BACKGROUND
Public health organizations have begun to use social media to increase awareness of health harms and positively improve health behavior. However, little is known about effective strategies for the digital dissemination of health education messages that ultimately result in optimal audience engagement with the health messages and with links to educational resource(s) specified in those messages.
OBJECTIVE
The objective of this study was to assess the difference in audience engagement with identical anti-smoking health messages on three social media sites: Twitter, Facebook, and Instagram, and with a referring link to a tobacco prevention website cited in these messages. We hypothesized health messages might not get the same user engagement on these media, although these messages were identical and distributed at the same time.
METHODS
We measured the effect of health promotion messages about the risk of smoking on users of three social media sites (Twitter, Facebook, and Instagram). We disseminated 1,275 health messages between April 19 to July 12, 2017 (85 days). The messages were distributed in identical form, at the same time, as organic (non-paid) and advertised (paid) messages, each including a link to an educational website with more information about the topic. Outcome measures included (i) message engagement, ie, the click-through rate (CTR) of the social media messages, and (ii) educational website engagement: the click-through rate on the educational website (wCTR). To analyze the data and model relationships, we used mixed effects negative binomial regression, z-statistic, and the Hosmer-Lemeshow goodness of fit test.
RESULTS
Comparisons between social media sites showed that CTRs for identical anti-tobacco health messages differed significantly across social media (P<.001 for all). Instagram showed the statistically significant highest overall mean message engagement, followed by Facebook, and Twitter. Facebook showed the highest CTR for any individual message as well some of the lowest. However, the message CTR is not indicative of the user engagement with the educational website content. Pairwise comparisons of the social media sites differed with respect to the wCTR (P<.001 for all). Messages on Twitter showed the lowest CTR, but they resulted in the highest level of website engagement, followed by Facebook, and Instagram. We found a statistically significant higher CTR for organic (unpaid) messages compared with paid ads (P<.001).
CONCLUSIONS
This work contributes to developing a scientific approach to select social media platform(s) for health promotion and increasing transparency of the processes and mechanisms that make digital health education effective.
CLINICALTRIAL
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