Presentation at the 2017 joint annual convention of the Philippine Society of Hypertension & the Philippine Lipid & Atherosclerosis Society 23 Feb 2017 at Crowne Plaza Galleria Manila. Also presented at the 2017 #HealthXPH Social Media & Healthcare summit 25 Apr 2017 at Marco Polo Hotel, Cebu City.

1. CAN SOCIAL MEDIA
CHANGE HEALTH
BEHAVIOR?
IRIS THIELE ISIP TAN MD, MSC
Professor, UP College of Medicine
Chief, UP Medical Informatics Unit
Director, UP Manila Interactive Learning Center
@endocrine_witch

2. I have nothing to disclose

3. www.fb.com/endocrinewitch

4. www.dokbru.endocrine-witch.net

5. POTENTIAL
EVIDENCE
STRATEGY
FUTURE

6. Patients are increasingly using online social networks to
connect with other patients and healthcare professionals
PEER-TO-PEER HEALTHCARE
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

7. CAN SOCIAL MEDIA CHANGE HEALTH BEHAVIOR?
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

8. People can participate as part of their
usual social media routine
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

9. Social media facilitates
self-help behavior
Logan A. Community hypertension programs in the age of mobile
technology & social media. Am J Hypertension 2014;27(8): 1033-1035

10. Berkman L, Glass T. (2000) Social integration, social networks, social support and health
SOCIAL INFLUENCE
How the presence,
actions or expectations
of others influence the
way one behaves

11. SOCIAL ENGAGEMENT
& ATTACHMENT
Berkman L, Glass T. (2000) Social integration, social networks, social support and health

12. How social network structure
affects access to resources
SOCIAL RECOMMENDATIONS
Berkman L, Glass T. (2000) Social integration, social networks, social support and health

13. SOCIAL CONTAGION
How health behaviours
may be ‘transmitted’ by
‘person-to-person spread’
across social networks Berkman L, Glass T. (2000) Social integration,
social networks, social support and health

14. SOCIAL SUPPORT
Emotional, functional and informational
assistance influences health Berkman L, Glass T. (2000) Social integration,
social networks, social support and health

15. POTENTIAL
EVIDENCE
STRATEGY
FUTURE

16. Social media in communicating health information:
an analysis of Facebook groups related to hypertension
Al Mamun M, Ibrahim HM, Turin TC. Prev Chronic Dis 2015;12:140265. DOI: http://dx.doi.org/10.5888/ pcd12.140265.
187 FB groups
8,966 Facebook users
1 to 2,161 individuals/group

17. Al Mamun M, Ibrahim HM, Turin TC. Prev Chronic Dis 2015;12:140265.
FACEBOOK GROUPS ON HYPERTENSION
Objective
Main topic
No. of members
Geographic
boundaries
Level of activity
Type of user-generated
content on wall
Likes & comments

18. Al Mamun M, Ibrahim HM, Turin TC. Prev Chronic Dis 2015;12:140265.
PRIMARY OBJECTIVE
Awareness creation 60%
Providing support to patients and caregivers 11%
Sharing disease experiences and life stories 11%
Fund raising for relevant organisations 8%
Product or service promotion 4%

19. THEME OF TOP-DISPLAYED RECENT WALL POST
Al Mamun M, Ibrahim HM, Turin TC. Prev Chronic Dis 2015;12:140265.
Product or service promotion 21%
Sharing hypertension
awareness-related
information 20%
Sharing external web
address related to health
13%
Query to members for
particular information 10%

20. Despite their small number and low activity level, the
hypertension-related Facebook groups provide a sounding
board for those affected …
Al Mamun M, Ibrahim HM, Turin TC. Prev Chronic Dis 2015;12:140265.

21. Any report of the status of a
patient’s health condition that
comes directly from the
patient, without interpretation
of the response by a clinician
or anyone else
PATIENT-REPORTED OUTCOME
Kear et al. J Am Soc Hypertens 2015;9(9):725–734

22. https://www.patientslikeme.com/

23. https://www.openresearchexchange.com/

24. Kear et al. J Am Soc Hypertens 2015;9(9):725–734
Develop a patient-reported hypertension instrument
using PRO data that incorporate patients’
experiences and feedback
Measures attitudes, lifestyle behaviors, adherence,
and barriers to hypertension management

25. SOCIAL MEDIA
VS
SOCIAL NETWORK
Social media is much broader than the concept of social
networking sites, and also includes blogs, discussion
boards, and wikis, among others.
Laranjo L, et al. J Am Med Inform Assoc 2015;22:243–256. doi:10.1136/amiajnl-2014-002841

26. Williams G,Hamm MP, Shulhan J, et al. Social media interventions for diet and exercise behaviours:
a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2014;4:e003926.
RCTs of social media interventions promoting
healthy diet and exercise behaviors
Interventions using social media, alone or
as part of a complex intervention

27. Williams G,Hamm MP, Shulhan J, et al. Social media interventions for diet and exercise behaviours:
a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2014;4:e003926.

