CHAPTER ONE

1.1) Introduction.

Health promotion is an effective tool for public health. It goes beyond preventing the spread of
diseases and reducing the disease burden. It includes interventions encompassing the creation
of supportive environments, building public health policy, developing personal skills, reorienting
health services and strengthening multisectoral community actions.

Everyone knows that Facebook Groups are highly popular. You go to the social media outlet,
which sees 4 billion people worldwide, find something you’re interested in, join the group, and
enjoy this powerful tool on the internet.

Since the use of social media worldwide has become a necessity for millions of people today,
the importance of using it for benefits is crucial.

Presently, the general public uses the internet to find services and locate healthcare
professionals. That is why an online healthcare provider has a better chance of gaining new
connections than one who isn’t.

Overall, social media and the internet can help support healthcare social media marketing,
offering advice to the world, one person at a time. However, it’s important to understand the
pros and cons of social media in healthcare before choosing to take it on in practice.

The review of existing literature in application of social media in health promotion campaigns
revealed a range of negatives and positives aspects of using this venue for public health and
medicine and challenged its effectiveness to ensure behaviour change, especially in the long-
term perspective. While some positive aspects include potential access to wider target
audience, more accurate health messaging and facilitated communication between health
professionals and public, the effectiveness of such health promotion campaigns and their
evaluation are somewhat questioned by improper communication strategies, lack of support,
self-diagnostic and concerns about short- and long-term changes in health behaviour.However,
clearly better research designs are needed to measure the effectiveness of social technologies
Social media serves as a collaborative dissemination platform to reach and influence the target
audience and deliver health related information . Social media can provide efficient, ubiquitous
and user-friendly approaches to attract large numbers of participants and demonstrate a
certain level of engagement with the health-related messages . Social media interventions may
improve early diagnosis of diseases and facilitate behaviour change techniques, such as
providing social support and emphasising the consequences of a health issue . Research has
revealed a significant positive influence of social media on public health protection with the
potential to change individuals’ behaviour towards establishing a healthy lifestyle.

Preliminary evidence shows that social media interventions can effectively promote health
behaviour change . Health promotion campaigns effectively contribute to increased awareness
of health issues using social media to enhance the willingness of social media users to discuss
the issues openly . Recent events related to COVID-19 are a vivid example where social media
was used to significantly raise awareness of public health topics and elicit behavioural changes
of individuals and thus increased protection against COVID-19 . However, there are challenges
in evaluating the impact of social media interventions in health promotion programs and
understanding how desired outcomes could be achieved for sustained engagement and
behaviour changes. The majority of past studies analysed social media from the viewpoint of
the organisations implementing health promotion campaigns and only limited studies
evaluated short-term and long-term changes in individuals’ health behaviour and lifestyle and
validated the effectiveness of social media beyond creating awareness . While social media
campaigns can provide a significant change in health behaviour and orchestrate health
promotion efforts, the evaluation methods to measure the outcome and analyse the success of
health promotion programs using social media platforms remain unexplored.

Use of social media in health promotion campaigns are of high interest among health
professionals, marketers, policy setters, regulators, and any health enthusiasts. But evaluating
the impact of such is a complex process . The main reason is that these initiatives are not
implemented in isolation, but rather complementary to each other, creating synergies and
blurring the effect. Such synergies make it difficult to isolate the impact of individual social
media in health promotion campaigns, as well as potentially, make the impact marginal or
complementary to other factors. For example, obesity and diabetes control involves individual
knowledge, awareness and motivation for both diet and exercise, but it also involves structural
and contextual factors such as urban design, food availability and pricing, access to appropriate
clinical services etc. . Similarly, smoking cessation involves taxation, restrictions on how and
where tobacco products are marketed and sold, smoke free public spaces etc. A systematic
review found that using online social networks may not enhance smoking cessation or weight
loss . However, some studies concluded that use of social media can improve physical activity
behaviours or facilitate healthier choices of eating and recipe tips in young adults, although
they are reluctant to share their information on the online social networks.

