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Inbound Marketing Strategy in Healthcare

Agency Explores Inbound Marketing Strategy in Healthcare PR Web (press release) “Some hospitals or physician practices may get discouraged when inbound marketing doesn't work overnight,” said Mark Shipley, President and Chief Strategic Officer of...
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What is inbound marketing?. It is any message that a patient might find on the web which causes them find your hospital like social media, like content, In general hospital are just learning to use in bound marketing. In bound marketing is where patient engagement is.

 

"Patients today want to be in control of their healthcare decisions by researching and digesting health information on their own terms through search engines and social media platforms. Outbound or traditional marketing messages may build awareness of hospital brands, but inbound marketing can help hospitals and physician practices engage patients and provide the depth of information that traditional marketing doesn’t allow"

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New App Store for Health Professionals Planned

New App Store for Health Professionals Planned | Hospitals: Trends in Branding and Marketing | Scoop.it
Epic Systems Corp. recently divulged plans to launch its own app store for healthcare professionals. Such a move could invite developers and companies to

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Social Media for Healthcare: Why Should I Use LinkedIn?

Social Media for Healthcare: Why Should I Use LinkedIn? | Hospitals: Trends in Branding and Marketing | Scoop.it

Here’s an important statistic in social media for healthcare: Based on the Pew Research Center’s most recent social media update, LinkedIn has seen significant increases over the past year in user engagement and its number of adult users. The share of users with college educations on LinkedIn reached 50%, and its chief audience — professionals and college graduates — has continued to grow.

What does this mean for your marketing strategy? Long story short: If you and your medical practice are not already on LinkedIn, now is the time to get started. Here, we’ll list the ways you can use the website to your marketing plan’s advantage.

Build your profiles — and fill everything out. 

Think of it this way: Part of the reason why social media for healthcare is so important is its ability to pop up on search results when prospective patients search for your practice’s name. You want your audience to be able to find the most relevant information about your practice, including the essentials — like contact information and services — and the factors that leave people with a positive first impression.

If your patients see a professional and thoughtfully complete LinkedIn company page for your medical practice, it will give them a better idea of your brand. And, not only that, but what happens if they search for a specific medical professional within your office? Will they find nothing, or will they find a wealth of information packed with a professional photo of their prospective doctor, credentials, and educational background? It’s easy to see which result will be more beneficial for you — so, set aside an hour to create a social media for healthcare profile on LinkedIn that accurately captures your office’s appeal.

Start with relevant contact information, but also create a company mission statement, and upload a cover photo and profile picture that echo your brand’s image. The Mayo Clinic and St. Jude Children’s Research Hospital are prime examples of branding done right.

Get involved with professionals, clients, and social media.

LinkedIn allows you to join up to 50 groups, which not only gives you an opportunity to engage with other professionals, but also provides additional forums to engage with other users. Share content with your networks, not only within your groups but also to your profile; cross-post blogs articles that appeal to your peers, and begin conversations with users to build your credibility.

This amount of social media for healthcare activity translates into a few different levels of positive feedback. Not only will it potentially increase the amount of clicks you receive to your homepage (which can translate into the ever-wonderful increases in organic search rankings we all want to see), but it can also turn into two of LinkedIn’s best features: testimonials and recommendations.

Testimonials and recommendations allow other professionals (or even clients, if they’re also on LinkedIn) to leave reviews on your individual profile page for everyone else to see. These steps can translate into a serious amount of credibility, which can motivate prospective patients to take their first few steps through your practice’s doors — and if that’s not a huge ROI, we’re not sure what is. Invest some time, build your relationships, and give users a chance to see what you and your practice are doing to share and build your practice online — it’s a smart move in social media for healthcare, and a smart move for your marketing plan overall.



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Storytelling in a Multi-Channel Universe - Medical Marketing and Media

Storytelling in a Multi-Channel Universe - Medical Marketing and Media | Hospitals: Trends in Branding and Marketing | Scoop.it
Marketers are only beginning to understand the intricacies of sharing a brand story on multiple connected channels and not just those in healthcare.Fro

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Impact of mHealth Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review

Impact of mHealth Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review | Hospitals: Trends in Branding and Marketing | Scoop.it

Impact of #mHealth Chronic Disease Management on Treatment #Adherence and Patient Outcomes: A Systematic Review http://t.co/IoM7WMHVJD


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What do patients really want from doctors?

