Exploring the Use of Social Media as a Part of Social and Behavior Change Communication Health Programs
Authors:   , Hauer Michael K. , Sood Suruchi 
Published: August 2023

Background: Social media is now ubiquitous in society and is here to stay. It is a revolutionary communication channel and tool that has the ability to reach audiences almost instantaneously (de Vere Hunt & Linos, 2022). Even though social media is no longer new, research on effectively operationalizing it as a component of social and behavior change communication (SBCC) programs is scarce. Traditional SBCC programs that incorporate other communication channels, such as television or radio, are beginning to utilize social media and document their process. More research is needed to understand how to leverage this new technology to affect social and behavior change. Therefore, the overarching question this dissertation aimed to answer is: How can social media be effectively used for SBCC? Specifically, three research questions were asked: (1) How have SBCC programs used social media for health promotion throughout their programming process? (2) What are the benefits and challenges with using social media for SBCC so we can leverage lessons learned from field experiences for future improvement? (3) How can an SBCC program follow the rigorous 5-step P process to effectively incorporate social media in its design, implementation, and evaluation? Methods: A mixed-methods approach was used to analyze the research questions. Study 1 is a systematic review of peer-reviewed publications and grey literature on social media use in SBCC health programs. An initial pool of 6,440 references were found when searching seven databases (i.e., PubMed, Ovid MEDLINE, PsychInfo, Sociological Abstracts, ProQuest, Web of Science, and Communication and Mass Media), which led to a final sample of 27 articles. Study 2 is a qualitative analysis of in-depth interviews with 25 key informants with SBCC social media experience. An iterative interview guide was developed and used. Eight themes were identified after a process of initial, focused, and axial coding. Study 3 is a case study of ReachHealth in the Philippines. Its program documents were analyzed, two interviews with ReachHealth team members were conducted, and its process of designing, implementing, and evaluating were explored in light of findings identified in studies 1 and 2. Results: In Study 1, one of the more significant findings of the systematic review was that even though 27 articles were identified that met the inclusion criteria, many did not provide sufficient details about their social media strategy. The description of social media often took a backseat to the description of other communication channels such as television or radio. This implies that information and lessons learned from other programs may need to be found in places other than online databases like the ones that were used in this dissertation. In Study 2, the thematic analysis that was conducted using key informant interview transcripts revealed eight themes: (1) going back to basics and revisiting "tried -and-tested" methods in research and program communication; (2) focusing on the "social" component of social media; (3) watching, iterating, and adapting social media in ways that is impossible with other communication channels; (4) shifting to a new evaluation paradigm; (5) investing in social media; (6) highlighting issues of equity and inclusion; (7) acknowledging social media's pitfalls but needing to be on it anyway; and (8) ethical dilemmas in social media work. In Study 3, the ReachHealth case study revealed several innovative social media strategies and ways of incorporating it into SBCC programs that have important implications for the field. In the design stage, rigorous formative research was used to segment audiences, create campaigns and materials that are interesting, relevant, and appropriate for the target audience, and to create brand personas. In the implementation stage, monitoring tools were used to understand how the audience was reacting and to adapt, course correct, and to create new content. This was done by checking traditional metrics as well as monitoring social media engagement. Finally, an impact assessment was conducted to evaluate whether any change occurred as a result of the program. Conclusions: Even though research has emerged over the last several years and researchers and practitioners are beginning to place more emphasis on social media, more research is needed to understand how to harness the power of this revolutionary communication channel.