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Please like me: Facebook and Public Health Engagement

Every public health organisation worth its grant money has a Facebook page but up until now there has been little evidence for their effectiveness.  James Kite and Becky Freeman from the School of Public Health, University of Sydney report on a study they undertook of high profile public health organisations’ Facebook pages and an analysis of the factors that influence consumer engagement.  They found that getting the content right is critical if social media is to play any role in achieving high user engagement but that there is no simple recipe to achieve this outcome.  With some useful tips and insightful analysis, this is an essential read for anyone who is working in a public health organisation or is responsible for promoting a public health message to consumers. [divide]

James Kite and Becky Freeman write:    

Facebook is the most widely used social media platform, with more than two-thirds of Australian adults maintaining an active profile. It is also the most intensely used platform, with two-fifths of users logging on 20 times or more per week.

This creates enormous marketing potential: well-designed content can reach as many, if not more, people than traditional broadcast media like television, often for comparatively little investment. The belief is that engaging content, that users react to, share, or comment on, generates viral word-of-mouth marketing between consumers.

Because consumers trust word-of-mouth marketing far more than direct commercial advertising, the likes of Coca Cola, McDonalds, Red Bull, and Bundaberg Rum have invested considerable resources into promoting their products on Facebook.

Widespread use

Public health organisations have also been quick to realise this potential and are widely using Facebook to share health messages. Our recent study identified no less than 63 public health-related pages from Australian-based organisations alone.

Current evidence suggests that users are generally receptive to receiving public health messages through social media but there is very little evidence available to guide public health organisations in developing engaging content.

Our study sought to fill this gap by reviewing the 20 most liked Facebook pages administered by Australian-based public health organisations and identifying the features associated with user engagement.

Study parameters

We looked at a year’s worth of content from pages such as beyondblue, Movember, RU OK Day, Cancer Council NSW, Sunsmart, and Heart Foundation and analysed both the type of post (photo, video, text etc.) and the communication style (emotional appeals, informative, call-to-action etc.) and marketing techniques (branding, competitions, sponsorships, celebrities etc.) employed.

Our results showed that while videos made up just 3% of the 5,356 posts we examined, they attracted the greatest amount of user engagement, being shared nearly 4 times more often than photo or image posts.

However, in an analysis that controlled for how many users were exposed to the post, video posts no longer stood out. This suggests that the Facebook algorithm is driving the association between video posts and engagement, rather than users being inherently more interested in videos per se.

Facebook reveals very little about the algorithm that determines what will be shown in users’ newsfeeds but our results suggest that videos are given a considerable boost, reaching far more users than any other post type.

Emotional appeals

As is the case in traditional broadcast media and commercial marketing on Facebook, we expected that emotional appeals would stand out as being more engaging. However, the results for emotive content were mixed: for instance, positive emotional appeals, content that tried to appeal to emotions like happiness, hope, and excitement, generated more likes but fewer shares than posts that encouraged users to undertake a specific action like registering for a program.

Informative posts on the other hand, were shared more than twice as often. We believe that there are 2 possible reasons for this: 1) either Facebook users are engaging with public health pages for different reasons than they are commercial pages; or, and we think the more likely reason, 2) public health content is either failing to generate a sufficient emotional response or is targeting the ‘wrong’ emotions.

Traditional marketing

As for traditional marketing elements, we found that these posts generally generated lower levels of engagement. In particular, emphasising or promoting sponsorships and partnerships and the use of persons of authority (e.g. doctors, politicians, CEOs etc.) consistently resulted in fewer likes, shares, and comments than posts without these elements.

Celebrities and sportspeople did at first appear to result in higher levels of engagement but when we took into account post reach, this association either disappeared or reversed.

Some research from commercial marketing has suggested that celebrities can be very beneficial for brands but there is also concern that they might overshadow the brand. How this translates to public health social media communication is unclear at this stage.

So what does all this mean for how public health organisations should use Facebook? First, use of videos should increase to take advantage of the Facebook algorithm’s current strong preference for video content.

Content matters

This doesn’t mean that the content of videos doesn’t also matter. Rather, to maximise the impact of posts with a higher reach, they must also include useful and sharable content. It’s also important to remember that most videos on Facebook are viewed without sound, meaning that the visuals and subtitles are equally critical.

Second, content creators need to experiment with what role emotion plays in generating engagement and, by extension, to what emotional response they should be appealing. Third, creators also need to think carefully about the more traditional marketing elements they use in content and monitor what effect they have on engagement.

The question of outcomes

In theory, generating more likes, shares, and comments should lead to greater public health outcomes, but this remains to be proven.

There is, however, evidence from the commercial world that shows that engagement with Facebook pages leads to increased sales and profitability. While this is of seemingly limited relevance to public health communication, it does suggest that simply being on Facebook is not enough.

Our study highlights the need for public health organisations to invest resources into better understanding and capitalising on the Facebook algorithm and researching the style of content that generates the most engagement in order to increase the chances of achieving positive public health outcomes.

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CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH