Document Type : Original Article
Authors
Abstract
BACKGROUND: COVID‑19 virus has resulted in significant psychological distress for many
individuals, particularly, those in underserved communities. Social media have the potential to be
one of the most effective tools for mental health campaigns, reaching wide audiences in the shortest
amount of time. In this paper, the potential of harnessing social media platforms to address mental
health needs in underserved populations is presented. In addition, description of the preliminary
implementation of a social media mental health campaign, the 5 × 5 campaign, is described
as an example of the feasibility and benefits of such efforts. Key implications gleaned from the
implementation process are also presented.
MATERIALS AND METHODS: Utilizing a participatory approach, the 5 × 5 campaign aimed to
improve recognition of mental health symptoms, promote help seeking, and provide immediate
strategies for self‑care for individuals experiencing psychological distress related to the COVID‑19
pandemic in low‑income, high‑risk communities in and around Guatemala City. Campaign content
was promoted on Facebook, Instagram, and WhatsApp from April 2020 to June 2020.
RESULTS: Preliminary analysis of the 5 × 5 campaign demonstrated feasibility and substantial
impact with over 84,000 individuals reached by the campaigns through initial messaging and shares.
CONCLUSION: The 5 × 5 highlights the feasibility of using social media campaigns for mental health
promotion and key factors that should be incorporated in the planning of social media mental health
campaigns aimed at promoting awareness, engaging underserved communities, and encouraging
help seeking.
Keywords
- Thackeray R, Neiger BL, Hanson CL, McKenzie JF. Enhancing
promotional strategies within social marketing programs: Use
of Web 2.0 social media. Health Promot Pract 2008;9:338-43.
2. Lau AY, Siek KA, Fernandez-Luque L, Tange H, Chhanabhai P,
Li SY, et al. The role of social media for patients and consumer
health. Yearb Med Inform 2001;20:131-8.
3. Lenhart A, Rainie L, Lewis O. Teenage Life Online: The Rise
of the Instant-Message Generation and the Internet’s Impact
on Friendships and Family Relationships. Washington, DC:
Pew Internet and American Life Project; 2001. Available from:
http://www.pewinternet.org/~/media//Files/Reports/2001/
PIP_Teens_Report.pdf.pdf. [Last accessed on 2020 Nov 25].
4. Bennett GG, Glasgow RE. The delivery of public health
interventions via the Internet: Actualizing their potential. Ann
Rev Public Health 2009;30:273-92.
5. Evers CW, Albury K, Byron P, Crawford K. Young people, social
media, social network sites and sexual health communication in
Australia: “This is funny, you should watch it”. Int J Commun
2013;7:18.
6. Lustria ML, Noar SM, Cortese J, Van Stee SK, Glueckauf RL, Lee J.
A meta-analysis of web-delivered tailored health behavior change
interventions. J Health Commun 2013;18:1039-69.
7. Portnoy DB, Scott-Sheldon LA, Johnson BT, Carey MP. Computerdelivered interventions for health promotion and behavioral risk
reduction: A meta-analysis of 75 randomized controlled trials,
1988–2007. Prev Med 2008;47:3-16.
8. Korda H, Itani Z. Harnessing social media for health promotion
and behavior change. Health Promot Pract 2013;14:15-23. - 9. Van Genugten L, Dusseldorp E, Webb TL, Van Empelen P.
Which combinations of techniques and modes of delivery in
internet-based interventions effectively change health behavior?
A meta-analysis. J Med Internet Res 2016;18:e155.
10. Webb T, Joseph J, Yardley L, Michie S. Using the internet to
promote health behavior change: A systematic review and
meta-analysis of the impact of theoretical basis, use of behavior
change techniques, and mode of delivery on efficacy. J Med
Internet Res 2010;12:e4.
11. Chou WY, Hunt YM, Beckjord EB, Moser RP, Hesse BW.
Social media use in the United States: Implications for health
communication. J Med Internet Res 2009;11:e48.
12. FrimmingRE, PolsgroveMJ, Bower GG. Evaluation of a health and
fitness social media experience. Am J Health Educ 2011;42:222-7.
13. Kontos EZ, Emmons KM, Puleo E, Viswanath K. Communication
inequalities and public health implications of adult social
networking site use in the United States. J Health Commun
2010;15 Suppl 3:216-35.
