Engaging with patients with diabetes: the role of social media in low-income healthcare organisations

Participation

Participation from health organisations can be gauged through the frequency of their posts and the size of their follower base. As shown in table 1, most healthcare organisations in Honduras have adopted broader content strategies, with a relatively small percentage of their posts dedicated to diabetes. Despite this, the significant number of followers attracted by these pages indicated a strong user interest in these contents.

The INADI stood out for its focused efforts on diabetes-related posts, reflecting a strong commitment to raising awareness of diabetes. In contrast, larger organisations, such as the Ministry of Health Honduras and IHSS, had broader content strategies, with only 3.02% and 3.06% of their posts related to diabetes, respectively. Despite the IHSS having a substantial follower base of 133 000, it posted minimally about diabetes, missing an opportunity to leverage its reach for a significant public health impact.

Recent studies have underscored the importance of targeted health communication for enhancing public health outcomes. A study by Hinyard and Kreuter23 showed that narrative communication, particularly with multimedia content, is effective in engaging users and conveying complex health information. These findings align with our analysis suggesting that visually enriched and focused posts can significantly improve user interactions and health outcomes.

In light of these insights, it is recommended that healthcare organisations, especially those with large follower bases, increase the frequency of diabetes-related posts and use more multimedia content. This approach could harness their potential to positively influence public health, aligning with recent recommendations for social media strategies in health communication.

Empowerment

Social media platforms have emerged as powerful tools for health organisations to disseminate content, particularly in the realm of diabetes awareness and management.24 Through a diverse array of content types, Facebook facilitates engagement, education and community-building, ultimately empowering individuals to take control of their diabetes journey.25 During our content analysis, a total of 517 posts were identified. The frequency of posts’ categories identified is summarised in table 3.

Similar to Gabarron et al,21 miscellaneous had the highest post coded (n=406), indicating that 78.5% of the posts published by organisations essentially highlight the organisations’ activities. Miscellaneous contents, while important, are less directly empowering on a daily basis. However, staying informed about policies helps individuals advocate for their rights and needs. Announcements about events, conferences and courses keep the community engaged and connected, but these posts primarily serve to maintain engagement rather than provide direct empowerment. Information about organisational activities builds trust and transparency, focusing more on maintaining support and engagement than direct empowerment.

Health education is the most significant form of empowerment among all categories, representing 11.02% of the diabetes-related posts. Self-management and self-monitoring content, in particular, offered immediate empowerment by providing essential skills and knowledge for daily diabetes management, especially in social media, providing the benefit of less time and money constraints for the users.26 27 Studies have shown that health education equips individuals with the tools for better health outcomes.28 29 By prioritising health education, individuals are empowered to take proactive steps in managing their diabetes effectively.

It is noteworthy that certain pivotal topics of empowerment, such as awareness days and celebrations (n=43), recipes and food-related information (n=6) and interviews and personal stories (n=3), appeared to be under-represented in the contents shared on organisations’ Facebook pages. These themes play a fundamental role in fostering empowerment among individuals with diabetes by offering valuable support, inspiration and practical guidance. Gabarron et al21 found that people who engaged most users featured interviews and personal stories and those who mentioned awareness days and other celebrations. The results also showed a lack of posts related to diabetes-related technology, research and innovation. These areas hold significant promise for empowering individuals by providing them with access to cutting-edge tools, therapies and knowledge that can profoundly influence their diabetes management outcomes.

Engagement

Analysing the engagement patterns of patients on Facebook provides valuable insights into their preferences and behaviours regarding healthcare-associated content. Patient engagement, especially on social media platforms, such as Facebook, plays a pivotal role in promoting health literacy, facilitating peer support and enhancing patient-provider communication.30 Examining engagement levels across different content topics reveals interesting trends in patient preferences. As suggested by Gabarron et al21 ‘social media liking patterns more accurately reflect users’ actual interests than do their responses to questionnaires about their preferences’, so this could be a powerful tool to lead organisations in developing better interventions.

Health education emerged as a prominent area of interest for patients, with consistently high levels of engagement across multiple metrics. This suggests that patients actively seek informative resources and value content aimed at empowering them with knowledge about their health. Healthcare organisations can capitalise on this interest by prioritising the creation and dissemination of educational content to meet patients’ information needs and support their decision-making processes regarding their health and well-being.

Interviews and personal stories also exhibited notable levels of engagement. These findings underscore the importance of human-centred content that fosters empathy, understanding and connection within online communities. By sharing personal experiences and narratives, healthcare pages can cultivate a sense of community and encourage meaningful interactions among patients.

Recipes and food-related information garnered the highest average engagement per post compared with other content categories, indicating patients’ interest in the content addressing dietary and nutritional concerns. Healthcare organisations can leverage this interest to incorporate practical lifestyle advice into their communication strategies. Providing patients with relevant and actionable information about nutrition can empower them to make healthier choices and improve their overall lifestyle and well-being. While awareness days, other celebrations, as well as miscellaneous topics, received comparatively lower levels of engagement, they still play a role in engaging patients on social media platforms.

Moreover, the analysis of engagement by posts’ features highlighted the significance of multimedia content in driving patients’ engagement on social media platforms. As demonstrated by previous studies,31 32 health organisations mainly use photos (76.4%) to communicate. This is likely due to the fact that visuals can make the presentation of complex information easier to comprehend, make it more attractive and can reach people of all literacy and education levels.33 Overall, multimedia content, images and videos are effective in capturing and maintaining audience attention, thereby encouraging patient interaction and engagement. The key findings related to healthcare communication strategies for diabetes management are summarised in table 5.

With the pros of using social media platforms for the interaction, engagement and empowerment of patients with diabetes, along with their overall role in reshaping healthcare, there are various barriers and limitations associated with them, which must be considered for their practical usage. Although these forms of communication may be helpful for healthcare professionals, some of the associated risks, such as social media’s potential for providing misinformation and questionable patient-to-patient medical advice, pose possible threats and must not be overlooked. Therefore, rather than fall victim to the pitfalls of social media, healthcare professionals can leverage these technologies appropriately to ensure their participation in meeting their patients’ education and support needs.

This study analysed data from healthcare organisations’ Facebook pages in Honduras, acknowledging limitations in generalising findings to diabetes patients not engaged in social media. Moreover, by concentrating solely on Facebook, insights from platforms like Twitter (X) and health-focused websites, such as WebMD, which may provide distinct perspectives and engagement levels, were not considered. Variations in healthcare systems, cultural dynamics and social media usage among individuals with T2D underscore the need for comprehensive research across diverse online health communication channels. A key limitation of this study was the underrepresentation of rural organisations, as rural-based pages did not engage with their audiences as frequently and thus did not meet the inclusion criteria set in the Methods section. This underscores the need for further future research that addresses disparities in online healthcare communication, particularly for underserved rural areas.