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Social Networking Websites as a Platform for Disseminating Social Marketing Interventions: An Exploratory Pilot Study Jennifer Uhrig; Carla Bann; Peyton Williams; W. Douglas Evans Online publication date: 22 February 2010

To cite this Article Uhrig, Jennifer , Bann, Carla , Williams, Peyton and Evans, W. Douglas(2010) 'Social Networking

Websites as a Platform for Disseminating Social Marketing Interventions: An Exploratory Pilot Study', Social Marketing Quarterly, 16: 1, 2 — 20 To link to this Article: DOI: 10.1080/15245000903528365 URL: http://dx.doi.org/10.1080/15245000903528365

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Social Networking Websites as a Platform for Disseminating Social Marketing Interventions: An Exploratory Pilot Study Downloaded At: 14:51 30 August 2010

BY JENNIFER UHRIG, CARLA BANN, PEYTON WILLIAMS, AND W. DOUGLAS EVANS

ABSTRACT

Social networking websites (SNSs) focus on building online social networks or communities of people who share interests and activities and provide ways for users to interact with each other online. Our exploratory pilot study gauged users’ receptivity to receiving health information via the SNSs they use. We presented several hypothetical scenarios and explored respondents’ reactions to each of them. Consistent with other research, we found that most respondents reported using SNSs to interact with people they already know as opposed to using SNSs to meet new people. Overall, respondents were generally receptive to the scenarios we explored. Spending more time on the Internet, spending a higher percentage of one’s Internet time on SNSs, and currently participating in online discussion groups were significantly associated with receptivity across several of the scenarios. These reactions suggest an association between heavier Internet use and receptivity to getting health information through this channel. The rapid growth of SNSs presents a significant opportunity to reach individuals with health communication and social marketing messages.

Introduction Consumers routinely recommend products and services to others based on their own experiences and preferences. Organizations recognize that this word-ofmouth exchange exists and deliberately employ strategies to turn communication

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among consumers into ‘‘word-of-mouth marketing’’ (Freeman & Chapman, 2008). When taken to the next level and coupled with online communication among individuals, this can result in ‘‘viral marketing.’’ Viral marketing occurs when a message spreads among individuals online quickly and exponentially (Balter & Butman, 2006; Porter & Golan, 2006). For example, individuals may see an interesting or entertaining video clip or photo and forward it to everyone in their e-mail address book or post a link to it on their Facebook profile. Thus, the message keeps being passed along in a similar fashion from person to person. In this context, contact between the originator of the message and the ultimate recipients is minimal. Only a few individuals are contacted directly by the message originator, but those few individuals then pass the message on to others (Freeman & Chapman, 2008). The concept of viral marketing is also relevant for social marketing health promotion and disease prevention topics. Indeed, it is already being applied in public health to a limited extent (e.g., Huhman, 2008). Social networking websites (SNSs) focus on building online social networks or communities of people who share interests and activities and provide ways for users to interact with each other online. Members of a social network usually post an online profile detailing their background and interests. The social network then facilitates online interactions and connections among people (Seeman, 2008). Friend-networking sites, such as MySpace and Facebook, are a specific type of SNS that have grown rapidly in popularity over the past few years (Raacke & Bonds-Raacke, 2008). There are also SNSs specifically geared toward professional networking (e.g., LinkedIn). The proportion of adult Internet users who have an SNS profile has grown from 8% of online adults in 2005 to 35% in 2008 (Lenhart, 2009). Although media coverage and policy attention tend to focus on how children and teens use SNSs, adults still comprise the majority of SNS users because adults make up a larger proportion of the U.S. population. However, a larger proportion of younger than older adults use SNSs. More specifically, 65% of online teens use SNSs, 75% of online adults aged 18 to 24 use SNSs, and 57% of online adults aged 25 to 34 use SNSs (Lenhart, 2009). SNS usage drops sharply among online adults over age 34 with only 30% of online adults aged 35–44, 19% of online adults aged 45–54, 10% of online adults aged 55–64, and 7% of online adults aged 65 and older using SNSs (Lenhart, 2009). Overall, SNS users report using the sites more for personal than for professional reasons. Most adult SNS users (89%) report using the sites to stay in touch with friends compared with less than 33% who report using them for professional reasons (Lenhart, 2009). The available research to date suggests that

