title: Feasibility and acceptability of Facebook for health promotion among people with serious mental illness.
abstract: OBJECTIVE
  Elevated obesity rates are a major contributor to the significantly reduced life expectancy impacting people with serious mental illness. With over 1.5 billion Facebook users worldwide, this platform may afford opportunities for reaching individuals with serious mental illness outside professional settings and fostering social support for adopting healthier behaviors. In this mixed methods pilot study, we explored the feasibility and acceptability of using Facebook to support a group lifestyle intervention for weight loss among obese adults with serious mental illness.
  
  
  METHODS
  Nine of eleven participants enrolled in a six-month lifestyle intervention delivered through a community mental health center agreed to join a private Facebook group to support their healthy eating and exercise goals. We measured participants' use of the Facebook group and collected post-intervention feasibility and acceptability questionnaires followed by in-depth qualitative interviews to elicit participants' perspectives and recommendations for improving the use of Facebook.
  
  
  RESULTS
  Of 188 posts to the Facebook group, the majority (79%) were from participants compared to study staff (21%). Participants also posted 186 comments, 299 likes, and recorded 1316 page views. Participants were positive about opportunities to interact and support each other outside group sessions, found content posted by other participants to be helpful, and indicated that the Facebook group was safe to use. Participants provided constructive feedback, including recommendations for more detailed instructions for accessing the group and posting content, finding ways to encourage more interaction within the group, and tips for responding to notifications or alerts directly from the Facebook website.
  
  
  CONCLUSIONS
  These findings suggest that Facebook may be feasible for supporting health promotion efforts targeting people with serious mental illness. Participants provided valuable feedback that can inform the use of Facebook for future health promotion efforts targeting this high-risk group.
authors.affiliation: Health Promotion Research Center at Dartmouth, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Naslund
authors.affiliation: Health Promotion Research Center at Dartmouth, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, USA.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Aschbrenner
authors.affiliation: Department of Psychiatry, Geisel School of Medicine at Dartmouth, USA; Center for Technology and Behavioral Health, Dartmouth College, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Marsch
authors.affiliation: Health Promotion Research Center at Dartmouth, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, USA; Center for Technology and Behavioral Health, Dartmouth College, USA; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
keywords: Facebook; Serious mental illness; community mental health; feasibility study; health promotion; mental health; obesity; social media