What do patients really want from doctors? | Hospitals: Trends in Branding and Marketing | Scoop.it

Ever wonder what patients really want from doctors?Is it the fancy buildings with marble fountains?Is it the board certifications and diplomas on the wall?Is it the expert medical jargon and starched white coats?


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In-Depth: Recent digital health moves by payers, health insurers


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Is healthcare is about to go virtual?

Is healthcare is about to go virtual? | Hospitals: Trends in Branding and Marketing | Scoop.it

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Content Marketing: The New Frontier in Hospital Marketing

Content Marketing: The New Frontier in Hospital Marketing | Hospitals: Trends in Branding and Marketing | Scoop.it
No matter what your business is, content marketing is a growing, cost-effective marketing tool that works. Read more
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Survey: Diabetes patients who use digital tools self-report better health

Survey: Diabetes patients who use digital tools self-report better health | Hospitals: Trends in Branding and Marketing | Scoop.it

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Physicians as Brand Ambassadors | HealthWorks Collective

Physicians as Brand Ambassadors | HealthWorks Collective | Hospitals: Trends in Branding and Marketing | Scoop.it
For population health and the related practice of integrative medicine, the physician has become a true healthcare partner.
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9 Tips for Marketing Your Hospital Using Online Physician Profiles

9 Tips for Marketing Your Hospital Using Online Physician Profiles | Hospitals: Trends in Branding and Marketing | Scoop.it
More than 90 percent of Americans consider choosing a doctor a major life decision. Word of mouth is still a primary influencer, but consumers are now seeking those “words” online.
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Mobile technologies: The future of medical education?

Mobile technologies: The future of medical education? | Hospitals: Trends in Branding and Marketing | Scoop.it

As medical futurist Bertalan Meskó (@Berci) stated in The guide to the future of medicine, new technologies will be fundamental for training he...


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PwC report shows importance of social media to healthcare

PwC report shows importance of social media to healthcare | Hospitals: Trends in Branding and Marketing | Scoop.it
One-third of consumers use sites such as Facebook, Twitter, YouTube and online forums to find health-related information, track symptoms and broadcast their thoughts about doctors, drugs, treatments, medical devices and health plans says a recent report by the Health Research Institute (HRI) at Pric

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Physicians need to be ready for the end of fee-for-service

Physicians need to be ready for the end of fee-for-service | Hospitals: Trends in Branding and Marketing | Scoop.it
As we advance the goals of value-based payments, we need to do everything possible to ensure the patient-doctor relationship.

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Art Jones's curator insight, February 26, 10:52 AM

Value based payments are coming, is healthcare ready?

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3 Reasons Why Digital Matters in Healthcare Marketing

3 Reasons Why Digital Matters in Healthcare Marketing | Hospitals: Trends in Branding and Marketing | Scoop.it

Everywhere you turn, digital dominates. Articles across the Web proclaim its importance in marketing strategies, and now, digital marketing is unavoidable. Why? Its benefits and ease of use are too great to ignore. But let’s get a little more specific. When it comes to healthcare marketing, why does digital matter?

In this article, we’ll discuss three key benefits of integrating digital marketing into your promotional strategy taking into account customer demands of the healthcare sector.

Before we get started, take a look at these impressive statistics:

  • 77% of online health seekers say they began their last session at a search engine such as Google, Bing, or Yahoo
  • 51% of patients say they’d feel more valued as a patient when doctors use social media, blogs, and other digital engagement outlets
  • 72% of internet users say they looked online for health information within the past year
  • Behind using search engines and checking email, the #3 activity people do online is search for health information

Customers and potential clients demand your presence on digital channels, but what’s in it for you as a healthcare marketer?

OPTIMIZED PROGRAMS

Unlike traditional marketing channels, digital marketing allows for the optimization of individual campaigns while the programs are live. Instead of sending out one message to a broadly targeted audience in say, a television, newspaper or radio ad, you can tailor your messaging according to keywords, devices, interests, locations, demographics and more. Digital programs also give advertisers the ability to adjust targeting techniques at any time. For example, a company started a marketing campaign to target woman age 30-50 for their cosmetic procedure. Shortly after the campaign launched, the company realized a better target for their procedure is males over the age of 65. Unfortunately the company has already bought TV and Radio ads on stations targeting women. Digital platforms allow companies to adjust their target criteria in real-time so that there is no wasted budget. Much like an investment portfolio, digital channels allow advertisers to "invest" budget in areas that perform and eliminate underperforming campaigns. Does radio, print or TV provide that capability? Once an ad is printed, filmed or recorded, there is no opportunity to make improvements or adjustments.  

