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Health Promotion Journal of Australia Health Promotion Journal of Australia Society
Journal of the Australian Health Promotion Association
RESEARCH ARTICLE

Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites

Megan S. C. Lim A B C D , Cassandra J. C. Wright A B , Elise R. Carrotte A and Alisa E. Pedrana A B
+ Author Affiliations
- Author Affiliations

A Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.

B School of Population Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, Vic. 3004, Australia.

C Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Vic. 3010, Australia.

D Corresponding author. Email: megan.lim@burnet.edu.au

Health Promotion Journal of Australia 27(3) 187-197 https://doi.org/10.1071/HE16057
Submitted: 16 May 2016  Accepted: 4 September 2016   Published: 6 October 2016

Abstract

Issue addressed: Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion.

Methods: A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included.

Results: Forty-seven studies were included. There were two main evaluation approaches: closed designs (n = 23), which used traditional research designs and formal recruitment procedures; and open designs (n = 19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates.

Conclusions: Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour.

So what?: Through use of quasi-experimental or well designed before–after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

Key words: behaviour change, evaluation methods, information and communication technology.


References

[1]  Socialbakers. Facebook statistics directory. Available from: http://www.socialbakers.com/statistics/facebook [Verified 13 September 2016].

[2]  Socialbakers. Twitter statistics directory. Available from: http://www.socialbakers.com/statistics/twitter [Verified 13 September 2016].

[3]  Capurro D, Cole K, Echavarria MI, Joe J, Neogi T, Turner AM (2014) The use of social networking sites for public health practice and research: a systematic review. J Med Internet Res 16, e79
The use of social networking sites for public health practice and research: a systematic review.Crossref | GoogleScholarGoogle Scholar | 24642014PubMed |

[4]  Veale HJ, Sacks-Davis R, Weaver ERN, Pedrana AE, Stoove MA, Hellard ME (2015) The use of social networking platforms for sexual health promotion: identifying key strategies for successful user engagement. BMC Public Health 15, 85
The use of social networking platforms for sexual health promotion: identifying key strategies for successful user engagement.Crossref | GoogleScholarGoogle Scholar | 25884461PubMed |

[5]  Gold J, Pedrana AE, Sacks-Davis R, Hellard ME, Chang S, Howard S, et al (2011) A systematic examination of the use of online social networking sites for sexual health promotion. BMC Public Health 11, 583
A systematic examination of the use of online social networking sites for sexual health promotion.Crossref | GoogleScholarGoogle Scholar | 21777470PubMed |

[6]  Maher CA, Lewis LK, Ferrar K, Marshall S, De Bourdeaudhuij I, Vandelanotte C (2014) Are health behavior change interventions that use online social networks effective? A systematic review. J Med Internet Res 16, e40
Are health behavior change interventions that use online social networks effective? A systematic review.Crossref | GoogleScholarGoogle Scholar | 24550083PubMed |

[7]  Korda H, Itani Z (2013) Harnessing social media for health promotion and behavior change. Health Promot Pract 14, 15–23.
Harnessing social media for health promotion and behavior change.Crossref | GoogleScholarGoogle Scholar | 21558472PubMed |

[8]  Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C (2013) A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res 15, e85
A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication.Crossref | GoogleScholarGoogle Scholar | 23615206PubMed |

[9]  Lim MSC, Hare JD, Carrotte ER, Dietze PM (2016) An investigation of strategies used in alcohol brand marketing and alcohol-related health promotion on Facebook. Digit Health 2, 1–17.
An investigation of strategies used in alcohol brand marketing and alcohol-related health promotion on Facebook.Crossref | GoogleScholarGoogle Scholar |

[10]  Byron P, Albury K, Evers C (2013) “It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information. Reprod Health Matters 21, 35–44.
“It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information.Crossref | GoogleScholarGoogle Scholar | 23684185PubMed |

[11]  Pedrana A, Hellard M, Gold J, Ata N, Chang S, Howard S, et al (2013) Queer as F**k: reaching and engaging gay men in sexual health promotion through social networking sites. J Med Internet Res 15, e25
Queer as F**k: reaching and engaging gay men in sexual health promotion through social networking sites.Crossref | GoogleScholarGoogle Scholar | 23391459PubMed |

