  • C. Lelutiu-Weinberger et al.

    Feasibility acceptability, and preliminary efficacy of a live-chat social media intervention to reduce HIV risk among young men who have sex with men

    AIDS Behav

    (2014)
  • S.D. Young et al.

    Online social networking for HIV education and prevention: a mixed methods analysis

    Sex Transm Dis

    (2013)
  • S.S. Bull et al.

    Social media-delivered sexual health intervention: a cluster randomized controlled trial

    Am J Prev Med

    (2012)
  • A.B. Mayer et al.

    Safe eats: an evaluation of the use of social media for food safety education

    J Food Protect

    (2012)
  • Cited by (42)

    • The menstrual cup knowledge, attitudes, and behaviors of Turkish women in reproductive age

      2024, European Journal of Obstetrics and Gynecology and Reproductive Biology
    • Social media narratives can influence vaccine intentions: The impact of depicting regret and character death

      2023, Computers in Human Behavior
      Citation Excerpt :

      For instance, during the COVID-19 pandemic, news outlets and public health organizations relied heavily on Twitter to quickly disseminate information, especially information conveying the gravity of the situation and encouraging the adoption of preventive behaviors such as vaccination (Wang et al., 2021). Despite the short format of a tweet, messages on Twitter are shown to be influential in shaping public attitudes about a range of health behaviors (Maher et al., 2016; McNeill et al., 2016; Tang et al., 2021). Situated in this context, we tested the potential for a simulated news tweet to influence COVID-19 booster vaccine intention by reporting a story about a couple who decided not to get vaccinated and regretted their choice after falling ill.

    • Biases in using social media data for public health surveillance: A scoping review

      2022, International Journal of Medical Informatics
      Citation Excerpt :

      These health-related posts on various social media platforms bring new opportunities for public health surveillance. There are different focuses of using social media data for public health surveillance, such as (1) disease surveillance,[3,4] (2) pharmacovigilance,[5,6] (3) misinformation surveillance,[7] (4) surveillance of human mobility and health behavior of a population, some of which use location-based social networks.[8–10] Nevertheless, the nature of social media data and associated analysis methods are very different from those that are used in traditional public health surveillance systems.

    • Feasibility, preliminary efficacy, and accessibility of a twitter-based social support group vs Fitbit only to decrease sedentary behavior in women

      2021, Internet Interventions
      Citation Excerpt :

      Additionally, Twitter messages (called tweets) have a 280-character limit, which enables messages to be short and accessible. Often used as a supplementary aid to in-person interventions or interventions hosted in other platforms, the potential for utilizing Twitter as a stand-alone to deliver health behavior interventions is not yet fully realized (Maher et al., 2016). When used, engagement strongly predicts the benefits (An et al., 2008; Cole-Lewis et al., 2019).

    • Walking for fun or for “likes”? The impacts of different gamification orientations of fitness apps on consumers’ physical activities

      2019, Sport Management Review
      Citation Excerpt :

      For instance, when going to a supermarket within walking distance, a consumer may still choose to drive because she or he may consider walking boring and time-wasting. With the rapid development of mobile technologies, an increasing number of companies now provide services through mobile applications (apps), aiming at helping consumers to stay physically active in their everyday life (Edwards et al., 2016; Maher, Ryan, Kernot, Podsiadly, & Keenihan, 2016; Payne, Lister, West, & Bernhardt, 2015). For instance, some apps help consumers to track their daily physical activities and notify them of their performance measures (Korinek et al., 2018; Walsh, Corbett, Hogan, Duggan, & McNamara, 2016), such as step counts, calories burned, and distances traveled.

    View all citing articles on Scopus
    View full text