Social Media Health Interaction Theory: A New Theory for Social Media Research


Ramos, D. (Summer, 2017). Social Media Health Interaction Theory: A New Theory for Social Media Research. Online Journal of Nursing Informatics (OJNI), 21(2), Available at


This article presents an overview of the theory of social media health interaction, which can potentially provide a valuable contribution to social media health research. It offers a new theory-based approach for studying how the media and citizens represent personal and social agenda colors according to age or situational frames. Fundamental communicative mechanisms such as social media exchange, social media interaction, and personal integration are posited in the theory. These mechanisms, with a set of subcategories are presented, with a demonstration on how they can be used as conceptual analytical tools in empirical analysis.


The importance of theory in nursing cannot be underestimated since the profession requires a sound theoretical base and strong methodology to evolve an evidence-informed body of knowledge. Wacker (1998) provided three reasons why theory is important for any profession and research: (a) it provides a framework for analysis, (b) it provides an efficient method for field development, and (c) it provides a clear explanation for the pragmatic world. However, researchers continue to debate the definition of what constitutes a theory (Harlow, 2009; Henderikus, 2007). Many researchers and theorists use typologies and classification systems to describe types of theories in the context of purpose, functions, boundaries, and goals (Gay & Weaver, 2011).

Social media and the internet have fundamentally transformed how we communicate and interact (Bosslet, Torke, Hickman, Terry & Helft, 2011; Chou & Hunt 2009; Hawn, 2009; Powell  & Darvell,  2003). Virtually, all of the world’s knowledge and experiences are available at any time with just a click of the mouse. Information is easily accessible and free to anyone with a computer, and communication across continents is as easy as e-mailing someone next door.

As the Internet expanded into our homes, there was a growing expectation of free and open access to information (Bosslet et al, 2011). Since information was easily accessible on so many sites, there developed an expectation that all information should be free and reliable.

Social media are broadly defined as the use of platforms of electronic communication through which users create online communities (Chou & Hunt, 2009). Social media use is common: 74% of Internet users spend time on social networking sites, with 71% of online adults using Facebook and 23% using Twitter. Women currently outpace men in social media use, with a recent survey finding 74% of women were users of social media compared with 62% of men (Social Networking Fact Sheet, Pew Research Center, 2015).

Social media have also become an integral tool for medical societies, professional groups, and advocacy groups. These groups are using social media to engage, teach, and connect, and they play an important role in providing accurate, vetted health information. Additionally, organizations have realized that encouraging live-tweeting or blogging of conferences provides opportunities for wide dissemination of content that far surpasses in-person attendance (Carroll, Bruno, Bosslet & Ramachandran, 2015).

The influence of social media on professional practice will vary depending on the user and the context of his or her practice. There are also concerns about the effect of social media use on professional and organizational credibility, the potential distribution of unreliable information through social media technologies, and the commitment to maintain professional standards while using these technologies. Thus, the Theory of Social Media Interaction was formulated.  

Theory of Social Media Interaction Components

Metaparadigm: A metaparadigm is a global perspective of a discipline and acts a framework for structure development (Eckberg & Hill, 1979) since each profession singles out specific phenomena of interest. The concepts and propositions are identified and inter-related with the identified phenomena and further conceptualized as the concepts that comprised the metaparadigm of a profession (Fawcett, 1994). The central concepts of the discipline of nursing have been identified as person, environment, health and nursing.

Person: The person according to the theory is the recipient of nursing care particularly the health education that he/she receives from social media.

Health: Health is defined as the state of equilibrium of the mind and body. The theory purports that health is managed through effective transfer of knowledge to individuals, clients, and families.

Environment: The environment is defined as the site where nurses and patients interact wherein it influences the individual’s behaviors and relationships.  Social media utilization is affected by external environmental factors such as norms.

Nursing: Nursing seeks to promote interactions between humans and the environment to strengthen the integrity of the human being and support the realization of optimal health potential.

Theory: Theory is an “organized coherent and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole” according to Meleis (2007, p. 29). All theories have specific key concepts that specify the point of the theory.

The Theory of Social Media Interaction was formulated to explain how stable social media interactions legitimatize particular thoughts and practices regarding issues such as health and illness, and help to transform individuals through effective transfer of knowledge through social media. The key concepts of the theory are defined accordingly;

Personal Health Agenda: Nurses set up social media sites so that clients can gain access to information, assess themselves, join programs and seek referrals from experts. Personal Health agenda settings are based on identified client needs that influence health-related actions. The utilization of social media for these purposes amplifies and highlights the personal health agenda and related issues.

Social media Transaction: This is defined as the utilization of social media in response to personal health agendas set by clients, guided by the following norm principles. Norms are human behaviors that are shaped by shared rules. For instance, the concept of reciprocity is applied where there is a commitment to return a favor done by others, and the concept of commitment is applied since there are expectations that users will respond to standards and obligations.

Social Exchange: individuals interact in a way that interaction translates behaviors as either health seeking or health motivating.

Personal/Social Integration: This is the process where the agenda or information has been accepted and filtered into an individual’s behavior. This usually occurs following a three- staged progression:

  • Mind Setting wherein an individual perceives that the agenda or information is the most important thing to focus on,
  • Scaffolding wherein an individual shares how they are attached to the importance of the information and frames the contextualization of the agenda and
  • Amplification where the contextualized agenda is expressed into action and transforms an individual in some way.

Action/Reaction; perceived thoughts are articulated and influence others, which changes an individual’s perceptions and actions.

Public Health Perception Agenda: The constant interaction within a social network spurs interest and awareness about other people and strengthens the significance of the personal health agenda to public health. Individuals become empowered when they share their personal health agenda with others in the network.

Wellness: is defined as good health as an actively sought goal (Merriam-Webster Dictionary, 2004)

Active Interaction: is defined as dynamic exchanges of mutual or reciprocal influence to persuade individuals to meet their health goals and be better informed about the percolated ideas or schema within the network.

Assumptions: are concepts, or connect concepts, and represent values, beliefs or goals. When assumptions are challenged they become propositions according to Meleis (2004).

The theory of Social Media Interaction has four underlying assumptions:

  1. Social Media is a means of accessing and gaining information.
  2. Social media creates a virtual community where interaction occurs.
  3. Different groups may have diverse cultural practices regarding the acquisition and dissemination of information.
  4. People who engage in interaction are rationally seeking to maximize their health.

Proposition: these are statements that describe relationships among events, situations or actions (Meleis, 2004).

The theory of Social Media Interaction has four fundamental propositions:

  1. Interaction changes over a period of time.
  2. Social media promotes wellness.
  3. Successful interaction leads to active participation.
  4. Social media proliferates information quickly.

Conceptual Model: is defined as a set of concepts and statements that integrate the concepts into a meaningful configuration (Fawcett, 1994). The theory of Social Media Interaction conceptual model is illustrated in Figure 1.


Social media has both intensive and extensive influences on individuals and groups. This paper presented the key concepts of the theory of Social Media Interaction that conceptualizes how health interaction can be influential in social media. The theoretical framework can help people understand the role of social media in disseminating health information and influence personal health agendas and behaviors.


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Author Bio
Dennis Glen G. Ramos RN, MSN graduated with a BSN in 1995. He finished his Masters Degree in nursing with a Major in Maternal and Child Health Nursing in the same institution in 2012. Currently, he is an Associate Professor at the Saint Louis University-School of Nursing where he has taught for the past 12 years. He is also completing his doctorate degree in Nursing (PhD Nursing) at Saint Louis University, Baguio City.