Using social media and social media marketing tools in health

● JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE ● 2/2014 ●

59 ● JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE ● No.1/2015 ●

Abstract – Introduction. The ubiquitous Internet and its mod-

ern information tools determine the current approach to com-

munication with present society. Access to the net poses chal-

lenges not only for businesses but also for state institutions

(e.g. communes), which want to effectively communicate with

their environment. The communes active in the field of health

promotion have at their disposal social media and social media

marketing tools. The range of these tools is broad and should

meet current demands and expectations of today’s consumers

in the field of health promotion and education.

Aim of the study. The aim of this study was to verify whether

Polish communes use internet marketing tools, in particular in

social media marketing activities related to health promotion.

Material and Methods. 207 Polish communes were examined

in the fourth quarter of 2013. The study was carried out by two

methods: CAWI and CATI, with the use of an original survey

questionnaire. The results were processed using standard statis-

tical methods. Results: 91.3 % of the surveyed communes are

engaged in activities in the field of health promotion. The main

fields of interest are stimulants (31.4%) and cancer (25.5 %). In

the opinion of Polish communes, most attractive, convincing

and trustworthy form of promotion among patients are tradi-

tional forms as information posters (14.7%) , direct promotion

and leaflets (11.4%), fillers information (11.4%) and TV spots

(10.9 %). 51.6% of the surveyed communes do not use portals

and social networking sites. Others declare that to promote

health they use: Facebook (11.6 %) or Wirtualna Polska (7.8

%). 74.1 % of communes do not apply the tools of social media

marketing. Only 13 respondents are active users of social net-

working sites, 11 read and resend fan pages and 9 communes

participate online in discussions on forums about health.

Conclusions.The majority of Polish communes do not use so-

cial media tools in marketing activities in the field of health

promotion. It is postulated to pay more attention to social me-

dia and social media marketing tools in the ongoing activities

in the field of health promotion by the commune authorities in

order to improve the communication efficiency with the current

information society.

Key words - marketing communication, social media, social

media marketing, health promotion.

Streszczenie – Wstęp. Wszechobecny Internet i jego

współczesne narzędzia informacyjne determinują aktualne

podejście do sposobów komunikacji z obecnym społeczeńst-

wem. Dostępność do sieci buduje także współczesne wyzwania

nie tylko dla przedsiębiorstw ale także dla instytucji państ-

wowych (np. gmin), chcących w sposób efektywny komu-

nikować się ze swoim otoczeniem. Gminy podejmując wszelkie

działania również z zakresu promocji zdrowia mają do swojej

dyspozycji media społecznosciowe i narzędzia social media

marketingu. Wachlarz tych narzędzi jest szeroki i powinien

sprostać obecnym wymogom oraz oczekiwaniom

współczesnych odbiorców akcji z zakresu promocji i edukacji

zdrowotnej.

Cel pracy. Celem badania było sprawdzenie czy polskie gminy

wykorzystują narzędzia marketingu internetowego ze szczegól-

nym uwzględnieniem social media marketingu w działaniach z

zakresu promocji zdrowia.

Materiał i metoda. Przebadano 207 polskich gminach w

czwartym kwartale 2013r. Badanie przeprowadzono dwoma

metodami: CAWI i CATI z użyciem autorskiego kwestionari-

usza ankietowego. Wyniki opracowano za pomocą stand-

ardowych metod statystycznych. Wyniki: 91,3 % przebadanych

gmin angażuje się w działania z zakresu promocji zdrowia a ich

głównymi tematami są używki (31,4%) i choroby nowotworo-

we (25,5%). W opinii pracowników polskich gmin najbardziej

atrakcyjną, przekonywującą i budzącą zaufanie wśród

pacjentów formą promocji są formy tradycyjne jak: plakaty

informacyjne (14,7%), promocja bezpośrednia i ulotki

(11,4%), wrzutki informacyjne (11,4%) i spoty telewizyjne

(10,9%). 51,6% badanych gmin nie korzysta z portali i ser-

wisów społecznościowych. Pozostałe deklarują, że wykorzys-

tują w przekazach promocyjnych dotyczących zdrowia: Face-

book (11,6%) czy Wirtualną Polskę (7,8%). 74,1% gmin nie

stosuje narzędzi social media marketingu. Tylko 13 badanych

urzędów jest aktywnym użytkownikiem portali społec-

znościowych, 11 czyta i przesyła fanpage (like page) a 9 gmin

uczestniczy w dyskusjach na forach internetowych na temat

zdrowia.

