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date: 26 July 2017

Blogging, Microblogging, and Exposure to Health and Risk Messages

Summary and Keywords

The widespread diffusion of social media in recent years has created a number of opportunities and challenges for health and risk communication. Blogs and microblogs are specific forms of social media that appear to be particularly important. Blogs are webpages authored by an individual or group in which entries are published in reverse chronological order; microblogs are largely similar, but limited in the total number of characters that may be published per entry. Researchers have begun exploring the use and consequences of blogs and microblogs among individuals coping with illness as well as for health promotion. Much of this work has focused on better understanding people’s motivations for blogging about illness and the content of illness blogs. Coping with the challenges of illness and connecting with others are two primary motivations for authoring an illness blog, and blogs typically address medical issues (e.g., treatment options) and the author’s thoughts and feelings about experiencing illness. Although less prevalent, there is also evidence that illness blogging can be a resource for social support and facilitate coping efforts. Researchers studying the implications of blogs and microblogs for health promotion and risk communication have tended to focus on the use of these technologies by health professionals and for medical surveillance. Medical professionals appear to compose a noteworthy proportion of all health bloggers. Moreover, blogs and microblogs have been shown to serve a range of surveillance functions. In addition to being used to follow illness outbreaks in real-time, blogs and microblogs have offered a means for understanding public perceptions of health and risk-related issues including medical controversies. Taken as whole, contemporary research on health blogs and microblogs underscores the varied and important functions of these forms of social media for health and risk communication.

Keywords: blog, blogging, microblog, microblogging, social media, illness disclosure, social support, medical surveillance, health communication, risk communication

Health Blogging and Microblogging

Among the many forms of social media relevant to health and risk communication, blogs and microblogs represent novel avenues for individuals to document and share their health-related experiences as well as a means for health promotion efforts by medical professionals and organizations. Weblogs or “blogs” are webpages that consist of a series of entries published in reverse chronological order (Herring, Scheidt, Bonus, & Wright, 2005). Blogs tend to be updated relatively frequently and often include a “blogroll,” which is a list of blogs that the author endorses and presumably follows. Surveys conducted by researchers at the Pew Internet and American Life Project suggested that 9% of adult Americans have authored a blog (Pew, 2011) and 32% have read someone’s blog (Zickhur, 2010). Although this review will focus primarily on blogs, research examining microblogs will also be considered. Microblogs are distinct in that entries are typically limited to a particular number of characters (Java, Song, Finin, & Tseng, 2007). During 2015, 17% of American adults were estimated to have used the popular microblogging service Twitter (Pew, 2015). The growing body of research examining the implications of blogs and microblogs for health and risk communication is marked by two distinct themes. Blogs have been primarily studied as a coping resource among people facing illness, and blogs and microblogs have received attention as tools for health promotion. Research exploring each of these themes will be reviewed in the remainder of this chapter.

Blogging About Illness

One of the major themes in scholarship on blogging and health communication involves the use and implications of blogs among people coping with illness. Personal-journal blogs resemble an online diary in which individuals discuss their thoughts, feelings, and experiences (Herring et al., 2005). In the case of people coping with illness, personal-journal blogs focus on bloggers’ experiences with their health condition(s). Miller and Pole (2010) conducted an analysis of 951 health blogs and found that almost 40% were written from the perspective of an individual patient or consumer. After first considering the factors that distinguish personal-journal health blogs from other technologies, research examining the characteristics of illness bloggers and motivations for blogging, blog content, and the outcomes of illness blogging will be evaluated.

Socio-Technical Characteristics of Illness Blogs

In the context of sharing illness experiences, personal-journal blogs are unique from older communication technologies like email and instant messaging as well as other forms of social media like social network sites in several important ways. First, blogs are typically dedicated to a single individual’s experience coping with illness. As a genre, blogs encourage extended self-disclosure in which individuals talk about their thoughts and feelings in-depth and without constraint (Rains & Keating, 2011). Second, blogs make it possible to communicate with both known and unknown others (Stefanone & Chyng-Yang, 2007). A blog reader’s audience can consist of strong ties such as family and friends as well as weak ties consisting of other people coping with a health condition. The potential to reach a diverse audience of strong and weak ties makes blogs a valuable tool for accessing a range of social resources.

