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Social Media for
Health Promotion & Education
ANN	MEREDITH	U.	GARCIA,	MD,	FPCP,	DPSMO,	MCMMO	
Internist	–	Medical	Oncologist	
Blessed	Family	Doctors	General	Hospital	
San	Carlos	City,	Pangasinan
Outline	
①  De?inition	&	examples	of	social	media	
②  Statistics	on	social	media	use	
③  Online	health-seeking	behavior	patterns	
④  Participative	medicine	&	healthcare	social	media	
(#hcsm)	
⑤  Uses	and	bene?its	of	social	media	for	health	
communication	
⑥  Examples	of	#hcsm	
⑦  CDC	health	communicator’s	social	media	toolkit	
⑧  Limitations	of	social	media	for	health	
communication
“Forms	of	electronic	
communication	(as	Web	
sites	for	social	networking	and	
microblogging)	through	which	
users	create	online	
communities	to	
share	information,	
ideas,	personal	
messages,	and	other	
content	(as	videos)”	
Social	media	h"p://www.merriam-webster.com/
Kaplan	&	Haenlein,	2010	
Social	media	
“A	group	of	Internet-
based	applications	
that	build	on	the	
ideological	and	techno-
logical	foundations	of	
Web	2.0,	and	that	
allow	the	creation	and	
exchange	of	user	
generated	content”
Social	networks	
Microblogs	
Wikis	
Forums	or	Listserv	
Social	photo	&	video	
sharing	tools	
Multi-user	virtual	
environments	
Social	
apps	&	
games	
Integration	of	
social	media	with	
health	information	
technologies	
Interna>onal	Medical	Informa>cs	Associa>on	Social	Media	Working	Group	
Others	
Social	media	types
h"p://www.adweek.com/
h"p://www.wearesocial.com/
h"p://www.wearesocial.com/
almost	Everyone	is	on	Facebook	almost	
^
Can	social	media	
be	used	for	
health	promotion	&	
education?	
THE	DOCTOR	IS	
IN
Personally,	 I	 feel	 to	 ignore	 the	
intersection	 between	
health	care	and	social	
media	is	to	potentially	ignore	
our	 own	 relevance	 as	 a	
h e a l t h 	 c a r e	
practitioner	 during	
the	next	decade.	
–	Dr.	Howard	Luks
of	 people	 using	 social	 media	 and	 digital	
medical	 information	 sources	 believe	 the	
tools	have	helped	them	achieve	a	better	health	
outcome	
h"ps://news.aetna.com/
h"p://www.pewresearch.org/	
72%	of	internet	users	said	they	looked	online	for	
health	information	within	the	past	year.
38.42%	
18.95%	
17.67%	
19.29%	
79.04%	
57.04%	
42.98%	
11.70%	
16.80%	
03.26%	
04.63%	
Kontos	et	al,	2014	
88.79%	of	respondents	said	they	ever	looked	for	information	about	
health	or	medical	topics	from	any	source.
h"p://www.pewresearch.org/	
How online searches affect health decisions
60% Affected a decision about how to treat an illness or
condition
56% Changed overall approach to maintaining health
53% Led to asking new questions or getting a second
opinion
49% Changed the way of thinking about diet, exercise, or
stress management
38% Affected a decision about whether to see a doctor
38% Changed the way of coping with a chronic condition
or managing pain
#Health-related	chatter	
h"p://www.master-of-health-administra>on.com/
h"p://visual.ly/	
#Health-related	chatter
Sarasohn-Kahn,	2008	Ÿ	h"p://www.pewresearch.org/
Internet	
(67.63%)	
Doctor	or	healthcare	
provider	
(15.66%)	
Publications	
(9.39%)	
Family/friends/co-workers	
(4.95%)	
Health	information	seekers	reported	
most	frequently	going	`irst	to	the…	
Volkman	et	al,	2014
Clinicians	remain	to	be	a	central	source	for	
health	information,	care,	or	support.	
h"p://www.pewresearch.org/
h"p://www.master-of-health-administra>on.com/
Chronic	care	model	
“Informed	and	activated	patient”	
“Prepared	and	proactive	practice	team”	
Kontos	et	al,	2014
Health	 information	 access	 for	
patients	 is	 a	 key	 facet	 of	 the	 provision	 of	
patient-centered	care.	
Patients	 require	 appropriate	
health	 information	 in	 order	 to	
participate	 in	 treatment	
decisions	 and	 increase	
communication	with	their	doctor	
or	healthcare	provider.	