SMQ | Volume XVI | No. 1 | Spring 2010

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SNS users primarily use the sites to communicate and=or reconnect with people they already know as opposed to browsing for new people to meet (Boyd & Ellison, 2007; Ellison, Steinfield, & Lampe, 2007; Lampe, Ellison, & Steinfeld, 2009; Lenhardt). SNS users appear to be about equally split by gender (Lenhart, 2009; Raacke & Bonds-Raacke, 2008). Lenhart (2009) found that approximately one half of SNS users have more than one profile. Furthermore, it is common for SNS users to have a profile on more than one site. A total of 83% of SNS users who have multiple profiles maintain profiles on more than one site (Lenhart, 2009). It is likely that different groups of friends maintain profiles on different SNSs, so to the extent that a user socializes with more than one circle of friends, he or she may have a profile on multiple sites to keep his or her social networks separate. Indeed, almost one quarter of those who have profiles on multiple sites said they do this to keep track of friends who may be spread across different SNSs (Lenhart, 2009). Almost one-fifth of those who maintain multiple profiles said that they do so to keep personal and professional profiles separate. Spending more time on the web and having access to the Internet at multiple locations are both associated with using SNSs (Hargittai & Hinnant, 2005; Hargittai, 2007). Raacke and Bonds-Raacke (2008) found that young adults who use Facebook and Myspace log into their accounts an average of four times per day, with men logging in more frequently than women. Women reported changing their site more often than men. Participants had a mean number of 236 friends linked to their site with men reporting more friends linked than women. About one-half of participants reported that their sites were set to private, and women are more likely than men to set their site to private, ensuring that only individuals identified as their ‘‘friends’’ could view the contents of their site. About half of the study participants reported knowing all of the friends linked to their site. Social marketing campaigns are beginning to incorporate SNSs into their dissemination efforts. For example, a campaign promoting recycling in North Carolina used both MySpace and Facebook to increase feedback and interactions among the target audience (Hamilton, Dennings, & Abroms, 2008). Similarly, ‘‘The Fifth Guy,’’ a social marketing campaign that aimed to increase hand washing and other behaviors to prevent the spread of the flu, used a MySpace page and accompanying blog to increase brand recognition, gain free exposure, and spread the campaign’s message (Plourde, Cook, Mitchell, & Jennings, 2008). However, descriptions of this practice and results from evaluations of social marketing campaigns employing this strategy are scarce in the published literature. Whether or not users of SNSs are interested in or receptive to the idea of getting health information through the SNSs that they use has not yet been

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assessed to our knowledge. Thus, our pilot study was exploratory and formative in design. We gauged users’ receptivity to getting health information via the SNSs they use by exploring three main research questions: 1. To what extent are SNS users receptive to health information delivered through SNSs? 2. Are there differences between subgroups of users in receptivity to health information delivered through SNSs? 3. What factors are associated with receptivity to health information delivered through SNSs?

Methods


Study design

We received approval from the Institutional Review Board at RTI International for this study. We conducted two focus groups (FGs) with individuals aged 18 to 29 who reported using a SNS and logging into that site at least once per week to gather some preliminary qualitative data on individuals’ use of SNSs. We recruited for the FGs by placing advertisements on online bulletin boards (e.g., Craig’s List) and Facebook. The purpose of the FGs was mainly to inform the development of our web-based survey instrument. We explored topics with participants in an open-ended format to generate potential response options for our closed-ended survey questions. We explored the time the participants spent online, what they do online, how they use SNSs, what they talk about within the context of an online SNS conversation, how they decide to request and approve friends, whether they use the Internet to find health information, the health topics they are interested in, how much they trust the health information they find online, how interested they would be in getting health information through SNSs and how this might work, and soliciting input from the participants on a few draft scenarios. We conducted one FG with men (n ¼ 8 participants) and the other with women (n ¼ 8 participants) in Raleigh-Durham, NC. Next, we developed a web-based survey instrument and cognitively pretested it with a small sample of SNS users aged 18 to 29 (n ¼ 5) to improve it before fielding it to the full sample. Our intention was to ensure that the questions were understood as intended, wording was clear, and response options were comprehensive. The survey instrument included questions in the following domains: demographics, health status, Internet and SNS use, interest in receiving health information on the Internet and via SNSs, sexual behavior, HIV testing behavior, and attitudes and beliefs about HIV.