A third feature that contributes to the uniqueness of blogs is the potential for anonymity (Qian & Scott, 2007). The ability to conceal one’s identity may be particularly beneficial for those who face a health condition that traditionally is stigmatized or who are otherwise concerned with privacy. Indeed, there is evidence that anonymity may facilitate self-disclosure among health bloggers who feel stigmatized (Rains, 2014). Finally, blogs are interactive in that they typically include a space for readers to provide feedback (Rains & Keating, 2015). Readers have the opportunity to directly share their thoughts and feelings about specific entries made by a blogger. Social support messages were a staple of reader feedback in at least one study (Tong, Heinemann-LaFave, Jeon, Kolodziej-Smith, & Warshay, 2013).

Demographics and Motivations of Illness Bloggers

Although data about the demographic characteristics of people who blog about their experiences with illness have been relatively limited, the available research suggests that this group is more likely to be female and younger. A content analysis of almost 1,000 health blogs showed that females were more likely to blog from the perspective of someone coping with illness, whereas male bloggers were more likely to write from the perspective of a medical professional (Miller, Pole, & Bateman, 2011). These results are consistent with survey data collected by the National Cancer Institute in which female and younger respondents were significantly more likely to have authored a health blog (Prestin, Vieux, & Chou, 2015).

Beyond demographics, researchers have identified several factors that explain why individuals choose to blog about their health experiences. One important motivation is to cope with the challenges presented by illness (Sundar, Edwards, Hu, & Stavrositu, 2007). Several scholars have discussed the potential for blogging to be cathartic (Nagel & Anthony, 2009; Tan, 2008). Articulating one’s thoughts and feelings related to illness can help to better understand one’s experiences. Connecting with others is a second motivation (Attard & Coulson, 2012). The public nature of blogging makes it possible to gain access to potential support providers. Particularly among people who feel misunderstood or isolated, blogging can serve as a means to connect with others who are going through or have gone through similar challenges. As such, blogging can help people to feel heard and accepted (Pettigrew, Archer, & Harrigan, 2016).

A third motivation for blogging about illness stems from a desire to help others (Chiu & Hsieh, 2013). Through documenting their experiences, bloggers create a record that people facing similar challenges can draw on for information and comforting. A fourth motivation for blogging is political in nature (Leggat-Cook & Chamberlain, 2012). Some bloggers desire to serve as a model and counter stereotypes about illness. Sharing their experiences can correct misinformation and misunderstanding about what it means to face a particular health condition.

Although not as prevalent as the previous four themes, a few other motivations for blogging appear in the literature and are worth noting. Cancer bloggers reported writing in order to be remembered and leave something behind after their death (Chiu & Hsieh, 2013). Blogging also served as a mechanism for accountability among weight-loss bloggers (Leggatt-Cook & Chamberlain, 2012). Publicly declaring their goals made bloggers feel more responsible for their weight-loss efforts. Finally, blogging helped to share information with and manage social networks (McCosker & Darcy, 2013). Blogs were used to share the author’s experiences with several audiences efficiently and without having to repeat the same information multiple times.

Limitations that may undermine the motivation to author an illness blog also warrant consideration. One key drawback involves issues related to privacy and stigma (Ressler et al., 2012). Bloggers writing about disordered eating, for example, reported being wary of others finding out about their health condition (Yeshua-Katz & Martins, 2013). A second limitation is that writing about illness could lead one to become overly focused on one’s health and, in the case of disordered eating (Yeshua-Katz & Martins, 2013), even trigger the very maladaptive behaviors one is trying to overcome.