[12]  Crutzen R, de Nooijer J, Brouwer W, Oenema A, Brug J, de Vries NK (2011) Strategies to facilitate exposure to internet-delivered health behavior change interventions aimed at adolescents or young adults: a systematic review. Health Educ Behav 38, 49–62.
Strategies to facilitate exposure to internet-delivered health behavior change interventions aimed at adolescents or young adults: a systematic review.Crossref | GoogleScholarGoogle Scholar | 21189422PubMed |

[13]  Neiger BL, Thackeray R, Burton SH, Giraud-Carrier CG, Fagen MC (2013) Evaluating social media’s capacity to develop engaged audiences in health promotion settings: use of Twitter metrics as a case study. Health Promot Pract 14, 157–62.
Evaluating social media’s capacity to develop engaged audiences in health promotion settings: use of Twitter metrics as a case study.Crossref | GoogleScholarGoogle Scholar | 23271716PubMed |

[14]  Strecher VJ, McClure J, Alexander G, Chakraborty B, Nair V, Konkel J, et al (2008) The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial. J Med Internet Res 10, e36
The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 18984557PubMed |

[15]  Napolitano MA, Hayes S, Bennett GG, Ives AK, Foster GD (2013) Using Facebook and text messaging to deliver a weight loss program to college students. Obesity (Silver Spring) 21, 25–31.
Using Facebook and text messaging to deliver a weight loss program to college students.Crossref | GoogleScholarGoogle Scholar | 23505165PubMed |

[16]  O’Grady L, Witteman H, Bender LJ, Urowitz S, Wiljer D, Jadad RA (2009) Measuring the impact of a moving target: towards a dynamic framework for evaluating collaborative adaptive interactive technologies. J Med Internet Res 11, e20
Measuring the impact of a moving target: towards a dynamic framework for evaluating collaborative adaptive interactive technologies.Crossref | GoogleScholarGoogle Scholar | 19632973PubMed |

[17]  Eysenbach G (2013) CONSORT-EHEALTH: implementation of a checklist for authors and editors to improve reporting of web-based and mobile randomized controlled trials. Stud Health Technol Inform 192, 657–61.

[18]  Baghaei N, Kimani S, Freyne J, Brindal E, Berkovsky S, Smith G (2011) Engaging families in lifestyle changes through social networking. Int J Hum Comput Interact 27, 971–90.
Engaging families in lifestyle changes through social networking.Crossref | GoogleScholarGoogle Scholar |

[19]  Young SD, Cumberland WG, Lee SJ, Jaganath D, Szekeres G, Coates T (2013) Social networking technologies as an emerging tool for HIV prevention: a cluster randomized trial. Ann Intern Med 159, 318–24.
Social networking technologies as an emerging tool for HIV prevention: a cluster randomized trial.Crossref | GoogleScholarGoogle Scholar | 24026317PubMed |

[20]  Youn SJ, Trinh NH, Shyu I, Chang T, Fava M, Kvedar J, et al (2013) Using online social media, Facebook, in screening for major depressive disorder among college students. Int J Clin Health Psychol 13, 74–80.
Using online social media, Facebook, in screening for major depressive disorder among college students.Crossref | GoogleScholarGoogle Scholar |

[21]  James KJ, Albrecht JA, Litchfield RE, Weishaar CA (2013) A summative evaluation of a food safety social marketing campaign “4-Day Throw-Away” using traditional and social media. J Food Sci Educ 12, 48–55.
A summative evaluation of a food safety social marketing campaign “4-Day Throw-Away” using traditional and social media.Crossref | GoogleScholarGoogle Scholar |

[22]  Nguyen P, Gold J, Pedrana A, Chang S, Howard S, Ilic O, et al (2013) Sexual health promotion on social networking sites: a process evaluation of The FaceSpace Project. J Adolesc Health 53, 98–104.
Sexual health promotion on social networking sites: a process evaluation of The FaceSpace Project.Crossref | GoogleScholarGoogle Scholar | 23583509PubMed |