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Finally, a nonprobability-based quota sample of individuals aged 18 to 29 who reported using an SNS and logging into it at least once per week were drawn from the e-Rewards web-based panel of participants (www.e-rewards.com). e-Rewards’ U.S. consumer panel includes over 2 million individuals who were recruited by invitation only through multiple channels. Members of the e-Rewards consumer panel receive incentives for being part of the panel. For the current study, e-Rewards set recruitment targets to achieve a balance of gender and age across respondents. e-Rewards fielded the survey instrument to their panel members in July 2008 and then delivered a raw data file to us for analysis. Measures

Sociodemographics


We collected data on each respondent’s gender, race, ethnicity, marital status, college status household income, and self-perceived health status. Internet and SNS Use

We collected data on the number of hours per day that respondents use the Internet for activities other than work or school (numerical response in hours from 0 to 24). We also asked respondents to report what percentage of all of the time they spend on the Internet is spent on SNSs (numerical responses from 0 to 100). We asked respondents what SNSs they have a profile on (Facebook, Myspace, Xanga, Tagged, Bebo, hi5, or other). We asked respondents how they decide to approve someone who requests to be their friend (know them offline, friend of a friend, live in dorm or in class together, work for same company, interesting profile, attractive profile picture, interested in getting to know them better, shared interests, career networking, approve anyone, other). We also asked how respondents decide to request that someone be their friend (know them offline, friend of a friend, live in dorm or in class together, work for same company, interesting profile, attractive profile picture, interested in getting to know them better, hope to meet offline, shared interest, career networking, other). In addition, we asked respondents whether they currently participate in any online interest or discussion groups via SNSs (yes or no). Interest and receptivity

We asked respondents whether they would use the Internet to look for information about a variety of health topics if they had a question. We also asked respondents which health topics they would be interested in receiving

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information about if the SNSs they use offered a way to get information about health. We asked respondents whether they would be interested in adding a health expert=advisor or any of six types of organizations as a friend on the SNSs that they use (yes or no). For the health expert=advisor and each of six types of organizations, we asked respondents whether they would be interested in receiving private messages about health from each source, the likelihood of sending a private message with a question about health to each source, whether they would read a blog written by the health expert=advisor or organization about a health topic of interest, and whether they would listen to a podcast linked from the SNS about a health topic of interest. Finally, we asked respondents whether they would participate in an online interest or discussion group about a health topic of interest if they were invited (very likely, somewhat likely, not likely).


Statistical analysis

For the statistical analyses, we began by calculating descriptive statistics of the survey responses. We also computed bivariate analyses of receptivity by demographics, Internet and SNS use. Finally, we estimated separate logistic regression models for each scenario, including the following variables related to demographics and Internet use in each model: gender, race=ethnicity, marital status, college student, number of hours on Internet each day, percentage of Internet time spent on SNSs, and whether the respondent had participated in online groups. Results Participant characteristics

A total of 518 individuals aged 18 to 29 who reported using an SNS and logging into that site at least once per week responded to our web-based survey. Survey respondents were almost equally split by gender, three-quarters were not married, and the majority were white (Table 1). Just over one-half reported annual household incomes of more than $50,000, about one-half reported being college students, and almost all reported being in good, very good, or excellent health. Internet and SNS use

Respondents reported spending an average of 6 hours per day on the Internet with an average of 39% of their Internet time spent on SNSs. All respondents


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TABLE 1

Demographic Characteristics of Survey Respondents N

%

252

49

White

366

71

Black

38

7

Hispanic

66

13

Other race

48

9

Married

130

25

College student

249

48

< $20,000

61

12

$21,000–$30,000

67

13

$31,000–$40,000

65

13

$41,000–$50,000

53

10

252

49

Excellent

187

36

Very good

232

45

92

18

7

1

Number of hours on Internet each day . . . mean (SD)

6

5

Percent of Internet time spent on SNSs . . . mean (SD)

39

27

132

25

VARIABLE

Male


Race

Household income

> $50,000 Health status

Good Fair=poor

Participate in online groups

reported having a profile on either Facebook (22%), MySpace (21%), or on both Facebook and MySpace (57%). Respondents reported typically going onto SNSs to interact with people they already knew offline as opposed to meeting new