Your audience is online, and as such, you should already be engaged in digital marketing. At the very least, you should be strongly considering adopting a digital strategy. Google Think surveys found that 76% of patients were using hospital websites for research, compared to 32% using TV, 20% using magazines and 18% using newspapers.

With the ability to closely monitor digital campaigns and act on real-time metrics and feedback, medical marketers can see better returns on investment.

MOBILE TARGETING

The mobile market is growing at an incredible rate. In fact, this year eMarketer predicts that worldwide smartphone penetration will reach two billion. Google research has already found that roughly 1/3 of patients use tablets or mobile devices on a daily basis for research and/or to book appointments.

The statistics below only go to show mobile’s rising prominence in the healthcare industry:

  • Of patients who found physicians and private practices on their mobile devices, 44% scheduled an appointment (Source)
  • Year-over-year (2012-13) the number of consumers using mobile devices to search for healthcare services increased 22% (Source)
  • 52% of smartphone users gather health-related information on their phones (Source)

You’ve no doubt figured out by now that mobile should be a priority when it comes to your healthcare digital marketing strategy. Luckily, most digital marketing platforms will allow you to target users by device. Just make sure that your ads and landing pages are optimized for mobile devices, or you may end up doing more harm than good.

PROGRAM FLEXIBILITY

As part of the healthcare industry, you know that in any situation, everything can change at the drop of a hat. New market research makes your campaign irrelevant? Marketing budgets get slashed? Management isn’t sold on your execution strategy? This can mean big trouble if you’re dealing with prepaid campaigns and/or advertising programs that can’t be paused immediately.

With digital marketing campaigns, these crises are easily averted. The freedom and flexibility offered by digital advertising methods are invaluable! There’s no need to pay weeks or even months in advance, and you have complete control with the ability to turn these programs on/off with the click of a button.

Healthcare digital marketing is no longer a suggestion. It’s a requirement. Customer demand for digital is constantly growing and the benefits of a digital strategy far outweigh its disadvantages. At this point, it’s a no brainer. Digital marketing matters, and in order for your healthcare practice to be successful, you’ll need to meet patients where they are: online.



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How Digital Do Millennials Want Their Doctors? - eMarketer

How Digital Do Millennials Want Their Doctors? - eMarketer | Hospitals: Trends in Branding and Marketing | Scoop.it
Tech-savvy millennials express interest in using digital methods throughout the healthcare experience, from finding a doctor to managing their well-being. Millennials are most interested in using mobile health technologies, such as apps provided by their doctors, and also want to make the appointment process more digital.

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Art Jones's curator insight, February 24, 11:40 AM

Excerpt:

After choosing a physician, millennials want to use a plethora of health technologies. Nearly three-quarters were interested in having their doctors use mobile devices during appointments to share info—allowing for easy, on-the-go access later—and over seven in 10 were interested in managing their well-being, reviewing health records and scheduling appointments through doctor-provided apps. - See more at: http://www.emarketer.com/Article/How-Digital-Do-Millennials-Want-Their-Doctors/1012095#sthash.BwHJGJO6.dpuf

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Manhattan: Half of patients now use mobile for health

Manhattan: Half of patients now use mobile for health | Hospitals: Trends in Branding and Marketing | Scoop.it

RT @jberkley22: Manhattan: Half of patients now use mobile for health http://t.co/e1j1U0CF7D via @MobiHealthNews


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5 best smartphone advances for doctors in the past 5 years

5 best smartphone advances for doctors in the past 5 years | Hospitals: Trends in Branding and Marketing | Scoop.it

Smartphone advances have made their way into the medical sector. Doctors use digital devices to review research, write prescriptions and text colleagues. Read more for the five best smartphone advances for doctors in the past five years.


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How Can Doctors Manage Their Online Presence?

How Can Doctors Manage Their Online Presence? | Hospitals: Trends in Branding and Marketing | Scoop.it

Online reviews can help or hurt any business. A doctor’s reputation is no different.

As a doctor you want as many people saying good things about you and your surgery as possible. People are more likely to visit you depending on the content of the review. Your own posts also mean a lot to people. What kind of message are you sending online? How can you craft your online messages to attract and keep more of your patients? You can manage your online presence easily and effectively with some of these tips.