Wnioski. Polskie gminy w większości nie stosują narzędzi

social media marketingu w działaniach z zakresu promocji

Using social media and social media marketing

tools in health promotion by the Polish com-

munes

(Korzystanie z mediów społecznościowych i narzędzi social media mar-

ketingu w promocji zdrowia przez polskie gminy)

M Syrkiewicz-Świtała A,D

, T Holecki B,E

, K Sobczyk C,F

, M Wróblewski

B, K Lar

B

● JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE ● No. 1/2015 (59-64) ●



zdrowia. Postuluje się o zwrócenie większej uwagi na media

społecznościowe i narzędzia social media marketingu w prow-

adzonych działaniach z zakresu promocji zdrowia przez gminy

w celu poprawy efektywności komunikacji z obecnym społec-

zeństwem informatycznym.

Słowa kluczowe – komunikacja marketingowa, media społec-

znościowe, social media marketing, promocja zdrowia.

Author Affiliations:

Medical University of Silesia in Katowice, Faculty of Public

Health, Healthcare Management and Economics Department

Authors’ contributions to the article:

A. The idea and the planning of the study

B. Gathering and listing data

C. The data analysis and interpretation

D. Writing the article

E. Critical review of the article

F. Final approval of the article

Correspondence to:

Magdalena Syrkiewicz-Świtała Ph.D., [email protected],

Str., PL-41-902 Bytom,e-mail: [email protected]

Accepted for publication: December 11, 2014.

I. INTRODUCTION

he 21st century has brought dynamic development of

information technologies. Revolutionary changes

connected with the development of the Internet and

modern communication technologies condition existence

of many entities in numerous markets and sectors. Health

care market and its main agents can also take profit from

modern communication technologies in many areas of

their activity [1-4]. Virtual and mobile technologies help

substantially reduce costs related to communication and

cooperation of institutions or enterprises with their envi-

ronment and message recipient groups.

Nowadays, the Internet has become not only a popular

medium, but also an effective and easily available mes-

saging channel. It enables us all to quickly search out and

enter new data online, as well as to use it individually at

the same time [4]. It provides smooth and fast transfer of

the necessary content. Internet users get together setting

up social networking sites through which they build so-

cial media. Efficient flow of information in social media

has been facilitated by the development of digital devices

which undoubtedly facilitate immediate and low-cost

dissemination of certain information [5]. Due to social

media development, new online marketing instruments

have emerged, in particular those related to social media

marketing, which is essentially “a collection of accounts,

behaviours, feelings, experiences and interactions be-

tween consumers and brands, wherein multi-way com-

munication takes place through an exchange of experi-

ences via advanced communication tools” [6]. The Inter-

net has not only become a medium which allows its users

to build social relations, but also a database on enter-

tainment, culture and information. The Internet stores

business information about products and services, as well

as about ideas. This, in turn, provides space where new

social attitudes and beliefs can be formed [7]. Social

media marketing enables monitoring of social opinions

or attitudes and testing of new actions in the field of

health promotion and education [8]. Thus, the Internet

uses words and pictures to serve as an effective tool in

communication with target groups in the field of health

promotion [9].

Aim of the study

The overriding aim of the study was to verify whether in

the era of the ubiquitous Internet Polish communes make

use of online marketing tools, in particular social media

marketing tools, in their health promotion actions. Rele-

vant objectives of the study, which referred to health

promotion activity in communes and application of social

media marketing tools, were defined as follows:

Identification of fields of activities concerned with

health promotion in communes, the smallest local

self-government units.

Identification of marketing communication tools which

communes use in activities connected with health

promotion.

Determining whether and if so, how communes use

social media marketing tools in their activities con-

cerning health promotion.

Presentation of results differentiation by type of the

commune.

Possible recommendations for communes in order to

improve their communication effectiveness in the

field of health promotion.