Content of Illness Blogs

The content of illness blogs and microblogs has been studied by researchers. Medical dimensions of illness and bloggers’ feelings and experiences with illness are the two most common topics. First, bloggers tend to write about the technical aspects of illness (Kim, 2009; Sundar et al., 2007). This can include information about diagnoses, medications, and treatment. In a study of microblog posts made by people in Japan coping with cancer showed that medical information related to diagnosis, symptoms, and treatment were common (Tsuya, Sugawara, Tanaka, & Narimatsu, 2014). Commensurate findings were reported in a keyword analysis of cancer blog entries (Kim, 2009). Medical terms such as “cancer,” “treatment,” and “cells” were among the most common words appearing among the blogs in the sample.

A second topic discussed in illness blogs involves the author’s thoughts and feelings about coping with illness. Blogs tend to feature the author’s attempts to articulate his or her illness experiences. In the case of one blogger, this involved sharing his “considerable existential distress” of experiencing a life-threatening health condition (Lowney & O’Brien, 2012, p. 858). Stigma and social rejection were common topics in blogs authored by people coping with multiple chronic illnesses (Markle, Attell, & Treiber, 2015). Yet, articulating one’s experiences can also involve more mundane aspects of living and coping with illness (McCosker & Darcy, 2013). Humor was prominent in one blogger’s experiences with terminal pancreatic cancer (Smith & Brunner, 2016).

Although medical issues and illness experiences were the two most frequent topics appearing in research on health blog content, social commentary was identified in a few studies. Researchers studying weight-loss blogs, in particular, noted entries addressing the meaning of beauty and obesity in contemporary society (Leggatt-Cook & Chamberlain, 2012). In another study, the role of the media, weight-loss industry, and medicalization of “fatness” were important discussion topics (Dickins, Browning, Feldman, & Thomas, 2016).

Consequences of Illness Blogging

Writing About illness

In addition to the motivations for blogging and blog content, scholars have considered the coping-related outcomes of authoring an illness blog. Drawing from research demonstrating the benefits of writing about significant life events such as illness (Pennebaker, 1997), scholars have argued that blogging may be therapeutic (Nagel & Anthony, 2009; Tan, 2008). This notion was directly tested in one study. Boniel-Nissim and Barak (2013) compared the effects of blogging versus writing privately or not at all over the course of 10 weeks among a group of adolescents experiencing social difficulties. Bloggers were asked to write about their thoughts and feelings using a publicly available blogging platform, whereas a second group made their entries in a private diary on their computer, and a third group did not engage in any writing. The results showed that bloggers tended to fair better than the other two groups in terms of changes in self-esteem, socioemotional difficulties, and participation in social activities. The results of Boniel-Nissim and Barak’s (2013) study are consistent with the findings from survey research in which bloggers self-reported gaining a broader perspective and coping more effectively with illness as a result of blogging (Ressler et al., 2012).

There is also evidence that the way in which bloggers discuss their illness experiences can be important. In one study, the use of insight words by illness bloggers over an eight-week period was associated with reduced health-related uncertainty and, among bloggers who posted more frequently, increased feelings of purpose in life (Rains & Keating, 2015). Insight words such as “realize” and “understand” signal that one is attempting to make sense of and better understand one’s experiences. In other research examining bloggers recovering from traumas such as cancer, the use of insight and causation words (e.g., “because”) were marginally associated with recovery (Hoyt & Pasupathi, 2008). Taken together, these studies suggest that attempting to make sense of one’s experiences can contribute to positive outcomes among illness bloggers.

The results from research examining the expression of positive and negative emotions in illness blogs have been much less straightforward. In one study, illness bloggers’ use of positive emotion words was unrelated to changes in their well-being (Rains & Keating, 2015). Further, bloggers’ use of negative emotion words was linked with detrimental changes in well-being. Among bloggers who posted less frequently, use of negative emotion words was associated with increased depression and decreased feelings of personal growth. Yet, a habituation effect seemed to occur with bloggers who posted more frequently. Among more active bloggers, use of negative emotion words was unrelated to changes in depression and personal growth. There is also evidence that the effects of expressing negative emotions may be contingent upon how frequently positive emotions are expressed. In their study of trauma blogs, Hoyt and Pasupathi (2008) found that the bloggers who used a larger ratio of positive to negative emotion words experienced greater recovery. Their findings indicate that expressing negative emotion may be most beneficial when it is coupled with an even greater focus on positive emotions.