LinkedIn Page

A LinkedIn page could be just what you need to keep a professional image online. People can see and rate your practice. They can also start discussions about your services as a doctor. A LinkedIn page gives you the chance to show and tell people your skills. You only have to update this page once every few days to stay current in the minds of your patients. If your patients are business owners and other busy professionals, then they will appreciate the ability to keep up with their surgeon on LinkedIn. Your practice will benefit from LinkedIn.

Facebook

 

Facebook is much more informal than LinkedIn. For that reason you should be careful about what you post on Facebook. But a quality page can attract more people than LinkedIn. You are more likely to connect with people who are looking for a clinic on Facebook. People often ask their Facebook friends for recommendations on new doctors in their area. You have the opportunity to position yourself as the go-to doctor in your specialty in your area with help from Facebook. The good news about your practice will spread quickly. Like LinkedIn, you can update your Facebook page every other day for best results.

Blog

You should start a blog for your clinic’s website. A quality blog post can establish you as a surgery expert. Longer posts show people what you know as well as your beliefs about being a surgeon. The best part about promoting a blog is that you can use LinkedIn and Facebook to get more people to read it. Your smaller updates on social media can help people connect with you. Your larger blog posts will educate them on you and your services. You will reach a larger audience in no time with the help of social media and blogs. You only need to make a longer blog post once per week.

YouTube

You could also create a YouTube video for your current and prospective patients. It’s always nice to see someone’s face and hear them talk directly to you. You would only have to create a YouTube video once every few months. But of course you could make videos more often if you like. You can introduce yourself and tell people what your skills and abilities include. Humans like working with people they can see and trust. A video increases your visibility, and it boosts your credibility as a quality surgeon with good people skills.

Social media and blogs will work in tandem to create an impressive online presence for any doctor. You can always pay someone to write blog posts and manage your social media profiles. Be sure to emphasize your surgical abilities as well as your ability to connect with people on a caring level.



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7 ways tech can help fix the US healthcare system

7 ways tech can help fix the US healthcare system | Hospitals: Trends in Branding and Marketing | Scoop.it
From R&D to patient care, technology has the opportunity to drastically improve the US healthcare system. Here are seven important ways it can happen.

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Art Jones's curator insight, February 22, 8:42 PM

Point number 3 speaks to the progress of making care more accessible. Reality is that growing numbers of people access information via smartphone and tablet however 36% of healthcare companies have no mobile strategy.


Are we making progress, yes however we have a long way to go.


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Stanford launches its HealthKit- and Epic-connected MyHealth app

Stanford launches its HealthKit- and Epic-connected MyHealth app | Hospitals: Trends in Branding and Marketing | Scoop.it

Many large hospitals in the U.S. are evaluating or developing pilot projects around Apple’s HealthKit platform. Stanford Health Care is among the first to actually offer a working app that exchanges data between the Epic patient record system and Apple’s platform.

SHC quietly announced Tuesday the release of its new iOS 8 MyHealth mobile app for patients (no Android app yet).

The app was developed in-house by Stanford Health Care (SHC) engineers, and connects directly with Epic’s electronic health records system, and with Apple’s HealthKit to collect data from consumer health data monitoring devices like Fitbit wearables, for example.

SHC says patients can use the app to view test results and medical bills, manage prescriptions, schedule appointments, and conducti video visits with Stanford physicians.

The app supports Stanford Health Care’s new ClickWell Care, a telemedicine service that connects patients with Stanford doctors online. ClickWell also provides patients with a customized wellness coaching program from a certified personal trainer, who monitors data from the patient’s home health devices.

“We provide care for some of the most technologically sophisticated patients in the country, whose lives revolve around innovation,” said Stanford Health Care CEO Amir Dan Rubin in a statement. “After carefully evaluating all of the available mobile technologies, we recognized that to meet the needs and expectations of our patients we had to develop our own solution that worked seamlessly with our existing electronic health record system,” Rubin added.

The MyHealth app also creates offers a secure messaging platform where patients can communicate directly with caregivers. Using HealthKit, the MyHealth app syncs automatically with whatever consumer wellness devices or clinical home care devices the patient might use. The data received from the devices is automatically added to the patient’s chart in Epic for their physician to review remotely.

“By integrating with companies like Withings, our physicians have access to meaningful patient data right in Epic, without having to ask the patient to come in for an appointment,” said SHC CIO Pravene Nath, MD, in a statement. “We believe this is the future of how care will be delivered for many types of chronic conditions.”

