Behavioural interventions delivered through interactive social media for health behaviour change, health outcomes, and health equity in the adult population (Review)

Petkovic J, Duench S, Trawin J, Dewidar O, Pardo Pardo J, Simeon R, DesMeules M, Gagnon D, Hatcher Roberts J, Hossain A, Pottie K, Rader T, Tugwell P, Yoganathan M, Presseau J, Welch V (2021)

Cochrane - DOI: 10.1002/14651858.CD012932.pub2.

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Evidence Categories

• Care setting: Virtual and digital
• Population group: General Population
• Population group: General population
• Intervention: Intra-/Inter-personal: Multicomponent programme remote
• Outcome: Healthy Eating: Energy intake
• Outcome: Healthy Eating: Fruit and veg intake
• Outcome: Healthy Eating: Calcium intake
• Outcome: Healthy Eating: Whole diet quality

Type of Evidence

Systematic Review

Aims

The authors state:

• "We aimed to assess the effectiveness of interactive social media interventions, in which adults are able to communicate directly with each other, on changing health behaviours, body functions, psychological health, well-being, and adverse effects."
• "Our secondary objective was to assess the effects of these interventions on the health of populations who experience health inequity as defined by PROGRESS-Plus. We assessed whether there is evidence about PROGRESS-Plus populations being included in studies and whether results are analysed across any of these characteristics."

Findings

The authors state:

• "We included 88 studies (871,378 participants),"
• "The majority of the studies were conducted in the USA (54%). In total, 86% were conducted in high-income countries."
• "The most commonly used social media platform was Facebook (39%) with few studies utilising other platforms such as WeChat, Twitter, WhatsApp, and Google Hangouts. Many studies (48%) used web-based communities or apps that mimic functions of these well known social media platforms."
• "We compared studies assessing interactive social media interventions with non-interactive social media interventions, which included paper-based or in-person interventions or no intervention."
• "There was little to no effect for other health behaviours, such as improved diet." 
• "Eight studies (n = 1240) assessed mean changes to self-reported diet quality using various scales, such as the Australian Eating Survey or daily consumption of fruits and vegetables. The combined data from these studies indicates that there may be little to no difference in effect for those receiving an interactive social 
  media intervention (SMD 0.11, 95% CI -0.25 to 0.47, substantial heterogeneity (I2 = 86%), low-certainty evidence, small effect) (Analysis 1.2). Re-expressed using weekly consumption of fruits and vegetables, this represents an increase of 0.35 servings (from 1.25 fewer servings to 1.96 more servings per week)."
• "Three studies n = 131) assessed mean changes in caloric intake and found that there is probably little to no difference in effect for those who received the interactive social media intervention (MD -53.75, 95% CI -152.48 to 44.97), no important heterogeneity (I2=0%), moderate-certainty evidence)."
• "One study (n = 209) found that interactive social media may improve calcium intake (RR 1.97, 95% CI 1.31 to 2.98)."
• "Adverse events related to the social media component of the interventions, such as privacy issues, were not reported in any of our included studies."
• "We were unable to conduct planned subgroup analyses related to health equity as only four studies reported relevant data."

Conclusions

The authors state:

"This review combined data for a variety of outcomes and found that social media interventions that aim to increase physical activity may be effective and social media interventions may improve well-being. While we assessed many other outcomes, there were too few studies to compare or, where there were studies, the evidence was uncertain."