	
I m p r o v e d	 p a t i e n t	 a c c e s s	 m a y	
increase	patient	satisfaction	
with	care	and	lead	to	better	health	
outcomes.	
Volkman	et	al,	2014
The	rise	of	the	e-Patient	
equipped	
	 	enabled	
	 	 	 	engaged 	 	 	
	 	 	 	 	 	empowered	 h"p://www.bmj.com/	Ÿ	h"ps://en.wikipedia.org/	
“The	value	delivered	by	
skilled	clinicians	is	still	there,	
but	now	we	can	see	that	it’s	
no	longer	the	only	source…	
Let	patients	help	de`ine	what	
value	in	medicine	is.”	
	
	
	
–	ePatient	Dave	
Participative	medicine
#	healthcare	social	media	
Health	2.0	
The	use	of	social	software	and	its	ability	to	
promote	collaboration	between	patients,	
their	caregivers,	medical	professionals,	and	
other	stakeholders	in	health	 Sarasohn-Kahn,	2008
Chre>en,	2013	
Key	social	media	interactions	
	among	patients,	physicians,	and	the	public
Lapointe,	2013	
The	users	and	functions	of	
social	media	
to	create	health	awareness
The	5	C’s	of	social	media	
Primary	Health	Care	Research	&	Informa>on	Service	
Connect
Moorhead	et	al,	2013
Moorhead	et	al,	2013
“Empowering	decision-
making	with	real-time	
access	to	insights	from	
over	a	billion	healthcare	
social	media	data	
points…”
Hoffmann,	2015	Ÿ	Potyraj,	2016	Ÿ	h"ps://en.wikipedia.org/	
A	 speci?ic	 sourcing	 model	 in	
which	 organizations	 use	
contributions	 from	 Internet	
users	 to	 obtain	 needed	
services	or	ideas.	
Collective	intelligence	
Crowd(+out)sourcing
Social	media	is	an	
	 	ideal	platform	for	
	 	 	 	healthcare	professionals.
Social	media	is	an	
	 	ideal	platform	for	
	 	 	 	patients	&	caregivers.
Social	media	is	an	
	 	ideal	platform	for	
	 	 	 	organizations.
“Powerful	tool	for	
public	education	
advocacy...”	
&	
Social	reinforcement	
Ventola,	2014
CDC	H1N1	campaign	
“The	 Centers	 for	 Disease	
Control	 and	 Prevention	 has	
become	 the	 star	 of	 the	
Government	 2.0	 movement	
recently,	 as	 the	 agency	 has	
been	 wildly	 successful	 in	
deploying	 social	 media	 to	
raise	 awareness	 of	 recent	
public	health	crises…”	
Centers	for	Disease	Control	and	Preven>on
We	are	the	nation	known	for	“breaking	the	Internet”	by	pushing	hundreds	
of	millions	of	tweets	about	a	noontime	show	segment…		
Filipinos’	increasing	reliance	on	information	and	
communications	technology	means	that	we	now	have	a	
huge	wealth	of	data	in	our	hands.	It	has	signi`icantly	altered	
the	way	we	work,	learn,	play,	and	live.	
h"p://www.rappler.com/
h"p://h"p://www.pchrd.dost.gov.ph/
–	Dr.	Iris	Thiele	Isip-Tan
Make	strategic	
choices	and	
understand	
the	level	of	
effort.	
Go	where	the	
people	are.	
Adopt	low-risk	
tools	`irst.	
Make	sure	
messages	are	
science-based.	
Create	
portable	
content.	
Facilitate	viral	
information	
sharing.	
Encourage	
participation.	
Leverage	
networks.	
Provide	
multiple	
formats.	
Consider	
mobile	
phones.	
Set	realistic	
goals.	
Learn	from	
metrics	and	
evaluate	your	
efforts.	
Social	media	toolkit	
h"p://www.cdc.gov/healthcommunica>on/toolstemplates/socialmediatoolkit_bm.pdf/
Moorhead	et	al,	2013
–	Dr.	Kevin	Pho	
h"p://www.kevinmd.com/blog/

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Social Media Health Promotion Guide

Editor's Notes

  1. The range of social media platforms exploded with arrival of Web 2.0, enabling new technologies including social and professional networking sites (eg, Facebook and LinkedIn), thematic networks, microblogs, wikis, social photo and video sharing tools, collaborative filtering tools, and multiuser virtual environment.
