To examine whether Facebook could support a community-based group lifestyle intervention for adults with serious mental illness. Participants with serious mental illness and obesity enrolled in a 6-month group lifestyle program were invited to join a secret Facebook group to support their weight loss and physical activity goals. Two peer co-facilitators moderated the Facebook group. The proportion of participants who achieved ≥5% weight loss or improved fitness was measured at follow-up. The relationship between this outcome and participants’ interactions in the Facebook group was examined. Interactions were defined as active contributions including posts, comments, or likes. Content of participants’ Facebook posts was also explored. Participants (n = 25) had major depression (44%), bipolar disorder (36%), and schizophrenia (20%). Nineteen (76%) participants joined the Facebook group, and contributed 208 interactions (70 posts; 81 comments; 57 likes). Participants who achieved ≥5% weight loss or improved fitness contributed more interactions in the Facebook group (mean = 19.1; SD = 20.5) compared to participants who did not (mean = 3.9; SD = 6.7), though this relationship approached statistical significance (t = −2.1; Welch’s df = 13.1; p = 0.06). Participants’ posts containing personal sharing of successes or challenges to adopting healthy behaviors generated more interaction compared to posts containing program reminders (p < 0.01), motivational messages (p < 0.01), and healthy eating content (p < 0.01). Facebook appears promising for supporting health behavior change among people with serious mental illness. These findings can inform social media initiatives to scale up health promotion efforts targeting this at-risk group.
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This study was supported by the National Institute of Mental Health (R01 MH089811). Additional support was received from the Dartmouth Health Promotion Research Center supported by a grant from the United States Centers for Disease Control and Prevention (Cooperative Agreement Number U48DP005018). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflict of interest
Lisa A. Marsch is a partner with HealthSim, LLC and Square2, Inc. These relationships are managed exclusively by Dartmouth College. This manuscript does not reference in any way the products of these entities. All remaining authors report no conflicts of interests.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the Dartmouth College Committee for the Protection of Human Subjects and the New Hampshire Department of Health and Human Services, and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in this study.
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Naslund, J.A., Aschbrenner, K.A., Marsch, L.A. et al. Facebook for Supporting a Lifestyle Intervention for People with Major Depressive Disorder, Bipolar Disorder, and Schizophrenia: an Exploratory Study. Psychiatr Q 89, 81–94 (2018). https://doi.org/10.1007/s11126-017-9512-0
- Social media
- Serious mental illness
- Lifestyle intervention
- Weight loss