BackgroundElectronic word-of-mouth on social network sites has been used successfully in marketing. In social marketing, electronic word-of-mouth about products as health behaviors has the potential to be more effective and reach more young adults than health education through traditional mass media. However, little is known about what motivates people to actively initiate electronic word-of-mouth about health behaviors on their personal pages or profiles on social network sites, thus potentially reaching all their contacts on those sites.ObjectiveThis study filled the gap by applying a marketing theoretical model to explore the factors associated with electronic word-of-mouth on social network sites about leisure-time physical activity.MethodsA Web survey link was sent to undergraduate students at one of the Midwestern universities and 439 of them completed the survey.ResultsThe average age of the 439 participants was 19 years (SD=1 year, range: 18-24). Results suggested that emotional engagement with leisure-time physical activity (ie, affective involvement in leisure-time physical activity) predicted providing relevant opinions or information on social network sites. Social network site users who perceived stronger ties with all their contacts were more likely to provide and seek leisure-time physical activity opinions and information. People who provided leisure-time physical activity opinions and information were more likely to seek opinions and information, and people who forwarded information about leisure-time physical activity were more likely to chat about it.ConclusionsThis study shed light on the application of the electronic word-of-mouth theoretical framework in promoting health behaviors. The findings can also guide the development of future social marketing interventions using social network sites to promote leisure-time physical activity.

Salt intake is associated with cardiovascular diseases that are the leading cause of death especially among African American communities in the Midwest. Interventions need to be developed to address the culture of this population to decrease the health disparities of cardiovascular disease. This study applying the Health Belief Model aims to explore the factors that are associated with the behavior of reducing salt intake among this population. Methods: Three hundred ninety-nine African American adults participated in the telephone surveys. Logistic regression analysis was performed. Results: We found that affective risk perception in the form of concern of salt intake as well as self-efficacy were associated with the behavior of reducing salt intake among this population. However, seeing advertisement on mass media about the effect of eating too much salt and talking to anyone about heart problems or high blood pressure issues could not influence their behavior of reducing salt intake. Conclusion: This study shed light on how public health practitioners can potentially persuade African American population in Midwest to reduce salt intake through designing culturally appropriate interventions educating them about the risk of eating too much salt and increase their confidence in reducing salt in community settings.

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BACKGROUND Because social media use among teenagers and young adults has proliferated in recent years, it is critical to explore how to use this tool to communicate health information to this population. Social media posts can contain various types of information within each post, and that information can be communicated using different modalities. Researchers and practitioners understand how young people react to these various modalities when presented with health information on social media. Young adults demonstrate the highest rate of unrestrained motor vehicle fatalities, making the promotion of seat belt restraint a priority for public health practitioners. OBJECTIVE Based on the elaboration likelihood model, we examined how young population reacted to various components of posts in the pilot of a promotion intervention Instagram campaign BuckleUp4Life. METHODS Using thematic analysis, we examined different appeals in three components (photo, text, and caption) of 198 posts in BuckleUp4Life and compared the number of likes for different appeals. RESULTS We found six appeals were used in the posts: rational, ego, social, fun, positive emotional and fear appeals. The results demonstrated that in photos, fun appeals were most popular. Rational and positive emotional appeals were the most appealing in text and captions. CONCLUSIONS Based on these findings, we recommend that public health practitioners utilize fun photos with rational and positive emotional appeals in text and captions, rather than fear or social appeals, when promoting seat belt use through social media, especially Instagram.

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