The current study developed a framework to guide the assessment of social media and
illustrate the potential functions of social media in promotion of public health. The examples of
functions that can influence the outcomes relevant to the evaluation of the effects of social
media on the public health are minimising the spread of misinformation and increasing public
awareness of accurate health-related information, enhancing real-time surveillance related to
incident disease, disease Control and mitigation, and screening or treatment interventions .

This research study develops a multifaceted review to address this gap and extends the study to
provide a structured and comprehensive map of methods used to evaluate the impact of social
media beyond awareness and on health behaviour change.

1.2 Objectives of the study.

The objective of the study is, ,

1) Examining the use of social media in health promotion in Kampala?

CHAPTER TWO.

2.0 Review literature.

1) Examining the use of social media in health promotion in Kampala

a) .Showcase Accomplishments and Activities through Social Media Platforms

Patients want to know that their doctors and nurses are involved in the community. When you
post information, you show that you care about your patients and their well-being. That makes
them more likely to visit you and value your practice.

It’s best to include your professional achievements to show that you’re a trustworthy
organization. This includes listing professional organizations that the doctors belong to, state
medical boards, and even news articles.

Communication is crucial in the health industry, and online communities are a great place for
the patient to post discussion-worthy information. However, social media options, such as
Twitter or Facebook are the top choices because people can share information with all of their
friends.

In a sense, social media breaks the ties that bind, allowing everyone to join in. With that,
potential patients can use social media to find out more information about the organization
itself. That gives them peace of mind and helps them feel confident about their choice of doctor

b.) Easily Build Relationships with Patients

The healthcare industry is focused on specific things. Research must be done to ensure that
they are providing the best services possible. However, patients want to feel that they have
close relationships with their physicians. Communication is crucial, and it’s easier to post
information and let others control when and how to share it.

According to a survey conducted on behalf of the American Osteopathic Association (AOA),

roughly 42 percent of adults want to follow their healthcare professional on a social media
platform like Twitter or Facebook. The ability to educate others is paramount here, and
potential patients like the idea of having these healthcare professionals in their news feed on
social media.

Overall, patients feel that the internet is the place to go to connect with all of their friends.
Physicians and other health employees can create comments, post information, and mention
other healthcare facilities to get everyone involved.
c.Cost-effective Marketing

There are no start-up costs associated with in-house healthcare social media marketing. In fact,
new patients gained from appropriate social media marketing can lead to more revenue for the
company. Overall, patients take their health seriously and want to know that you do, as well.

A physicians’ practice that has a strong internet presence can educate people and post helpful
information online. From there, the patient reads the information and even shares it with their
friends. They can promote their health, but they get the word out about new health issues,
concerns, and options. Everyone can discuss things they’re interested in, allowing everyone to
stay in control of their own health.

d) .Attract Healthcare Professionals to the Workplace

Research shows that about 90 percent of physicians use social networking sites, and 65 percent
of them use social media for professional reasons. If your goal is to find more doctors and
nurses to join your company, it’s crucial to have an online presence.

You show others that you’re online, and you’re proud of your abilities. From there, they can get
information easily and converse with you through social media platforms. That translates into
you being “with the times,” allowing them to feel confident about working with you.

e) .Patients Use Social Media Sites

As of 2021, there are about 4.48 billion social media users worldwide, and this number is highly
unlikely to go down in the coming years.

About 80 percent of patients used the internet to make one healthcare-related search in the
past year, and that number is likely more. Therefore, it’s important to connect your practice
and its services to the internet. Organizations often find that about 63 percent of people chose
one provider based on their strong online presence.
The idea is to get into your patient’s social media feed. That way, you can offer advice and lead
people to the networks that meet their needs best. While there are concerns about social
media in healthcare, most people like the idea of having control over their lives and the
benefits they receive. Still, each organization must focus on the business aspect of their
healthcare practice.

