Exploring Health Advice Adoption in Digital Spaces: A Dual-Theory Approach
DOI:
https://doi.org/10.26740/vubeta.v3i1.39662Keywords:
Digital health, coping mechanisms, misinformation, privacy protection, social media platforms, healthcare providers, health literacy, professional accountability., Digital health , Coping mechanisms , Privacy protection , Healthcare providers , Professional accountabilityAbstract
Digital health platforms, including social media sites like TikTok and Facebook, have become important spaces for health communication, offering opportunities for peer support and information sharing. However, these platforms also pose significant risks, including misinformation, privacy violations, and a lack of professional oversight. This scoping review investigates the coping mechanisms used by patients and healthcare providers in digital health environments, with a focus on navigating misinformation and unregulated content on social media. A total of 36 peer-reviewed studies published between 200 and 2025 were reviewed across databases such as PubMed, Scopus, and Google Scholar. A thematic analysis was conducted to identify dominant coping strategies and recurring challenges. The most common coping strategies included cross-checking health information with verified sources, avoiding unverified accounts, and seeking direct consultation with qualified professionals. Despite these strategies, users remain vulnerable due to inconsistent regulation, limited digital health literacy, and the lack of mechanisms for verifying professional credentials online. Digital health ecosystems must be supported by more robust and enforceable regulatory frameworks. Strengthening privacy protocols and issuing platform-specific guidelines for ethical conduct can further protect users and improve trust in digital health communication. This study advances understanding of coping mechanisms in digital health by synthesizing how users manage misinformation, privacy, and oversight challenges on social media, offering insights to improve safety and accountability and to inform future policy.
References
[1] Adams, N.-R., “Privacy and data protection in healthcare in South Africa”, Data protection and privacy, October 15, 2024.
[2] Arksey, H., & O’Malley, L., “Scoping studies: Towards a methodological framework”, International Journal of Social Research Methodology, vol. 8, no. 1, 19–32, 2005, https://doi.org/10.1080/1364557032000119616
[3] Aseri, A., “The implication of the European Union's General Data Protection Regulation (GDPR) on global data privacy”, Vanderbilt Journal of Transnational Law, vol. 53, no. 2, Article 6, 2020.
[4] Basch, C. H., Hillyer, G. C., Zagnit, E. A., & Basch, C. E., “YouTube coverage of COVID-19 vaccine development: Implications for awareness and uptake”, Human Vaccines & Immunotherapeutics, vol. 16, no.11, pp. 2582-2585, 2020 https://doi.org/10.1080/21645515.2020.1790280
[5] Alyafei, A., & Easton-Carr, R., “The Health Belief Model of behavior change”, StatPearls Publishing, 2024
[6] Badr, J., Motulsky, A., & Denis, J., “Digital health technologies and inequalities: A scoping review of potential impacts and policy recommendations”, Health Policy, vol. 146, 105122, 2024. https://doi.org/10.1016/j.healthpol.2024.105122
[7] Bene, B. A., Ibeneme, S., Fadahunsi, K. P., Harri, B. I., Ukor, N., Mastellos, N., Majeed, A., & Car, J., “Regulatory standards and guidance for the use of health apps for self-management in Sub-Saharan Africa: Scoping review”, Journal of Medical Internet Research, vol. 26, e49163, 2024. https://doi.org/10.2196/49163
[8] Bouabida, K., Lebouché, B., & Pomey, P., “Telehealth and COVID-19 pandemic: An overview of the telehealth use, advantages, challenges, and opportunities during the COVID-19 pandemic”, Healthcare, vol. 10, no. 11, 2293, 2022. https://doi.org/10.3390/healthcare10112293
[9] Busse, T. S., Nitsche, J., Kernebeck, S., Jux, C., Weitz, J., Ehlers, J. P., & Bork, U., “Approaches to improvement of digital health literacy (eHL) in the context of person-centered care”, International Journal of Environmental Research and Public Health, vol. 19, no. 14, 8309, 2021. https://doi.org/10.3390/ijerph19148309
[10] Bussey, L. G., & Sillence, E., “The role of internet resources in health decision-making: A qualitative study”, Digital Health, vol. 5, 2055207619888073, 2019. https://doi.org/10.1177/2055207619888073
[11] Burke, M., & Kraut, R. E., “The Relationship between Facebook Use and Well-Being Depends on Communication Type and Tie Strength”, Journal of Computer-Mediated Communication, vol. 21, pp. 265-281, 2016. https://doi.org/10.1111/jcc4.12162
[12] Canadian Institute for Health Information, “Digital health literacy and professional accreditation in Canada”, 2021
[13] Chandrakar, E., & Dahiya, A., “The legal and public health implications of digital health technologies. South Eastern European Journal of Public Health, no. 1289, 2024. https://doi.org/10.70135/seejph.vi.1289
[14] Chen, J., & Wang, Y., “Social media use for health purposes: Systematic review”, Journal of Medical Internet Research, vol. 23, no. 5, e17917, 2021. https://doi.org/10.2196/17917
[15] Chou, S. W. Y., Gaysynsky, A., & Cappella, J. N., “Where we go from here: Health misinformation on social media”, American Journal of Public Health, vol. 110, S3, S273-S275, 2020. https://doi.org/10.2105/AJPH.2020.305905
[16] Cliffe Dekker Hofmeyr, “A new era for traditional healers: A step towards formalisation and regulation”, 2024.
