Download PDF
CC BY-NC-ND 4.0 · Yearb Med Inform 2022; 31(01): 082-087
DOI: 10.1055/s-0042-1742503
Special Section: Inclusive Digital Health
Working Group Contributions

Social Media, Digital Health Literacy, and Digital Ethics in the Light of Health Equity

IMIA Participatory Health and Social Media Working Group
Octavio Rivera-Romero
1   Instituto de Ingeniería Informática (I3US), Universidad de Sevilla, Sevilla, Spain
2   Electronic Technology Department, Universidad de Sevilla, Sevilla, Spain
,
Elia Gabarron
3   Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
4   Department of Education, ICT and Learning, Østfold University College, Halden, Norway
,
Talya Miron-Shatz
5   Ono Academic College, Israel
6   Winton Centre for Risk and Evidence Communication, Cambridge University, England
,
Carolyn Petersen
7   Mayo Clinic, United States
,
Kerstin Denecke
8   Institute for Medical Informatics, Bern University of Applied Sciences, Bern, Switzerland
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Summary

Objective: Social media is used in the context of healthcare, for example in interventions for promoting health. Since social media are easily accessible they have potential to promote health equity. This paper studies relevant factors impacting on health equity considered in social media interventions.

Methods: We searched for literature to identify potential relevant factors impacting on health equity considered in social media interventions. We included studies that reported examples of health interventions using social media, focused on health equity, and analyzed health equity factors of social media. We identified Information about health equity factors and targeted groups.

Results: We found 17 relevant articles. Factors impacting on health equity reported in the included papers were extracted and grouped into three categories: digital health literacy, digital ethics, and acceptability.

Conclusions: Literature shows that it is likely that digital technologies will increase health inequities associated with increased age, lower level of educational attainment, and lower socio-economic status. To address this challenge development of social media interventions should consider participatory design principles, visualization, and theories of social sciences.