While there are many benefits of having a social media presence, it’s not all fun and games.
There are actually many cons of social media in healthcare, and you must figure out the ways
to overcome them if you want to be successful in integrating social media into your business.
Here are just a few things to watch for.

a) . Security Risks

One of the biggest fears social media users have is that their private information might get
stolen. At the beginning of 2018, more than 56 percent of the compromised data records (over
4.5 billion of them) were from social media issues.

While more current information indicates that health information is protected, for the most
part, there are still security and data breaches all the time. Patient privacy is something that
everyone must focus on, especially the healthcare provider.

If you let slip social security numbers and other protected information, you could be held liable
legally. Having social media gives you more chances to mess up.

HIPAA now provides specific rules for safe online posting. This includes the censorship or
elimination of a patient’s name, health insurance or social security number, birth date, or
photos, and also entitles the patient to delete specific details about a rare illness, such as its
diagnosis and its dates.Therefore, the employees need proper training to reduce the risk of
compliance violations. They must know what they can share and what they can’t.

b) . False Information.

Most people worry about false information popping up in healthcare social media marketing
tactics, and it happens quite a bit. It actually takes six times as long for the truth to reach 1,500
people as it does falsehoods. The health of your patients is at stake here, and social media is
known for promoting inconsistent information.

About three-fourths of the top health stories in 2018 contained false information or were
misleading. With that, most people on social media focus solely on the headline and don’t even
read the content.

This means false information is 70 percent more likely to be shared than the truth. To avoid this
issue, it’s best to include easy-to-read headlines that get right down to the point.

c) . Lack of Control from the Healthcare Professional

Another drawback of social media in healthcare is the lack of control you have. There’s no way
to prevent negative comments from popping up on the things you share, and each person’s
social media feed shows these things. Overall, there are bound to be unrelated responses to
your messages and even criticism.The other problem you might have is that, once it’s out there,
it’s there forever. You might be able to delete negative responses, but enough people have
seen them change their outlook about you.

It’s best to stay on top of any negativity. Don’t try to brush it under the rug; stand up to it and
state your case immediately. That way, you show others that you care enough about your
reputation to argue your point and help others understand.

d) . Time-consuming.

Having a social media presence isn’t easy because it’s a time-consuming task. Even if you only
use one or two social media accounts, you must produce new content all the time and keep the
buzz going. More channels ultimately demand more time, but your healthcare professionals are
already spread thin, especially in today’s world.

On top of that, the results are not immediate. You could share things for months before you
build a large following. There are so many other healthcare facilities competing for the time of
each user of social media, so the struggle of being the best never fully goes away.

e.) The Danger of Self-Diagnosis.

Though potential patients tend to do at least one healthcare-related search each year, they
turn to social media to self-diagnose. They may go to your page to find information about their
condition instead of booking an appointment with your company.

CHAPTER THREE.

3.0 Methods used.

A search of review articles on health promotion using social media conducted using Medline
and Google Scholar.

Application of Facebook.

Existing research recognised Facebook as a social media platform used to change health
behaviour with the potential to deliver strategies in successful health promotion interventions
to promote healthy lifestyles . One study evaluated Facebook posts beyond reach, shares, and
likes to identify important components that influence health behaviour . Analysing the content
of Facebook accounts of health insurance companies that promote health through education
showed that many providers could not actively interact with a wider audience on Facebook.

One study investigated the impact of social media to reduce smoking habits and promote
healthy behaviour among Indigenous people in Australia by sharing tobacco control content on
Facebook . One study explored the use of Facebook by Australian public health organisations to
understand what features and strategies are associated with wider and bigger user engagement

Application of twitter.

