Study Looks at Feasibility of Using Facebook as an Intervention Tool for Cardiac Rehab Patients

Lee Anne Siegmund, PhD, RN, ACSM-CEP, a nurse scientist at Cleveland Clinic’s Office of Nursing Research and Innovation, has developed an interest in the use of social media in research. “That’s the direction we are going in,” says Siegmund. “In the future, researchers will have to incorporate all kinds of modern technology, including social media.”

Siegmund has written two articles on the topic, the first, “Social Media: The Next Research Frontier,” in the journal Clinical Nurse Specialist® in 2018 and the second, “Like Us on Facebook: Nursing in a World of Social Media,” to be published in September in the Journal of Radiology Nursing. In her most recent research project, she conducted a feasibility study using a social media intervention for cardiac rehabilitation adherence.

Background and study methods

Prior to working as a nurse scientist, Siegmund was an exercise physiologist in cardiac rehabilitation. She experienced first-hand the issues with low patient adherence, attendance or engagement in rehab. This influenced her decision to launch the study.

“Patients talk about barriers related to transportation, time and convenience. But we also know that peer support is an important aspect in adherence,” says Siegmund. “I wanted to determine the feasibility of using Facebook as an intervention to affect change in motivation and self-determination for exercise and adherence for cardiac rehab.”

Siegmund recruited cardiac rehabilitation participants by phone, then randomly assigned them to the Facebook group or the comparison group. She created a private Facebook group and an intervention for participants in that group that included supportive, educational and motivational posts on the Facebook site. She also encouraged peer interaction.

All participants completed two questionnaires at intake and exit, after 12 weeks of cardiac rehab: Psychological Needs Satisfaction in Exercise and Behavioral Regulations in Exercise. In addition, Siegmund added eight questions to the exit interview related to how often the participants logged in to Facebook and what the perceived benefits were for the Facebook group.

Results and conclusions

Siegmund screened 522 patients for eligibility and was able to contact 210 cardiac rehabilitation patients to participate. A total of 48 adults were assigned to either the Facebook group or a comparison group who received educational emails. In total, 12 (5 Facebook group and 7 comparison group) completed intake and exit questionnaires and participated in the intervention. The results for those who participated in the Facebook intervention were as follows:

• Participants logged into the Facebook page an average of 1 time per week.
• There were 15 “likes” of posts per person over 12 weeks of rehabilitation.
• There were 21 comments in the group.
• Average Likert scores on post-intervention questions was high for: “Did you feel supported?” “Did you feel in touch with providers?” and “Do you feel healthier?”
• The post-intervention question, “Did you chat with others?” scored in the low range.

“The activity in the Facebook group was lower than I wanted, although the experiences of the small group were very positive,” says Siegmund. “Participants felt supported and in touch with their providers as a result of the intervention.” Siegmund speculated that low activity may have been because the questionnaires were too burdensome. In addition, the study enrollment and data collection periods coincided with controversy over Facebook and privacy issues that made national news, which may have limited participant confidence in being in an unknown Facebook group.

The current study was not feasible as designed. Siegmund adds that future research could include the addition of interactive posts or Facebook Live, as well as recruitment by Facebook rather than phone to draw more participants.