[17] Cohen, I. G., & Mello, M. M.,“Big data, big tech, and protecting patient privacy”, JAMA, vol. 322, no.12, 1141, 2019. https://doi.org/10.1001/jama.2019.11365
[18] Centola, D., “How behavior spreads: the science of complex contagions”, Princeton University Press, 2018. https://doi.org/10.23943/9781400890095
[19] Competition Commission, “Competition in the digital economy”, 2020
[20] Davis, F. D., “Perceived usefulness, perceived ease of use, and user acceptance of information technology”, MIS Quarterly, vol. 3, no.3, pp. 319–340, 1989. https://doi.org/10.2307/249008
[21] DLA Piper. (n.d.). How is telehealth regulated? In South Africa - DLA Piper Telehealth Around the World.
[22] Edemekong, P. F., Annamaraju, P., Afzal, M., & al., “Health Insurance Portability and Accountability Act (HIPAA) compliance. In StatPearls. StatPearls Publishing, 2024.
[23] European Parliament & Council of the European Union, Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data (General Data Protection Regulation). Official Journal of the European Union, L119, pp. 1-88, 2016.
[24] Eysenbach, G., “What is e-health?”, Journal of Medical Internet Research, vol. 3, no. 2, 2001. https://doi.org/10.2196/jmir.3.2.e20
[25] Federal Ministry of Health, “Digital Healthcare Act (Digitale-Versorgung-Gesetz – DVG)”, 2020.
[26] Fernandes, F., & Chaltikyan, G., “Analysis of legal and regulatory frameworks in digital health: A comparison of guidelines and approaches in the European Union and United States”, Journal of the International Society for Telemedicine and EHealth, vol. 8, e11, pp. 1-13, 2020. https://doi.org/10.29086/JISfTeH.8.e11
[27] Ferreira Caceres et al., “The impact of misinformation on the COVID-19 pandemic”, AIMS Public Health, vol. 9, no. 2, 262, 2022 https://doi.org/10.3934/publichealth.2022018
[28] Filkins, B. L. et al., “Privacy and security in the era of digital health: What should translational researchers know and do about it?”, American Journal of Translational Research, vol. 8, no. 3, 1560, 2016. https://pmc.ncbi.nlm.nih.gov/articles/PMC4859641/
[29] Fitzpatrick, P. J., “Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners”, Frontiers in Digital Health, vol. 5, 1264780, 2023. https://doi.org/10.3389/fdgth.2023.1264780
[30] Garett, R., & Young, S. D., “The role of social media in monitoring COVID-19 vaccine uptake”, Journal of Evaluation in Clinical Practice, vol. 28, no. 4, 650, 2022. https://doi.org/10.1111/jep.13656
[31] Gasser, U., & Almeida, V. A. F., “A layered model for AI governance”, IEEE Internet Computing, vol. 21, no. 6, pp. 58–62, 2017. https://doi.org/10.1109/MIC.2017.4291056
[32] Guraya, S. S., Guraya, S. Y., & Bahri Yusoff, M. S., “Preserving professional identities, behaviors, and values in digital professionalism using social networking sites: A systematic review”, BMC Medical Education, vol. 21, no. 381, 2021. https://doi.org/10.1186/s12909-021-02802-9
[33] Health Professions Council of South Africa”, HPCSA media statement: Guidelines on telemedicine in South Africa, 2021
[34] Helberger, N., Pierson, J., & Poell, T., “Governing online platforms: From contested to cooperative responsibility”, The Information Society, vol. 34, no. 9, pp. 1–14, 2018. https://doi.org/10.1080/01972243.2017.1391913
[35] Hohlfeld, A., Kredo, T., & Clarke, M.,“A scoping review of activities intended to reduce publication bias in randomised trials”, Systematic Reviews, vol. 13, no. 310, 2024. https://doi.org/10.1186/s13643-024-02742-1
[36] Joseph, A. M. et al., “COVID-19 misinformation on social media: A scoping review”, Cureus, vol. 14, no. 4, e24601, 2022. https://doi.org/10.7759/cureus.24601
[37] Katz, E., Blumler, J. G., & Gurevitch, M., Uses and gratifications research, Public Opinion Quarterly, vol. 37, no. 4, pp. 509–523 1973. https://doi.org/10.1086/268109
[38] Keesara, S., Jonas, A., & Schulman, K., “Covid-19 and health care’s digital revolution”, New England Journal of Medicine, vol. 382, no. 23, e82, 2020. https://doi.org/10.1056/NEJMp2005835
[39] Keller, E. J., Mlambo, V. C., Resnick, S. A., & Vogelzang, R. L., “Ethical and legal issues involving medical social media”, Seminars in Interventional Radiology, vol. 39, no. 2, 203, 2022. https://doi.org/10.1055/s-0042-1745717
[40] Kirby, N., & Geel, J., “The legal and ethical processing of healthcare information”, Legal Brief, 2023.