II. MATERIALS AND METHODS

Material

The study was of quantitative nature. It was carried out

on a random sample in the fourth quarter of 2013. Its

T



scope covered entire Poland and its target group included

communes – the smallest self-government units in the

country. Direct respondents of Commune Offices partici-

pating in the study were health officers who represented

either Health Department or Health Promotion Office,

depending on the commune’s structure. The analysis

results presented in this article are part of the more ex-

tensive studies carried out in an entity affiliated by au-

thors which investigated social involvement of self-

government units and non-governmental organisation

operating in Poland.

Methods

The study was conducted by two methods, the primary

being CAWI (Computer-Assisted Web Interview) and

CATI (Computer Assisted Telephone Interview) as its

supplementary method, with the use of one research tool

– a questionnaire survey prepared by authors. The CAWI

questionnaire was used in the first place and the choice

of such research method was driven by the desire to re-

duce costs and time needed to collect data, eliminate

error associated with inference of a person carrying out a

survey, enhance respondents’ feeling of anonymity, get

to respondents by means of the mailing list and ensure a

random choice of interviewed persons with regard to

time and place of the survey. Such research method was

applied and representative sample of the studied popula-

tion was obtained only due to the fact that all communes

have access to the Internet. A phone helpdesk (business

days: 8:30am-4:30pm) and e-mail helpdesk (24/7) were

opened for the CAWI target group and made available to

any person taking part in the study in need of personal

contact and information about technical issues concern-

ing completion of the questionnaire, the study itself and

any related matters. Since an expected return rate has not

been achieved, a missing number of questionnaires was

obtained by way of telephone interview (CATI - Comput-

er Assisted Telephone Interview). To this end, a call cen-

tre was opened. This method allowed experienced inter-

viewers to carry out the survey by phone, which was to

ensure higher probability of getting responds than in the

case where a respondent would devote some time to fill

in an online questionnaire. Other advantages which de-

termined the choice of this method include: speed of the

interview procedure, the level of the interviewer’s con-

trol over the quality of the questionnaire and automatic

filters which minimise the possibility of error or missing

data. Thanks to this method, interviewers’ work could be

controlled on an ongoing basis, which provided more

reliable and better data. CATI studies were carried out

with the use of eCRF.biz™, a state-of-the-art original

programme.

In the first place, email invitations to take part in the

survey were sent to all 2,479 communes in whole Poland

(including 305 urban, 1,566 rural and 608 urban-rural

communes) [10]. Invitations contained a cover letter,

basic information about the project underway, and

a link to an online questionnaire (CAWI). E-mail ad-

dresses were taken from Biostat’s database, a company

responsible for the technical side of the study, and mes-

sages were sent to entities operating in a health-related

business. Mailings were sent three times every few days.

The strategy involved population sampling, which was

not based on random selection of persons. Due to an un-

satisfactory response rate, the CATI method was applied.

In order to complete the missing number of question-

naires, a call centre was opened (CATI) and the CATI

survey was carried out on all persons who had not pro-

vided answers in the online survey (CAWI). In this case,

respondents were selected based on a simple random

procedure, thanks to which all Commune Offices were

equally likely to be the chosen sample. All properly

filled-in questionnaires were subject to analysis before

the survey termination date, December 31st 2013. Even-

tually, the study involved 207 communes comprising

a representative sample on the basis of which analyses

and findings could be referred to the whole population.

In the studies, the confidence interval was 0.95 and max-

imum error was 0.6. Results were processed according to

STATISTICA 10 standard statistical methods.

III. RESULTS

The study involved 207 communes from whole Po-

land, the highest number of which are located in Śląskie

(20; 9.66%) and Lubelskie Provinces (20; 9.66%). The

lowest number of surveyed communes are located in

Świętokrzyskie (4; 1.93%), Lubuskie (6; 2.90%) and

Kujawsko-pomorskie Province (8; 3.86%) (Fig. 1). In the

studied group of self-government units, the highest num-

ber constituted rural communes, representing 56% (116)

of all entities under analysis, then urban and rural com-

munes (54; 26.1%), and lastly – urban communes (37;

17.9%).