14. Lariscy RW, Reber BH, Paek HJ. Examination of media channels
and types as health information sources for adolescents:
Comparisons for black/white, male/female, urban/rural.
J Broadcast Electron Media 2010;54:102-20.
15. Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A,
Hoving C. A new dimension of health care: Systematic review
of the uses, benefits, and limitations of social media for health
communication. J Med Internet Res 2013;15:e85.
16. Ralph LJ, Berglas NF, Schwartz SL, Brindis CD. Finding teens
in TheirSpace: Using social networking sites to connect youth to
sexual health services. Sex Res Soc Policy 2011;8:38-49.
17. Van Uden-Kraan CF, Drossaert CH, Taal E, Smit WM, Moens HJ,
Van de Laar MA. Determinants of engagement in face-to-face and
online patient support groups. J Med Internet Res 2011;13:e106.
18. Corley CD, Cook DJ, Mikler AR, Singh KP. Text and structural
data mining of influenza mentions in Web and social media. Int
J Environ Res Public Health 2010;7:596-615.
19. Adams SA. Revisiting the online health information reliability
debate in the wake of “web 2.0”: An inter-disciplinary literature
and website review. Int J Med Inform 2010;79:391-400.
20. World Health Organization. Preventing Suicide: A Global
Imperative; 2014. Available from: https://www.who.int/
mental_health/suicide-prevention/world_report_2014/en/[Last
accessed on 2020 Oct 15]
21. Branas CC, Dinardo AR, Polanco VD, Harvey MJ, Vassy JL,
Bream K. An exploration of violence, mental health and substance
abuse in post-conflict Guatemala. Health 2013;5:825.
22. Herrera W, de Jesús Mari J, Ferraz MP. Mental disorders and
the internal armed conflict in Guatemala. Actas Esp Psiquiatr
2005;33:238-43.
23. Puac-Polanco VD, Lopez-Soto VA, Kohn R, Xie D, Richmond TS,
Branas CC. Previous violent events and mental health outcomes
in Guatemala. Am J Public Health 2015;105:764-71.
24. Rissman YZ, Khan CT, Isaac SK, Paiz JA, DeGolia SG. Developing
a mental health curriculum to build capacity and improve access
to mental health care in rural Guatemala. Acad Psychiatry
2016;40:692-4.
25. Godoy-Paiz P. Obstacles to achieving mental health in post-war
Guatemala: The Intersection of Political and Structural. Nexus
2005:18.
26. Abdullah T, Brown TL. Mental illness stigma and ethnocultural
beliefs, values, and norms: An integrative review. Clin Psychol
Rev 2011;31:934-48.
27. Brennan M, Vega M, Garcia I, Abad A, Friedman MB. Meeting
the mental health needs of elderly Latinos affected by depression:
Implications for outreach and service provision. Care Manag J
2005;6:98.
28. Cheng HL, Kwan KL, Sevig T. Racial and ethnic minority college
students’ stigma associated with seeking psychological help:
Examining psychocultural correlates. J Couns Psychol 2013;60:98.
29. Rastogi M, Massey-Hastings N, Wieling E. Barriers to seeking
mental health services in the Latino/a community: A qualitative
analysis. J Syst Ther 2012;31:1-17.
30. Marquez JA, Ramírez García JI. Family caregivers’ narratives of
mental health treatment usage processes by their Latino adult
relatives with serious and persistent mental illness. J Fam Psychol
2013;27:398.
31. Minkler M, Wallerstein N, editors. Community-Based
Participatory Research for Health. San Francisco: Jossey-Bass;
2003.
32. Baum F, MacDougall C, Smith D. Participatory action research.
J Epidemiol Community Health 2006;60:854-7.
33. Coleman J. Social capital in the creation of human capital. Am J
Soc 1988;94:95-120.
34. Putnam RD. Bowling Alone: The Collapse and Revival of
American Community. New York: Simon and Schuster; 2000.
35. Prell C. Social Capital as Network Capital: Looking at the Role
of Social Networks among Not-For-Profits. Soc Res Online
2006;11:39-52.
36. Beck AT. Thinking and depression. I. Idiosyncratic content and
cognitive distortions. Arch Gen Psychiatry 1963;9:324-33.