[41] Levac, D., Colquhoun, H. & O'Brien, K.K., “Scoping studies: advancing the methodology”, Implementation Sciences, vol. 5, no. 69, 2010. https://doi.org/10.1186/1748-5908-5-69
[42] Li, H. O.-Y., Bailey, A., Huynh, D., & Chan, J., “YouTube as a source of information on COVID-19: A pandemic of misinformation?”, BMJ Global Health, vol. 5, no. 5, e002498, 2022. https://doi.org/10.1136/bmjgh-2020-002498
[43] Maltby, J., Rayes, T., Nage, A., Sharif, S., Omar, M., & Nichani, S., “Synthesizing perspectives: Crafting an Interdisciplinary view of social media’s impact on young people’s mental health”, Plos One, vol. 19, no. 7, e0307164, 2024. https://doi.org/10.1371/journal.pone.0307164
[44] Mohamed, F., & Shoufan, A., “Users’ experience with health-related content on YouTube: An exploratory study”, BMC Public Health, vol. 24, no. 86, 2024. https://doi.org/10.1186/s12889-023-17585-5
[45] Mörelius, E., Robinson, S., Arabiat, D., & Whitehead, L., “Digital interventions to improve health literacy among parents of children aged 0 to 12 years with a health condition: Systematic review”, Journal of Medical Internet Research, vol. 23, no. 12, e31665, 2021. https://doi.org/10.2196/31665
[46] Moorhead, S. A., Hazlett, D. E., Harrison, L., Carroll, J. K., Irwin, A., & Hoving, C., “A new dimension of health care: Systematic review of the uses, benefits, and limitations of social media for health communication”, Journal of Medical Internet Research, vol. 15, no. 4, e85, 2013. https://doi.org/10.2196/jmir.1933
[47] Mumtaz, H., Riaz, et al., “Current challenges and potential solutions to the use of digital health technologies in evidence generation: A narrative review”, Frontiers in Digital Health, vol. 5, 1203945, 2023. https://doi.org/10.3389/fdgth.2023.1203945
[48] Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E., “Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach”, BMC Medical Research Methodology, vol. 18, no. 143, 2018. https://doi.org/10.1186/s12874-018-0611-x
[49] Nittas, V., Daniore, P., Chavez, S. J., & Wray, T. B., “Challenges in implementing cultural adaptations of digital health interventions”, Communications Medicine, vol. 4, no. 7, 2024. https://doi.org/10.1038/s43856-023-00426-2
[50] NHS England, Verified health content and partnerships, 2022.
[51] Ohannessian, R., Duong, T. A., & Odone, A., “Global telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: A call to action”, JMIR Public Health and Surveillance, vol. 6, no. 2, e18810, 2020. https://doi.org/10.2196/18810
[52] South Africa, National Health Act No. 61 of 2003. Government Gazette, 2003.
