The innovation of social media may be as revolutionary for behavioral health as the microscope was for biology. New online communities are enabling scientists to zoom in on large groups of interconnected people and study health-related behaviors in new ways.
That could help them better understand the social dimensions of health, how best to promote healthy behaviors, and usher in more effective health policies, according to Damon Centola, PhD. Centola is an assistant professor of behavioral and policy sciences at MIT and an alumnus of the Robert Wood Johnson Foundation (RWJF) Scholars in Health Policy Research program (2006-2008), a two-year post-doctoral fellowship for recent graduates of PhD programs in the social sciences who are engaged in health policy research.
“Similar to studying how microbes in a petri dish give rise to harmful or beneficial cultures, we can now closely and carefully study how the online social ‘worlds’ in which people are living can give rise to harmful and beneficial collective patterns of health behavior,” Centola said. His study was published on May 28 in Circulation, a cardiology journal published by the American Heart Association.
The association between social factors and health behaviors, such as those related to diet, exercise, cigarette use, and preventive screenings, is well established. But limitations in social science methodologies have prevented scientists from pinpointing how systematic changes in social ties can directly impact population-level changes in health-related behaviors.
“It is much like the way that empirical studies kept finding correlations between certain fungi and antibacterial properties,” Centola explained. “These data provided important evidence that somehow these fungi could be used to great medical effect, but did not allow us to identify the exact conditions that produce penicillin.”
Behavioral health scientists, for example, have shown that smokers tend to hang out with other smokers. But they haven’t been able to measure the influence one smoker has on another smoker’s behaviors. Obtaining reliable measurements about behavior change, and sussing out the independent causal effects of various other social factors such as status differences or similarities, sharing friends, or neighborhood constraints that create normative influences, has not been possible using traditional methodologies, Centola said.
But social media sites present researchers with new opportunities to address those and many other factors because they provide access to countless potential subjects with diverse health backgrounds whose behaviors can be monitored and recorded.
The sites may enable behavioral health researchers to conduct randomized controlled trial studies—the gold standard of medical research—on the influence that social interactions have on health-related behaviors. Larger, more rigorous studies could lead to a more detailed understanding of the social dimensions of health and enable researchers to discover more effective ways to promote healthy behaviors.
“This can allow us to ask many new kinds of questions about the social determinants of health, which previously would have been impossible to study,” Centola said. “For researchers, the exciting possibility is that we can glean causal insights that may lead to new strategies for health policy.”
Sites like Facebook and Twitter can provide researchers with large-scale data about the behavioral effects of health-related social interactions, Centola said, citing examples such as propagating Twitter feeds about the effects of vaccinations or health messages that “go viral.”
Further, “intentionally designed” online health communities, which cater to a specific population with shared health interests, could be even more valuable for researchers seeking ways to create positive behavioral change. In addition to being valuable “petri dishes” for studying the effects of social influence on familiar health behaviors, like participating in exercise or diet programs, these sites can also give rise to novel kinds of social implications for health.
“Online health communities can allow strangers to provide each other with encouragement to maintain their medication routines, or have follow-up visits with their physician,” Centola said. “These are typically very personal decisions, discussed only with immediate family, and therefore very difficult to study. But the fact that hundreds of thousands of people are discussing such topics in these virtual spaces means that these interactions can have significant consequences” for health and health care. “These communities have emerged as potentially important sites for informing and influencing health policy in their own right.”
Social media could lead to a revolutionary new era in health research, and Centola plans to keep looking through the magnifying lens of the Internet to learn more. After studying the influence of social interactions on behavior, he plans to study the influence of online social interactions on measurable health outcomes, such as heart disease. “That’s the important frontier for both research and policy,” he said.
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