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Using social media to increase preventative behaviors against arboviral diseases: a pilot study among teens in the Dominican Republic.

Background
Social media presents new opportunities for community-based interventions. However, studies demonstrating effectiveness and practicality in resource-poor areas of Latin America and the Caribbean are lacking. In these areas at high risk for vector-transmitted illnesses, disease prevention practices at the community level are necessary for sustainable improvement. This study evaluated social media as a peer-to-peer health communication tool to promote education and encourage preventative behaviors against arboviral diseases among youth in the Dominican Republic.


Methods
In 2016, 31 youth ages 14-18 years from three cities in the Dominican Republic were enrolled into either of two Facebook groups receiving a 3-month arbovirus prevention-focused intervention with weekly educational posts, or a control group. Arboviral prevention, knowledge, and practice were evaluated with pre-and post-surveys. The level of online engagement was analyzed through online metrics. Linear regression models were used to determine the association between metrics of online activity and pre- and post-survey score difference.


Results
Knowledge scores increased significantly in the intervention groups (51.1% increase) compared to the control group (1.2% increase, P<0.0001). The intervention groups also showed a significant increase in the frequency of preventative behaviors in all categories (primary bite prevention P=0.017, household vector control P=0.0024, community vector control P=0.0021). Increased online engagement parameters were associated with statistically significant increases in survey scores (P<0.0001) and preventative behaviors in all categories (P=0.0007-0.0011), even between intervention groups (P<0.0001).


Conclusions
This study provides evidence of the effectiveness of engagement in social media peer-to-peer education groups as an accessible and practical intervention to improve arboviral disease knowledge and prevention practices among youth in a low- and middle-income country. The different levels of online engagement that were observed between intervention groups strongly correlated to changes in participant knowledge and behavior. Possible explanations of the divergent online activity between study groups are discussed within a theoretical framework and should be taken into consideration in future studies.