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people or networking. Respondents most often reported going onto SNSs to connect with people they know (91%), get updates or see photos of people they know (78%), or reconnect with someone they knew in the past (74%). Far fewer respondents reported going onto SNSs to find someone they met briefly offline (22%), network for their career (16%), find new friends (15%), find a boyfriend or girlfriend (7%), or find a sexual partner (5%). When we asked how respondents decided whether to approve someone who requests to be their ‘‘friend,’’ most respondents reported that they had to know someone offline to accept a friend request from the person (92%). Other common reasons respondents’ cited for accepting a friend request included if the requester was a ‘‘friend of a friend’’ (68%) or worked for the same company (50%). Less common reasons included living in the same dorm or being in the same class as the requester (39%), being interested in getting to know the requester better (25%), sharing the same interests (24%), the requester looks attractive in his or her profile picture (20%), the requester’s profile looks interesting (18%), hope to meet the requester offline (9%), or the respondent approves everyone who requests to be his or her friend (4%). SNS users can join any number of online discussion groups on topics that interest them. One-quarter of respondents reported currently participating in an online discussion group through an SNS. Only 19% of respondents reported always or often reading banner advertisements that appear on SNSs, while 36% reported sometimes reading them. Fewer respondents reported actually clicking on banner advertisements appearing on SNSs–3% reported always or often clicking on them, while 13% reported sometimes clicking on them. Receptivity to receiving health information through SNSs

Most of the respondents (92%) reported using the Internet to find health information. When asked whether they would use the Internet to look for health information on specific topics, responses varied by topic and ranged from a low of 52% (would look up information about heart disease) to a high of 80% (would look up information about fitness) (Table 2). For the purpose of this study, we were specifically interested in whether respondents would be receptive to receiving information about various health topics through the SNS they use. Similarly, receptivity differed by health topic and ranged from a low of 20% being interested in receiving information about heart disease to a high of 55% being interested in receiving information about fitness. To learn about SNS users’ receptivity to the idea of obtaining information about health through SNSs, we presented several hypothetical scenarios and


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TABLE 2

Health Topics Respondents Would Look for on the Internet or Would Like to Receive Information About via SNS WOULD USE INTERNET

INTERESTED IN RECEIVING

TO LOOK FOR INFORMATION

INFORMATION VIA SNS

N

%

N

%

HIV/AIDS

284

55

126

24

Sexually transmitted diseases

320

62

157

30

Reproduction/sexual health

324

63

152

29

Mental health

304

59

134

26

Eating disorders

297

57

119

23

Stress

342

66

183

35

Sleep disorders

301

58

119

23

Alcohol/drugs

326

63

149

29

Acne

334

64

153

30

Nutrition

383

74

228

44

Diet/weight loss

387

75

231

45

Fitness

415

80

283

55

Skin

342

66

184

36

Beauty

316

61

184

36

Cold and flu

328

63

157

30

Allergies

370

71

156

30

Asthma

287

55

116

22

TOPIC

Sexual health


Mental health/substance use

Beauty/fitness/diet

Respiratory conditions

(Continued)

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TABLE 2

Continued WOULD USE INTERNET

INTERESTED IN RECEIVING

TO LOOK FOR INFORMATION

INFORMATION VIA SNS

N

%

N

%

Cancer

305

59

116

22

Diabetes

286

55

109

21

Heart disease

268

52

102

20

Back pain

316

61

136

26

Injuries

323

62

138

27

Migraines/headaches

318

61

142

27

TOPIC

Chronic diseases


Pain

gauged respondents’ reactions to each of them (Table 3). The objective was to understand how receptive respondents would be to three potential social marketing approaches for promoting positive health behaviors through SNSs with the anticipation that others can use these findings to develop, implement, and pilot test an actual intervention. Scenario #1: Health expert=advisor

In this scenario, we explored the idea of adding a health expert=advisor as a friend. We defined a health expert=advisor as a trained health care professional who would be available to provide the user with information and to answer their questions. The majority of respondents (53%) said that they would be interested in adding a health expert=advisor as a friend (Table 4). In our multivariate model, spending more of one’s Internet time on SNSs (p < .01) and participating in online discussion groups (p < .001) were significantly associated with respondents’ receptivity to adding a health expert=advisor as a friend (Table 5). Next, we explored respondents’ interest in periodically receiving a private message from a health expert=advisor through the SNS on a health topic that interested them as well as whether they would send a private message to a health


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Specific activities

Defined as

of interest

. Read their blog . Listen to their podcasts

. Listen to their podcasts

questions about health

. Ability to send private messages with

. Read their blog

questions about health

. Ability to send private messages with

messages about health topics

. Periodically receive private

. Periodically receive private messages

about health topics of interest

. Add as a friend

. Add as a friend

. health insurance company

. not-for-profit organization

. hospital or health system

. health department

. major university or medical center

. government agency

Six types of organizations:

health

.

