Facebook for health: opportunities and challenges for driving behavior change.
ABSTRACT Obesity, mood, and associated behaviors spread within social networks . Facebook, the primary representation of these networks, shapes our perceptions of social norms and the expectations we set for ourselves. As such, Facebook holds potential to influence health behaviors of individuals and improve public health. This panel explores that potential from a variety of perspectives including psychology, public health, privacy, and design innovation. Panelists include: Margie Morris and Sunny Consolvo, researchers at Intel who have created novel mobile health and Facebook applications; Sean Munson, a social computing researcher at University of Michigan; Kevin Patrick, of UCSD, who is investigating social media for preventing and reducing weight gain in young adults; and Janice Tsai, from Microsoft, who focuses on privacy implications of Facebook. This panel will identify opportunities for health interventions on Facebook to have a broad social impact, challenges to implementing effective interventions on this dynamic platform, appropriate research methods, and considerations related to privacy and ethics.
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ABSTRACT: BACKGROUND: Physical activity is reduced during the post-partum period. Facebook is frequently used by Australian mothers, and offers flexibility, high levels of engagement and the ability to disseminate information and advice via social contacts. The Mums Step it Up Program is a newly developed 50 day team-based physical activity intervention delivered via a Facebook app. The program involves post-partum women working in teams of 4--8 friends aiming to achieve 10,000 steps per day measured by a pedometer. Women are encouraged to use the app to log their daily steps and undertake social and supportive interactions with their friends and other participants. This study aims to determine the effectiveness of the Mums Step it Up Program.Method/design: A sample of 126 women up to 12 months post-partum will be recruited through community-based health and family services. Participants will be randomly allocated into one of three groups: control, pedometer only and the Mums Step it Up Program. Assessments will be completed at baseline, 6 weeks and 6 months. The primary outcome (objective physical activity) and the secondary outcomes (sleep quality and quantity, depressive symptoms, weight and quality of life) will be used to determine the effectiveness of the Mums Step it Up Program compared with the control and pedometer only groups. Analyses will be undertaken on an intention-to-treat-basis using random effects mixed modeling. The effect of theorized mediators (physical activity attitudes, subjective norms and perceived behavioral control) will also be examined. DISCUSSION: This study will provide information about the potential of a Facebook app for the delivery of health behavior interventions. If this intervention proves to be effective it will be released on a mass scale and promoted to the general public.Trial registration: Australia and New Zealand Clinical Trials Register: ACTRN12613000069752.BMC Public Health 05/2013; 13(1):518. · 2.32 Impact Factor
Conference Paper: Participatory design of an online therapy for youth mental health[Show abstract] [Hide abstract]
ABSTRACT: Online therapy has the potential to extend existing face-to-face support for mental health, but designers face challenges such as lack of user engagement. Participatory design could improve outcomes but is difficult to pursue in the mental health context. By working with a research-focused clinic we have been able to employ participatory design methods over a period of three years to develop and test an online therapy for young people with psychosis. This paper discusses our methods and results in the light of existing design frameworks for youth mental health, and reports experiences which will be useful for other researchers in the field. We have found that participatory approaches are indeed challenging in the mental health context, but can result in technology that is efficacious and acceptable to young people.Proceedings of the 25th Australian Computer-Human Interaction Conference: Augmentation, Application, Innovation, Collaboration; 11/2013
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ABSTRACT: This chapter presents the Appeal, Belonging, Commitment (ABC) conceptual framework, which describes how online social networks can be designed to motivate positive health behaviour change. The ABC Framework is based on the existing theoretical models that describe the determinants for motivating the use of online social networks and health behaviour change. Common themes are drawn from these theoretical models and combined to provide the determinants for the three emergent themes: Appeal (individual determinants), Belonging (social determinants) and Commitment (temporal determinants). Results from a questionnaire survey and interviews are presented to validate and iterate the ABC Framework. Based on these themes and their determinants, design suggestions are presented. A case study implementation of the ABC Framework is shown through the design of VivoSpace. The design strategies are interpreted to design the online social health system, VivoSpace, and the ABC Framework is used to evaluate the design. This case study shows that the ABC Framework provides the best methodology to design and evaluate an online social network that will lead to a committed user base and motivate health behaviour change.Advances in Network Analysis and its Applications, Edited by Evangelos Kranakis, 01/2013: pages 232-248; Springer., ISBN: 978-3-642-30904-5
