Behavior Change Communication Using Social Media A Review
The emergence of social media introduced a new dimension to communication. The media is increasingly being used in almost every aspect of human endeavor from marketing and brand promotion to information sharing and relationship building. In view of the participatory nature of social media and its potential for expansive reach of audience, public health professionals are enthusiastic about employing it for communicating behavior change interventions. While evidence indicates the potential benefits of social media tobehavior change communication, this paper, drawing on current literature, emphasizes the need for a strategic deployment of the media. The review highlights some of the challenges of using social media for behavior change communication purposes. Many of the challenges can, however, be mitigated, and this paper highlightsstrategiesthat could enhancethe value of social media for behavior change communication. The paper stresses the need for a two way communication using social media, working with the audience in developing appropriate communication strategies, and the need for effective evaluation. Key words: behavior change, communication, social media, health communication, internet. Introduction The advent of social media has transformed every facet ofhuman life, facilitating information sharing and building ties across social, demographic and geographic divides (Luo Smith, 2015) With a remarkable capacity for a widespread public engagement, social media is perhaps the fastest and most cost effective means of connecting with any desired audience. The media is increasingly being used in all manners of communication ranging from personal and academic communications (Campbell Craig, 2014) to professional, health and wellbeing related communications (Shaffer Hudkins, Johnson, Melton, Wingert, 2014) Social media is not only important for creating an online presence, ithas become a veritable platform for marketing and relationship building (Manfred, Verena, Daniela, 2012) Individuals and organizations now interact with their clients, consumers, friends and/or fans using social media platforms.Notwithstanding the several millions(over a billion) already on themedia, available data reveals that more people are embracing it on a daily basis, and the majority of users operate accounts on multiple platforms (eMarketer, 2013; PewResearch, 2015) Given the unique benefits in social media forexpansive and targeted audience reach, and the promises it holds for the future of communication, public health professionals are keen on adopting the media for the delivery of health promotion and behavior change intervention programs (Freeman, Potente, Rock, McIver, 2015).However, as noted by Freeman et al. (2015) the current body of knowledge on the appropriate use of social media for public health purposes is limited. Whilesocial mediais believed to hold a considerable potential for behavior change communication [BCC] (Freeman et al. 2015; Korda Itani, 2013) there is evidence that the media is limited and may not always be suitable for achieving the objectives of BCC(Korda Itani, 2013).These observations underscore thenecessity for this study which aims to highlight how social media may be strategically applied towards achieving BCC objectives.Accordingly, this paper discusses the use of social media in BCC with a particular focus on its benefits, limitations, and waysto better harness the media for BCC purposes. Stimulating academic discussions THE INTERNATIONAL JOURNAL OF COMMUNICATION AND HEALTH 2016 No. 9 110 through such analysis of the potential benefits and challenges is critically important if social media is to be effectively deployed towards communicating behavior change interventions. Method A search of the literature was conducted using the online databases of PubMed, Science Direct, Google Scholars, E book library, and Willey online library, between July and October, 2015. Several terms and combination of terms relevant to the topic were used, including but not limited to 'social media' 'behavior change' 'behavior change communication' 'health communication' 'social media and health communication' 'behavior change communication using social media' 'limitation of social media' and 'benefits of social media' Journal articles reviewed were only those published in English language, relevant to the topic and with complete text availability. These included original researches, reviews, commentaries and other academic papers. Relevant webpages on social media and health communication were visited for data and reports. A few studies were obtained by searching the reference lists of some of the high quality publications. Similarly, appropriate e books were searched and information extracted from them where deemed relevant. Lastly, a purposeful search of the website of 'The International Journal of Communication and Health' was carried