Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 7, 2023
Open Peer Review Period: Feb 7, 2023 - Feb 21, 2023
Date Accepted: Apr 19, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A model of social media effects in public health communication campaigns
ABSTRACT
Background:
Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behaviour change. These concepts need to be re-evaluated in the age of social media.
Objective:
To describe a conceptual pathway of effects for how social media marketing may influence health-related outcomes.
Methods:
We conducted a systematic review of studies reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platform(s) used, and measures of campaign performance (PROSPERO Registration: CRD42021287257). We used these data to develop our conceptual model.
Results:
We identified 99 eligible studies reporting on 93 campaigns. The campaigns were conducted in over 20 countries, targeted a variety of health issues, and predominantly used Facebook, Twitter, Instagram, and/or YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behaviour change. Process measures (n=68; e.g., reach, impressions) and/or engagement measures (n=73; e.g., likes, retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behaviour, or social norms. Our model suggests that campaign exposure can lead to individual behaviour change and improved health outcomes, either via a direct or indirect pathway. ‘Engagement’ is positioned as critical to success and all types of engagement is treated as equal and good. Additionally, the process is no longer linear and sequential and indirect effects on behaviour change or improved health outcomes, via social or policy changes, are possible.
Conclusions:
Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes. Our new model provides campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of ‘engagement’.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.