Laugh Model: Restructuring the Framework of Public Health in Social Media

Theoretical Background and research questions/hypothesis: Public health has traditionally used social media platforms (facebook.com/ youtube.com) to distribute educational public health messages. Research has found these educational approaches to be severely limited in their reach, in that few social media users ever see these messages. One possible explanation is that although public health is focused primarily on education, U.S. social media is geared primarily toward entertainment. This preference for entertainment is illustrated by several case studies. For example, the media campaign “This is Public Health," reached 46,000 views in four years, while “Dumb Ways to Die,” a humorous video with a brief safety message, reached 11 million views within four days. Our research sought to investigate response to a public health message by assessing user activity on YouTube, with a goal of developing an effective model of health promotion or social marketing in social media. 

Methods and Results (informing the conceptual analysis):  Tobacco public service announcements (PSAs) on YouTube were monitored for user activity by tracking how often and where users clicked after watching the PSA videos. URLs of videos were pulled from where users clicked and then categorized into content groups (humor/entertainment, sexual videos, etc.). Groups were mapped by computers searching through titles and comments on videos. Users were found to navigate away from tobacco health messages within three clicks.  Overall, users were subsequently found watching either strictly humorous or sexual videos on YouTube.  These findings were compiled and contextualized into a new framework, “The Laugh Model,” developed to provide a model for developing effective public health messages.  

Conclusions:  Our finding is consistent with existing research that found online user preference for entertainment, and that educational videos are not only watched less often, but do not get forwarded to others. Without the forwarding of health videos or PSAs, there is little chance to achieve “viral status” or a large number of views. Based on these trends, we suggest a paradox of social media-based health education. Specifically, we propose that entertaining videos have the potential for greater public health impact than overtly educational videos, given that research has shown entertainment to have greater reach and public preference.

Implications for research and/or practice:  We propose the introduction of The Laugh Model, a new social media paradigm in which public health videos are designed primarily to entertain, while including understated and discreet public health messages. Core components of this model (adapted from Edutainment model and viral marketing) include Motive Replacement, Health Need Assessment, Product Development, Non-Traditional Partners, Behavioral Monitoring, and Sustainability. The Laugh Model has two overarching goals: 1) to help public health messages better reach and inform the public, and 2) to incorporate a sustainable business model where advertisers and interest groups pay developers to create popular public health videos. To have a behavioral impact via social media, public health first needs to gain a captive audience. This new model proposes a way to achieve this end and does so in a sustainable manner, reducing or eliminating the need for public funding for health promotion.