The Use of Social Networking Sites for Sexual Health Promotion

The use of social networking sites for sexual health promotion: identifying key strategies for successful user engagement

Megan Lim

Background •  Social networking sites have huge potential for

sexual health promotion –  Reach and popularity –  Potential to encourage active participation and engagement

•  Although programs are being implemented, few are reported or evaluated in scientific literature

•  Evaluation methodologies are underdeveloped

Aims •  Identify and describe social media profiles in

sexual health

•  Identify profiles that successfully attract and engage users

•  Identify key strategies used to achieve this success

•  Establish methods for measuring success

Step 1: Systematic review

Review results 178 activities identified •  71% used Facebook •  43% organisations, 16% government, 12%

private, 11% academic institutes •  4% from middle income countries •  57% sexual health in general, 25% HIV-specific •  Main purpose

–  63% organisation/program presence –  29% campaign or intervention –  6% connect individuals

Review conclusions •  Sexual health promotion on SNS is happening

•  Very little reported evaluation

•  Most not taking advantage of Web2.0 features

What next? • Are these activities successful?

• What makes them actually successful?

• And what is success?

Definitions Categories Metrics

Reach Facebook: Number of total Facebook page ‘likes’ (users) Twitter: Number of followers (users)

Interaction Facebook: i. Number of comments made on posts ii. Number of ‘likes’ of posts and of comments Twitter: i. Number of ‘retweets’ by users (both of host tweets - ‘first degree retweets’, and of host retweets - ‘second degree retweets’) ii. Number of ‘replies’ by users iii. Number of ‘mentions’ by users

Methods: Identifying factors and strategies associated with success •  Started with 178 SNS activities •  Excluded MySpace (n=48) •  Excluded if they were no longer available

online or were ‘inactive’ (n=30) •  Extracted 1month of activity •  Selected top 10 Facebook and Twitter profiles •  Compared to less successful profiles •  Quantitative and qualitative analyses

undertaken

The Top 10 profiles •  70% sexual health or HIV, 30% general •  Target audience

–  40% general population –  35% people living with HIV –  20% women –  5% young people

•  Purpose –  80% sharing/disseminating health info –  45% advocacy –  50% social support/communities

The Top 10 profiles: Facebook 1.  Planned Parenthood 2.  CDC 3.  Greater than AIDS 4.  EmpowHER 5.  UNAIDS 6.  Net Doctor 7.  POZ magazine 8.  AIDS.gov 9.  GYT now 10. TheBody.com

The Top 10 profiles: Twitter 1.  CDC 2.  Planned Parenthood 3.  EmpowHER 4.  AIDS.gov 5.  UNAIDS 6.  Healthy Boston 7.  POZ magazine 8.  TheBody.com 9.  AIDS Healthcare 10. Greater than AIDS

Top ten profiles Median

All other profiles Median

Reach: Number of users

15156

560

Interaction: No. Likes No. Comments No. Likes of comments Total interaction score

1155 125 47 1325

12 2 0 16

Interaction per user 0.07 0.03

Activity: No. Posts 46 9

Facebook results

Top ten profiles Median

All other profiles Median

Reach: Number of users

8558

852

Interaction: No. first degree user retweets No. second degree user retweets No. of user replies No. of mentions by user Total interaction score

368 93 52 270 937

8 0 6 21 37

Interaction per user:

0.09 0.04

Activity: No. Tweets 124 29

Twitter results

Strategies framework 1.  Regular activity 2.  3.  4.  5.  6. 

Qualitative analysis

• Developed and piloted a framework of ‘strategies’ – 6 broad categories

•  16 Facebook strategies •  17 Twitter strategies

• Reviewed content of top 10 and bottom 5 profiles against framework

Strategies framework 1.  Regular activity 2.  Direct engagement with users 3.  Links in with established user bases and

cross promotion with other orgs 4.  Encourages interaction and online

community amongst users 5.  Makes content broadly relevant and

engaging 6.  Increases following/visibility

2. Direct engagement with users 2.1 Acknowledges/supports followers ‘Thanks @username for helping to spread the word and the great article on…’

–  TOP 10 = 60% TOP 10 = 90%

BOTTOM 5 = 20% BOTTOM 5 = 0%

2.2 Host replies directly to user ‘Sorry to hear about your ills. The most likely cause for your symptoms is a virus. Viral infections…’

–  TOP 10 = 100% TOP 10 = 70%


3. Links with established user base and cross promotion with other groups 3.1 Hash tags “Heard about #Contagion this weekend? CDC has been involved in similar outbreaks in the past.”