Join the group if invited

information, and users could contact the organization with questions about

group about a health topic of interest through an SNS

links to credible sources of health

Online interest or discussion

GROUP

SCENARIO #3: ONLINE DISCUSSION

and answer questions

The organization’s page would have

SCENARIO #2: ORGANIZATION

would be available to provide information

A trained health care professional who

SCENARIO #1: HEALTH EXPERT/ADVISOR

Summary of Hypothetical Scenarios

TABLE 3


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TABLE 4


Percentage Indicating Receptivity to Information from Health Experts and Organizations ADD AS

READ

LISTEN

SEND

RECEIVE

A FRIEND

BLOG

TO PODCAST

MESSAGE

MESSAGE

Health expert/advisor

53

71

37

78

56

Government agency

40

45

26

55

36

Major university/medical center

53

57

31

66

42

Health department

27

34

17

58

24

Local hospital

32

34

19

62

26

Not-for-profit organization

33

30

16

55

27

Health insurance company

11

12

6

33

10

expert=advisor with a question about their health, if that option were available to them. The majority of respondents (56%) indicated that they were interested in receiving a private message from a health expert=advisor, while 78% said that they would send a private message to a health expert=advisor with a question they had about health. Participation in online discussion groups (p < .01) was significantly associated with respondents’ receptivity to both sending and receiving messages, while spending more time on the Internet per day (p < .05) and spending a greater percentage of their Internet time on SNSs (p < .01) were significantly associated with indicating they would send a message. Finally, we assessed respondents’ interest in reading a blog posted by a health expert=advisor or listening to a podcast from a health expert=advisor linked from an SNS about a health topic of interest to them. Almost three-quarters of respondents (71%) said that they would read a health expert=advisor’s blog, while only 31% said that they would listen to a podcast on a health topic of interest to them. Scenario #2: Organization

Similar to the previous scenario described, we also proposed the idea of adding an organization as a friend on the respondents’ online network because many organizations (e.g., the Centers for Disease Control and Prevention) have profile pages on SNSs. In the scenario we described, we said that the organization’s


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2.29 (1.48, 3.54)

p < .05;

p < .01;

p < .001.

Note: Odds ratio (95% confidence interval).

online groups

Participated in

spent on SNSs

Internet time

Percentage of

per day

1.11 (1.04, 1.20)

1.96 (1.18, 3.26)

1.13 (1.04, 1.22)

1.01 (0.97, 1.05)

Number of hours 1.04 (1.00, 1.08)

on Internet

1.18 (0.78, 1.80)

1.29 (0.87, 1.89)

0.89 (0.56, 1.42)

1.30 (0.63, 2.70)

College student

1.54 (0.81, 2.95)

Other race

1.20 (0.65, 2.21)

1.43 (0.92, 2.23)

1.30 (0.74, 2.26)

Hispanic

1.28 (0.56, 2.94)

0.96 (0.64, 1.44)

ORGANIZATION

Married

1.97 (0.92, 4.22)

0.75 (0.52, 1.10)

HEALTH EXPERT

Black

Race

Male

VARIABLE

ADD TO FRIENDS LIST

1.82 (1.21, 2.75)

2.22 (1.49, 3.30)

1.10 (1.03, 1.17)

1.05 (1.01, 1.09)

1.04 (1.00, 1.08)

1.10 (1.03, 1.18)

1.04 (0.73, 1.48)

0.89 (0.60, 1.32)

2.01 (1.31, 3.09)

1.02 (0.95, 1.09)

1.02 (0.98, 1.06)

0.84 (0.57, 1.22)

0.76 (0.50, 1.17)

0.70 (0.38, 1.29)

1.82 (1.00, 3.31)

1.18 (0.68, 2.04)