Facebook for Health: Opportunities
and Challenges for Driving Behavior
Obesity, mood, and associated behaviors spread within
social networks . Facebook, the primary
representation of these networks, shapes our
perceptions of social norms and the expectations we set
for ourselves. As such, Facebook holds potential to
spread health behaviors. This panel explores that
potential from a variety of perspectives including
psychology, public health, privacy, and design
innovation. Panelists include: Margie Morris and Sunny
Consolvo, researchers at Intel who have created novel
mobile health and Facebook applications; Sean Munson,
a social computing researcher at University of
Michigan; Kevin Patrick, of UCSD, who is investigating
social media for preventing and reducing weight gain in
young adults; Kendra Markle, who leads a Facebook
project in the Persuasive Computing Lab at Stanford
and Janice Tsai, from Microsoft, who focuses on privacy
implications of Facebook. This panel will identify
opportunities for health interventions on Facebook to
have a broad social impact, challenges to implementing
effective interventions on this dynamic platform,
appropriate research methods, and considerations
related to privacy and ethics.
Copyright is held by the author/owner(s).
CHI2011, May 7–12, 2011, Vancouver, BC, Canada.
Margaret E. Morris
Sean A. Munson
School of Information
University of Michigan
Calit2/School of Medicine
UC San Diego
Health, Goal setting, Facebook, Social networks,
ACM Classification Keywords
Design, Human Factors
There is general consensus that behavioral shifts, such
as increased physical activity, are essential to address
the epidemic of obesity and chronic disease. To
motivate behavioral change, health messaging needs to
be both persuasive and pervasive. It needs to be part
of the rituals and environments – social as well as
technological – that define daily life. For many,
Facebook is a defining environment. Like the mobile
phone, which because of its ubiquity has become a
compelling vehicle for persuasive messaging, so too
may Facebook prove an environment in which we can
effectively nudge individuals and their friends to initiate
and sustain lifestyle changes.
Recent epidemiological research has highlighted the
viral nature of health such as the spread of obesity and
related behaviors in social networks . We’ve learned
that “our friends are making us fat”  and that this
viral effect extends to our friends’ friends. A large body
of research has demonstrated that the right social
network can also help support positive health changes
, , . Without changing an individual’s network
or social environment, the benefits of individually
focused efforts may be short lived. To increase the
impact of health interventions, public health
researchers are now starting to target the network
rather than the individual. Network approaches have
been examined to encourage flu vaccinations and
exercise , . Among other findings, this research is
helping to identify the most influential members of
networks to target for interventions related to obesity.
It has been found, for example, that individuals on the
edges of overweight and normal weight clusters may be
the most effective in influencing sustained weight loss
across the network .
Facebook is an obvious tool to explore social network
approaches to behavioral change. Facebook offers a
communication channel and a broad lens onto our
social networks. As such, it is a dominant way in which
we form perceptions about the behavior of peers. These
perceptions of social norms have been shown to
powerfully shape behavior . Furthermore, Facebook
is itself an environment that exerts influence. The
representation on our screens of its vast membership –
500 million users, 50% of whom log in on any given
day, with an average of 130 friends per user  –
creates a sense of possibility for connectedness and for
change. The power of social media, now actively used
to market products, provides equally compelling
opportunities to promote health and wellness.
In this panel, we explore the potential of Facebook for
personal health improvement. Panelists will share
diverse perspectives on technology innovation and its
social consequences. Panelists will draw upon research
about how people are currently using Facebook and
other technology to share personal information and
obtain inspiration and role modeling from others. Along
with the potential of Facebook as a platform for health
improvement, obstacles and perils will be discussed.