Stanford Health Care consists of a large university hospital, primary care offices throughout the Bay Area, and outpatient clinics in Redwood City and Palo Alto, California.


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OracleVoice: Why Healthcare Is (Finally) In For Big Changes

OracleVoice: Why Healthcare Is (Finally) In For Big Changes | Hospitals: Trends in Branding and Marketing | Scoop.it
With smart cloud computing and hundreds of connected devices, we’re witnessing a digital health revolution. I’m confident that this trend will keep accelerating for years to come.

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50% of Execs Think mHealth will be Key to Patient Engagement

50% of Execs Think mHealth will be Key to Patient Engagement | Hospitals: Trends in Branding and Marketing | Scoop.it
SOURCE February 15, 2015 Half of executive leaders believe that patient engagement will rely heavily on mobile health technologies within the next five years, according to a poll conducted by The Economist.  mHealth technologies will be key to providing patients with their personal health information, supplementing population health management programs, and reducing strain on the overextended healthcare delivery system, the survey found. The poll of 144 healthcare executives revealed optimism ab

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Online Marketing for Doctors: 6 Things That Happen If You Don't Do It

Online Marketing for Doctors: 6 Things That Happen If You Don't Do It | Hospitals: Trends in Branding and Marketing | Scoop.it
Don't think you can afford online marketing for doctors? Be warned, here's 6 things that will happen if you don't invest in internet marketing.

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Preventing Chronic Disease : An Analysis of Facebook Groups Related to Hypertension

Preventing Chronic Disease : An Analysis of Facebook Groups Related to Hypertension | Hospitals: Trends in Branding and Marketing | Scoop.it

Abstract

Introduction
We studied Facebook groups related to hypertension to characterize their objectives, subject matter, member sizes, geographical boundaries, level of activity, and user-generated content.

Methods
We performed a systematic search among open Facebook groups using the keywords “hypertension,” “high blood pressure,” “raised blood pressure,” and “blood pressure.” We extracted relevant data from each group’s content and developed a coding and categorizing scheme for the whole data set. Stepwise logistic regression was used to explore factors independently associated with each group’s level of activity.

Results
We found 187 hypertension-related Facebook groups containing 8,966 members. The main objective of most (59.9%) Facebook groups was to create hypertension awareness, and 11.2% were created primarily to support patients and caregivers. Among the top-displayed, most recent posts (n = 164), 21.3% were focused on product or service promotion, whereas one-fifth of posts were related to hypertension-awareness information. Each Facebook group’s level of activity was independently associated with group size (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI], 1.01–1.03), presence of “likes” on the most recent wall post (AOR, 3.55, 95% CI, 1.41–8.92), and presence of attached files on the group wall (AOR, 5.01, 95% CI, 1.25–20.1).

Conclusion
The primary objective of most of the hypertension-related Facebook groups observed in this study was awareness creation. Compared with the whole Facebook community, the total number of hypertension-related Facebook groups and their users was small and the groups were less active.

Top of Page

Introduction

Because the Internet is a vast source of information, people are increasingly using it to search for health or medical information (1,2), to participate in support groups (2,3), and to consult with health professionals (2). Online support groups offer people complementary and supplementary care, create networks with peers to share common experiences, increase problem-solving skills, and increase confidence in making life-improving changes (2,4). Because Internet sites are convenient, easily accessible, available 24 hours a day, cost-effective, and informative (2), people search the Internet for information about medical conditions and treatment more frequently than they communicate with their physicians about their health care (5).

Social media are convenient means of communication by which people create, share, and exchange information and ideas across Internet-based communities and networks throughout the world (6). Social media sites are popular because users can easily generate content and instantaneously make that content widely available and accessible (7). In general, user-generated content refers to a wide range of information, photos, pictures, videos, tags, reviews, and play-lists created and posted by registered users belonging to a particular social media site (6). YouTube, Twitter, Facebook, MySpace, Google+, and Flickr are some well-known examples of popular social media (6). Facebook (www.facebook.com) is the most popular and largest social networking platforms and comprises more than one billion active users (8–10). A major feature of Facebook is a user’s “wall,” which is a space where either the users or visitors can post statuses or comments, upload videos or photos, or attach files. Another Facebook feature is the “like” button: readers can click “like” as a way to indicate their “liking” of or agreement with a comment, photo, video, or other post.

Hypertension, or high blood pressure, is a global public health burden that contributes to morbidity, mortality, and health care cost in both developing and developed countries (11–13). A 2013 study reported that 67% of American adults living with hypertension were Internet users, and 58% of them accessed a website that provided information about a specific medical condition or problem (14). Since appropriate controlling of hypertension reduces the risk of adverse health events, support activities through social networking sites could be effective in hypertension control. Although numerous studies focused on people’s use of various social media sites in the context of diseases other than hypertension (3,5,15–19), studies on the use of social media sites for hypertension-related information and communication are limited.

Literature is limited on how Facebook groups are used by people with hypertension-related diseases or how these groups foster awareness regarding hypertension among Internet users throughout the world. We studied Facebook groups related to hypertension to characterize the following: a) objective (the main purpose for creating each group), b) subject matter or main discussion topic of each group (eg, type of hypertension), c) number of members in each group, d) geographic boundaries (are group activities targeted to a specific regional population or the global population), e) level of activity (frequency with which group members post to the site), and f) type of user-generated content posted on the wall of each group (ie, individual member’s health status, photos, videos, events, or files), their “likes,” and comments regarding the items posted.

Top of Page

Methods

On September 14, 2013, we performed a systematic search of Facebook using the keywords hypertension, high blood pressure, raised blood pressure, and blood pressure. We limited our search to groups that were accessible to anyone having a Facebook account and used the options provided by Facebook’s built-in search engine. For example, while we typed “open groups” and “hypertension” consecutively in the Facebook search box, numerous automated texts (search options) appeared in the search box. Among those automated search options, we selected only “open groups named hypertension” to obtain a precise search result. Reviewing all search results, we excluded the groups that contained subject matter either unrelated to hypertension or not in English (Figure). Facebook pages for individual users, organizations, events, and applications were not included in our study. “Facebook groups” and “Facebook pages” are different aspects of the social network site: Facebook groups provide a closed space for small groups of people to share their common interests and to express their opinion, whereas Facebook pages allow real organizations, businesses, celebrities, and brands to communicate broadly with people who like them (20). For our study, we focused on Facebook groups and did not include Facebook pages.

Figure. Process for including Facebook groups related to hypertension in analysis of Facebook groups related to hypertension. [A text description of this figure is also available.]

Two researchers (M.A. and T.C.T.) extracted the following data from the content of each eligible group: title of the group; Web address (URL); introductory description; total number of members; most recent top-displayed wall post with posting date, number of “likes,” and comments on that post; and an indication as to the presence or absence of photos, videos, events, and attached files on the group’s wall. Using the method of content analysis (21–23), M.A. and T.C.T. developed a unified coding and categorizing scheme for the whole data set by reviewing the content of the first 100 groups on the basis of the theme present in each group. The main objective of each group was derived from the content of the group title, introductory description, or any message posted by the group creator or administrator. M.A. and T.C.T. independently assigned a specific code for each main objective by using a coding scheme we developed for this study. We assigned a specific code for each of the main objectives, which ultimately led to the identification of 7 major categories of hypertension groups: (a) awareness-creating groups; (b) support groups for patients and caregivers; (c) experience-sharing groups; (d) fundraising groups; (e) product promotion groups; (f) research-conducting groups; (g) health professionals groups. The same 2 coders also coded each of the top-displayed recent wall posts on the basis of the theme of that particular wall post. The intercoder reliability (agreement between two coders) was measured by calculating the percentage of agreement episodes between both coders during the coding process (22). Disagreements between the 2 coders were resolved by discussions until a consensus was reached, or by an adjudication by the third investigator (H.M.I.).

According to the date of the most recent wall post or comment, we placed the Facebook groups into 2 categories: active (most recent wall post or comment was posted on or after January 1, 2013, and before September 14, 2013, and less active (most recent wall post or comment was posted before January 1, 2013). Because we collected data for our study during September 2013, we arbitrarily chose a cutoff point of January 1, 2013 (the beginning date of the same year), to measure the recency of the latest wall post or comment of each Facebook group. Recency measure was preferred, because it was simpler and less time-consuming than other measures of activity such as counting total number of wall posts, comments, likes, or re-posts in each Facebook group; and measuring total number of past events in each group could give an impression of the volume of overall activities, but not necessarily the recency of those activities.

Descriptive statistics comprised the calculation of mean for continuous variables and absolute numbers and percentages for categorical variables. Categorical variables were summarized in 2 frequency tables showing corresponding absolute numbers and percentages. From our everyday experience of Facebook use, it is evident that many Facebook groups become inactive or less active as time goes on. From this perspective, we emphasized and measured the level of activity of the Facebook groups and selected level of activity as an outcome variable for logistic regression analysis.