The Social Implications of Illness Blogging

As previously discussed, illness blogs are unique in that they can be interactive. A bloggers’ audience often has the potential to directly respond using the “comments” feature available on many blogs. This potential creates an avenue for blogging to serve as a means to marshal social support from blog readers. Indeed, there is evidence that blog readers can serve as a valuable support resource and that the support received or available from blog readers can have important consequences for bloggers’ coping efforts.

Several studies of illness bloggers illustrate the support potential of blogging. Sanford (2010) interviewed weight-loss bloggers and found that blogging served as a means to acquire emotional support, advice, and validation from readers. These or related themes were present in the results from studies of blogging among new mothers (Pettigrew et al., 2016) and women coping with disordered eating (Yeshua-Katz & Martins, 2013). In content-analytic studies, emotional support was most common in reader responses to pro-anorexia blogs (Tong et al., 2013), and informational support messages were most common in microblog posts made by participants in a weight-loss intervention (Turner-McGrievy & Tate, 2013). There is also evidence linking social support with blogging behavior. In one study, a sample of illness bloggers was surveyed and the number of posts made by bloggers and reader comments during the preceding six weeks were identified (Rains & Keating, 2011). The number of posts made by bloggers as well as the proportion of posts with at least one reader comment were positively associated with bloggers’ perceptions of support available from their blog readers.

Beyond serving as a resource for social support, qualitative and quantitative studies indicate that the support acquired and available from blog readers can facilitate coping efforts. In several qualitative studies, researchers have reported evidence of the benefits of blog reader support (Sanford, 2010). The support received by bloggers writing about obesity helped them to better cope with instances of discrimination during everyday life (Dickins et al., 2016). In Rains and Keating’s (2011) survey of health bloggers, they found that support available from blog readers was positively associated with bloggers’ perceptions of health self-efficacy and personal growth resulting from illness. In a follow-up survey of the same sample conducted three years later, they examined changes in perceptions of blog reader support and blogger’s well-being (Keating & Rains, 2015). Increased support available from blog readers was associated with improved health-related uncertainty but not associated with changes in bloggers’ loneliness or self-efficacy.

One question in research examining the consequences of illness blogging involves the degree to which some groups benefit more than others from blog reader support. In adapting the optimal matching model, Turner and colleagues argued that computer-mediated support may be most beneficial to those people who lack support resources in their offline relationships (Turner, Grube, & Meyers, 2001). A similar argument was made by Kraut and colleagues who proposed the social compensation hypothesis in which people who lack support resources offline most benefit from Internet use (Kraut et al., 2002). Evidence consistent with optimal matching and social compensation can be found in qualitative research in which bloggers writing about their experiences with disordered eating reported that their readers could be more helpful than their family and friends (Yeshua-Katz & Martins, 2013). Yet, other research showed that participation in a blogging community and adopting the ideas advocated in the community created tension in some bloggers’ offline relationships with friends and family (Dickins et al., 2016).

Researchers surveying health bloggers have also reported evidence consistent with social compensation and optimal matching. Rains and Keating (2011) found an interaction effect between blog reader support and family/friend support for bloggers’ perceptions of personal growth and loneliness. Support available from blog readers was most beneficial for those illness bloggers who perceived lower levels of support available from their friends and family members. However, the results of their follow-up survey three years later examining change in support perceptions and well-being were less promising (Keating & Rains, 2015). As opposed to offsetting inadequate support from family and friends, their findings indicated that blog reader support functioned to complement offline support resources. Increased support available from bloggers’ family and friends was associated with a reduction in loneliness among only those bloggers who reported no change or increased support available from their blog readers over the three-year period. Among bloggers who perceived a decrease in support available from their blog readers, changes in family/friend support were unrelated to loneliness perceptions. It is noteworthy, however, that this project focused on changes in support perceptions over the three-year period and not the degree to which bloggers perceived support to be available.

