Can Social Media Really Influence Health Behaviors? A Small Clinical Trial Argues The Answer Is Yes.

Thanks to the technologic allure of iPhones replacing stethoscopesapps substituting for doctors and electronic information substituting for having to actually talk to patients, this thoroughly modern correspondent is all about medical-social media.

Think Facebook for the flu.  Twitter for tinnitus. Egads, listen to the typical consultant, pundit or futurist and it’s easy to believe that we’re on the verge of a silicon-based health care revolution.

But then reality intrudes and some skeptic somewhere always asks about the bang for the buck, the juice for the squeeze, the return for the investment. It’s a good question.

For something of an answer, consider the results appearing in a recently published randomized clinical trial by researchers at UCLA. Over a 4 month period, “at risk persons” were recruited for a clinical research trial with on-line ads (Facebook banners, Craigslist, for example) as well as announcements in community settings and venues.  Once subjects met the inclusion criteria and had a unique Facebook account, they were randomly assigned to one of two treatment arms.

One treatment arm used a closed Facebook group to coach persons about their at risk condition.  The other treatment arm similarly used Facebook to coach persons about general health improvement.  Lay “Peer Leaders,” who were given a three hour training session on “epidemiology of the condition or general health subjects and ways of using Facebook to discuss health and stigmatizing topics,” were assigned to lead the groups.

Peer Leaders attempted to reach out to their assigned group persons with messaging, chats and wall posts.  Once the link was established, the relationship in the intervention group included communication about prevention and treatment of the condition. At the end of 1, 2 and three months of the study, participants completed a variety of surveys.


57 individuals were in the control general health group and 55 were in the condition coaching group.  According to the surveys, intervention patients were ultimately statistically significantly more likely to agree to condition testing (44%) than the control patients (20%).  Because there were few participants, the modest decrease in actual tests or risk behaviors were not statistically meaningful.

This correspondent’s take:

While this was a small study, this is the first time that I have seen reasonable proof that social media by itself can move the behavior needle.  On the other hand, this did not result in a patient engagement stampede toward better care or hard clinical outcomes.  A majority of participants (56%) did not appear to benefit.  Nonetheless, the results do support the inclusion of Facebook-style closed group social media in the suite of population health management services.

That being said, the condition at risk was HIV and study population was men who have sex with men (“MSMs”).  It doesn’t necessarily follow that what would work in this community of persons would necessarily be transferrable to other conditions, such as diabetes.  This correspondent finds it credible that 112 persons with diabetes or hypertension would probably achieve the same kind of results (A1c testing or home blood pressure monitoring) in a similarly tailored Facebook closed group.

Here’s the study.

Let the research continue!

Jaan Sidorov, MD, is a primary care internist and former Medical Director at Geisinger Health Plan with over 20 years experience in primary care, disease management and population-based care coordination. He shares his knowledge and insights at Disease Management Care Blog, where an earlier version of this post originally appeared.

4 replies »

  1. Living in a technologically advanced world, interacting with this generation in a technological way is a must. Engaging Tech savvy people who demand instant access to information 24 hours a day requires those providers and facilitators of care who desire increased communication with their patients to use all forms of technology, including social media, to communicate with their patients. Social media also makes it easier to link people to the goods or services that they want and health providers and organizations designed to disseminate health information should stand poised to take advantage all available tools.
    Lawson (2014), educates us of the function of social medias role in health care is the same as it is in other industries , and that is of mass communication, global reach, engagement, and instantaneous feedback between groups and individuals. Social media is vulnerable to to attack from hackers looking to extract protected information and individuals who misrepresent themselves as professionals. As easily as social media can be used to disseminate positive or helpful information it can be used to filter false and harmful information as well. Without an overall governing body for the internet, attacks can go unnoticed and harm can be done without notice (Lawson, 2014).Though the potential for harm will be ever present, the benefits do out weight the risks. Any additional costs associated with internet and cyber security will be returned through cost savings in labor in person office costs.

    Lawson, G. W. (2014). Healthcare Social Media: A New Era In Patient Education, Interaction & Engagement. Insights To A Changing World Journal, 2014(1), 2-9.

  2. Social networks can provide great benefit and great disaster if not organized well and by knowledgeble people. Sharing of information is good thing but some time it can misslead and cause damage.

  3. I think it will ever be more important social media facecobook and the rest, because they also make their service and allows fluid communication between people of the same community or group and from the issue of health is very good but also can comnvertir a double-edged sword to be a more sensitive issue. I liked the article, thank you very much for sharing.

  4. I’m not qualified to weigh in on the accuracy of the methodology here but this does sound promising ..

    Would be interesting to do a little more comparison and understand more about what’s going on here. How effective is an intervention like this compared to -let’s say – a simple text message? A direct message on Twitter? A knock on the door?

    Interesting when you think about the implications of all of this and where it all seems to be heading. What’s to stop the CDC from sending Americans at risk of let’s say – diabetes or heart disease – a good old fashioned email?