Abstract
BACKGROUND: Nonprofit organizations have always played an important role in health promotion. Social media is widely used in health promotion efforts. However, there is a lack of evidence on how decisions regarding the use of social media are undertaken by nonprofit organizations that want to increase their impact in terms of health promotion. OBJECTIVE: The aim of this study was to understand why and how nonprofit health care organizations put forth social media strategies to achieve health promotion goals. METHODS: A multiple case study design, using in-depth interviews and a content analysis of each social media strategy, was employed to analyze the use of social media tools by six North American nonprofit organizations dedicated to cancer prevention and management. RESULTS: The resulting process model demonstrates how social media strategies are enacted by nonprofit organizations to achieve health promotion goals. They put forth three types of social media strategies relative to their use of existing information and communication technologies (ICT)-replicate, transform, or innovate-each affecting the content, format, and delivery of the message differently. Organizations make sense of the social media innovation in complementarity with existing ICT. CONCLUSIONS: For nonprofit organizations, implementing a social media strategy can help achieve health promotion goals. The process of social media strategy implementation could benefit from understanding the rationale, the opportunities, the challenges, and the potentially complementary role of existing ICT strategies.