Keywords

Social media - health equity - digital health literacy - ethics - accessibility

Supplementary Material



Publication History

Article published online:
02 June 2022

© 2022. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Smailhodzic E, Hooijsma W, Boonstra A, Langley DJ. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Serv Res 2016 Aug 26;16(1):442.
    PubMed
  • 2 Hussain W. Role of social media in COVID-19 pandemic. The International Journal of Frontier Sciences 2020;4(2):59-60.
    PubMed
  • 3 Gabarron E, Oyeyemi SO, Wynn R. COVID-19-related misinformation on social media: a systematic review. Bull World Health Organ 2021 Jun 1;99(6):455-463A.
    PubMed
  • 4 Petkovic J, Duench S, Trawin J, Dewidar O, Pardo Pardo J, Simeon R, et al. Behavioural interventions delivered through interactive social media for health behaviour change, health outcomes, and health equity in the adult population. Cochrane Database Syst Rev 2021 May 31;5(5):CD012932.
    PubMed
  • 5 Dunn AG, Mandl KD, Coiera E. Social media interventions for precision public health: promises and risks. NPJ Digit Med 2018;1:47.
    PubMed
  • 6 Welch V, Petkovic J, Pardo Pardo J, Rader T, Tugwell P. Interactive social media interventions to promote health equity: an overview of reviews. Health Promot Chronic Dis Prev Can 2016 Apr;36(4):63-75.
    PubMed
  • 7 World Health Organization. Social determinants of health. 2021. Available from: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_3
    PubMed
  • 8 Shadmi E, Chen Y, Dourado I, Faran-Perach I, Furler J, Hangoma P, et al. Health equity and COVID-19: global perspectives. Int J Equity Health 2020 Jun 26;19(1):104.
    PubMed
  • 9 Crawford A, Serhal E Digital Health Equity and COVID-19: The Innovation Curve Cannot Reinforce the Social Gradient of Health. J Med Internet Res 2020 Jun 2;22(6):e19361.
    PubMed
  • 10 Friis-Healy EA, Nagy GA, Kollins SH. It Is Time to REACT: Opportunities for Digital Mental Health Apps to Reduce Mental Health Disparities in Racially and Ethnically Minoritized Groups. JMIR Ment Health 2021 Jan 26;8(1):e25456.
    PubMed
  • 11 Nadison M, Flamm LJ, Roberts A, Staton T, Wiener L, Locke J, et al. Kaiser Permanente's Good Health & Great Hair Program: Partnering With Barbershops and Beauty Salons to Advance Health Equity in West Baltimore, Maryland. J Public Health Manag Pract 2022 Mar-Apr 01;28(2):E369-E379.
    PubMed
  • 12 King AC, Odunitan-Wayas FA, Chaudhury M, Rubio MA, Baiocchi M, Kolbe-Alexander T, et al. On Behalf Of The Our Voice Global Citizen Science Research Network. Community-Based Approaches to Reducing Health Inequities and Fostering Environmental Justice through Global Youth-Engaged Citizen Science. Int J Environ Res Public Health 2021 Jan 21;18(3):892.
    PubMed
  • 13 Kazevman G, Mercado M, Hulme J, Somers A. Prescribing Phones to Address Health Equity Needs in the COVID-19 Era: The PHONE-CONNECT Program. J Med Internet Res 2021 Apr 6;23(4):e23914.
    PubMed
  • 14 Gómez-Ramírez O, Iyamu I, Ablona A, Watt S, Xu AXT, Chang HJ, et al. On the imperative of thinking through the ethical, health equity, and social justice possibilities and limits of digital technologies in public health. Can J Public Health 2021 Jun;112(3):412-6.
    PubMed
  • 15 Yang WE, Spaulding EM, Lumelsky D, Hung G, Huynh PP, Knowles K, et al. Strategies for the Successful Implementation of a Novel iPhone Loaner System (iShare) in mHealth Interventions: Prospective Study. JMIR Mhealth Uhealth 2019 Dec 16;7(12):e16391.
    PubMed
  • 16 Zellner Lawrence T, Douglas MD, Rollins L, Josiah Willock R, Cooper DL, Gooden RA, Francis S, et al. Health Policy Engagement Strategy for the Health Information Technology Policy Project of the Transdisciplinary Collaborative Center for Health Disparities Research. Ethn Dis 2019 Jun 13;29(Suppl 2):377-84.
    PubMed
  • 17 Leath BA, Dunn LW, Alsobrook A, Darden ML. Enhancing Rural Population Health Care Access and Outcomes Through the Telehealth EcoSystem™ Model. Online J Public Health Inform 2018 Sep 21;10(2):e218.
    PubMed
