Influence agenda setting through Twitter for health promotion
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We are in what is known as the new media era, and it impacts all dimensions and aspects of people’s lives. Through advanced technology and the internet, new media continues evolving to change people’s lives so that they rely heavily on it for communication. The revolution of new media through various tools, channels and platforms requires that many of the classic and traditional presuppositions about communication are reviewed and revised. This extends to all domains of life including that of health. The promotion of health using new media lacks the research basis for effective application in practice. The purpose of this study is to explore the ability of traditional communication theories in understanding and using new media for health promotion. It does this in the context of the dissemination of tweets about road traffic accidents in Saudi Arabia. The study utilised an agenda-setting function from communication theory as a general framework through a three-stage research structure. The first stage focuses on the identification of influential opinion leaders in diffusing their influence among users of the new media channels. The study examined several methods and tools to identify these opinion leaders and to evaluate their impact in influencing others. In total, 99 Saudi Twitter influencer accounts were identified. In addition these accounts were classified to investigate the influential groups among Saudis who were 25 religious men/women, 16 traditional media, 14 sports related, 10 new media, 6 political, 6 company and 4 health accounts. The second stage used the Diffusion of Innovations Theory to examine how this influence can spread. The study investigated different statistical measures and indicators to understand how the diffusion of influence can be evaluated and enhanced. It utilised the innovation/imitation coefficients (p and q) Bass Model, a model of Diffusion of Innovations to propose an informative indicator of successful tweets diffusion. Moreover, the results provided a primary evaluation of using traditional communication message design for new media communications. The third stage explored the effectiveness of using agenda-setting for health promotion in the new media era. It proposed adaptations to the agenda-setting model to be explored reflecting two levels of engagement: agenda setting within the new media sphere and the position of new media within classic agenda setting. Multiple hypotheses were developed to test these two levels of engagement. The results showed significant ratification of the study hypotheses at both levels of engagement proposed in the model adapted for Agenda Setting in the new media era. The findings from the study identified the key influentials on Twitter in Saudi Arabia. This group can be used to promote health. Indicators to evaluate the diffusion processes were also identified in relation to the Diffusion of Innovations Theory. This can inform further development of health promotion practices. Most importantly the study findings support the proposed adaptation of agenda setting in the new media era. This will facilitate innovative programmes using new media platforms. Traditional communication theory can provide some insight into the best use of new media but the uniqueness of new media must be reflected in the development of communication theory for health promotion.