Figure 1 Communes under study in given provinces

Source: own studies

Involvement of communes in activities related

to health promotion and education was subject to analy-

sis in the first place. 91.3% (189) of the communes de-

clare their participation in health promotion related activ-

ities, and only 8.7% (18) do not undertake such actions.

Most preferably, communes engage in health education

activities concerning stimulants (31.4%; 160), cancer

(25.5%; 130) and family violence (24.8%; 126). They

are considerably less active in fighting child obesity

(6.9%; 35), cardiovascular diseases (4.9%; 25) or lung

diseases (4.5%; 23). Communes are least inclined to un-

dertake any activities related to adult obesity (2%; 10).

From the statistical point of view, tests carried out for the

quantitative variables whose p-value was higher than a

significance level did not show any statistically material

correlation between the type of a commune and activities

undertaken in the field of health promotion and educa-

tion.

Since communes in particular declare that they focus

on activities against stimulants and cancer, their main

areas of interest in promotional and educational actions

were defined. Anti-alcohol (39.5%;151) and anti-drugs

(36.1%; 138) campaigns are most often undertaken by

communes in the context of health promotion actions

concerning stimulants. Anti-tobacco actions, considered

less common in Polish communes, take the third place

(24.3%; 93).

As regards cancer-prevention activities, communes

consider women to be their target group, focusing in par-

ticular on the types of cancer which directly threat them –

breast cancer and cervical cancer (73,5%; 122). Further,

activities targeted by communes at men concerns the

problem of prostate cancer (16.9%; 28). Education about

other cancers is provided to local communities to a con-

siderably lesser extent (9.6%; 16).

Analysis also included forms and means of marketing

communication which can be applied to health promotion

and education. These studies aimed to examine opinions

of employees at commune offices as to which is the most

attractive, convincing and trustworthy form of health

promotion campaign according to their recipients. Out of

the all available marketing forms of health promotion,

respondents could tick a maximum of 5 answers, which

is why the results presented here do not total 100. As the

most attractive, convincing and trustworthy forms of

health promotion commune employees find information

posters (14.7%; 104). They also listed direct promotion

and leaflets (11.4%; 81), fillers information (11.4%; 81),

TV spots (10,9%; 77), brochures (8,8%; 62) and press

releases (7,8%; 55). Other forms, including those based

on the Internet, are, according to commune employees,

definitely less important for recipients of health promo-

tion and education campaigns. Tests carried out for the

quantitative variables whose p-value was higher than a

significance level did not show any statistically material

correlation between the type of a commune and a promo-

tion method.

In the employees’ opinion, the marginal im-

portance of the online forms of health promotion affects

an extent to which communes use social media such as

portals or social networking sites in their health promo-

tion activity. Over half of the communes (51.6%; 133)

participating in the study do not use social media. Other

state that to promote health they use: Facebook (11.6%;

30), Wirtualna Polska (7.8%; 20), Onet (8.5%, 22), E-

zdrowie (5.8%; 15), or Znanylekarz (2.7%;7). Only sin-

gle communes use other portals and social networking

sites in their health promotion activities.

The study also involved defining which social

media marketing tools are most preferably used by com-

munes for their health promotion and protection purpos-

es. Interviewed employees of commune offices could tick

a maximum of three responds out of the tools provided in

the questionnaire, which is why the results do not total

100. The analysis of results showed that the majority of

communes (74.1; 157) do not use such tools. Employees

from only 13 surveyed offices stated that their communes

actively use social networking sites, whereas in 11 enti-

ties employees declared they eagerly visit and resend fan

pages of the brands they trust. Only 9 communes take

part in online discussions on forums about health. Using

other available social media marketing tools to promote

health is scarce in Polish communes. Tests carried out for

the quantitative variables whose p-value was higher than

a significance level did not show any statistically materi-

Number of studied

communes



al correlation between the type of a commune and the use

of social media marketing tools.