  2. The success of interactive conversational technologies (including discussion forums, Listservs, wikis, blogs, microblogs, and social networking sites (SNS), is contingent on members joining and participating in ongoing interaction; these are therefore the main types of social media platforms capable of creating virtual communities. These real-life virtual communities or networks created by social media establish intrapersonal communication channels, overcoming barriers of time and geography, empowering users to communicate and interact (network) with a broad range of colleagues.
  3. The popularity of social networking in the Philippines can be traced in the Filipinos' culture of "friends helping friends.”
  4. Everyone you know has a social media profile: Your friends, your grandma, even your dog has a social following. But what about your medical practice?
  5. Orthopedic surgeon and digital media and medicine specialist
  6. National survey by the Pew Research Center’s Internet & American Life Project This includes searches related to serious conditions, general information searches, and searches for minor health problems.
  7. National Cancer Institute’s 2012 Health Information National Trends Survey (HINTS)
  8. Social media users will talk about nearly anything. One of the things that people like talking about is their health.
  9. National survey by the Pew Research Center’s Internet & American Life Project
  10. National Cancer Institute’s Health Information National Trends Survey (HINTS 2011–2013) Historically, people have always tried to answer their health questions at home and made personal choices about whether and when to consult a clinician. Many people want to talk about their various medical problems to seek guidance, but they don’t want to spend the money to actually visit a doctor unless the problem is serious. Compared to other sources of health information, doctors and other healthcare providers still represent an important, trusted group for health or medical information, in particular for older patients, those with less education, patients who have health insurance and those who perceive themselves as being in poor health. Interestingly, those who turn to their doctor first were still Internet users in general, but chose to solicit a doctor or healthcare provider for health information instead of the Internet for a recent health or medical need.
  11. It will never completely replace a physical consultation, but in our roles as trusted physicians as well as consumers, it is important for us to understand its impact, strengths, and weaknesses.
  12. 60% of social media users are the most likely to trust social media posts and activity by doctors over any other group. Doctors as respected members of society are also highly revered for their opinions when they are shared on social media, which is even more reason to help boost your reach as a healthcare professional and actively use social media. Social media allows doctors to engage current patients and attract new patients by providing relevant, timely and educational information. It allows you to build credibility and trust, particularly for a younger audience. As a healthcare professional, you have an obligation to create educational content to inform your audience about health-related issues. As great as social media tools can be, there is a lot of misinformation being shared. This is your opportunity to become an accurate source for information.
  13. The interaction between an “informed and activated patient” and a “prepared and proactive practice team” has been highlighted as a fundamental model for optimum care. The field of eHealth (healthcare practice supported by electronic processes and communication) has enabled public health and medical practitioners to communicate with patients in both traditional and novel ways to address health concerns.
  14. The movement in the past decade toward patient-centered care has increasingly emphasized patient empowerment in health care.
  15. Richard Davies deBronkart is a metastatic kidney cancer patient and blogger who, in 2009, became a noted activist for healthcare transformation through participatory medicine and personal health data rights. Information gleaned on ACOR led Dave to more effectively learn about his cancer from fellow patients like him, and also helped him better decide on optimal subsequent treatments based on other patients paying it forward by sharing their patient perspectives and cancer details. E-patients—those who are equipped, enabled, empowered and engaged in their health and health care decisions—are the key to improving quality within the health system.
  16. Healthcare social media is more than just a marketing buzzword; as the Internet increasingly becomes the medium of choice for researching health information, social media has become an important channel for connecting with patients and disseminating and expanding the reach of healthcare information. It is a radical shift in the way we communicate; the healthcare conversation is no longer a one-way narrative but is evolving into a global, participatory discussion facilitated by social media.
  17. Solid line circles denote secure interactions. Dotted line circles denote personal networking interactions.
  18. Figure 1 illustrates how organizations and individuals interact and engage with each other to create a community around cancer awareness through social media. By addressing the different topics that are critical for the community, it becomes possible for the members of this community to collaborate to reach their common goal.
  19. The primary health care community is able to consume, share, comment on and debate content with existing and potential stakeholders using social media and the benefits are best described as the five C’s of social media. Connect - Connect with others in your community, often in real time. Communicate - Through social media platforms, primary health care professionals and researchers can communicate with an online community and share health promotion messages and information. Collaborate - Social media allows for the establishment of a network or online community of global stakeholders and to share ideas, collaborate and develop alliances. Consume - By joining a social media community, the primary health care community has access to that community’s latest research information. Converse - Unlike traditional media which is a one-way channel of communication, social media allows for two-way conversations and knowledge exchange between members of a social group.