Blogs and Microblogs in Health Promotion and Risk Communication

A second major theme in research on blogging and health communication involves the use of blogs and microblogs for health promotion and risk communication. Research on this topic is varied, but tends to coalesce around two more specific issues. Scholars have sought to better understand the use of blogs by medical professionals and the potential of blogs and microblogs as tools for surveillance. After first considering the socio-technical characteristics of blogs that distinguish them from other technologies in the context of health promotion and risk communication, research examining each of these issues will be discussed.

Social-Technical Characteristics of Blogs for Health Promotion and Risk Communication

Several characteristics of blogs distinguish them from other technologies in the context of health promotion. First, blogs and microblogs make it possible to gain access to a potentially sizable sample of lay people who are actively coping with or concerned about a particular health issue. As such, they offer a great deal of potential for surveillance and better understanding the public’s health behavior and perceptions (Denecke et al., 2013)—particularly related to health risks. Second, blogs not are typically subject to formal gatekeepers and, as a result, offer opportunities for health promotion and risk communication. Relative to mass media outlets such as television or print news, blogs make it possible to directly communicate with stakeholders in health communication efforts (Rains, Brunner, & Oman, 2014). This can extend to rapidly disseminating information about crises in real time (Macario, Ednacot, Ullberg, & Reichel, 2011) or to narrowly targeted groups (Sapp & Gogdill, 2010). Third, blogs can allow audience interactivity (Neiger et al., 2013). It is possible for health professionals to get direct feedback about health promotion and risk communication efforts from their target audience. Finally, the information posted on blogs can reverberate in other contexts. Materials posted on blogs can be recirculated in other forms of social media (i.e., “go viral”) or even amplified by traditional media outlets (Silver, 2012).

Use of Blogs and Microblogs by Doctors and Medical Professionals

Researchers have begun to examine doctors and other medical professionals’ use of blogs. These two groups make up a noteworthy proportion of all health bloggers. Researchers examining almost 1,000 health blogs reported that over half of the blogs they identified were written from the perspective of a health or medical professional (Miller et al., 2011). Approximately 20% of bloggers were identified as physicians and almost 30% were identified as working in another health occupation. There were also some demographic differences between physicians and other types of health bloggers. Physician bloggers were more likely to be male and have a greater level of education than bloggers working in other health or non-health occupations. Physician bloggers were also more likely than the other two groups to write about health news and research. However, there were few substantive differences among the three groups in terms of blog features. The most notable differences involved physicians being more likely to include advertising and external links in their blogs than non-health professionals.

Other researchers examined the content of blogs authored by almost 300 physicians or nurses (Lagu, Kaufman, Asch, & Armstrong, 2008). Most of the blogs were relatively anonymous. Less than one-third included the blogger’s last name or an identifiable photo of the blogger, although almost half provided location information. In terms of content, patients were a topic of discussion in less than half of the blogs, and under one-fifth included negative or positive depictions of patients. Almost half of the blogs included commentary on the health care system. Approximately 10% of the blogs promoted health care products. These findings are fairly consistent with the results from an analysis of 44 pharmacists’ blogs (Clauson, Ekins, & Goncz, 2010). Less than one-third of the pharmacist bloggers included their full name or identified their workplace. Their geographic location, however, was provided by most bloggers. Almost a third of the pharmacist bloggers discussed pharmacologic therapies or current events in health care. At least one-quarter of the bloggers used positive language in describing the pharmacy profession, other health care workers, and patients. Critical language was more prevalent. More than half of the pharmacist bloggers used critical language in discussing patients and over 40% did so in discussing other health care professionals. Explicit language was present in almost half of the blogs.