[53] Omboni, S. et al., “The worldwide impact of telemedicine during COVID-19: Current evidence and recommendations for the future”, Connected Health, vol. 1, no.7, 2022. https://doi.org/10.20517/ch.2021.03
[54] Paul, M., Maglaras, L., Ferrag, M. A., & Almomani, I., “Digitisation of healthcare sector: A study on privacy and security concerns”, ICT Express, vol. 9, no. 4, 571-588, 2023. https://doi.org/10.1016/j.icte.2023.02.007
[55] Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B., “Guidance for conducting systematic scoping reviews”, International Journal of Evidence-Based Healthcare, vol. 13, no. 3, pp. 141–146, 2015 https://doi.org/10.1097/XEB.0000000000000050
[56] Rogers, E. M., Diffusion of innovations (5th ed.). Free Press, 2003
[57] Shanmugasundaram, M., & Tamilarasu, A., “The impact of digital technology, social media, and artificial intelligence on cognitive functions: A review”, Frontiers in Cognition, vol. 2, 2023. https://doi.org/10.3389/fcogn.2023.1203077
[58] Sharma, D., & Gahane, S., “Connecting health and technology: A comprehensive review of social media and online communities in healthcare”, Cureus, vol. 16, no. 3, e55361, 2024. https://doi.org/10.7759/cureus.55361
[59] Shaw, J. A., & Donia, J., “The sociotechnical ethics of digital health: A critique and extension of approaches from bioethics”, Frontiers in Digital Health, vol. 3, 725088, 2021. https://doi.org/10.3389/fdgth.2021.725088
[60] Smailhodzic, E., Hooijsma, W., Boonstra, A., & Langley, D. J., “Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals”, BMC Health Services Research, vol. 16, no. 1, Article 410, 2016. https://doi.org/10.1186/s12913-016-1691-0
[61] Suarez-Lledo, V., & Alvarez-Galvez, J., “Prevalence of health misinformation on social media: Systematic review”, Journal of Medical Internet Research, vol. 23, no. 1, e17187, 2021. https://doi.org/10.2196/17187
[62] Sundar, S. S., & Marathe, S. S., “Personalization versus customization: The importance of agency, privacy, and power usage”, Human Communication Research, vol. 36, no. 3, pp. 298–322, 2010. https://doi.org/10.1111/j.1468-2958.2010.01377.x
[63] Swales, L., “The Protection of Personal Information Act 4 of 2013 in the context of health research: Enabler of privacy rights or roadblock?”, PER, vol. 25, no. 1, pp. 1-32, 2022. https://doi.org/10.17159/1727-3781/2022/v25i0a11180.
[64] Swire-Thompson, B., & Lazer, D., “Public health and online misinformation: Challenges and recommendations”, Annual Review of Public Health, vol. 41, pp. 433–451, 2020. https://doi.org/10.1146/annurev-publhealth-040119-094127
[65] Ruggiero, T. E., “Uses and gratifications theory in the 21st century”, Mass Communication & Society, vol. 3, no. 1, pp. 3–37, 2000, https://doi.org/10.1207/S15327825MCS0301_02.
[66] The Protection of Personal Information Act 4 of 2013 (POPIA), Republic of South Africa, 2013
[67] Topol, E., Deep medicine: How artificial intelligence can make healthcare human again. Basic Books, 2019
[68] Vayena, E., Haeusermann, T., Adjekum, A., & Blasimme, A., “Digital health: Meeting the ethical and policy challenges”, Swiss Medical Weekly, vol. 148, w14571, 2018. https://doi.org/10.4414/smw.2018.14571
[69] Venkatesh, V., & Davis, F. D., “A theoretical extension of the Technology Acceptance Model: Four longitudinal field studies”, Management Science, vol. 46, no. 2, pp. 186–204, 2020. https://doi.org/10.1287/mnsc.46.2.186.11926
[70] Ventola, C. L., “Social media and healthcare professionals: Benefits, risks, and best practices”, Pharmacy and Therapeutics, vol. 39, no. 7, pp 491-501, 2014.
[71] Vosoughi, S., Roy, D., & Aral, S., “The spread of true and false news online”, Science, vol. 359, no. 6380, pp. 1146–1151, 2018. https://doi.org/10.1126/science.aap9559
[72] Walwema, J., “The WHO Health Alert: Communicating a global pandemic with WhatsApp”, Journal of Business and Technical Communication, vol. 35, no. 4, Article 105065192095850, 2020. https://doi.org/10.1177/1050651920958507
[73] Waszak, P. M., Kasprzycka-Waszak, W., & Kubanek, A., “The spread of medical fake news in social media – The pilot quantitative study”, Health Policy and Technology, vol. 7, no. 2, pp. 115-118, 2018. https://doi.org/10.1016/j.hlpt.2018.03.002
[74] World Health Organization, WHO Health Alert brings COVID-19 facts to billions via WhatsApp, 2021, April 26.
[75] World Health Organization, Universal health coverage (UHC). World Health Organization, March 26, 2025.
[76] Xiang, D., & Cai, W., “Privacy protection and secondary use of health data: Strategies and methods”, BioMed Research International, pp. 1-11, 2021. https://doi.org/10.1155/2021/6967166
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