[23]  Villa Hernández TE, Ocampo MA, Sabido RC (2012) Internet social networks in spreading tobacco: clinical experience of against tobacco general hospital of Mexico “Eduardo Liceaga”. Gac Med Mex 148, 438–47. [In Spanish]

[24]  Marton C (2012) Consumer health 2.0 in Canada: tweeting about cancer. J Can Health Lib Assoc 33, 98–102.
Consumer health 2.0 in Canada: tweeting about cancer.Crossref | GoogleScholarGoogle Scholar |

[25]  Ko NY, Hsieh CH, Wang MC, Lee C, Chen CL, Chung AC, et al (2013) Effects of Internet popular opinion leaders (iPOL) among Internet-using men who have sex with men. J Med Internet Res 15, e40
Effects of Internet popular opinion leaders (iPOL) among Internet-using men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 23439583PubMed |

[26]  Gabarron E, Serrano JA, Wynn R, Armayones M (2012) Avatars using computer/smartphone-mediated communication and social networking in prevention of sexually transmitted diseases among north-Norwegian youngsters. BMC Med Inform Decis Mak 12, 120
Avatars using computer/smartphone-mediated communication and social networking in prevention of sexually transmitted diseases among north-Norwegian youngsters.Crossref | GoogleScholarGoogle Scholar | 23110684PubMed |

[27]  Jones K, Baldwin KA, Lewis PR (2012) The potential influence of a social media intervention on risky sexual behavior and chlamydia incidence. J Community Health Nurs 29, 106–20.
The potential influence of a social media intervention on risky sexual behavior and chlamydia incidence.Crossref | GoogleScholarGoogle Scholar | 22536914PubMed |

[28]  Purdy CH (2011) Using the Internet and social media to promote condom use in Turkey. Reprod Health Matters 19, 157–65.
Using the Internet and social media to promote condom use in Turkey.Crossref | GoogleScholarGoogle Scholar | 21555096PubMed |

[29]  Bull SS, Levine DK, Black SR, Schmiege SJ, Santelli J (2012) Social media-delivered sexual health intervention: a cluster randomized controlled trial. Am J Prev Med 43, 467–74.
Social media-delivered sexual health intervention: a cluster randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 23079168PubMed |

[30]  D’Alessandro AM, Peltier JW, Dahl AJ (2012) Use of social media and college student organizations to increase support for organ donation and advocacy: a case report. Prog Transplant 22, 436–41.
Use of social media and college student organizations to increase support for organ donation and advocacy: a case report.Crossref | GoogleScholarGoogle Scholar | 23187063PubMed |

[31]  Glasgow RE (2007) eHealth evaluation and dissemination research. Am J Prev Med 32, S119–26.
eHealth evaluation and dissemination research.Crossref | GoogleScholarGoogle Scholar | 17466816PubMed |

[32]  Garnett BR, Buelow R, Franko DL, Becker C, Rodgers RF, Austin SB (2014) The importance of campaign saliency as a predictor of attitude and behavior change: a pilot evaluation of social marketing campaign Fat Talk Free Week. Health Commun 29, 984–95.
The importance of campaign saliency as a predictor of attitude and behavior change: a pilot evaluation of social marketing campaign Fat Talk Free Week.Crossref | GoogleScholarGoogle Scholar | 24359343PubMed |

[33]  Eysenbach G (2005) The law of attrition. J Med Internet Res 7, e11
The law of attrition.Crossref | GoogleScholarGoogle Scholar | 15829473PubMed |

[34]  Young SD (2014) Social media technologies for HIV prevention study retention among minority men who have sex with men (MSM). AIDS Behav 18, 1625–9.
Social media technologies for HIV prevention study retention among minority men who have sex with men (MSM).Crossref | GoogleScholarGoogle Scholar | 24062015PubMed |