  20. ● Improving practice efficiency by providing educational videos on general topics such as vaccine safety in advance of scheduled appointments, enabling deeper and more meaningful face-to-face discussions to address particular patient questions. ● Making subspecialty expertise on rare diseases and conditions available broadly via video, giving patients new access to information while also favourably positioning the expert. ● Facilitating patient-to-patient support groups that would be impractical without social networking platforms that overcome barriers of time and space. ● Engaging medical professionals in online discussions, providing evidence-based perspectives on current public health challenges. ● Recruiting subjects for clinical trials and improving the informed consent process. ● Providing continuing education asynchronously and on a global scale through online learning communities.
  21. Provides a comprehensive list of health specific hashtags around the world making it easier for users to navigate. The project also provides detailed reports about the top influencers to follow and transcripts of events such as conferences or TweetChats. Aims to connect everyone and anyone in healthcare more efficiently and without missing too many gaps. The aim is to do more than just passively observe healthcare conversations on the social web, but to dig deeply; recognizing trends, gaps, and business, research or social opportunities. This could be particularly valuable for early researchers, who are wanting targeted questions for a topic they are interested in, and have done exhaustive literature searches already; it can help them connect with those people and organizations who have similar interests and similar questions, and this can help redefine the area under observation. Or it may even help in getting some funding!
  22. It’s a collaborative effort of healthcare stakeholders. Participating in tweet chats like #HealthXPH enables a global conversation between health professionals, patients, industry & policy makers. HealthXPh aims to make the impact of social media in Philippine healthcare a positive one through participatory medicine. #HealthXPh aims to give insights on how to effectively manage the upsurge of social media and other emerging technologies that are making itt easier for patients to access their healthcare professionals, institutions and policy makers. . It aims to educate all healthcare stakeholders. It is open and free to all the stakeholders.
  23. Crowdsourcing in healthcare can trace its roots back to 2006. Advantages of using crowdsourcing may include improved costs, speed, quality, flexibility, scalability, or diversity. Research has emerged that outlines the use of crowdsourcing techniques in the public health domain. The collective intelligence outcomes from crowdsourcing are being generated in three broad categories of public health care; health promotion, health research, and health maintenance. Crowdsourcing also enables researchers to move from small homogeneous groups of participants to large heterogenous groups, beyond convenience samples such as students or higher educated people.
  24. Social media provides an ideal platform for healthcare professionals to share ideas, experiences and medical journal articles with each other. By building a personal learning network on social media, health professionals can keep up to date with advances in medicine. This helps ensure better patient outcomes, as doctors can conveniently build their knowledge in real time and facilitate faster adoption of best clinical practices.
  25. Diagnosis and treatment to help deal with “medical mysteries” and facilitate more accurate and timely decision-making.
  26. Patients can find peer/social/emotional support on social media. It enables visual sharing of health information and stories.
  27. One well-established example is PatientsLikeMe, a global patient network of 400,000-plus members. Within this platform, members connect with others who have the same disease or condition to track and share information about their experiences. This dynamic helps generate data about the real-world nature of disease to help develop more effective products, services, and care.
  28. Organizations establish pages for community outreach, patient education, marketing and crisis communications, taking advantage of the rapid speed and engaging nature of these sites. Sharing of healthcare information across social media networks is also of value for physicians and healthcare institutions. A well thought and implemented social media policy is a powerful tool for initial health consumer engagement. It may also be of alternative as a patient follow through in areas where access to physicians and healthcare institutions is difficult.
  29. Some healthcare institutions in the Philippines are already using social media to solidify their online presence and engage their clientele.
  30. Physician associations and societies are beginning to build up their social media presence too.
  31. Social media have created vast global networks that can quickly spread information and mobilize large numbers of people to facilitate greater progress toward public health goals. The widespread use of social media can also influence public health behaviors and goals through social reinforcement. Because human beings are a highly social species, they are often in influenced by their friends. Public health is also taking advantage of the reach of social media by enlisting it for “Infoveillance” (9). Organizations can use social media for syndrome surveillance, by monitoring the frequency of searches related to a particular illness, enlisting the public to report infections or symptoms, and mapping outbreaks with new tools and data mined from existing social networking sites (9). Furthermore, surveying the public’s beliefs regarding a public health topic can provide critical information informing the types of messages that will be most effective (9). Social media can monitor public response to health issues [54], track and monitor disease outbreak [111], identify misinformation of health information [72], identify target areas for intervention efforts [106], and disseminate pertinent health information to targeted communities [57]. Health professionals can aggregate data about patient experiences from blogs and monitor public reaction to health issues. Other public health organizations use keyword content from Twitter and other social networks, in combination with location-tracking technologies, to respond rapidly to disasters and to monitor the health and welfare of populations. When used in this way, real-time social media sites provide greater agility and enhanced preparedness for responses to disasters and public health emergencies.
