Daferera Maria Final Msc Thesis Report 31 10 14
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1 CONTENTS Abstract ........................................................................................................................................ 5 Preface and Acknowledgements.................................................................................................... 7 1. Introduction ................................................................................................................. 9 2. Definitive and sensitizing concepts ............................................................................. 12 2.1. Definitive concepts ............................................................................................. 12 2.1.1. E-health ..................................................................................................................... 12 2.1.2. Social Connectors ....................................................................................................... 12 2.1.3. Word of Mouth Marketing ......................................................................................... 12 2.2. Sensitizing Concepts ........................................................................................... 13 2.2.1. E-health programs ..................................................................................................... 13 2.2.2. E-health reach ............................................................................................................ 14 2.2.3. Social Connectors ....................................................................................................... 14 2.2.4. Facebook – Mediated Activities .................................................................................. 15 3. Aim and research questions ....................................................................................... 16 4. Theoretical Framework ............................................................................................... 17 5. Research Methods……………………………………………………………………………………………………21 5.1. Research sub-question 1: Literature review ...................................................... 20 5.1.1. Review Protocol ......................................................................................................... 20 5.2. Research sub-question 2: Literature review ...................................................... 24 5.3. Research sub-question 3: Empirical research .................................................... 26 5.3.1. research population and Sampling method ................................................................ 26 5.3.1.1. Limitations ................................................................................................................. 28 6.0. Findings from the literature review ....................................................................................... 32 6.1. Introduction…… …………………………………………………………………………………………………………………32 6.1.1. Narrative Summary of Relevant Literature ......................................................................... 32 6.2. Introduction ………………………………………………………………………………………………………………………37 6.2.2. opinion leaders: The influential messengers ...................................................................... 38 6.2.2.1. Practices for identifying opinion leaders ......................................................................... 38 6.2.2.2. Practices for reaching opinion leaders ........................................................................ 41 6.2.2.3. Influencing the influencers: Practices for motivating opinion leaders to spread the word .......................................................................................................................... 42 6.2.2.4. Word of Mouth Marketing best practices that do not target opinion leaders directly . 49 2 6.2.3. Engineering contagious messages: properties of the message itself .................. 52 6.2.3.1. Social Currency ............................................................................................................... 53 6.2.3.2. Triggers ...................................................................................................................... 57 6.2.3.3. Emotion ..................................................................................................................... 59 6.2.3.4. Public ......................................................................................................................... 61 6.2.3.5. Practical Value ........................................................................................................... 64 6.2.3.6. Stories ....................................................................................................................... 65 6.2.4. Measuring effects .............................................................................................. 66 7.0. Empirical Findings ............................................................................................... 67 7.1. Introduction………………………………………………………………………………………………………………69 7.2. Summary .......................................................................................................... 70 7.3. Personal Involvement; “Facebook reflects my lifestyle” .................................. 78 7.3.1. Activities of interest to health promotion reflected on Facebook ............................... 79 7.3.2. Personal Involvement and willingness to share health promotion content.. ............... 80 7.4. Favorable image construction .......................................................................... 83 7.4.1. The content is expected to reflect positively on the sharer ......................................... 83 7.4.2. Content is expected to reflect negatively on the sharer .............................................. 87 7.5. Practical Value .................................................................................................. 91 7.5.1. The content is perceived to be Useful ................................................................................ 92 7.6. Emotional Arousal ...........................................................................................106 7.7. Social benefits .....................................................................................................................107 7.7.1. being close to Specific Others ...........................................................................................108 7.7.2. Connecting with Similar Others .........................................................................................109 8.0. Conclusion and discussion .................................................................................................. 113 8.1. Reflection…………………………………………………………………………………………………………………………113 8.2. Notable results and dissagreements in evidence ..................................................................116 8.3. The added value of Facebook ..............................................................................................141 8.4. Summary of selected strategies ...........................................................................................141 8.5. Other themes in research ....................................................................................................143 Appendix A ................................................................................................................................ 145 Appendix B ................................................................................................................................ 148 Appendix C ................................................................................................................................ 151 INFORMATION SHEET ........................................................................................................... 151 Interview guide______________________________________ ................................................ 153 3 Appendix D ............................................................................................................................... 156 List of publications included in our literature research ...............................................................156 Appendix E ................................................................................................................................ 161 References ................................................................................................................................ 165 4 ABSTRACT M OTIVATION The internet has revolutionized communication and this holds interesting implications for health promotion as well. E-health programs are internet delivered health promotion interventions, with a focus on prevention and with a focus on lifestyle. These programs have been shown to be effective in producing cognitive and behavioral outcomes, like actual changes in physical activity or smoking cessation. Free and flexible access are thought to make e-health programs attractive for users while their potential high reach implies high cost effectiveness for health promotion organizations, if said potential is redeemed. PROBLEM AND GAP OF K NOWLEDGE Evidence from efficacy trials shows that exposure rates or participation in e-health programs is generally low; hence their high reach potential is not being expressed. Previous research at the PhD level stresses the need for future research to address e- health programs’ successful dissemination and concludes that using the equivalent of word of mouth marketing strategies in response to this problem seems very