The nature and quality of information posted on blogs offering medical advice was examined in another study (Buis & Carpenter, 2009). Several differences were found between blogs authored by individuals with and without medical credentials. Blogs authored by people who ostensibly had medical expertise were more likely to include topic-specific posts, responses to the media, and links to external blogs compared to blogs authored by non-experts. There is also evidence to suggest that the blogs and microblogs authored by health professionals can be persuasive. Lee and Sundar (2013) conducted an experiment in which they manipulated the authority of the microblog author along with the number of followers the microblogger had and examined participants’ perceptions and responses to controversial messages about weight loss. The controversial messages (e.g., “The tongue patch diet—having a patch surgically applied to your tongue helps weight loss by making it painful to eat solid foods”) were viewed most positively and most influential when they came from a doctor who had a larger number of followers. The findings from Lee and Sundar’s study demonstrate some conditions under which health blog and microblog posts may be particularly influential to readers.

Finally, researchers have considered the use of microblogs by health organizations. In one study, the authors evaluated the microblog accounts and posts from 114 health organizations in Australia (Dumbrell & Steele, 2013). Most of the microblogs were operated by nonprofit organizations followed by for-profit organizations and governmental agencies. Over 40% of microblogs posts made by the three types of organizations focused on health awareness or advice. Organizational news and fundraising were also addressed frequently. The authors found some variation in the content of posts across the three types of health organizations. Maternity and pharmaceuticals were more common topics in posts made by for-profit organizations, whereas cancer, diabetes, and vaccines were more frequent topics in posts made by nonprofit organizations.

Blogs and Microblogs as Tools for Medical Surveillance

A second area of interest among researchers studying the implications of blogs and microblogs for health promotion has been the potential of these technologies as tools for medical surveillance. Blogs and microblogs are being used as a means to understand a particular group’s health-related behavior or perceptions—particularly involving health risks. Large scale analyses of microblog and blog posts have been conducted to better understand insomnia (Jamison-Powell, Linehan, Daley, Garbett, & Lawson, 2012), dental pain (Heaivilin, Gerbert, Page, & Gibbs, 2011), cervical and breast cancer screening (Lyles, López, Pasick, & Sarkar, 2013), and perceptions of mental health (Marcus, Westra, Eastwood, & Barnes, 2012). For example, microblog posts that included the words “dementia” or “Alzheimer” were examined over a 24-hour period by one group of researchers (Robillard, Johnson, Hennessey, Beattie, & Illes, 2013). Of the more than 9,000 posts identified, 10% were evaluated to determine the types of people posting about dementia and the nature of their messages. Health professionals were among the most frequent contributors and posts discussing research were most prevalent.

Blogs and microblogs have also been used to better understand the lay public’s risk-related perceptions and behavior. Researchers have attempted to identify public misconceptions or evaluate the prevalence of inaccurate information about health issues. Love and colleagues examined almost 7,000 microblog posts related to vaccination (Love, Himelboim, Holton, & Stewart, 2013). Although scientific claims made about the various types of vaccination tended to be substantiated, unsubstantiated claims were consistently observed in the data. In a similar study, microblog posts were examined for information about antibiotics (Scanfeld, Scanfeld, & Larson, 2010). Of the almost 1,000 posts evaluated, over 5% reflected a misunderstanding or misuse of antibiotics. In a study of concussion-related microblog posts, almost 10% were evaluated as downplaying or minimizing the significance of concussions (Sullivan et al., 2012).

In addition to misconceptions, blogs and microblogs have served as a window into public perceptions of health controversies. One group of scholars evaluated blog posts regarding the human papilloma virus (HPV) vaccine debate (Keelan, Pavri, Balakrishnan, & Wilson, 2010). In the approximately 300 blogs they identified, a little more than half showed support for the vaccine, focusing on the risks of HPV and efficacy of the vaccine. Approximately 40% of blogs did not support the vaccine, focusing on risks of vaccination. Notably, blogs advocating positive and negative positions had equivalent numbers of reader comments and approval ratings from readers. In another study of the HPV controversy, posts from political, general news, health, and science blogs were evaluated based on the degree to which they addressed elements from the health belief model (Daily, Nan, & Briones, 2015). Health blogs were most likely to discuss the benefits of the vaccine in the form of its effectiveness as well as susceptibility to HPV. Health and science blogs were most likely to address severity by discussing the connection between HPV and cancer. Political blogs were most critical of the vaccine.