37. Beck AT. Thinking and depression: II. Theory and therapy. Arch
Gen Psychiatry 1964;10:561-71.
38. Beck AT. Cognitive Therapy and the Emotional Disorders.
New York: International Universities Press; 1976.
39. Knapp P, Beck AT. Cognitive therapy: Foundations, conceptual
models, applications and research [Fundamentos, modelos
conceituais, aplicações e pesquisa da terapia cognitive]. Rev Bras
Psiquiatr 2008;30 Suppl II: S54-64.
40. Baer RA. Mindfulness training as a clinical intervention:
A conceptual and empirical review. Clin Psychol Sci Pract
2003;10:125-43.
41. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using
self-report assessment methods to explore facets of mindfulness.
Assessment 2006;13:27-45.
42. Mandal SP, Arya YK, Pandey R. Mental health and mindfulness:
Mediational role of positive and negative affect. SIS J Proj Psychol
Ment Health 2012;19:150-9.
43. Brown KW, Ryan RM. The benefits of being present: Mindfulness
and its role in psychological well- being. J Personal Soc Psychol
2003;84:822-48.
44. Micheal LS, Graham JR. Mindfulness, subjective well-being, and
social work: Insight into their interconnection from social work
practitioners. Soc Work Educ 2011;30:29-44.
45. Speca M, Carlson L, Goodey E, Angen MA. Randomized wait-list
controlled trial: The effects of a mindfulness meditation based
stress reduction program on mood and symptoms of stress in
cancer outpatients. Psychosom Med 2000;62:613-22.
46. Ryan RM, Deci EL. On happiness and human potentials: A review
of research on hedonic and eudemonic well-being. Ann Rev
Psychol 2001;52:141-66.
47. Gratz KL, Roemer L. Multidimensional assessment of emotion
regulation and dysregulation: Development, factor structure, and
initial validation of the difficulties in emotion regulation scale.
J Psychopathol Behav Assess 2004;26:41-54.
48. Boden MT, Thompson RJ. Facets of emotional awareness and
associations with emotion regulation and depression. Emotion
2015;15:399.
49. Berking M, Wupperman P. Emotion regulation and mental health:
Recent findings, current challenges, and future directions. Curr
Opin Psychiatry 2012;25:128-34.
50. Gross JJ, Jazaieri H. Emotion, emotion regulation, and
psychopathology: An affective science perspective. Clin Psychol
Sci 2014;2:387-401.
51. Saxena P, Dubey A, Pandey R. Role of emotion regulation difficulties in predicting mental health and well-being. SIS J Proj
Psychol Ment Health 2011;18:147.
52. Gross JJ. Emotion regulation: Affective, cognitive, and social
consequences. Psychophysiology 2002;39:281-91.
53. Gross JJ. Emotion regulation: Current status and future prospects.
Psychol Inq 2015;26:1-26.
54. Pandey R, Choubey AK. Emotion and health: An overview. SIS
J Proj Psychol Ment Health 2010;17:135-52.
55. Alkoby A, Pliskin R, Halperin E, Levit-Binnun N. An eight-week
mindfulness-based stress reduction (MBSR) workshop increases
regulatory choice flexibility. Emotion 2019;19:593.
56. Roemer L, Williston SK, Rollins LG. Mindfulness and emotion
regulation. Curr Opin Psychol 2015;3:52-7.
57. Thiruchselvam R, Blechert J, Sheppes G, Rydstrom A, Gross JJ.
The temporal dynamics of emotion regulation: An EEG study of
distraction and reappraisal. Biol Psychol 2011;87:84-92.
58. Webb TL, Miles E, Sheeran P. Dealing with feeling: A metaanalysis of the effectiveness of strategies derived from the process
model of emotion regulation. Psychol Bull 2012;138:775-808.
59. Firestone R, Rowe CJ, Modi SN, Sievers D. The effectiveness of
social marketing in global health: A systematic review. Health
Policy Plan 2017;32:110-24.
60. BargerVA, LabrecqueL. An integrated marketing communications
perspective on social media metrics. Int J Integr Mark Commun
20135 (1);64-76.
61. Hair E, Pitzer L, Bennett M, Halenar M, Rath J, Cantrell J, et al.
Harnessing youth and young adult culture: Improving the
reach and engagement of the truth campaign. J Health Commun
2017;22:568-75.
