THE FUTURE OF SOCIAL MEDIA IN HEALTH - PART THREE

In this three-part blog, we look at ways in which social media can become integrated into the fabric of our nation’s health care; we look at how it can and must become a means of fostering all-round well-being, from simple fitness all the way through treatment adherence to chronic disease management.  Part One looked at the quality dimension, part two tackled cost and value, and in this final part three, we explore the role of influence -- and offer a closing perspective.

INFLUENCE

Social network health effects

The Internet and social media are certainly important for the information content that they carry – the statistics, figures, names of conditions, steps for treatment, brands that can help and other factual information.  These elements can be parsed by smart agents to spot key words and “listen” for trends.  This approach has been used by First Life Research (see blog 2) and by Google.org with Flu Trends, which explains: “We've found that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate current flu activity around the world in near real-time”.

However, there’s more to communication than the facts that are communicated and the words used to communicate them.  There are also the “between the lines” impressions that build up over time; there are also the habits and conventions that evolve.  The effects of these invisible elements can be slow but powerful, and can operate over several degrees of social connection.

Analyzing the mass of data from people in the famous longitudinal Framingham Heart Study that started in 1948,Harvard professors Nicholas Christakis and James Fowler made some surprising discoveries, most notably the spread of obesity across social networks. Looking at data from 12,067 people connected at some point during their study period (1971 to 2003) they found that“obesity may spread in social networks in a quantifiable and discernable pattern that depends on the nature of social ties. Moreover, social distance appears to be more important than geographic distance within these networks […] our observations suggest an important role for a process involving the induction and person-to-person spread of obesity.”

The study was widely covered in global media, with headlines such as “are your friends making you fat?” and the revelation that “we may become obese just by knowing someone who knows someone who is fat."

It wasn’t all bad news. Christakis and Fowler went on to examine the data for the dynamics of smoking cessation – people quitting smoking. As with obesity, they found patterns of cessation spreading through networks:  “decisions to quit smoking are not made solely by isolated persons, but rather they reflect choices made by groups of people connected to each other both directly and indirectly at up to three degrees of separation.”

These social network effects spread to other attitudes and behaviors such as drinking, happiness and even loneliness.  The data from the study clearly indicated that people are tied not just to those around them, but to others in a web that stretches farther than they know; a changed behavior can jump across links. The data shows clear and consistent correlations that beg the question; what’s the mechanism?  How does a behavior spread from person A to person C without the link person B changing their behavior?  There are plenty of theories but no proof on this issue. 

Social media health effects

Social media was not around during the study period (1971-2003) and therefore had no influence on the effects observed.  However, it’s impossible to look at the study now and not think of the social media implications. Christakis thinks that the same human basics apply online as offline: “online interactions can indeed facilitate an influence process among people who are actually truly connected or who have meaningful relationships with each other.”

With the speed and reach of social media, the implications for health care professionals are exciting but with important considerations.

The first is that there was nobody in a controlling position across the networks in the Christakis-Fowler studies; they were entirely peer-to-peer.  There is no guarantee that similar social network effects would happen if professional influencers tried to enter the networks. 

Secondly, there was no consistent agenda being driven through the networks.  Nobody in the networks was intending to influence others to change their behavior in any specific way.  Rather, change happened as it does in a flock of birds or a herd of animals wheeling round.  There is no guarantee that people in the network would respond if they knew that somebody was trying to influence them.

Thirdly, it seems the changes in behavior were largely unconscious, with no large-group awareness of the changes; it’s only with hindsight, through the work of academics, that group members have become aware of what they were part of.  By contrast in social media it’s unusual for any changes to happen without somebody noticing them and commenting on them. For influencers with a health care agenda, network self-awareness could have an amplifying effect if their agenda is what network members want for themselves.

In the era of fast-reacting, self-aware social media driven by technology, the sweet spot for health care influencers in pharma and health brands is likely to be found at the intersection of:

• smart apps and products with
• individual consumer aspirations and
• group interactions

In the health care area there are some basic individual consumer aspirations shared by millions: losing excess weight, getting fitter and quitting smoking.

There have long been services and products that support these aspirations and now there are technological apps that not only support the individual but also feed into group interactions on social media where the day-to-day progress can be shared with others interested in the same aspirations.

Weight loss apps such as Fit-ify , Calorie Counter and Calorie Tracker and exercise apps such as MapMyRun and Runkeeper enable users to track what they’re achieving and then share the results with others.  Sharing the results with others is thought to be an important aid to building and maintaining motivation.

Tapping natural influencers

In large networks of individuals, not all members of the networks are equally influential. Obesity researcher Dr James O. Hill and physicist David Bahr constructed a large-scale computer simulation to model the results of the Framingham Study.  Having created the model, they then tested ways to spread weight loss rather than weight gain.  They gleaned two key pointers.  One is to get people to skip a link and hook up with friends of friends to change their behavior.  The other is to ensure that those changing behaviors are in the right spots in the network to maximize their effect; they don’t need to be numerous, but they need to be the right people.

As Hill and Bahr reported it in 2009: “… our simulations also show that interventions targeting well-connected and/or normal weight individuals at the edges of a cluster may quickly halt the spread of obesity. Furthermore, by changing social forces and altering the behavior of a small but random assortment of both obese and normal weight individuals, highly effective network-driven strategies can reverse current trends and return large segments of the population to a healthier weight.”

Health and pharma influencers wanting to achieve better health outcomes in large groups can maximize their effectiveness by addressing the right individuals in the right positions with the right approaches.  This is in line with Euro RSCG’s practice of identifying Prosumers in our research and surveys.  Whether in health care or other segments, it’s essential to know what the most proactive consumers are thinking and doing; it makes sound marketing sense for influencers to ensure that these consumers have early access to new products, services and initiatives.  

Conclusion - to play or not to play?

Many health and pharma brands are trying things out in social media, which is as it should be: kudos to them.  However, some executives seem to be merely going through the motions, possibly thinking – or hoping – that it’s all passing fad, and looking forward to getting back to business as usual. 

Some consumers and consumer advocates resent the presence of brands in social media; they don’t like the commercial exploitation of peer-to-peer interactions; they don’t want sales pitches and brand advertising to intrude in their conversations. 

As we see it, both reluctant executives and resentful consumers are right according to the way the old brand-consumer dynamic played out, but they’re wrong in the new dynamic. Social media is already creating new dynamics, and with the participation of smart brands and consumers, it will foster a lot more. In the drive to improve health and health care, health and pharma brands need to be fully engaged in social media playing creative, constructive, helpful roles.

It’s vital for health and pharma companies to understand to their core that social media isn’t just people poking each other on Facebook and talking about their breakfast on Twitter.  The term “social media” is fooling many health care professionals into thinking it’s just another flavor of media, where marketers place their messages; this is a profoundly misguided mindset.  Zoom in on social media and what you see is many millions of ongoing spontaneous personal interactions online: these words don’t trip off the tongue but they sum up the essence of how pharma and health professionals must think about social media:

• Ongoing– happening through time – not just one-off
• Spontaneous– happening in time, not planned far in advance
• Personal– between real people with real personalities
• Interactions– conversations, discussions, even arguments – not messaging

There are clear basic health care tasks to be tackled: getting more people actively engaged in health, helping those who need therapies to find treatment and encouraging those being treated to comply with their treatment.  The more health and pharma companies can understand the essence of social media, the better they will be able to show their value in tackling the health care tasks.