Blogs and microblogs have played a role as a reference point for news media coverage of a health event. In a study focusing on the influenza H1N1 pandemic during 2009, researchers examined the way coverage was framed in newspaper articles and eight expert health blogs over a six-month period (Gao, Zhang, & Sadri, 2011). Action, reassurance, and economic consequence frames for the pandemic were more common in newspaper articles than blogs. Newspapers were also more likely to use both expert and non-expert sources. Another group of researchers examined public anxiety about the H1N1 pandemic by focusing on the language used in blogs and newspaper articles over a two-week period (Tausczik, Faasse, Pennebaker, & Petrie, 2012). Use of words related to health, death, and anxiety in blog entries and newspaper articles published on the same day were significantly correlated. However, appearance of the terms “H1N1” and “swine flu” in blogs and newspaper articles were less strongly correlated.

Finally, blogs and microblogs have been used to better understand and track the outbreak of illness. One group of researchers collected microblog posts and used them to track public concern about the influenza H1N1 pandemic as well as estimate flu activity in real time (Signorini, Segre, & Polgreen, 2011). The researchers were able to fairly accurately track public concern about specific issues related to the outbreak such as hand hygiene, masks, and the vaccine. Using geolocation information along with the content of microblog posts, they were also able to estimate influenza-like-illness activity in a specific region of the United States in real-time.

Concluding Thoughts on Blogging and Microblogging in Health and Risk Communication

Although research on blogging and microblogging is still in its infancy, the findings from existing studies suggest that these technologies have important implications for health and risk communication. Blogs appear to be important resources among individuals coping with illness. Blogs and microblogs also can serve as valuable mechanisms for health promotion and risk communication, particularly in providing a means for medical surveillance. Despite this potential, additional research is essential to more fully understand the use and consequences of these technologies for health and risk communication.

Discussion of the Literature

Research on health blogging and microblogging has largely focused on two issues. First, scholars have sought to better understand the use and consequences of blogs among people coping with illness. The majority of this research has been descriptive with motivations for blogging receiving most of the attention. Although such works are important, additional research is essential to examine the outcomes of blogging about illness. Relatively little is known about the degree to which blogs help or hinder coping efforts. Additionally, studies of illness blogs and bloggers tend to neglect theory. Incorporating theory in scholarship on illness blogging would serve to make this body of research more systematic and rigorous. Beyond gaining insights about the consequences of blogging about illness, researchers would be better positioned to understand the underlying mechanisms that bring about such consequences. Theories and models related to identity, social support, self-disclosure, relationship development, computer-mediated communication, and social networks all have good potential to yield important insights about illness blogging.

A second trend in research on health blogging and microblogging involves efforts to study the implications of these technologies for health promotion and risk communication. Much of this work has been descriptive and addressed topics such as the content of blogs authored by medical professionals and microblog posts about specific health topics or events. These works make important contributions to research on health blogging. Yet, advancing this body of scholarship requires broadening the topics of study and research approaches. The impact of a medical professional’s blog on his or her relationship with patients deserve study. The use of blogs by medical professionals for information sharing, peer support, and in concert with other forms of social media also should be explored. Surveillance research would benefit from more directly considering the social and technical characteristics of blogs and microblogs. At present, these two technologies appear to simply be a source for acquiring discourse about a particular health topic or event. The implications the socio-technical characteristics of these technologies warrants greater consideration. Scholars might further evaluate the ways these technologies could be leveraged to disseminate health and risk information more quickly and effectively. It would also be valuable to, while continuing descriptive research, focus greater efforts on using the health-related discourse posted on blogs and microblogs to make predictions about the occurrence and outcomes of health events. As the preceding discussion suggests, the potential implications of blogs and microblogs for health communication demand greater and more systematic research efforts in order to be fully understood.

