Using The Social Network As A Public Health Treasure Trove

Here's a bit of a recent thread on QuitNet, an online social forum to help people quit smoking, tagged "Can't STOP the Tears:"

Gidget74: “I am crying a lot for no reason.  I just think of it as another way for my body to purge the nicotine.”

divinem: “I shed an ocean of tears during my first year.  Let them wash away the pain deep inside.  Quitting takes us to new heights – and depths”

lynnTheSurvivor:  “Thank you ALL so much J!  Feeling better today J”

kickthehabit101: “Glad you are better…one thing about getting so far down…the only way to go st up!”

lynnTheSurvivor:  “I think the world of you!  Thanks hunny!”

That conversation may look like a run-of-the-mill online chat to you, but to Professor Damon Centola, a researcher at MIT’s Sloan School of Management, it is a new kind of laboratory — and an example of a potential goldmine of information on how to help people live healthier lives.

“Online health environments may provide a brand new opportunity for research on the social determinants of health,” he  said.

Centola published a paper in the American Heart Association’s journal Circulation  last month on how Facebook, Twitter and specialized social networks like QuitNet form a new frontier for researching health behavior. He analyzed the results of several studies examining the link between online influence and health behaviors, which suggest successes in behaviors like smoking cessation, exercise and medication compliance can be shaped by interactions over web-based social platforms.

It’s no shocker that social networks can influence behavior — everything from succeeding at Weight Watchers, for instance, to actually getting a mammogram after years of delays and canceled appointments.  What Centola is fired up about is the idea that online social forums are treasure troves for gleaning real-time behavioral data,

the gold nuggets needed for realizing the gold standard approach to scientific research, the randomized control trial. “Large scale public health theories typically cannot be tested experimentally," he says.

To do that, researchers would have to compare the outcomes of social interventions on entire populations; a daunting task.

Randomized control trials have traditionally been almost exclusively the domain of physical scientists.  Social scientists studying behavior, like Centola, have been stuck with the murkier method of the observational study.  Though they produce important associative pictures, like how television habits of 20 plus hours a week are linked to significantly shriveled sperm counts,  observational studies can leave causal considerations shrouded in mystery.

Ambiguous results often mean unclear policy recommendations coming from behavioral scientists, but  Centola says that his method could change all of that He says the potential to use social media for the basis of such experiments is vast because, “hundreds of thousands, or in some cases, millions of people are participating in these online communities, making these sites active domains of public health.”

Is the idea that what happens on Facebook stays on Facebook really the case these days?  Centola suggests that some researchers consider the digital universe to be an entirely separate space from the “real world” where you actually have to interact with people face to face. “Online and offline behaviors are two different worlds of research right now," he says. "The suggestion [in this study] is that these are all interacting problems.”

Centola argues that these online networks are not mere proxies of what happens in real-life, but they are actually interactive spaces embedded in the real-life, modern experience. “My goal is to connect these online health interactions with real offline health outcomes, such as changes in medication, blood pressure, and obesity,” he says.

But what about my grandma who has never even touched a computer, never mind tweeting about, say, osteoporosis prevention? There remain vast segments of the population who don’t access online interactive spaces.  Centola appreciates the problem of the "Digital Divide."

“With the excitement over the Internet and a number of sources of big data, even in observational data, the representativeness of the population can get lost,” he says.

Centola explains that his online methods for data collection do not eclipse the standard practices of social science research.  Rather, he says, his methods should be considered complimentary to other modes of data-gathering.

So what does the future hold for using online networks to analyze health behavior?  Centola thinks his method holds a lot of promise for the future of public health intervention design, but the implications are only now beginning to be explored. “[The study is] meant to be thought provoking in terms of what the potential is in doing massive, significant research online on changes in health behavior.”