Framing health: how health communication theories and strategies shape NCD prevention content on Facebook Sri Lanka.

BACKGROUND: Social media platforms like Facebook are increasingly used for health communication, particularly for the prevention of non-communicable diseases (NCDs). This study evaluates the use of health communication theories and strategies in Facebook campaigns in Sri Lanka organized by the entities of the Ministry of Health. METHODS: A two-phase approach was used. First, a literature review identified suitable theories and strategies to create an evaluation framework. Second, 15 Facebook posts from Sri Lanka’s NCD Unit, Health Promotion Bureau (HPB), and Ministry of Health were analyzed. Data were evaluated based on a scoring system to assess the application of health communication theories and strategies. RESULTS: The Health Belief Model (HBM), a psychological model that explains and predicts health behaviors by focusing on individual perceptions of health risks and benefits, and the Social Marketing Mix (SMM) and Lasswell’s 5W, were identified as the most popular and comprehensive theories and strategies in health communication. Results showed strong strategic use, including audience targeting and content structure, but the use of health communication theories, such as HBM, is minimal. Posts aligned well with the Social Marketing Mix and Lasswell’s 5W model. Animated videos showed the best theoretical alignment, but engagement was low unless posts were boosted with paid promotions. Content on physical inactivity was underrepresented. CONCLUSIONS: Facebook posts used strategies but lacked strong theoretical foundations. Training content creators to include theory-based approaches and balancing theory with strategy can improve the quality of health communication. This study highlights the need for better policies, training programs, and further research to make social media a more powerful tool in preventing NCDs.