1.50 (0.72, 3.12)

1.25 (0.86, 1.81)

HEALTH EXPERT

0.55 (0.35, 0.86)

0.93 (0.86, 1.00)

0.99 (0.95, 1.03)

0.95 (0.64, 1.40)

1.50 (0.97, 2.31)

0.55 (0.27, 1.10)

1.02 (0.58, 1.77)

0.93 (0.45, 1.91)

1.14 (0.78, 1.66)

ORGANIZATION

RECEIVE PRIVATE MESSAGES

1.60 (0.96, 2.68)

0.96 (0.50, 1.82)

0.95 (0.67, 1.33)

ORGANIZATION

1.00 (0.68, 1.47)

1.27 (0.82, 1.96)

1.44 (0.77, 2.69)

1.32 (0.76, 2.28)

1.39 (0.70, 2.78)

0.90 (0.62, 1.31)

HEALTH EXPERT

SEND PRIVATE MESSAGES

4.35 (2.64, 7.15)

1.03 (0.96, 1.13)

1.08 (1.04, 1.13)

1.16 (0.78, 1.73)

0.96 (0.61, 1.51)

1.34 (0.69, 2.62)

1.21 (0.68, 2.14)

2.11 (0.92, 4.82)

0.76 (0.52, 1.12)

GROUP

ONLINE DISCUSSION

Logistic Regression Models of Receptivity to Scenarios for Receiving Health Information through SNSs

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profile page would have links to credible sources of health information, and the user would have the ability to contact the organization with questions about health. For the purposes of the scenario, we explored receptivity regarding six different types of organizations: a government agency, major university or medical center, state or local health department, local hospital or health system, notfor-profit health organization, or a health insurance company. Receptivity to adding an organization as a friend varied by organization type and ranged from a low of 11% (health insurance company) to a high of 53% (major university or medical center) (Table 4). Spending more of one’s Internet time on SNSs (p < .01) and participating in online discussion groups (p < .01) were significantly associated with respondents’ receptivity to adding any organization as a friend (Table 5). Next, we explored respondents’ interest in periodically receiving a private message from an organization through the SNS on a health topic that interested them, as well as their interest in the ability to send a private message to an organization with a question about their health. Overall, respondents were more receptive to the idea of sending messages to (33% to 66%) rather than receiving private messages from organizations (10% to 42%) (Table 4). Being of other race=ethnicity relative to white (p < .05) and spending more time on the Internet (p < .01) were significantly associated with respondents indicating that they would send messages to organizations, while spending more of one’s Internet time on SNSs was significantly associated with respondents’ receptivity to both sending (p < .01) and receiving messages (p < .05). Participating in online discussion groups was also significantly associated with respondents’ receptivity to both sending (p < .01) and receiving messages (p < .01). Finally, we assessed respondents’ interest in reading an organization’s blog posted on an SNS or listening to a podcast by an organization linked from an SNS about a health topic of interest to them (Table 4). Interest in reading a blog posted on an SNS by an organization varied widely by organization-type ranging from 12% for a blog written by a health insurance company to 57% for one written by a major university=medical center. Similarly, 6% of respondents would listen to a podcast from an insurance company, while 31% would listen to one from a major university or medical center. Scenario #3: Online interest or discussion group

Finally, we asked respondents how likely they would be to participate in an online interest or discussion group about a health topic of interest to them through an SNS if they were invited. The majority of respondents (56%) said that they


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would be somewhat or very likely to participate if invited. Significant predictors included spending more time on the Internet (p < .001) and currently participating in online discussion groups (p < .001) (Table 5). Discussion Consistent with other research, we found that a substantial proportion of respondents had a profile on both Facebook and MySpace (57%). Also consistent with other research, most respondents reported using SNS to interact with people they already know as opposed to using SNS to meet new people. Overall, respondents were generally receptive to the scenarios we explored. Over one-half of respondents were interested in adding a health expert=advisor as a friend. The majority of respondents indicated interest in receiving private messages from the health expert=advisor, reported interest in sending messages, were interested in reading a health expert=advisor’s blog, and more than one third were interested in listening to a health expert=advisor’s podcast. Respondents’ interest in adding an organization as a friend varied by the organization type. However, the majority of respondents indicated interest in adding a major university or medical center, 40% indicated interest in adding a government agency, and about 33% were interested in adding a not-for-profit organization or local hospital. The majority of respondents indicated interest in sending a private message to all of the organization types we asked about, except for the health insurance company. Interest in receiving messages from organizations was much lower – more than one-third of respondents only indicated interest in receiving messages from a major university or medical center (42%) or government agency (36%). The majority of respondents indicated interest in reading a blog from a major university=medical center, and more than one-third were interested in reading a blog from a government agency, health department, or local hospital. Interest in listening to a podcast was much lower – less than one-third of respondents indicated interest in listening to podcasts from any of the organization types. Finally, the majority of respondents indicated interest in joining an online discussion group on a topic of interest if they were invited. Conclusion

