Social Media for Empowering Persons with Type 2 Diabetes

SOCIAL MEDIA FOR EMPOWERING
PERSONS WITH TYPE 2 DIABETES
IRIS THIELE ISIP TAN MD, MSC
Professor 3, University of the Philippines College of Medicine
Director, UP Manila Interactive Learning Center
Chief, University of the Philippines Medical Informatics Unit

NOTHING TO DISCLOSE
I give consent for the audience to tweet this talk
and give me feedback (@endocrine_witch).
Feel free take pictures of my slides (though it
will be on www.slideshare.net/isiptan).

… the average person with
diabetes spends no more
than 0.1% of their time in
the course of an entire year
discussing health matters
with a medical
professional.
Hernandez M. Diabetes Manage. 2013;3(3):203-205
“

Social media & peer-
to-peer healthcare
Predicting user
engagement
YouTube as an
information source

SOCIAL
INTERACTION
Symbolic, mutual exchange between two or
more individuals, who possess a common or
shared history, in which information is
communicated both verbally and nonverbally
Lewinski AA & Fisher EB. Chronic Illness 2016 Chronic Illness 12(2):116-144.

Forum, video conferencing, email, text chat
NOT social media, but likely applicable

SYNCHRONOUS COMMUNICATION
Health care professional led a
discussion speciﬁc to T2D
Peers could text chat
each other for support
and information

ASYNCHRONOUS COMMUNICATION
Individuals do not have to be
present online for an infinite
amount of time to obtain
information

The beneﬁts of synchronous and asynchronous
channels are limited by the activity level, and
engagement, of the individuals participating.

THE ABILITY TO CONNECT
WITH SIMILAR PEERS

Interactions are not constrained by
geographical limitations.

PRESENCE OR
ABSENCE OF
A MODERATOR

Moderators are not
a requirement for
social interaction
BUT …

Personalization of feedback regarding
individual progress and self-management

The ability of individuals to
maintain choice during
participation

The lack of privacy limits choice when an
individual wants to discuss personal matters.

PHILIPPINES
CHINA
KOREA
MALAYSIA
SINGAPORE
TAIWAN
AVERAGE
%
0 25 50 75 100
USE OF FACEBOOK FOR HEALTH INFORMATION
Pei-Li Teh & Marc Yates (2013)
researchpartnership.com

Illness Representations, Coping, and Illness Outcomes in People with Cancer: A Systematic Review and Meta-Analysis: Systematic
Review Illness Representations in Cancer - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/
The-common-sense-model-of-self-regulation-of-health-and-illness-Leventhal-et-al-1980_fig1_305344696 [accessed 27 Dec, 2018]
THE COMMON SENSE MODEL OF
SELF-REGULATION AND ILLNESS

IDENTITY
CAUSE
TIMELINE
CONSEQUENCES
CONTROL
CORE ATTRIBUTES OF
ILLNESS REPRESENTATION
illness label and
associated symptoms
how the condition
came about
acute, cyclical, or chronic nature
of the illness
potential social, physical, and
other potential outcomes
treatment options
and one’s ability
to inﬂuence
illness
progression
Rus HM & Cameron LD. Ann Behav Med 2016;50(5):678-689.

ILLNESS COGNITION
COMMON SENSE MODEL
CONCEPTUAL
linguistic,
reasoned
processes
CONCRETE-
EXPERIENTIAL
imagery and
perceptual
memory
processes

NEGATIVE vs POSITIVE AFFECT
Common Sense Model
Social support as motivation
to use health-related
Facebook pages
Content eliciting positive
affect such as hope, humor,
and happiness may reduce
negative affect

Content analysis of health communications
posted on diabetes-related Facebook pages
(n=10; 50 posts each)
Coding categories:
•illness representation
information (identity, cause,
consequence, control, and timeline),
imagery
•negative affect
•positive affect
•social support
•positive identity
•crowdsourcing
•use of external links and
videos

HYPOTHESIS
Illness
representation,
imagery, positive
affect, social
support and
positive self-
identity —> higher
user engagement
(likes, shares,
comments)
Negative affect
will deter
engagement

Posts with imagery had
4.25 times more likes vs
posts without imagery

IMAGERY AND USER ENGAGEMENT
LIKES

SHARES

ILLNESS REPRESENTATION
ATTRIBUTES AND USER ENGAGEMENT
Symptoms and timeline
information did not
predict user engagement
Shared/liked
more: control
information
Shared more:
consequence
information

COMMENTS

AFFECTIVE TONE AND USER ENGAGEMENT
Positive affect did not predict higher
engagement.
Text-only messages with negative affect had
relatively higher likes and comments.

Reach: 1.3M
Engagements: 167,526

SOCIAL SUPPORT & POSITIVE IDENTITY
AND USER ENGAGEMENT
Social support posts prompt
comments
Positive identity posts
motivate users to share the
message with others

CROWDSOURCING AS AN
ENGAGEMENT STRATEGY
More comments but …
Text-only messages soliciting user input
were shared less frequently than those
without solicitations
Solicitations with illustrative images were
shared more frequently relative to other
messages with images

EXTERNAL LINKS AS AN
ENGAGEMENT STRATEGY
55% of posts had external
links
Had lower user
engagement

Gimenez-Perez, Gabriel & Robert-Vila, Neus & Tomé-Guerreiro, Marta & Castells Fuste, Ignasi & Mauricio, Didac.
Health Informatics Journal 2018. 146045821881363. 10.1177/1460458218813632.
Are YouTube videos useful for patient self-
education in type 2 diabetes?
Search terms: “diabetes diet”
and “diabetes treatment”
n = 393 videos

MISLEADING
VIDEOS IF:
Afﬁrmed/insinuated curability
Advocated for specific diets
or treatments while implying
other approaches invalid
Provided
pathophysiological
explanations or
treatment effects
without evidence

YOUTUBE VIDEOS WITH
MISLEADING INFORMATION

INFORMATION IN VIDEOS PUBLISHED BY
OR DISPLAYING HEALTH PROFESSIONALS

Are YouTube videos useful for patient self-
education in type 2 diabetes?
Probability of videos with
AADE7 is <50%; high odds of
finding misleading information

Is YouTube Useful as a Source of Health Information
for Adults With Type 2 Diabetes? A South Asian
Perspective
Leong AY et al. Can J Diabetes. 2018 Aug;42(4):395-403.e4
Search terms:
Diabetes, Diabetes
type 2, Diabetes
South Asians,
Diabetes Punjabi
and Diabetes Hindi
n = 71 videos

CLASSIFICATION OF VIDEOS
Useful: scientifically
sound information about
type 2 diabetes
Misleading:
scientifically erroneous
or unproven
information
Personal
experience

VIDEOS REVIEWED
Comprehensiveness
Source of upload
Technical/production
quality
Global quality scale
(5-point Likert scale)
Reliability (5-item
questionnaire modified
from DISCERN tool)

Is YouTube Useful as a Source of Health Information
for Adults With Type 2 Diabetes? A South Asian
Perspective
45 (63%) useful
videos vs 23 (32%)
misleading videos
Misleading
videos were more
popular than useful
videos (233 vs 8.3
views/day)

Social Media for Empowering Persons with Type 2 Diabetes

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