[35]  Young SD, Holloway I, Jaganath D, Rice E, Westmoreland D, Coates T (2014) Project HOPE: online social network changes in an HIV prevention randomized controlled trial for African American and Latino men who have sex with men. Am J Public Health 104, 1707–12.
Project HOPE: online social network changes in an HIV prevention randomized controlled trial for African American and Latino men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 25033137PubMed |

[36]  Chen L, Shi J (2015) Social support exchanges in a social media community for people living with HIV/AIDS in China. AIDS Care 27, 693–6.
Social support exchanges in a social media community for people living with HIV/AIDS in China.Crossref | GoogleScholarGoogle Scholar | 25532704PubMed |

[37]  Khoja S, Durrani H, Scott RE, Sajwani A, Piryani U (2013) Conceptual framework for development of comprehensive e-health evaluation tool. Telemed J E Health 19, 48–53.
Conceptual framework for development of comprehensive e-health evaluation tool.Crossref | GoogleScholarGoogle Scholar | 22957502PubMed |

[38]  Mayer AB, Harrison JA (2012) Safe Eats: an evaluation of the use of social media for food safety education. J Food Prot 75, 1453–63.
Safe Eats: an evaluation of the use of social media for food safety education.Crossref | GoogleScholarGoogle Scholar |

[39]  Campbell BB (2012) A novel approach to educating men about preventative health in the digital age. J Men’s Health 9, 45–50.
A novel approach to educating men about preventative health in the digital age.Crossref | GoogleScholarGoogle Scholar |

[40]  Cavallo DN, Tate DF, Ries AV, Brown JD, DeVellis RF, Ammerman AS (2012) A social media-based physical activity intervention: a randomized controlled trial. Am J Prev Med 43, 527–32.
A social media-based physical activity intervention: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 23079176PubMed |

[41]  Duncan MJ, Vandelanotte C, Rosenkranz RR, Caperchione CM, Ding H, Ellison M, et al (2012) Effectiveness of a website and mobile phone based physical activity and nutrition intervention for middle-aged males: trial protocol and baseline findings of the ManUp Study. BMC Public Health 12, 656
Effectiveness of a website and mobile phone based physical activity and nutrition intervention for middle-aged males: trial protocol and baseline findings of the ManUp Study.Crossref | GoogleScholarGoogle Scholar | 22894747PubMed |

[42]  Frimming RE, Polsgrove MJ, Bower GG (2011) Evaluation of a health and fitness social media experience. Am J Health Educ 42, 222–7.
Evaluation of a health and fitness social media experience.Crossref | GoogleScholarGoogle Scholar |

[43]  George DR, Dellasega C, Whitehead MM, Bordon A (2013) Facebook-based stress management resources for first-year medical students: a multi-method evaluation. Comput Human Behav 29, 559–62.
Facebook-based stress management resources for first-year medical students: a multi-method evaluation.Crossref | GoogleScholarGoogle Scholar |

[44]  Kelty TL, Morgan PJ, Lubans DR (2012) Efficacy and feasibility of the “Girls’ Recreational Activity Support Program Using Information Technology”: a pilot randomised controlled trial. Adv Physiol Educ 2, 10–6.
Efficacy and feasibility of the “Girls’ Recreational Activity Support Program Using Information Technology”: a pilot randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |

[45]  Kernot J, Olds T, Lewis LK, Maher C (2013) Effectiveness of a Facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol. BMC Public Health 13, 518
Effectiveness of a Facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol.Crossref | GoogleScholarGoogle Scholar | 23714411PubMed |

[46]  Kolt GS, Rosenkranz RR, Savage TN, Maeder AJ, Vandelanotte C, Duncan MJ, et al (2013) WALK 2.0 – using Web 2.0 applications to promote health-related physical activity: a randomised controlled trial protocol. BMC Public Health 13, 436
WALK 2.0 – using Web 2.0 applications to promote health-related physical activity: a randomised controlled trial protocol.Crossref | GoogleScholarGoogle Scholar | 23642010PubMed |

[47]  Li TM, Chau M, Wong PW, Lai ES, Yip PS (2013) Evaluation of a web-based social network electronic game in enhancing mental health literacy for young people. J Med Internet Res 15, e80
Evaluation of a web-based social network electronic game in enhancing mental health literacy for young people.Crossref | GoogleScholarGoogle Scholar | 23676714PubMed |

[48]  Mackert M, Kim E, Guadagmo M, Donovan-Kicken E (2012) Using Twitter for prenatal health promotion: encouraging a multivitamin habit among college-aged females. Stud Health Technol Inform 182, 93–103.