Overall, sociodemographics were not significantly associated with receptivity to the extent that we may have expected. More specifically, race=ethnicity was only significantly associated with interest in sending private messages to an organization. No other demographic variable was statistically significant in any of the

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other models, although we acknowledge that we may not have had enough variance in our sample to detect differences by sociodemographics. Conversely, spending more time on the Internet, spending a higher percentage of one’s Internet time on SNSs, and currently participating in online discussion groups were significantly associated with receptivity across several of the models, suggesting that heavier Internet users were more receptive to getting health information through this channel. Previous research offers some possible explanations for these findings. First, once individuals acclimate to media such as TV, print, or Internet, they may attend more to messages delivered in those media (Evans, 2008). This form of selective attention by media type offers an opportunity to segment by media preference and more effectively reach audience segments attuned to, for example, SNSs as a source of information and entertainment. Second, content within preferred media, such as friends’ SNS posts or posts from corporate or health expert sources, may be more salient due to characteristics such as branding, or factors such as social modeling and peer norms derived from Social Cognitive Theory (Evans & Hastings, 2008; Bandura, 2004). Limitations

We acknowledge that there are some limitations to the current study. First, our sample was a nonprobability-based quota sample of SNS users aged 18 to 29. It is possible that individuals who chose to participate in the study may be more motivated or interested in the topic than others. For these reasons, we caution readers about generalizing findings from our study to all SNS users. Second, our study was exploratory and formative in design. Although we found that certain characteristics were significantly associated with receptivity, our study was not designed to establish a causal relationship. Therefore, we cannot determine whether modifying these factors would change individuals’ receptivity to the scenarios presented with the data from this study. Finally, our measures are all self reported and may be subject to response bias or poor recall. Future research may consider the use of tracking software to measure time spent on the Internet and=or SNS use. Implications for Social Marketing New media are growing and are a potentially valuable tool for implementing and evaluating public health campaigns. The potential to use new media alone and=or in combination with traditional public health campaigns to get the word out; increase awareness; and change knowledge, attitudes, beliefs, intentions, and behaviors seems promising (Abroms et al., 2008). A handful of social marketing


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campaigns have employed the use of new media to complement traditional channels (Hamilton et al., 2008; Hoff, Mishel, & Rowe, 2008; Huhman, 2008; Plourde et al., 2008), but little is known about the effectiveness of these new channels. Relatively few studies have been published specifically on the use of SNSs as a social marketing strategy (Abroms et al., 2008). The rapid growth of SNS presents a significant opportunity to reach individuals with health communication and social marketing messages. Some ways that SNSs can be used for health communication and social marketing include sending individualized messages to users, sharing photos and videos to diffuse messages, and creating new or capitalizing on existing online discussion groups to build on messages communicated through ads, websites, and other direct-to-consumer promotion. SNSs can be used to both brand the message through imagery and peer leadership and to diffuse the messages (Evans et al., 2009). However, social marketing interventions implemented through SNSs will only reach individuals who use SNSs. Therefore, social marketers should be cognizant of whether their target audience uses SNSs to determine whether implementation through a SNS may be an appropriate channel to reach their particular audience. This pilot study was only a first step in some preliminary formative research. The next step would be to develop, pretest, and implement a social marketing intervention via an SNS and evaluate its effectiveness. This could be accomplished by adding an SNS component to a campaign already under development or developed and incorporate an evaluation of the channel into the evaluation design.

About The Authors Jennifer Uhrig, Ph.D., is deputy director of the Health Communication Program and senior health communication scientist at RTI International, Research Triangle Park, NC. Carla Bann, Ph.D., is fellow and senior director of Program Evauation and Outcome Measurement at RTI International, Research Triangle Park, NC. Peyton Williams, B.A., is a health communication analyst with RTI International, Research Triangle Park, NC. W. Douglas Evans, Ph.D., is a professor in the Departments of Prevention and Community Health and Global Health, and director of Public Health Communication and Marketing at George Washington University, Washington, DC.

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References Abroms, L. C., Schiavo, R., & Lefebvre, R. C. (2008). New media cases in Cases in Public Health Communication & Marketing: The promise and potential. Cases in Public Health Communication & Marketing, 2, 3–10. Balter, D., & Butman, J. (2006). Clutter cutter. Marketing Management, 15, 49–50. Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31, 143–164. Boyd, D. M., & Ellison, N. B. (2007). Social network sites: Definition, history, and scholarship. Journal of Computer-Mediated Communication, 13(1), article 11. Retrieved from http:==jcmc. indiana.edu=vol13=issue1=boyd.ellison.html


Ellison, N., Steinfield, C., & Lampe, C. (2007). The benefits of Facebook ‘‘friends’’: Exploring the relationship between college students’ use of online social networks and social capital. Journal of Computer-Mediated Communication, 12(3), article 1. Retrieved from http:==jcmc.indiana. edu=vol12=issue4=ellison.html Evans, W. D. (2008). Social marketing and children’s media use. Future of Children: Children, Media, and Technology, 18(1), 181–204. Evans, W. D., & Hastings, G. (2008). Public health branding: Recognition, promise, and delivery of healthy lifestyles. In W. D. Evans and G. Hastings (Eds.), Public health branding: Applying marketing for social change (pp. 3–24). London, England: Oxford University Press. Evans, W. D., Santoro, K., Murphy, B., & Schoenman, J. (2009). Recommended adolescent health care utilization: How social marketing can help. NIHCM Foundation Issue Brief. Retrieved from http:==nihcm.org=pdf=NIHCM-SocialMarketing-FINAL.pdf Freeman, B., & Chapman, S. (2008). Gone viral? Heard the buzz? A guide for public health practitioners and researchers on how Web 2.0 can subvert advertising restrictions and spread health information. Journal of Epidemiology and Community Health, 62, 778–782. Hamilton, L., Dennings, K., & Abroms, L. C. (2008). RE3.org: A case study of using new media to promote recycling in North Carolina. Cases in Public Health Communication & Marketing, 2, 178–189. Retrieved from http:==www.casesjournal.org=volume2 Hargittai, E. (2007). Whose space? Differences among users and non-users of social network sites. Journal of Computer-Mediated Communication, 13(1). Retrieved from http:==jcmc.indiana. edu=vol13=issue1=hargittai.html Hargittai, E., & Hinnant, A. (2005, March). New dimensions of the digital divide: Differences in young adults’ use of the Internet. Paper presented at the Eastern Sociological Society, Washington, D.C. Hoff, T., Mishel, M., & Rowe, I. (2008). Using new media to make HIV personal: A partnership of MTV and the Kaiser Family Foundation. Cases in Public Health Communication & Marketing, 2, 190–197.


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Huhman, M. (2008). New media and the VERB Campaign: Tools to motivate tweens to be physically active. Cases in Public Health Communication & Marketing, 2, 126–139. Retrieved from http:==www.casesjournal.org=volume2 Lampe, C., Ellison, N., & Steinfield, C. (2006). A Face(book) in the crowd: Social searching vs. social browsing. In Proceedings of CSCW—2006 (pp. 167–170). New York, NY: ACM Press. Lenhart, A. (2009). Pew Internet Project data memo. Retrieved from http:==www.pewinternet. org=Reports=2009=Adults-and-Social-Network-Websites.aspx Plourde, C., Cook, L. C., Mitchell, P., & Jennings, C. (2008). Talk to the fifth guy: A lesson in social marketing. Cases in Public Health Communication & Marketing, 2, 39–54. Porter, L., & Golan, G. J. (2006). From subservient chickens to brawny men: A comparison of viral advertising to television advertising. Journal of Interactive Advertising, 6, 30–38. Raacke, J., & Bonds-Raacke, J. (2008). MySpace and Facebook: Applying the uses and gratifications theory to exploring friend-networking sites. CyberPsychology & Behavior, 11, 169–174.


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