Stepwise logistic regression (backward elimination method) was used to explore the factors independently associated with the level of activity of the Facebook groups related to hypertension. We preferred stepwise logistic regression because a) our data consisted of multiple potential explanatory variables, b) the important covariates on which to base the model-building were unknown, and c) the outcome we studied was relatively new. A stepwise selection procedure can screen numerous variables in a quick and effective way and can fit numerous logistic regression equations simultaneously (24).

All variables having a univariate level of significance P < .10 were selected for inclusion in the base model for multivariable analysis. Unadjusted and adjusted odds ratios (AORs) along with 95% confidence intervals (CIs) were calculated. All reported P values were 2-sided, and P < .05 was considered significant. Model fit was assessed by the Hosmer–Lemeshow test. All analyses were performed by using SPSS version 16.0 (IBM Corporation).

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Results

Our search results yielded 263 groups on Facebook; 187 groups were eligible for data extraction and analysis after exclusion criteria were applied (Figure). A total of 8,966 Facebook users were members of these eligible groups related to hypertension, and the membership size of each group ranged from 1 to 2,161 individuals. Overall intercoder reliability in our study was 89.8%.

Table 1 shows the general characteristics of the Facebook groups included in the study. Group activities were restricted to a particular geographical location (country or region) for 15% of the groups as indicated by the title of these groups (eg, Singapore Hypertension Club, Pulmonary Hypertension Support Group for Southern Alberta, High Blood Pressure North Florida ), and the remaining 85% of the groups were considered global. By analyzing the main objective of each group we identified the following 7 major categories of hypertension groups by their group descriptions: a) awareness-creating groups (“Our goal is to make people aware about hypertension”), b) support groups for patients and caregivers (“This is a support group for people living with pulmonary arterial hypertension and their family and friends”), c) disease experience-sharing groups (“I am 27 and I have 3 beautiful kids and I am now living with severe idiopathic pulmonary hypertension. I need to know how some of you deal with knowing you are fighting for your life every single day and not break down”), d) fundraising groups (“This group is for those that wish to help us by offering donations or by volunteering yourself, your time, your talents for the organization”), e) product-promotion groups (selling online-generic Lopressor (metoprolol) at discount prices), f) research groups (High Blood Pressure Clinical Research Trial], g) health professional groups (Libyan Academy of Hypertension). Our analyses revealed that most (59.9%) of the Facebook groups were created mainly to promote hypertension awareness. Table 1 lists the key objectives of the Facebook groups and the number and percentage of groups with each objective.

Most (21.3%) of the top-displayed most recent wall posts focused on promoting a product or service related to hypertension. The themes of the Facebook groups’ top-displayed most recent wall posts with respective proportions and percentages are illustrated in Table 2. Of the 187 groups analyzed, 27.8% had activity since January 1, 2013, and 72.2% groups had no activity since that date (Table 1). Stepwise logistic regression analyses showed that the level of activity of the hypertension-related Facebook groups was independently associated with group size (AOR, 1.02; 95% CI, 1.01–1.03), presence of at least 1 “like” on the most recent wall post (AOR, 3.55; 95% CI, 1.41–8.92), and presence of at least 1 attached file on the group wall (AOR, 5.01; 95% CI, 1.25–20.1). These associations should be interpreted with caution, because the variable “group-size” was not normally distributed and showed relatively small magnitude in CI, and the variable “presence of attached file” showed wide CI, possibly because of the small number of analyzed Facebook groups). Further studies with larger numbers may confirm our findings. Finally, the Hosmer–Lemeshow test indicated that the logistic regression model fitted the data in our study well (P = .24). Table 3 illustrates the association of selected characteristics with level of activity of the Facebook groups.

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Discussion

In recent years, many people with diagnosed diseases have formed Internet communities and used the Internet as a platform for accessing timely and relevant health-related information (1,2). Since Facebook is one of the largest social network sites whose user base includes people of all ages and backgrounds, understanding how Facebook groups are raising health awareness among users can assist in developing interventions for health information, education, and communication. Although several studies explored the content and role of Facebook groups pertinent to different chronic diseases such as diabetes (5,15,16), breast cancer (3,15), and colorectal cancer (15) and risk factors such as tobacco use (25), our study is the first to analyze the content of the Facebook groups related to high blood pressure. Our study echoes the importance of community hypertension programs in the era of mobile technology and social media emphasized by Logan et al in a recent article (4).

