Social internet sites as a source of public health information
So cial Internet Sitesas a Source of PublicHealth I nformation
Karl Vance, William Howe, Robert P. Dellaval e, MD, PhD, MSPH
Viral marketing Web 2.0 YouTube Twitter MySpace Facebook Social media
Patients rely on the Internet more frequently than
creative new ideas virtually free of charge. Creative
their physicians as a source of health care informa-
videos often are then widely disseminated by
tion, and emerging social media Web sites play an
viewers via e-mail and hyperlinks on personal
increasing role in online health searches.Socially
Web sites. Analogously, in the dermatology com-
oriented sites, such as YouTube, Facebook,
munity, the Sulzberger Institute for Dermatologic
MySpace, Twitter, and Second LifeÒ, comprise
part of the user-generated content constituting
the best video promoting sun safe behavior.
Web 2.0 and are popular particularly among Amer-icans aged 18 to 30, two thirds of whom say theyvisit the sites A health-specific social
In contrast to the music and film industries, which
allows patients who have similar illnesses to
rapidly adapted social media marketing, this me-
communicate and share medical experiences.
dium remains underused by public health profes-sionals despite its low cost and wide reach.
MySpace and Facebook pages for musical bandsand new movies abound, encouraging fans to lis-
‘‘Social media marketing’’ encompasses advertis-
ten to new tracks or view theatrical trailers. Politi-
ing and promotional efforts that use social media
cal campaigns also reach out to young adults
Web sites.It is a form of viral marketing, a term
through social networking sites: 8% of people
coined by Harvard professor Jeffrey F. Rayport in
polled under age 30 became an online ‘‘friend’’
1996, to illustrate how a message spreads through
of one of the presidential candidates in the 2008
an online community rapidly and effortlessly.The
Physicians similarly could be ‘‘friended.’’
content of social media marketing campaigns
The young adult demographic using social media
often is user generated; companies, such as
sites are attractive to media for spreading public
General Motors, JetBlue, and Sony, have spon-
health messages targeting this population, such
sored contests for viewers to submit videos
as sun safety awareness, tobacco cessation, and
promoting their products, simultaneously involving
customers in the marketing process and obtaining
Just as young adults can ‘‘friend’’ their favorite
Supported by University of Colorado Denver, School of Medicine, Colorado Health Informatics Collaborationinterdisciplinary academic enrichment funds (RPD) and by National Cancer Institute grant K-07 CA92550 (RPD).
a Department of Dermatology, University of Colorado at Denver and Health Sciences Center, P.O. Box 6510,Mail Stop F703, Aurora, CO 80045, USAb Department of Veterans Affairs Medical Center, 1055 Clermont Street, #165, Denver, CO, USAc Colorado School of Public Health, 13001 E. 17th Place, Campus Box B119, Aurora, CO, 80045, USA* Corresponding author. Colorado School of Public Health, 13001 E. 17th Place, Campus Box B119, Aurora,CO 80045.
E-mail address: (R.P. Dellavalle).
Dermatol Clin 27 (2009) 133–136doi:10.1016/j.det.2008.11.0100733-8635/08/$ – see front matter ª 2009 Elsevier Inc. All rights reserved.
band, movie, or political candidate, they could add
ranging from ‘‘An Accutane Story: The Chapstick
a link on their personal page to a skin health site
Chronicles’’ to ‘‘Accutane is POISON! DO NOT
with updates on acne treatment and other health
USE IT!!!!’’ The majority of videos are mainly posi-
tive accounts by Accutane users sharing their per-sonal experiences with other viewers. An overviewof the top three videos by relevance is provided in
More than 100 million videos are viewed on You-
A similar YouTube search for the term ‘‘Botox’’
Tube daily, and that number continues to rise.
returns 2750 videos; the top three videos sorted
Several recent public health studies have looked
at the content of videos hosted on YouTube that
the top Botox videos actually are advertisements
have tobacco and human papillomavirus vaccina-
posted by Botox providers. These promotional
videos often include footage of Botox injections
tential power YouTube holds for personal health
and personal testimonials by patients receiving
decision making. A cursory search on YouTube
treatments. Frequently, the patients receive dis-
for the term ‘‘Accutane’’ results in 87 hits with titles
counts for their participation, raising ethical
Table 1A summary of the top three videos ranked by relevanceresulting from aYouTube search for ‘Accutane’ or‘‘Botox’ on August 15, 2008
personal story of how themedication helped him,a warning of side effects,and a request for otherpatients to share theirexperiences.
Accutane suggesting thatAccutane will help youget out and participate inlife.
patient, phone number,and Web site address ofthe provider’s office.
Kelly Ripa talks abouta book describingalternatives to Botox andstates that she has nothad any injections.
a Relevance refers to the default ranking for YouTube queries and is determined by a proprietary algorithm.
questions.Paid testimonials may not reflect pa-
be applied, however, to social media Web sites,
tient experience accurately. Social media market-
and thoughtful action should be taken to provide
patients with sound medical advice within online
governmental regulation. It is important for the
dermatology community to be aware of dermatol-ogists advertising on these new media. Such mon-itoring will promote the integrity of the profession.
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