The panel will address risks associated with these
interventions, such as the inadvertent broadcasting of
personal health data not only to the network but also to
Facebook and associated companies.
Broadcasting personal health: We will discuss
ethnographic research on how people broadcast health
status and health goals on Facebook and the apparent
social consequences of such sharing . We will
describe the challenges and strategies of people who
combine Facebook with specialized online communities
to improve their health.
Applications as research probes: We will describe
Facebook applications created by panelists and others
that were created to examine goal setting and social
influence. These include applications created by
students working with Kendra Markle at Stanford, a
goal setting application in development by Sean
Munson and Sunny Consolvo, a positive psychology
exercise developed into a Facebook app by Sean
Munson and others at the University of Michigan ,
the Using Social Media and Mobile Technologies to
Promote Improved Health Behaviors (SMART) project
led by Kevin Patrick, and the “With a Little Help from
my Friends” Facebook application that Margie Morris
and colleagues developed to examine loss of social
capital as a behavior change technique (See Figure 1).
Privacy: We will examine the tensions associated with
using social network applications for personal health
and health research. Facebook and other applications
hold potential to effect broad and sustained behavior
change but significant risk of exposing health data.
Personal health information may be inadvertently
exposed not only to members of one’s social network
but, through Facebook, to countless other individuals
Integration: How much should Facebook be integrated
with the rest of our devices? Should my Sonicare or
seatbelt link to my goal setting tools on Facebook? Will
my insurer know? We will explore the tradeoffs and
implications of such intelligence. Seamless integration
may decrease burden and the biases of self-report, but
miss opportunities to invite self-reflection and agency.
figure 1.“With a Little Help from my Friends” representing loss
of social capital to motivate adherence to health goals. Friends
fade in response to lapses but can be redeemed by getting
back on track. http://apps.facebook.com/helpfrommyfriends/
This panel will explore potential for Facebook to
influence health and associated challenges. Researchers
will draw upon expertise in psychology, social
computing, public health, privacy and design. Panelists
will discuss current sharing of health information on
Facebook and other applications, changes within social
network services that would help people optimize
health improvement and interpersonal effectiveness,
research methods and the use of Facebook applications
as research probes. In addition, the panel will explore
controversial issues related to privacy and integration
of Facebook with personal devices. Audience members
will be encouraged to share insights, experiences and
questions. Even at this nascent stage, the use of
Facebook for health promotion merits discussion within
the CHI community.
 Christakis, NA and Fowler, JH. (2009). Connected.
Little, Brown and Company.
 Cohen R, Havlin S, ben-Avraham D. (2003)
Efficient immunization strategies forcomputer networks
and populations. Phys Rev Lett 91: 1–4.
 Consolvo, S; Everitt, K; Smith, I; Landay, J.
(2006.) “Design requirements for technologies that
encourage physical activity,” CHI 2006.
 Bahr DB, Browning RC, Wyatt HR, Hill JO (2009)
Exploiting social networks tomitigate the obesity
epidemic. Obesity 17: 723–728.Facebook Press Page.
 Munson, S., Lauterbach, D., Newman, M., &
Resnick, P. Happier Together: Integrating a Wellness
Application Into a Social Network Site. In Proc. of
Persuasive 2010, Springer, (2010), 27-39.
 Newman M, Lauterbach D, Munson, S., Resnick, P.,
Morris, M. ”It's not that I don't have problems, I'm just
not putting them on Facebook: Challenges and
Opportunities in Using Online Social Networks for
Health,” CSCW 2011.
 Olsen, E; Kraft, P. (2009). “ePsychology: A pilot
study on how to enhance social support and adherence
in digital interventions by characteristics from social
networking sites,” Persuasive 2009.
 Persuasive Technology Lab, Stanford University.
 Cialdini, R. (2008). Influence: Science and Practice,
5th edition. Prentice Hall.
 Thompson, C. Are Your Friends Making You Fat?
New York Times, (Sep 10, 2009).
 Wellman, B and Wortley S. 1990. “Different strokes
from different folks: Community ties and social
support,” American Journal of Sociology: 558-588.