TOP 10 = 100%

BOTTOM 5 = 20%

3.2 Retweets content from others “RT @samhsagov announces $42.6 million in new grants for HIV AIDS programs http://ow.ly/6Ii7s”

TOP 10 = 100%

BOTTOM 5 = 40%

3. Links with established user base and cross promotion with other groups 3.3 Links to campaigns/events “Today is Natl Gay Men's HIV/AIDS Awareness Day! Show your support & take an HIV test at a site near you: http://go.usa.gov/8Qq”

–  TOP 10 = 80% TOP 10 = 100%


3.4 Host website links to SNS profile –  TOP 10 = 80% TOP 10 = 80%


4. Encourages interaction/community 4.1 Polls/quizzes/surveys

–  TOP 10 = 50% TOP 10 = 50%


4. Encourages interaction/community 4.2 Poses questions ‘New web-based intervention program teaches teen bystanders to ‘get in the way’. What do you think?’

–  TOP 10 = 100% TOP 10 = 100%


4.3 Allows users to post –  TOP 10 = 60% –  BOTTOM 5 = 0%

5. Makes content broadly relevant and engaging 5.1 Links to relevant content

–  TOP 10 = 100% TOP 10 = 100%


5.2 Uses humour

–  TOP 10 = 20% TOP 10 = 20%


5. Makes content broadly relevant and engaging 5.3 Posts time-relevant content ‘FREE HIV testing & STD screening at Richard Steele Boxing Facility today from 1pm-5pm. Details: http://bit.ly/7ciAkW’

–  TOP 10 = 90% TOP 10 = 100%


5.4 Involves experts or trusted sources ‘Check out these two new resources about HIV among women, from our colleagues at the CDC.”

–  TOP 10 = 30% TOP 10 = 80%


5. Makes content broadly relevant and engaging 5.5 Uses multimedia (video/photos/audio)

–  TOP 10 = 70% TOP 10 = 90%

–  BOTTOM 5 = 40% BOTTOM 5 = 20%

5.6 Highlights celebrity involvement ‘Perez Hilton on why YOU should GYT: You matter! Your health matters!

–  TOP 10 = 60% TOP 10 = 80%


6. Increases following/visibility 6.1 Incentives/prizes/competitions ‘We are @GreaterThanAIDS ! Txt “GREATER” to 23088 for a chance 2 win free tixs 2 #StateFairClassic & get Dallas>AIDS updates’

–  TOP 10 = 20% TOP 10 = 50%


6.2 Encourages posting/sharing/tagging photos “Today’s the day: Grab your camera, snap some photos and take part in @A_Day_With_HIV --- more info at bit.ly/nqHEPL”

TOP 10 = 40% TOP 10 = 20%


Survey with Host Organisations

• Online survey sent to top 10 profile hosts – Response rate 25%

• Identified measures of success – Reach and interaction – Public sentiment or awareness – Real-world change (behaviour, policy, etc)

Summary: Characteristics of success •  Greater activity (number of posts/tweets)

•  Type of activity –  Regular individualized interaction –  Questions and encouraging conversation –  Uploading media and relevant links –  Celebrity or expert involvement

Defining success

• Reach and interaction: are they all equal?

• Quality of content (e.g. humour/prizes)

• Beyond metrics – Behaviour change – Health/policy impact

Limitations • Superficial content analysis

• Limited statistical power

• New features (e.g. Share)

• Top profiles from large, established, well-known organisations

Conclusions • We found 178 sexual health social media

profiles

• We identified the most successful profiles in terms of high reach and interaction

• We identified strategies associated with success

• We developed a framework for analysing these strategies

Thank you

The Use of Social Networking Sites for Sexual Health Promotion

Health & Medicine

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