# Instagram and WhatApp in Health and Healthcare: An Overview
## 4 Discussion  
Instagram's uses fall into two main categories, namely educational/informational and motivational/supportive applications. Instagram's public timelines feature enables health organizations, such as the US CDC [10], to reach out and disseminate visually rich public health messages to hundreds of millions of potential readers who are using the service. There are also some documented negative uses of Instagram, e.g., by the tobacco industry [15]. According to [PERSON] et al. [49], Instagram users have five primary social and psychological motives: social interaction, archiving, self-expression, escapism, and peeking, but these motives are not always without negative consequences (see, for example, [23]). [PERSON] et al. [50] found that more frequent Instagram use had negative associations for people who follow more strangers, but positive associations for people who follow fewer strangers, with social comparison and depressive symptoms among 18-29 year olds.  
Sharing text, documents and images on WhatsApp may have a role in improving clinical decision-making and patient care for clinicians, from consultation to bedside. The tool facilitates and improves communication for healthcare teams, providing good ways for physicians to monitor work performed by clinical staff. For example, [PERSON] et al. [51] found WhatsApp to be a useful communication tool between physicians, especially for emergency department consultants when they are outside the hospital.  
One can also think of a good use of WhatsApp involving members of the general public subscribing to receive WhatsApp alerts that are relevant to their health needs, e.g., health information and health-related motivational messages covering weight loss coaching and support, healthy lifestyle tips, or smoking cessation, among other topics. WhatsBroadcast [52] can be used to deliver such alerts to subscribers. Lay users can also benefit from hosting relevant virtual peer-to-peer support groups in WhatsApp, e.g., for patients with chronic conditions, HIV-positive youth, etc.  
Moreover, WhatsApp has been successfully used in health and medical education and learning. All respondents (\(n\) = 61 dermatologists) in a survey by [PERSON] et al. [31] agreed that WhatsApp discussions enriched their clinical knowledge, not only with regard to particular clinical case discussions, but generally by sharing learning resources about relevant references/journal articles and upcoming conferences/meetings. WhatsApp group-chat dynamic also enables junior doctors to contact, and learn from, senior doctors more easily where they may not previously have felt able to phone them directly [53].  
Both Instagram and WhatsApp enjoy ease of use, particularly of image uploading and downloading, with generally fast loading times (see, for example, the results reported in [31]). A number of studies we covered in this review concluded that Instagram and WhatsApp, being free to use, are suitable for low-resource settings (e.g., [27; 37; 38; 39; 40]). Different studies also concurred that the high photo quality (transmission and display) offered by these services is more than adequate for clinical diagnostic purposes in telecosultations (e.g., [40; 41; 42]), although diagnostic picture quality is also dependent on other factors such as the user's camera specifications (includingcamera lens specifications), lighting, and camera angle/position and distance from photographed lesions, particularly in disciplines such as clinical dermatology.  
Table 1 presents some of the above discussed themes in relation to Instagram and WhatsApp uses in health and healthcare.