[49]  Moreno MA, Vanderstoep A, Parks MR, Zimmerman FJ, Kurth A, Christakis DA (2009) Reducing at-risk adolescents’ display of risk behavior on a social networking web site: a randomized controlled pilot intervention trial. Arch Pediatr Adolesc Med 163, 35–41.
Reducing at-risk adolescents’ display of risk behavior on a social networking web site: a randomized controlled pilot intervention trial.Crossref | GoogleScholarGoogle Scholar | 19124701PubMed |

[50]  Park S, Lee SW, Kwak J, Cha M, Jeong B (2013) Activities on Facebook reveal the depressive state of users. J Med Internet Res 15, e217
Activities on Facebook reveal the depressive state of users.Crossref | GoogleScholarGoogle Scholar | 24084314PubMed |

[51]  Patrick K, Marshall SJ, Davila EP, Kolodziejczyk JK, Fowler JH, Calfas KJ, et al (2014) Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART). Contemp Clin Trials 37, 10–8.
Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2c7ltVykuw%3D%3D&md5=91ef77db491cab9022fa4606232aff8cCAS | 24215774PubMed |

[52]  Prybutok G (2013) YouTube: An effective web 2.0 informing channel for health education to prevent STDs. Inf Sci 16, 19–36.

[53]  Rovniak LS, Sallis JF, Kraschnewski JL, Sciamanna CN, Kiser EJ, Ray CA, et al (2013) Engineering online and in-person social networks to sustain physical activity: application of a conceptual model. BMC Public Health 13, 753
Engineering online and in-person social networks to sustain physical activity: application of a conceptual model.Crossref | GoogleScholarGoogle Scholar | 23945138PubMed |

[54]  Spence PR, Lachlan KA, Spates SA, Lin X (2013) Intercultural differences in responses to health messages on social media from spokespeople with varying levels of ethnic identity. Comput Human Behav 29, 1255–9.
Intercultural differences in responses to health messages on social media from spokespeople with varying levels of ethnic identity.Crossref | GoogleScholarGoogle Scholar |

[55]  Turner-McGrievy G, Tate D (2011) Tweets, apps, and pods: results of the 6-month Mobile Pounds Off Digitally (Mobile POD) randomized weight-loss intervention among adults. J Med Internet Res 13, e120
Tweets, apps, and pods: results of the 6-month Mobile Pounds Off Digitally (Mobile POD) randomized weight-loss intervention among adults.Crossref | GoogleScholarGoogle Scholar | 22186428PubMed |

[56]  Turner-McGrievy GM, Tate DF (2013) Weight loss social support in 140 characters or less: use of an online social network in a remotely delivered weight loss intervention. Transl Behav Med 3, 287–94.
Weight loss social support in 140 characters or less: use of an online social network in a remotely delivered weight loss intervention.Crossref | GoogleScholarGoogle Scholar | 24073180PubMed |

[57]  Valle CG, Tate DF, Mayer DK, Allicock M, Cai J (2013) A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors. J Cancer Surviv 7, 355–68.
A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors.Crossref | GoogleScholarGoogle Scholar | 23532799PubMed |

[58]  Young SD, Jaganath D (2013) Online social networking for HIV education and prevention: a mixed-methods analysis. Sex Transm Dis 40, 162–7.