Further Reading

Boniel-Nissim, M., & Barak, A. (2013). The therapeutic value of adolescents’ blogging about social–emotional difficulties. Psychological Services, 10(3), 333.Find this resource:

Chiu, Y.-C., & Hsieh, Y.-L. (2013). Communication online with fellow cancer patients: Writing to be remembered, gain strength, and find survivors. Journal of Health Psychology, 18(12), 1572–1581.Find this resource:

Lagu, T., Kaufman, E. J., Asch, D. A., & Armstrong, K. (2008). Content of weblogs written by health professionals. Journal of General Internal Medicine, 23(10), 1642–1646.Find this resource:

Love, B., Himelboim, I., Holton, A., & Stewart, K. (2013). Twitter as a source of vaccination information: Content drivers and what they are saying. American Journal of Infection Control, 41(6), 568–570.Find this resource:

McCosker, A., & Darcy, R. (2013). Living with cancer: Affective labour, self-expression and the utility of blogs. Information, Communication & Society, 16(8), 1266–1285.Find this resource:

Miller, E. A., & Pole, A. (2010). Diagnosis blog: Checking up on health blogs in the blogosphere. American Journal of Public Health, 100(8), 1514–1519.Find this resource:

Rains, S. A., & Keating, D. M. (2011). The social dimension of blogging about health: Health blogging, social support, and well-being. Communication Monographs, 78, 511–534.Find this resource:

Rains, S. A., & Keating, D. M. (2015). Health blogging: An examination of the outcomes associated with making public, written disclosures about health. Communication Research, 42(1), 107–133.Find this resource:

Signorini, A., Segre, A. M., & Polgreen, P. M. (2011). The use of Twitter to track levels of disease activity and public concern in the U.S. during the influenza A H1N1 pandemic. Plos One, 6(5), e19467–e19467.Find this resource:

Yeshua-Katz, D., & Martins, N. (2013). Communicating stigma: The pro-ana paradox. Health Communication, 28(5), 499–508.Find this resource:

References

Attard, A., & Coulson, N. S. (2012). A thematic analysis of patient communication in Parkinson’s disease online support group discussion forums. Computers in Human Behavior, 28(2), 500–506.Find this resource:

Boniel-Nissim, M., & Barak, A. (2013). The therapeutic value of adolescents’ blogging about social–emotional difficulties. Psychological Services, 10(3), 333.Find this resource:

Buis, L. R., & Carpenter, S. (2009). Health and medical blog content and its relationships with blogger credentials and blog host. Health Communication, 24(8), 703–710.Find this resource:

Chiu, Y.-C., & Hsieh, Y.-L. (2013). Communication online with fellow cancer patients: Writing to be remembered, gain strength, and find survivors. Journal of Health Psychology, 18(12), 1572–1581.Find this resource:

Clauson, K. A., Ekins, J., & Goncz, C. E. (2010). Use of blogs by pharmacists. American Journal of Health-System Pharmacy, 67(23), 2043–2048.Find this resource:

Daily, K. M., Nan, X., & Briones, R. (2015). Analysis of HPV vaccine information on influential blog sites: A snapshot amid the 2011 republican presidential primary debates. Atlantic Journal of Communication, 23(3), 159–177.Find this resource:

Denecke, K., Krieck, M., Otrusina, L., Smrz, P., Dolog, P., Nejdl, W., et al. (2013). How to exploit Twitter for public health monitoring?Methods of Information in Medicine, 52(4), 326–339.Find this resource:

Dickins, M., Browning, C., Feldman, S., & Thomas, S. (2016). Social inclusion and the fatosphere: The role of an online weblogging community in fostering social inclusion. Sociology of Health & Illness, 38, 797–811.Find this resource:

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