Use of social media for the delivery of health promotion on smoking, nutrition, and physical activity: a systematic review

Abstract

BackgroundThe internet has emerged as a new setting within which people live their everyday lives. As such, adults' online lives provide an opportunity for health promotion to empower behaviour change. In a systematic review, we aimed to explore the use of health promotion and education activities for diet, physical activity, and smoking, delivered through the internet and social media only. MethodsWe searched the Cochrane Library, HMIC, EMBASE, Medline, and PsycINFO (in English between Jan 1, 2000, and April 14, 2016) along with reference lists of eligible studies using a combination of MeSH terms and text words (appendix). Studies of any design were eligible for inclusion provided they delivered health promotion via social media and did not include one-to-one contact or advice. We included studies that presented data on multiple measures including engagement and behaviour change. Studies considering the content of social media interactions were ineligible. Data extraction was conducted by the lead reviewer and independently checked by a second reviewer. Reviewers recorded study design and intervention details, and completed a behavioural taxonomy checklist. Risk of bias was assessed with National Institute for Health and Care Excellence methodology. We performed narrative data synthesis. FindingsSearches produced 1585 results. 11 studies were included, predominantly of weak to moderate quality. Most studies were delivered via Facebook or custom websites with social components (eg, forums). Other social media outlets (Twitter, Pinterest, YouTube) were also used. Of eight studies that measured behaviour change, four considered smoking, two weight management, and two physical activity. Studies found that the inclusion of online, social elements did not enhance smoking cessation or weight loss; however, two small studies of short duration suggested that use of social media could improve physical activity levels. Six studies reported on “reach”; some failed to engage users (eg, 225 users across 19 countries) whereas others reached large audiences (eg, >10 000 website visits over 6 weeks). Cost-effectiveness was poorly reported. InterpretationThere was insufficient evidence of quality to determine the effectiveness of health promotion delivered using social media to improve health. Evidence suggests that social media incurs a small additional cost, without producing an important benefit. More high-quality studies are required. FundingNone.