Online Social Networking by Patients with Diabetes: A Qualitative
Evaluation of Communication with Facebook
Jeremy A. Greene, MD, PhD
, Niteesh K. Choudhry, MD, PhD
, Elaine Kilabuk, BA
and William H. Shrank, MD, MSHS
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women
s Hospital and Harvard
Medical School, Boston, MA, USA;
Center for American Political Studies, Harvard University, Boston, MA, USA.
Several disease-specific information
exchanges now exist on Facebook and other online
social networking sites. These new sources of knowl-
edge, support, and engagement have become important
for patients living with chronic disease, yet the quality
and content of the information provided in these digital
arenas are poorly understood.
To qualitatively evaluate the content of
communication in Facebook communities dedicated to
We identified the 15 largest Facebook groups
focused on diabetes management. For each group, we
downloaded the 15 most recent
and the 15
most recent discussion topics from the 10 largest
Four hundred eighty unique users were
identified in a series of 690 comments from wall posts
and discussion topics.
Posts were abstracted and aggre-
gated into a database. Two investigators evaluated the
posts, developed a thematic coding scheme, and applied
codes to the data.
Patients with diabetes, family mem-
bers, and their friends use Facebook to share personal
clinical information, to request disease-specific guid-
ance and feedback, and to receive emotional support.
Approximately two-thirds of posts included unsolicited
sharing of diabetes management strategies, over 13% of
posts provided specific feedback to information
requested by other users, and almost 29% of posts
featured an effort by the poster to provide emotional
support to others as members of a community. Approx-
imately 27% of posts featured some type of promotional
activity, generally presented as testimonials advertising
products. Clinically inac-
curate recommendations were infrequent, but were
usually associated with promotion of a specific product
or service. Thirteen percent of posts contained requests
for personal information from Facebook participants.
Facebook provides a forum for
reporting personal experiences, asking questions,
and receiving direct feedback for people living with
diabetes. However, promotional activity and personal
data collection are also common, with no account-
ability or checks for authenticity.
social networks; online social media; information seeking
behavior; Facebook; diabetes; disease management.
J Gen Intern Med 26(3):287