  • 18 McBride B, O'Neil JD, Hue TT, Eni R, Nguyen CV, Nguyen LT. Improving health equity for ethnic minority women in Thai Nguyen, Vietnam: qualitative results from an mHealth intervention targeting maternal and infant health service access. J Public Health (Oxf) 2018 Dec 1;40(suppl_2):ii32-ii41.
    PubMed
  • 19 Graham GN, Ostrowski M, Sabina AB. Population health-based approaches to utilizing digital technology: a strategy for equity. J Public Health Policy 2016 Nov;37(Suppl 2):154-66.
    PubMed
  • 20 Ramirez AG, Aguilar RP, Merck A, Despres C, Sukumaran P, Cantu-Pawlik S, Chalela P. Use of #SaludTues Tweetchats for the Dissemination of Culturally Relevant Information on Latino Health Equity: Exploratory Case Study. JMIR Public Health Surveill 2021 Mar 1;7(3):e21266.
    PubMed
  • 21 Despres C, Aguilar R, McAlister A, Ramirez AG. Communication for Awareness and Action on Inequitable Impacts of COVID-19 on Latinos. Health Promot Pract 2020 Nov;21(6):859-61.
    PubMed
  • 22 Brewer LC, Fortuna KL, Jones C, Walker R, Hayes SN, Patten CA, Cooper LA. Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health. JMIR Mhealth Uhealth 2020 Jan 14;8(1):e14512.
    PubMed
  • 23 Dehlin JM, Stillwagon R, Pickett J, Keene L, Schneider JA. #PrEP4Love: An Evaluation of a Sex-Positive HIV Prevention Campaign. JMIR Public Health Surveill 2019 Jun 17;5(2):e12822.
    PubMed
  • 24 Laing SS, Alsayid M, Ocampo C, Baugh S. Mobile Health Technology Knowledge and Practices Among Patients of Safety-Net Health Systems in Washington State and Washington, DC. J Patient Cent Res Rev 2018 Jul 30;5(3):204-17.
    PubMed
  • 25 Trezona A, Rowlands G, Nutbeam D. Progress in Implementing National Policies and Strategies for Health Literacy-What Have We Learned so Far? Int J Environ Res Public Health 2018 Jul 23;15(7):1554.
    PubMed
  • 26 Miron-Shatz T, Mühlhauser I, Bower B, Diefenbach M, Godacre B, Smith RSW, et al. Barriers to Health Information and Building Solutions. In: Gigerenzer G, Gray JAM, editors. Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020. The MIT Press; 2011 [cited 2021 Oct 6] Available from: https://direct.mit.edu/books/book/3370/better-doctors-better-patients-better
    PubMed
  • 27 Hilfiker SW, Santana S, Freedman M, Harris LM. There's a Gap Between Digital Health Information and Users - Let's Close It. Stud Health Technol Inform 2020 Jun 25;269:324-31.
    PubMed
  • 28 Sentell T, Vamos S, Okan O. Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19. Int J Environ Res Public Health 2020 Apr 26;17(9):3010.
    PubMed
  • 29 World Health Organization. WHO Health Promotion Glossary. In: World health organization; 1998. Available from: http://apps.who.int/iris/bitstream/handle/10665/64546/WHO_HPR_HEP_98.1.pdf;jsessionid=0186BA611D0C8F21D9CBB3574D663F6A?sequence=1
    PubMed
  • 30 Huilgol YS, Miron-Shatz T, Joshi AU, Hollander JE. Hospital Telehealth Adoption Increased in 2014 and 2015 and Was Influenced by Population, Hospital, and Policy Characteristics. Telemed J E Health 2020 Apr;26(4):455-61.
    PubMed
  • 31 Latulippe K, Hamel C, Giroux D. Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies. J Med Internet Res 2017 Apr 27;19(4):e136.
    PubMed
  • 32 Mackert M, Mabry-Flynn A, Champlin S, Donovan EE, Pounder, K. Health Literacy and Health Information Technology Adoption: The Potential for a New Digital Divide. J Med Internet Res 2016 Oct 4;18(10):e264.
    PubMed
  • 33 Azzopardi-Muscat N, Sørensen K. Towards an equitable digital public health era: promoting equity through a health literacy perspective. Eur J Public Health 2019 Oct 1;29(Supplement_3):13-7.
    PubMed
  • 34 Mertens A, Brandl C, Miron-Shatz T, Schlick C, Neumann T, Kribben A, et al. A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation: A crossover design study comparing documentation via iPad with paper-based control. Medicine (Baltimore) 2016 Sep;95(36):e4446.
    PubMed
  • 35 Olsen E. Alexa launches service to help caregivers remotely monitor and assist seniors. mobihealthnews; 2021. Available from: https://www.mobihealthnews.com/news/alexa-launches-service-help-caregivers-remotely-monitor-and-assist-seniors#:~:text=The%20subscription%2C%20which%20Amazon%20will,on%20an%20aging%20loved%20one
