JMIR Publications

ABSTRACT

Background:

The use of digital communication platforms to improve health behaviors has increased dramatically in the last decade. Public health practitioners have adopted digital media and marketing technologies such as text messages, mobile applications, and social media to reach diverse populations. However, the relative effectiveness of different digital communication platforms used by community-serving agencies to improve health behaviors remains unclear, and patterns of engagement and acceptability of different platforms have not been studied.

Objective:

This review aimed to identify types of digital marketing strategies used by community-serving organizations to promote healthy behaviors and to describe the degree of consumer engagement with and acceptability of the strategies. The population of interest included low-income pregnant women, parents and caregivers of young children, and adolescents.

Methods:

A systematic review was conducted according to the PRISMA guidelines using PubMed, Scopus, Web of Science, CINAHL, and APA PsycInfo. The most recent search was conducted in April 2022. Gray literature was searched using a database of resources related to WIC. Studies were included if they examined the use of digital marketing (i.e., texting, mobile apps, and/or social media) to promote healthy behaviors among the target population and were excluded if they discussed industry marketing. Risk of bias and strength of evidence were assessed using the EPHPP Risk of Bias tool and criteria from AHRQ, respectively. At least two reviewers assessed the degree of engagement and acceptability of the digital platforms in each study.

Results:

24 academic and gray literature studies published between 2012 to 2022 based on research conducted in the US, UK and Australia are included in the review. The sample comprised 13, 6, 3, and 2 studies exploring the use of texting, apps, social media, and multiple platforms, respectively. Targeted health behaviors included: healthy diet, physical activity, obesity prevention, healthy pregnancy, breastfeeding, vaccine utilization, smoking cessation, WIC retention, and WIC benefit redemption. The median sample size was 77.5. There were moderate to high levels of engagement and high levels of acceptability across digital platforms. Engagement tended to be higher with texting and mobile app campaigns than with social media campaigns. All three platforms appeared to be highly acceptable, with no notable differences in acceptability between the platforms.

Conclusions:

Although the effectiveness of these strategies in improving health behaviors is inconclusive, low-income pregnant women, parents of young children, and adolescents demonstrated moderate levels of engagement with and high levels of acceptability of digital media health campaigns conducted by community serving agencies. More research is needed to consistently measure and report on participant engagement within and across platforms. This information could be helpful for community serving agencies in their decision-making around which platforms and strategies would best meet their clients’ needs. Clinical Trial: This review was not registered, and a review protocol was not prepared.