out for relevant publications. Social Media: The Overview The introduction of web 2.0 Internet technologies that enable collaborative and expansive communication led to the emergence of online platforms for interactive engagement (Cheung Lee, 2009) These innovative technologies were harnessed in social media for a consumer generated information sharing and a multi way communication system (Kaplan Haenlein, 2010) Social media, also known as 'participative internet communication' (Fox, 2011) represents a group of Internet based applications for creating and exchanging 'user generated contents' [videos, photographs, graphic files and so on] (Osborne Gowey, 2014) Although the nature and nomenclature of connections differ with sites, social media are initiated, created, circulated and utilized in networking as well as in promoting relationship, personalities, products, services, issues and/or brands (Mangold Faulds, 2009) Interactivity, cost effectiveness, and adaptability are some of the advantages social media has over traditional media [radio, television, and so on] (Moorhead et al. 2013) In addition to its potential for expansive audience reach, social media gives avoice to the voiceless(Keller, 2009; Korda Itani, 2013) For instance, while editors determine what gets into the public domain in conventional media, the case is different with social media, where ordinary citizens or anybody who choose to, can air their views. Social media websites are probably the most visited sites on the internet. About 72% of adults with access to the internet use social media (Fox, 2011) In the United States (US) out of the 85% of adults with internet access, at least 67% use one form of social networking sites or the other (Duggan Brenner, 2013 cited in Campbell Craig, 2014) As further revealed by Duggan and Brenner (2013) about 60% of those using social media in the US visit the sites at least once daily. Recent data from PewResearch indicates that about two third of all adults in the US now use social media networking sites an increase of about 10% in a decade (PewResearch, 2015) The term 'Social media' is broad, encompassing a spectrum of web based communication tools and channels (Korda Itani, 2013) First, there are 'social networking sites' (SNS) in which individuals create personal profiles (public or semi public) and share same with a list of other users (Taylor, 2012) Examples of SNS include Facebook, Twitter, and LinkedIn (Laranjo et al. 2015) The second category is known as 'content sharing sites' for example, YouTube, Instagram and Flickr (Rainie, Brenner, Purcell, 2012; Taylor, 2012) These sites are commonly used for rating, discussing and sharing videos and photographs (Taylor, 2012) There are several, and diverse other types/categories of social media platforms, and examples include Wikis, Blogs, Weblogs, geolocation tools, Moblogs and so on (Mangold Faulds, 2009; Taylor, 2012) In addition to the general social media types, a number of healthspecific networking sites exist, for instance, 'TuDiabetes' and 'PatientLikeMe' (Korda Itani, 2013; Laranjo et al. 2015) Similarly, there are social media sites designed primarily for behavior change interventions;ready examples would be sites for promoting smoking cessation (Cobb, Graham, Abrams, 2010) and physical activities (Vandelanotte et al. 2014) Health and Behavior Change Communication BCC, also known as 'social and behavior change communication' (SBCC) ispart of the broader sub discipline of health communication the study and application of communication strategies for promoting positive health outcomes (Kreps Maibach, 2008) Some authors have attempted to distinguish between the terms "BCC" and "SBCC" (Fabrizio, Liere, Pelto, 2014; The THE INTERNATIONAL JOURNAL OF COMMUNICATION AND HEALTH 2016 No. 9 111 Manoff Group, 2012) however, in this paper, the synonymous use is adopted. BCC or SBCC is a participatory process for encouraging positive health behavior change in individuals and communities throughthe strategic application of targeted messages, and the provision of a supportive environment (Briscoe Aboud, 2012) BCCencompasses social and community mobilization as well as health communication approaches, being a product of information, education and communication (IEC) strategies(Koenker et al. 2014) This type of communication goes beyond the mere dissemination of perceived necessary health information (Portsmouth, Trede, Olsen, 2012) It is rather a two way process that involves three cyclical stages listening, dialoguing and actioning (Portsmouth et al. 2012) Listening enables health professionals (communicators) to learn about their target audience while dialoguing aims at developing culturally appropriate and easy to understand strategies (Portsmouth et al. 2012) Actioning on the other hand,deals with implementing and maintaining changes often in partnership with other professionals (Portsmouth et al. 2012) The need for constant eva