[59]  Apatu EJI, Alperin M, Miner KR, Wiljer D (2013) A drive through web 2.0: an exploration of driving safety promotion on Facebook. Health Promot Pract 14, 88–95.
A drive through web 2.0: an exploration of driving safety promotion on Facebook.Crossref | GoogleScholarGoogle Scholar |

[60]  Bullen PB (2013) Using a mobile photo booth and Facebook to promote positive health messages among men who have sex with men in Cambodia. Am J Public Health 103, 251–2.
Using a mobile photo booth and Facebook to promote positive health messages among men who have sex with men in Cambodia.Crossref | GoogleScholarGoogle Scholar | 23237170PubMed |

[61]  Dixon-Gray LA, Mobley A, McFarlane JM, Rosenberg KD (2013) Amor y Salud (love and health): a preconception health campaign for second-generation Latinas in Oregon. Am J Health Promot 27, S74–6.
Amor y Salud (love and health): a preconception health campaign for second-generation Latinas in Oregon.Crossref | GoogleScholarGoogle Scholar | 23286668PubMed |

[62]  Goldstein K, Briggs M, Oleynik V, Cullen M, Jones J, Newman E, et al (2013) Using digital media to promote kidney disease education. Adv Chronic Kidney Dis 20, 364–9.
Using digital media to promote kidney disease education.Crossref | GoogleScholarGoogle Scholar | 23809289PubMed |

[63]  Manning J, VanDeusen K (2011) Suicide prevention in the dot com era: technological aspects of a university suicide prevention program. J Am Coll Health 59, 431–3.
Suicide prevention in the dot com era: technological aspects of a university suicide prevention program.Crossref | GoogleScholarGoogle Scholar | 21500064PubMed |

[64]  Phua J (2013) Participating in health issue-specific social networking sites to quit smoking: how does online social interconnectedness influence smoking cessation self-efficacy? J Commun 63, 933–52.
Participating in health issue-specific social networking sites to quit smoking: how does online social interconnectedness influence smoking cessation self-efficacy?Crossref | GoogleScholarGoogle Scholar |

[65]  Rossotti R, Gabrielli E, Gervasoni C, Rosso R, Sabbatini F, Uglietti A, et al (2012) HIV education and counselling using Facebook: a possible new approach. J Telemed Telecare 18, 239–40.
HIV education and counselling using Facebook: a possible new approach.Crossref | GoogleScholarGoogle Scholar | 22604274PubMed |

[66]  Siddiqi S, Mama SK, Lee RE (2011) Developing an obesity prevention intervention in networked virtual environments: The International Health Challenge in Second Life. J Virtual Worlds Res 3, 4–26.

[67]  Woolley P, Peterson M (2012) Efficacy of a health-related Facebook social network site on health-seeking behaviors. Soc Mar Q 18, 29–39.
Efficacy of a health-related Facebook social network site on health-seeking behaviors.Crossref | GoogleScholarGoogle Scholar |

[68]  Yager AM, O’Keefe C (2012) Adolescent use of social networking to gain sexual health information. J Nurse Pract 8, 294–8.
Adolescent use of social networking to gain sexual health information.Crossref | GoogleScholarGoogle Scholar |

[69]  Munson SA, Lauterbach S, Newman MW, Resnick P (2010) Happier together: integrating a wellness application into a social network site. Lect Notes Comput Sci 6137, 27–39.
Happier together: integrating a wellness application into a social network site.Crossref | GoogleScholarGoogle Scholar |

[70]  Rice E, Tulbert E, Cederbaum J, Adhikari AB, Milburn NG (2012) Mobilizing homeless youth for HIV prevention: a social network analysis of the acceptability of a face-to-face and online social networking intervention. Health Educ Res 27, 226–36.
Mobilizing homeless youth for HIV prevention: a social network analysis of the acceptability of a face-to-face and online social networking intervention.Crossref | GoogleScholarGoogle Scholar | 22247453PubMed |

[71]  Sadasivam RS, Volz EM, Kinney RL, Rao SR, Houston TK (2013) Share2Quit: web-based peer-driven referrals for smoking cessation. JMIR Res Protoc 2, e37
Share2Quit: web-based peer-driven referrals for smoking cessation.Crossref | GoogleScholarGoogle Scholar | 24067329PubMed |