article · Societies
During the 2024 cholera outbreak in Lagos, Nigeria, residents in hotspot areas primarily relied on social media peers to exchange risk information. An investigation examined how constructs of the Health Belief Model featured in peer interactions across Facebook and X, evaluating their links to risk perception and preventive behaviours. Drawing on a survey of 350 Lagos Island residents and an analysis of 540 Facebook posts and 894 X posts, the study revealed substantial exposure to peer-generated health messages and cues to action. Engagement differed significantly across different Health Belief Model constructs, and exposure to peer-generated cues to action was significantly linked to the adoption of preventive cholera behaviours. These observations suggest that public health agencies can improve the reach and effectiveness of digital health campaigns during outbreaks by engaging influential local voices on social media platforms.
Cholera outbreaks remain a major public health hazard when communities lack clear risk awareness. Understanding how individuals share health information on digital platforms helps authorities design better response strategies. Demonstrating that peer-led communication encourages people to adopt protective habits provides a practical pathway for health organisations to curb disease spread by collaborating directly with trusted local social media figures during health crises.
This applied research provides direct insights for public health authorities, digital health communication teams, and social media analytics providers designing targeted disease intervention programmes. While not a commercial product, the findings can inform the development of data-driven risk communication toolkits and influencer engagement frameworks for outbreak response. The work represents an applied study tested during an active crisis, ready to inform upcoming public health communication campaigns and social listening strategies.
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Background: Cholera remains a persistent and deadly global public health challenge. Recent resurgences have caused large-scale outbreaks. Due to gaps in public health risk awareness, effective risk communication using the HBM is now critical for cholera control and prevention. During the 2024 cholera outbreak, Lagos Island residents mainly relied on social media peers to exchange risk information. This study examined cholera risk perception among residents in the hotspot areas, established how the six HBM constructs were used in the cholera-related social media peer interactions, identified dominant cues to action in social media peer interactions, and established the association between exposure to peer-generated cholera messages and risk perception and the adoption of preventive behaviours. Methods: This is a cross-sectional study that combined a survey of social media users on Lagos Island and a quantitative content analysis of Facebook and X posts during the outbreak. A total of 350 Lagos Island residents were surveyed using a multi-stage cluster sampling strategy; 540 Facebook posts and 894 X tweets were content-analysed from a large corpus of data scraped from the platforms. Results: Findings showed high exposure to peer-generated cholera messages and cues to action on X and Facebook. HBM constructs appeared in varying proportions across platforms. ANOVA results and Games–Howell post-hoc comparisons showed a statistically significant difference in average engagement across the HBM constructs [p < 0.05]. Chi-square tests indicated a significant association between exposure to peer-generated cues to action and the adoption of cholera health behaviours [p < 0.05]. Conclusions: The study concluded that social media peer communication was significantly associated with residents’ understanding and perception of cholera risk during the outbreak. Health agencies should identify influential local voices on X and Facebook and assimilate them into public health communication strategies to strengthen the relevance, resonance, and effectiveness of digital health messages in outbreak contexts.
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DOI: 10.3390/soc16090287
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