Social Media and…Theory?
by Tom Hipper
In November of last year, I attended the mHealth Summit in Washington, D.C. Two things really struck me while I was there:
1. The future is bright with respect to technology and innovation in the world of health. From an Augmented Reality Tool, a headset worn by an EMT/medic designed to assist in providing advanced medical care in the field, to a Chemical Sensor Attachment that turns your cell phone into a portable hydrocarbon detector, the summit was filled with exciting new gadgets designed to improve our health and safety.
2. No matter how innovative the technology, we must not lose sight of a key ingredient to health: behavior change. While the interaction afforded by these devices can play a key role in interventions, merely placing a slick new device in people’s hands will not, in and of itself, change their behavior.
Ok, so what? And what does this have to do with social media?
Just like the gadgets on display at the mHealth Summit, social media is a shiny, new tool for us to use in the always challenging, often rewarding, never-ending quest to improve the health of our nation. But as we embrace social media and begin thinking about the many creative ways we can utilize it, we must not forget the science behind behavior change. More specifically, when we use social media to communicate, we must not forget about the importance of communication theory.
Stop cringing and hear me out on this one.
Theory gets a bad rap in the applied world. It’s often seen as academic fluff. Broad, macro-level concepts thought up in the ivory tower, tested on college sophomores, and not applicable to the “real world.” Or, as a colleague of mine once said, “a bunch of hooey.” And while my days in graduate school confirmed that some theories out there fit these descriptions, many do not. In fact, some have been instrumental in changing behavior!
A good theory does a few very important things. Number one, it provides a framework for your message or intervention. It tells you what characteristics you need to know about your target audience, and what variables are likely to impact their behavior. Perhaps most importantly, it also allows you to evaluate the effectiveness of your intervention and, subsequently, either replicate your success or improve upon your failures. And the good news? Theory can provide these benefits when we use social media. So as to rebuff the perception that theory is too, well, overly theoretical, let’s go ahead and apply one right now, shall we?
The Extended Parallel Process Model (EPPM) (Witte, 1992; 1994) stems from the fear appeal literature and is based around two key variables: Threat and Efficacy. Threat is comprised of Susceptibility (do you think “threat x” will happen to you) and Severity (do you think “threat x” is serious enough to warrant your attention). Efficacy is comprised of Self Efficacy (do you believe you can perform the provided solution to “threat x”) and Response Efficacy (do you believe the provided solution will work in minimizing “threat x”).
The theory posits that in order to produce the desired reaction in your audience, your message must: 1) Produce sufficiently high levels of both Threat and Efficacy and 2) Your messages should produce higher levels of Efficacy. If a message does not communicate sufficient levels of susceptibility or severity, your audience will likely disregard your message as not relevant to them. If your message produces a level of threat, but a low level of efficacy, your audience will engage in “fear control” (denial or avoidance). When your message contains both high threat and high efficacy, your audience is more likely to engage in “danger control” (constructive behavior to reduce the threat). Fortunately, the results have shown that following these recommendations in message design can indeed cause the desired health behavior change (Witte & Allen, 2000).
Let’s say you are designing messages about the importance of having a carbon monoxide detector in the home. With a little formative research, and the help of EPPM, you can determine where your audience currently stands with respect to Threat and Efficacy and design your social media messaging strategy accordingly. Do they not see CO poisoning as a likely threat? Emphasize Susceptibility in your messages. Do they think obtaining an alarm is too costly? Your messages should emphasize Efficacy by providing details on the many low-cost ways to obtain an alarm. After running these messages, you can evaluate their effectiveness by determining the extent to which Threat and Efficacy levels in your target audience have changed and, most importantly, the extent to which your messages actually changed behavior. And because you used a theory you are not only more likely to change behavior, but more likely to know exactly what caused that change.
The field of communication has taught us that merely providing information to your audience is rarely enough. Knowing your audience is key, and knowing what it takes to move them toward the desired behavior is even more important. Theory helps you do that. There may be many of you out there who see the constructs discussed above and think, “I already think about these things when creating messages, I just don’t use a theory.” I would implore those of you who fit this description to consider thinking about your messages in accordance with a behavior change theory such as EPPM. By explicitly thinking about Threat and Efficacy as they are described in EPPM, we as health communicators replace our gut feelings with a science that provides a blueprint for understanding our audience, designing messages for them, and determining precisely which factors caused any subsequent change.
So as we continue to utilize social media because of its unique ability to allow us to interact and converse with our audience, let us also consider how theory can help ensure that our conversations actually change their behavior.
Questions, comments, and experiences with theory (good and bad) are welcomed!
Witte, K. (1992). Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs, 59(4), 329-349.
Witte, K. (1994). Fear control and danger control: A test of the extended parallel process model (EPPM). Communication Monographs, 61(2), 113-134.
Witte, K., & Allen, M. (2000). A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Education & Behavior, 27(5), 591.
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