The Internet is becoming an increasingly common source of health information. Approximately 60% of Internet users report using the Internet to look for health information [1,2]. In addition to seeking health information, Wen et al [3] found that 15% of Internet users also tracked personal health information on the Internet. Determinants of seeking health information online include education, gender, race, age, presence of children in the home, having a poor personal health condition, and geographic residence [1,4-7]. Similarly, predictors of using the Internet to track personal health information include gender, race, education, and having a health care provider [3].

Historically, online health seeking meant visiting an agency- or organization-sponsored website. Recently, social media sites are emerging as a potential source of online health information [8]. Social media refers to “activities, practices, and behaviors among communities of people who gather online to share information, knowledge, and opinions using conversational media” [9]. These social media are broadly categorized as forums and message boards, review and opinion sites, social networks (eg, Facebook), blogging and microblogging (eg, Twitter), bookmarking, and media sharing (eg, YouTube) [10].

Individual use of social media is steadily increasing. Nearly two-thirds (65%) of adult Internet users in the United States are involved with a type of social media called social networking sites (SNS), such as MySpace, Facebook, or LinkedIn [11]. Technorati currently registers over 1.3 million blogs [12], 13 percent of Internet users (140 million people) have a Twitter account [13,14], and Facebook has 955 million active users [15]. By 2015, it is estimated that the number of individuals and corporations who have social networking accounts will reach over 3 billion [16].

Social media and SNS use varies by demographics. There are statistically significant differences in SNS use between younger and older ages and between males and females [11]. However, SNS are used fairly equally across education, income, race/ethnicity, and rural and urban locations [11]. Chou and colleagues [17] found that age and education were predictors of 3 forms of social media use (ie, participating in online support groups, blogging, and visiting a SNS).

In contrast to going online to seek health information, social media technologies allow online social media users to create, distribute, and share information independent of an organization. The level of use and involvement with social media technologies varies by individual. Bernoff and Anderson [18] and Li and Bernoff [19] classify individuals based on how they use social media. These classifications, although not mutually exclusive, include creators, conversationalists, critics, collectors, joiners, or spectators. Similarly, Hoffman and Novak [20] identify 4 goals for social media use: create, connect, consume, and control. The main conclusion from both typologies is that the range of social media activities that people engage in varies from consuming to creating content.

Despite the near ubiquity of social media use and the high prevalence of health information seeking on the Internet, there is a dearth of literature about the characteristics of people who use social media for seeking health information and how these people engage with social media. Thus, additional research is needed to determine whether social media users are primarily spectators, or if they are creators or critics. That is, are they looking for information or are they becoming part of the information creation and sharing process? Knowing the correlates of social media use for health information can allow health professionals to more accurately segment populations and tailor interventions accordingly. Therefore, the aim of this research was two-fold. First, to establish the frequency of various forms (eg, spectators, creators, or critics) of online health-seeking behaviors. Second, this research seeks to identify correlates of 2 health-related online activities: (1) using SNS for health-related activities, and (2) consulting online user-generated content for answers about health care providers, health facilities, or medical treatment.

This study examined the frequency of engaging in content creation through posting on social media sites, consumption of online rankings and reviews, and use of SNS for health-related activities. In addition, correlates for engaging in those behaviors were examined. The rate of online health information seeking behavior was similar to what has been reported previously [1,2]. Results show that although social media technologies allow people the opportunity to participate in the creation of online information, this is not very common; less than 15% of people reported doing so. In contrast, people are more likely to consume content with 30% to 40% of respondents reporting use of SNS for health-related activities and use of online rankings or review of doctors, hospitals, and medical treatments.

The lack of creating and contributing content is an intriguing finding. The value of social media is in the sharing of information within social networks. The rate of contributing opinions and experiences on other social media venues, such as product reviews or rankings sites (eg, Amazon or TripAdvisor), is similar to what we found in the current study [22]. People are not contributors. One explanation might be related to the fact that the frequency of encounters with doctors, hospitals, or medical treatments is less often, so there may be less motivation to share experiences. It could also be due to users’ feelings of incompetence relating to health topics, preferring to leave such discussions to trained professionals. Overall, there is a need for more research to understand the motivations and perceived benefits of contributing to health-related online forums, discussion boards, rating sites, and other social media venues.

Use of SNS for health was more common among females and younger people. These findings are not surprising given that this same group is more likely to use SNS in general [11]. Although growing in popularity among older populations, SNS use is still more common among people younger than 50 years of age, and particularly among the 18-29 year age group [11], which is consistent with our findings that younger audiences are more likely to use SNS for health-related activities.

People with chronic disease were twice as likely to consult online rankings or reviews. Previous research has shown that people in poorer health are more likely to seek health information online [6,23], hence consulting online data about doctors, hospitals, and medical treatments is probably reflective of the need for information to manage their condition. In addition, people who more frequently use health care services may be more invested in their health and, therefore, seek high quality experiences. Additionally, individuals with a chronic disease may also have greater medical knowledge about their condition and may feel more competent sharing that knowledge in a social media venue. It may be that use of social media for health is most applicable for specific segments of the population, such as those people who are trying to manage a chronic health condition.

Higher income was also associated with increased likelihood of consulting online rankings and reviews. This is similar to research that found health information seeking was also more common among higher income groups [24]. This may be because people with higher income use the Internet more often [25]. Alternatively, more health care options may be available to those with higher income than to those with lower income because of health insurance coverage, so they are able to discriminate among their choices in providers and treatment.

Regression models showed that having a regular health care provider is the only significant variable associated with both consulting online rankings and reviews and for using SNS for health-related activities. This is consistent with previous research that found that having a health care provider is associated with tracking personal health information on the Internet [26]. It might also be an artifact of higher income; individuals with a regular health care provider may also be wealthier. But the findings are inconsistent with Chou et al [17] who found that having a health care provider was not associated with social media use for health-related purposes, primarily due to age.

Variables that are traditionally associated with online health-seeking behavior, including race, geography, health insurance coverage, marital status, and education were not significant in terms of consulting online rankings for reviews or using SNS for health, both a type of health-seeking behavior. Thus, using social media for health seeking may be less influenced by common sociodemographic variables and may be better explained by other factors. For example, research on social network use has shown that personality traits, such as extroversion and neuroticism, are associated with social media use and sharing of information [27,28].