Twitter is applied as a supplementary tool to enhance social engagement by spreading

information and strengthening social networks in various online health promotion programs as
a potential source of public and searchable data relating to health behaviour . One study tested
the feasibility of designing, implementing, and evaluating social media interventions using
Twitter data for prevention purposes . Some studies investigated Twitter data to conclude how
the majority of tweets can promote specific preventive behaviours. One study explored the
association between the content of tweets related to national mental health campaign and the
real number of suicides to compare the suicide counts during the event to a control timeframe
and the associated behaviour change to diminish suicide rates to promote help-seeking and
resilience.

Secondary searches were conducted using references and citations from selected articles.

3.1 Discussion.

Social media has potential of being an effective health promotion tool in South Africa. It
presents an opportunity for scaling health promotion programs because of its low cost, its
ability to have virtual communities and the ease of access eliminating geographical barriers. It
also allows real-time communication between various stakeholders. It allows information to
spread far and fast and leaving irrespective of the credibility of the source of information. There
is a need to take into account country specific socio-economic issues, which may perpetuate
unintended consequences related to the digital divide, data costs and the varying levels of
health literacy.

Evidence shows that the awareness initiatives could increase the rate of reach, exposure,
impression, impact and engagement of social media users in health promotion programs and
impact on health knowledge and behaviour outcomes .Most research addresses specific
interventions and approaches, which vary widely in focus, target population, theoretical
foundations, mode of delivery, functionality, and usability. This variation makes it difficult to
find out what works and how, and it complicates efforts to compare approaches .

Recent reviews of social media interventions for health behaviour change have concluded that
these kinds of interventions can have small but significant beneficial effects on health
behaviour change. The low participant engagement with social media interventions is a critical
obstacle to improving health behaviour outcomes .Some studies focused on analysis of the
content of the posts on social media in raising awareness rather than promoting treatment,
help-seeking behaviours and resilience, which would likely have a more significant behaviour
change outcome. Other studies found social media as a tool to engage participants in the health
promotion programs and other health behaviour change interventions, although no participant
baseline characteristics significantly predicted the engagement in the studies . Another study
suggested that use of social media platforms can positively influence awareness of public
health, behavioural changes and public health protection.

However, it is important to acknowledge that engagement with social media does not
necessarily reflect real-life behaviour and simply measuring the metrics related to the activity of
users on social media does not necessarily demonstrate the behaviours of the social media
users . No consensus has emerged yet on whether this medium has the potential to facilitate or
undermine public health efforts and ultimately promote health behaviours .There is no widely
accepted conceptual model exists for examining the roles that social media can play with
respect to promotion of public health .
Evaluating the performance of social media campaigns to promote health behaviours towards
establishing a healthy lifestyle is a complex process. Emerging research focused on evaluating
the potential of social media as an opportunity to create awareness. The examples of functions
that can influence the outcomes relevant to the evaluation of the effects of social media on the
public health are minimising the spread of misinformation and increasing public awareness of
accurate health-related information, enhancing real-time surveillance related to incident
disease, disease Control and mitigation, and screening or treatment interventions. Further
research attempted to go beyond awareness, and employ social media to evaluate the success
of health promotion campaigns for a range of health behaviour and prevention topics including
controlling overweight and obesity, smoking cessation, cancer prevention, control diabetes,
promotion of oral health, eating disorder prevention, COVID-19 prevention, suicide prevention
and mental health and wellbeing.

The review identified that most studies adopted quantitative methods to evaluate the health
behaviour outcomes on social media. Facebook and YouTube were effectively used for
intervention and education purposes to change health behaviour and Twitter and Instagram
were used more to observe the trend of changes in health behaviour. Majority of studies
adopted Social Cognitive Theory (SCT) as the health promotion framework to evaluate health
behaviour change. Most papers used social media for communication rather than education to
evaluate the outcome for behaviour change.

3.2 Conclusion:

Considering the opportunities presented by social media, the ministry of health needs to review
its health promotion strategy and include the use of social media as an enabler. They also need
to address to explore intersectoral measures to address issues which threatening equitable
access to credible health promotion information.
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