  32. In the recent H1N1 scare, the CDC made use of a variety of social media platforms to share information about the flu, monitor public concerns, and enhance the CDC’s profile as a trusted and accessible public resource. These advantages were of particular relevance in the context of the H1N1 outbreak, which demanded not only a rapid initial response, but the capacity to update information, evaluate and respond to the concerns and understandings of the public, and respond continuously to changing conditions
  33. In the Philippine context, yes. Social media has value when used in healthcare by any or all of its stakeholders. I wrote about the value of social media presence for healthcare professionals in 2011, here. In terms of patient engagement, much has to be explored and learned. The Filipino “friendliness”, “friend helping friend” or “bayanihan” attitude is postulated to be reason why Philippines is the social media capital of the world. Such attitude easily recognizable across all social media networks where Filipinos are, could be of great value to support groups in health care. Why are we on social media?
  34. Social media, a great information equalizer, is radically transforming the way people communicate around the world. Access to technology is often cited as a major barrier to health promotion using ICT. While social media does not eliminate disparities between groups, less reliance on hardware, the no or low-cost of social media tools themselves, coupled with an increasing global spread of stable Internet access has lowered barriers globally. Social media also reduces social inequities created by organisation size and social position. Social media allows information to be presented in modes other than text and can bring health information to audiences with special needs; for example, videos can be used to supplement or replace text and can be useful when literacy is low. Health professionals should ensure that information is correct and accessible.
  35. Early detection of cancer greatly increases the chances for successful treatment. There are two major components of early detection of cancer: 1) education to promote early diagnosis (e.g. education on early signs of cancer such as lumps, sores that fail to heal, abnormal bleeding, persistent indigestion, and chronic hoarseness) and 2) screening, which refers to the use of simple tests across a healthy population to identify individuals who have the disease, but do not yet have symptoms.
  36. 1. Be strategic when deciding on their objectives, audience and key messages for a social media campaign. This includes taking into account the time and effort necessary for such a campaign. 2. Social media is “where the people are”, so it makes sense to take the messages you want to provide to them. As one public health unit representative put it, “social media has reached a critical mass”, and it is only logical to follow the public there to better communicate with them. 3. Adopting low-risk solutions such as videos, podcasts and widgets, first is a good way to experiment with social media and avoid investing too many resources too fast. 4. Like all other health communications, social media messages should be accurate, credible and accountable. 5. Take advantage of portable content, such as videos and widgets , which make it easy for users to spread your message. 6. Using social networking sites to facilitate viral information sharing among users can expand reach and allow users to become health advocates. 7. Encouraging participation by interacting with users over social media and accepting their contributions can help create valuable partnerships, facilitating future communication. 8. Reach can be greatly expanded by taking advantage of the existing social networks of your audience on social networking sites. 9. Multiple formats expand reach by giving users different ways to engage in health information and interact with public health. 10. Mobile phones can expand reach even more, given their current popularity. 11. Develop clear goals for social media and adhere to them. 12. Take advantage of metrics provided by social media for evaluation purposes.
  37. The main recurring limitations of social media are quality concerns and the lack of reliability of the health information. Policy reactions to address concerns include providing training in how to use and navigate social media technologies and validate accuracy of information found, or bringing more credible sites into the mainstream and making them fully accessible Several studies highlighted concerns about privacy and confidentiality, data security, and the potential harms that emerge when personal data are indexed. Social media users are often unaware of the risks of disclosing personal information online and with communicating harmful or incorrect advice using social media. As information is readily available, there is the potential of information overload for the user. The general public may not know how to correctly apply information found online to their personal health situation. There is the potential that adverse health consequences can result. There may be negative health risk behaviors displayed online, such as unsafe sexual behavior. There is also the possibility that social media may act as a deterrent for patients from visiting health professionals.
  38. Twitter and other social media tools might not bring health to all, but they can help to bring accurate health information to many more people than ever before. After all, one fact sheet or an emergency message about an outbreak can be spread through Twitter faster than any influenza virus. It’s an opportunity for health professionals to explore, listen and engage. In healthcare, professionals and organizations must recognize society’s ever- increasing use of social media tools, and that abdicating their leadership role on the issues raised by these tools would have harmful effects because the conversations will continue with or without them. Social media as being the equivalent of a surgical scalpel— both are excellent tools but only if they are used appropriately and wisely!