IV. DISCUSSION

Thanks to its common availability and usage as a me-

dium, the Internet in Poland has gained importance in the

recent years. According to the Public Opinion Research

Center (CBOS) data, in years 2002-2012 regular internet

usage was dynamically increasing, while now the pace of

growth is slowing down. In 2013, 60% of all adults were

regularly online [11]. In 2012, as in the previous year,

the number of adult internet users totalled 56%, whereas

ten years earlier only 17% of adult Poles used the Inter-

net on a regular basis (at least once a week) [12]. The

CBOS study finds that all adults with a higher education

degree and two-thirds of persons with secondary educa-

tion use the Internet, whereas the group of the digitally

excluded consists primarily of elderly and poorly educat-

ed persons. Most often, they go online at home (97% of

adult Poles) and over two-thirds of the Internet users

(73%) use wireless network via mobile devices. 29%

read blogs, 5% run them and the same number have their

own websites. 47% use text messengers, and 33% of

adults have an account on a social networking site (rep-

resenting 59% of all users). Every fourth Internet user

(26%) participates in online discussions on forums, and

62% of them browse social networking sites looking for

new friendships and relationships, as well as for enter-

tainment, culture and other information [13]. According

to the Central Statistical Office of Poland (GUS) data

concerning persons aged 16-74, 38% of all persons using

the Internet in 2012 were looking for health-related in-

formation [14]. 53% of Poles have a very positive atti-

tude towards this medium and find a lot of benefits in the

Internet and new technologies in IT and mobile network,

claiming that they make the world a better place to live

[15].

New communication and information technologies fa-

cilitate communication process, reducing its cost and

improving its efficiency. In this way, it can be easily

adapted to fluctuating market conditions and expecta-

tions of its recipients. Rapid development of mobile

communication and electronic mass media evolution lead

to material changes of specific entities, households, local

communities, and national institutions on the global scale

[16]. Nowadays, consumers, including patients, have

wider access to information, therefore they choose media

they consider fit for their needs. The Internet and mobile

technologies allow them to immediately exchange views

and form discussion groups. This also applies to health

communication as it creates a new communication area

for health promoting activities. The Internet allows for

easier and less expensive gathering of information about

a relevant health problem. Also, persons receiving health

promoting messages are becoming more demanding as

they want to get them in the most convenient and acces-

sible way suited to their needs, which obliges their au-

thors to create them with a more innovative approach

[17].

Internet communication tools, including social media

marketing instruments, are storming into more and more

market areas in which entities run their businesses [18].

Undertaking their activities, communes should take the

challenge and adjust to present requirements and expec-

tations of various social groups to whom they communi-

cate health promotion and educational information. A

substantial target group of health promotion campaigns

run by communes demands that they follow current

trends in online communication. In particular, young

persons (e.g. generation Y – born in 1980-1995) are in-

creasingly more distrustful of traditional forms of promo-

tion (e.g. advert), whereas lack of time, greater flexibility

and wider access to online information result in departure

from traditional media: TV, radio or press in favour of

internet media [19]. Therefore, it is recommended that

communes pay more attention to social media and social

media marketing tools in order to improve efficiency of

their health communication.

V. CONCLUSIONS

In the era of the ubiquitous Internet Polish communes

generally do not use internet marketing tools; in particu-

lar, they do not make use of social media and social me-

dia marketing in their activities aimed to promote health.

Most preferably, communes get involved in health pro-

motion and education actions concerning stimulants and

cancers. Most popular actions include anti-alcohol and

anti-tobacco campaigns. As for cancer-preventive activi-

ties, they focus on breast and cervical cancer. As the

most attractive, convincing and trustworthy form of pro-

motion employees of Polish communes indicate tradi-

tional information posters, direct promotion or leaflets.

In their opinion, other forms, in particular those based on

the Internet, are of far less importance. Over half of the

communes taking part in the study do not use social me-

dia (portals and websites) in their health promotion activ-

ities, whereas one-tenth of them uses Facebook and Wir-

tualna Polska portal. Two-thirds of Polish communes do

not use social media marketing tools in their promotional



campaigns and the rest marginally engage in social net-

work portals, read and resend fan pages of the brands

they trust, or take part in internet discussions on forums

about health. None of the surveyed areas showed any

results differentiation with respect to the type of a com-

mune. It is recommended that communes pay more atten-

tion to social media and social media marketing tools in

their health promotional activities with a view to improv-

ing efficiency of their communication with current in-

formation society.

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Documents

Using social media and social media marketing tools in health