Our study found approximately 9,000 Facebook users connected with hypertension-related groups. This number is a small contingent of Facebook’s more than 1 billion active-users and suggests that hypertension awareness has a small sounding board on the social network site. Our study revealed that activities of the hypertension-related Facebook groups were mostly (85%) global or international, which was similar to the finding of a case study of a diabetes group (16). Given that our search was limited to English and thus excluded Facebook groups that use other languages, our estimate of geographic boundaries of the groups (global or regional) may not reflect the real situation.

According to our study, most (59.9%) hypertension-related Facebook groups were formed mainly for hypertension-related awareness, whereas Bender et al reported that most (44.7%) of the breast cancer-related Facebook groups were created chiefly for fundraising purposes (3). Farmer et al found that only 28.1% of Facebook groups related to noncommunicable disease were providing support to patients and caregivers (17). Similarly, in our study we found a low proportion (11.2%) of hypertension-related groups working as support groups for patients and caregivers. It is not surprising that our study showed that awareness creation is the main objective of most hypertension-related Facebook groups, rather than fundraising or supportive care activities. Hypertension treatment is less expensive than treatment for many other chronic diseases. Regarding group members’ contributions to the groups, we found few user-generated contributions , which we assessed as cumulative “likes” and comments (24.4% and 17.7%, respectively), on the top-displayed recent wall post indicating that most group members were ”lurkers,” (a member of an online community who observes but does not actively take part] (26), rather than “posters.” This finding is not unusual for an Internet community (26,27) and is also consistent with the findings of the study on breast cancer-related Facebook groups conducted by Bender et al (3).

While analyzing the themes of the top-displayed most recent wall posts, we observed that 21.3% of wall posts were related to promotional products or services for people with hypertension, which suggests the active presence of representatives of medical or pharmaceutical companies among the group members. This finding is troubling, because of the unknown quality and safety of products and services promoted in open environments such as Facebook groups. Similar to our study’s result, Kumar et al reported that 20.1% of hypertension-based YouTube videos contained product advertisements, and many of them advocated unproven alternative treatments of hypertension, which raises concerns about patient safety (28). Moreover, the World Health Organization pointed out the potential harm to individuals’ and the public’s health from medical products sold via the Internet (29).

We found that about one-fifth of the top-displayed and most recent wall posts were focused on providing group users with information related to hypertension awareness. Two qualitative studies about diabetes-related Facebook groups conducted by Greene et al and Zhang et al reported that more than 60% of wall-post topics were based on sharing information about diabetes (5,16). However, neither of those studies (5,16) nor our study examined the scientific accuracy of the information posted on Facebook group walls. Although vetting the accuracy of the information posted to the hypertension-related Facebook groups’ walls was beyond the scope of our project, some studies have explored the accuracy of health-related information available on the Internet (28,30).

Our study has several limitations. We collected data only from the “open” Facebook groups, that is, groups that were completely accessible to the public. Unfortunately, we were unable to collect information from closed or secret groups because of their privacy settings. Thus, we do not know if closed and secret Facebook groups related to hypertension show similar or different content than open groups. This study reflects only the content of hypertension-related Facebook groups and does not represent data from other large social media sites such as Twitter, Myspace, or Google+. Moreover, our data collection was restricted to groups operated in English, although Facebook is available in many other languages. Only the top-displayed, most recent wall post from each Facebook group was assessed, and other wall-posts were not considered. Although we calculated intercoder reliability, intracoder reliability was not assessed. Membership in the 187 Facebook groups may have overlapped. Unfortunately, we were not able to determine how many of the groups were interconnected or to account for membership overlap. In addition, there is the possibility that some users visit the hypertension-related open Facebook groups but do not join them for privacy reasons. Furthermore, we were unable to determine the sex or race of Facebook group members.

In conclusion, this study was a systematic search of Facebook’s open hypertension-related groups. Because it is the first of its kind, our study sheds light on a small Internet community and opens the door to future research. We found that the number of English hypertension-related Facebook groups and their users was small compared with the whole Facebook community, and the groups’ activity levels were low. Despite their small number and low activity level, the hypertension-related Facebook groups provide a sounding board for those affected by the chronic illness, inasmuch as most hypertension-related Facebook groups boost awareness. Facebook groups may be a useful platform for creating hypertension awareness across a global population.



Via Plus91, Giuseppe Fattori
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