Commentary: Facebook: “Liking” the Benefits of Health Behavior Interventions

By Dr. Nathan Cobb | November 20, 2012 | Leave a comment | Filed in Addiction, Healthcare & Tobacco


This month Facebook announced that it had reached one billion active users. Not one billion accounts or registrants, but one billion individuals using the website every month. Of these approximately 200 million are in the U.S. and Canada – a staggering number. Each one of the users is connected to hundreds of their friends, actively exchanging information, sharing photos and news and even playing games together.

Two studies published at the same time in the American Journal of Preventive Medicine suggest that Facebook can do more. It can be used to deliver evidence-based health behavior interventions. Particularly interesting was the study by Sheanna Bull and colleagues where they used Facebook with youth to increase condom use and potentially prevent sexually transmitted diseases. Not only did their randomized control trial show that it’s possible to build an effective intervention within Facebook, but they also showed that a well-designed intervention will spread from friend to friend more efficiently than something that lacks interest or utility.

Taken together, these facts suggest that we may be on the cusp of a tremendous change in how we deliver health behavior interventions. An intervention that can reach people where they live and work, but can also involve and spread through their own social network, would have tremendous impact. An accompanying editorial that I wrote with Dr. Amanda Graham lays out some of this potential. But equally important, here at Legacy we have similar work underway, including a randomized control trial funded by the National Cancer Institute to evaluate how a Facebook app may spread through a quitter’s network and involve their friends.

We think that health behavior change interventions in the future will be inherently social, leveraging the Internet to involve your friends, family and co-workers, but also exposing you to people you have never met. What role Facebook will ultimately play is unknown, but as of today, the future is incredibly exciting.


Dr. Nathan Cobb

Nathan Cobb, MD, is a Research Investigator at the Schroeder Institute for Tobacco Research and Policy Studies at Legacy®, a practicing physician, and expert in the field of behavioral informatics. His prior work as a smoking cessation counselor and computer programmer for health risk assessments were a springboard for the development of QuitNet, one of the first Internet based behavior change interventions. Dr. Cobb’s current work leverages social networks to effect behavior change through social support and social influence. This includes both retrospective exploration of a 10 year database of interactions of participants in the QuitNet network, as well as novel interventions using social utilities such as Facebook and alternative delivery mechanisms such as text messaging.