    PubMed
  • 36 Devine T, Broderick J, Harris LM, Wu H, Hilfiker SW. Making Quality Health Websites a National Public Health Priority: Toward Quality Standards. J Med Internet Res 2016 Aug 2;18(8):e211.
    PubMed
  • 37 Miron-Shatz T. Your Life Depends On It: What You Can Do to Make Better Choices about Your Health. New York: Basic Books; 2021.
    PubMed
  • 38 Rodriguez JA, Clark CR, Bates DW. Digital Health Equity as a Necessity in the 21st Century Cures Act Era. JAMA 2020 Jun 16;323(23):2381-2.
    PubMed
  • 39 Lai L, Wittbold KA, Dadabhoy FZ, Sato R, Landman AB, Schwamm LH, et al. Digital triage: Novel strategies for population health management in response to the COVID-19 pandemic. Healthc (Amst) 2020 Dec;8(4):100493.
    PubMed
  • 40 Nef T, Ganea RL, Müri RM, Mosimann UP. Social networking sites and older users - a systematic review. Int Psychogeriatr 2013 Jul;25(7):1041-53.
    PubMed
  • 41 Fried TR. Shared Decision Making--Finding the Sweet Spot. N Engl J Med 2016 Jan 14;374(2):104-6.
    PubMed
  • 42 Aldrich F. Graphicacy: the fourth'r'?. Primary Science Review 2000;64(1):8-11.
    PubMed
  • 43 Friel SN, Curcio FR, Bright GW. Making Sense of Graphs: Critical Factors Influencing Comprehension and Instructional Implications. J Res Math Educ 2001 Mar;32(2):124.
    PubMed
  • 44 Lipkus IM. Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations. Med Decis Making 2007 Sep-Oct;27(5):696-713.
    PubMed
  • 45 Oudhoff JP, Timmermans DR. The effect of different graphical and numerical likelihood formats on perception of likelihood and choice. Med Decis Making 2015 May;35(4):487-500.
    PubMed
  • 46 Timmermans DR, Ockhuysen-Vermey CF, Henneman L. Presenting health risk information in different formats: the effect on participants' cognitive and emotional evaluation and decisions. Patient Educ Couns 2008 Dec;73(3):443-7.
    PubMed
  • 47 Ancker JS, Senathirajah Y, Kukafka R, Starren JB. Design features of graphs in health risk communication: a systematic review. J Am Med Inform Assoc 2006 Nov-Dec;13(6):608-18.
    PubMed
  • 48 Henneman L, Oosterwijk JC, van Asperen CJ, Menko FH, Ockhuysen-Vermey CF, Kostense PJ, et al. The effectiveness of a graphical presentation in addition to a frequency format in the context of familial breast cancer risk communication: a multicenter controlled trial. BMC Med Inform Decis Mak 2013 Apr 29;13:55.
    PubMed
  • 49 Damman OC, De Jong A, Hibbard JH, Timmermans DR. Making comparative performance information more comprehensible: an experimental evaluation of the impact of formats on consumer understanding. BMJ Qual Saf 2016 Nov;25(11):860-9.
    PubMed
  • 50 Murphy M, Cavill N. Do physical activity infographics, report cards and policies influence behaviour? Sport Exerc Sci 2015;46.
    PubMed
  • 51 Scott H, Fawkner S, Oliver C, Murray A. Why healthcare professionals should know a little about infographics. Br J Sports Med 2016 Sep;50(18):1104-5.
    PubMed
  • 52 Hawley ST, Zikmund-Fisher B, Ubel P, Jancovic A, Lucas T, Fagerlin A. The impact of the format of graphical presentation on health-related knowledge and treatment choices. Patient Educ Couns 2008 Dec;73(3):448-55.
    PubMed
  • 53 Braveman P, Gruskin S. Defining equity in health. J Epidemiol Community Health 2003;57(4):254-8.
    PubMed
  • 54 World Health Organization. 2020-2025 global strategy. Available from: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf
    PubMed
  • 55 Sørensen K, Karuranga S, Denysiuk E, McLernon L. Health literacy and social change: exploring networks and interests groups shaping the rising global health literacy movement. Glob Health Promot 2018 Dec;25(4):89-92.
    PubMed
  • 56 Marhefka SL, Lockhart E, Turner D, Wang W, Dolcini MM, Baldwin JA, et al. Social Determinants of Potential eHealth Engagement Among People Living with HIV Receiving Ryan White Case Management: Health Equity Implications from Project TECH. AIDS Behav 2020 May;24(5):1463-75.
    PubMed