28. Williams G,Hamm MP, Shulhan J, et al. BMJ Open 2014;4:e003926.

29. Williams G,Hamm MP, Shulhan J, et al. Social media interventions for diet and exercise behaviours:
a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2014;4:e003926.
Dietary fat consumption decreased significantly among
participants exposed to social media

30. Williams G,Hamm MP, Shulhan J, et al. BMJ Open 2014;4:e003926.
Voluntary recruitment may have resulted in increased
participant motivation and selection bias
Losses to follow-up were very high [challenges of adherence
and keeping participants engaged]
LIMITATIONS
Participants mostly female, Caucasian
of higher socioeconomic status

31. Evaluate the use and effectiveness of interventions using
social networking sites (SNSs) to change health behaviors
Laranjo L, et al. J Am Med Inform Assoc 2015;22:243–256. doi:10.1136/amiajnl-2014-002841
Meta-analysis
8 RCTs

32. Laranjo L, et al. J Am Med Inform Assoc 2015;22:243–256
FACEBOOK
HEALTH-SPECIFIC
TWITTER
social network sites
12 studies (n=7411)
8 RCTs

33. Laranjo L, et al. J Am Med Inform Assoc 2015;22:243–256
Slight positive effect of SNS interventions on health
behavior-related outcomes
Considerable heterogeneity

34. Low-cost opportunity to virally spread health information
PUBLIC HEALTH IMPACT
Laranjo L, et al. J Am Med Inform Assoc 2015;22:243–256
SNSs may be used in a synergistic way with personal
health records and mobile devices

35. POTENTIAL
EVIDENCE
STRATEGY
FUTURE

36. The new challenge for hypertension programs is
maintaining community interest while reiterating the
same health messages.
“
Logan A. Community hypertension programs in the age of mobile
technology & social media. Am J Hypertension 2014;27(8): 1033-1035

37. HOW TO PACKAGE
MESSAGES ON
SOCIAL MEDIA
Logan A. Community hypertension programs in the age of mobile
technology & social media. Am J Hypertension 2014;27(8): 1033-1035

38. DEFINE PARAMETERS
Modality
Purpose
Community type
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

39. Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24
Behavior
counseling
Supplemental
information
Maximize attendance
& retention
Place to
connect
PURPOSE

40. PLATFORM
SELECTION
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

41. Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24
TARGET POPULATION
Platform users
Non-users
User of any platform

42. RECRUITMENT
Social media
Local
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

43. Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24
CONTENT CONVERSION/DEVELOPMENT

44. CONTENT LIBRARY
Pagoda S. et al. Adapting Behavioral Interventions for Social
Media Delivery J Med Internet Res 2016;18(1):e24
Web page conversion
Posts
Curated online content

45. ENGAGEMENT PLAN Group chats
Micro-
counseling
Pagoda S. et al. Adapting Behavioral Interventions for Social
Media Delivery J Med Internet Res 2016;18(1):e24

46. TRAINING
Interventionist
Participant Pagoda S. et al. Adapting Behavioral Interventions for Social
Media Delivery J Med Internet Res 2016;18(1):e24
How to
maximize
experience

47. Pagoda S. et al. Adapting Behavioral Interventions for Social
Media Delivery J Med Internet Res 2016;18(1):e24
REPORTING
How many likes?
How many replies?
How many posts did participants make?

48. POTENTIAL
EVIDENCE
STRATEGY
FUTURE

49. What is the optimal size for an online network
for a behavioral intervention?
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

50. What is the ideal structure of a group intervention?
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

51. Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24
WHAT IS MEANINGFUL
ENGAGEMENT?

52. FOR
WHOM?
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

53. IRIS THIELE ISIP TAN MD, MSC
Professor, UP College of Medicine
Chief, UP Medical Informatics Unit
Director, UP Manila Interactive Learning Center
@endocrine_witch