62. Abu-Omar K, Rütten A, Burlacu I, Schätzlein V, Messing S,
Suhrcke M. The cost-effectiveness of physical activity
interventions: A systematic review of reviews. Prev Med Rep
2017;8:72-8.
63. Bertrand JT, Anhang R. The effectiveness of mass media in
changing HIV/AIDS-related behaviour among young people
in developing countries. Tech Rep Series World Health Organ
2006;938:205.
64. Patton G, Bond L, Butler H, Glover S. Changing schools, changing
health? Design and implementation of the Gatehouse Project.
J Adolesc Health 2003;33:231-9.
65. Rogers EA, Fine S, Handley MA, Davis H, Kass J, Schillinger D.
Development and early implementation of the bigger picture, a
youth-targeted public health literacy campaign to prevent type 2
diabetes. J Health Commun 2014;19 Suppl 2:144-60.
66. Wakefield MA, Loken B, Hornik RC. Use of mass media
campaigns to change health behaviour. Lancet 2010;376:1261-71.
67. Yadav RP, Kobayashi MA. Systematic review: Effectiveness of
mass media campaigns for reducing alcohol-impaired driving
and alcohol-related crashes. BMC Public Health 2015;15:857.
68. Allen LN, Pullar J, Wickramasinghe KK, Williams J, Roberts N,
Mikkelsen B, et al. Evaluation of research on interventions
aligned to WHO ‘Best Buys’ for NCDs in low-income and lowermiddle-income countries: A systematic review from 1990 to 2015.
BMJ Global Health 2018;3:e000535.
69. Aminde LN, Takah NF, Zapata-Diomedi B, Veerman JL. Primary
and secondary prevention interventions for cardiovascular
disease in low-income and middle-income countries: A systematic
review of economic evaluations. Cost Eff Resour Alloc 2018;16:22.
70. Graziose MM, Downs SM, O’Brien Q, Fanzo J. Systematic review
of the design, implementation and effectiveness of mass media
and nutrition education interventions for infant and young child
feeding. Public Health Nutr 2018;21:273-287.
71. Naugle DA, Hornik RC. Systematic review of the effectiveness
of mass media interventions for child survival in low-and
middle-income countries. JHealth Commun 2014;19Suppl1:190-215.
72. Niederdeppe J, Kuang X, Crock B, Skelton A. Media campaigns
to promote smoking cessation among socioeconomically
disadvantaged populations: What do we know, what do we
need to learn, and what should we do now? Soc Sci Med
2008;67:1343-55.
73. Shea B, Andersson N, Henry D. Increasing the demand for
childhood vaccination in developing countries: A systematic
review. BMC Int Health Hum Rights 2009;9:S5.
74. Maher CA, Lewis LK, Ferrar K, Marshall S, De Bourdeaudhuij I,
Vandelanotte C. Are health behavior change interventions that
use online social networks effective? A systematic review. J Med
Internet Res 2014;16:e40.
75. Marcus BH, Williams DM, Dubbert PM, Sallis JF, King AC,
Yancey AK, et al. Physical activity intervention studies: What
we know and what we need to know: A scientific statement
from the American Heart Association Council on Nutrition,
Physical Activity, and Metabolism (Subcommittee on Physical
Activity); Council on Cardiovascular Disease in the Young; and
the Interdisciplinary Working Group on Quality of Care and
Outcomes Research. Circulation 2006;114:2739-52.
76. Randolph W, Viswanath K. Lessons learned from public health
mass media campaigns: Marketing health in a crowded media
world. Annu Rev Public Health 2004;25:419-37.
77. Noar SM. A 10-year retrospective of research in health mass
media campaigns: Where do we go from here? J Health Commun
2006;11:21-42.
78. Anghelcev G, Sar S. The influence of pre-existing audience mood
and message relevance on the effectiveness of health PSAs:
Differential effects by message type. Journal Mass Commun Q
2011;88:481-501.
79. Alonzo D, Popescu M, Zubaroglu Ioannides P. Mental health
impact of the Covid-19 pandemic on parents in high-risk, low
income communities. Int J Soc Psychiatry January 2021;EPub
20764021991896.