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The question of whether and how digital media use and digital communication affect people’s and particularly adolescents’ well-being has been investigated for several decades. Many studies have analyzed how different forms of digital communication influence loneliness and life satisfaction, two comparatively stable cognitive indicators of subjective well-being. Despite this large body of empirical work, the findings remain ambivalent, with studies resulting in positive, negative, or nonsignificant effects. Several meta-analyses suggest that the overall effect of digital communication on life satisfaction is probably too small to suggest a detrimental effect. The net effect of digital communication on loneliness, by contrast, is positive, but likewise small. Yet the studies on which these meta-analyses are based suffer from several limitations. They often adopt a limited perspective on the phenomenon of interest as a disproportionate amount of work focuses on interpersonal differences instead of intra-individual, contextual, and situational effects, as well as their interactions. Furthermore, studies are often based on cross-sectional data, use unvalidated and imprecise measurements, and differ greatly in how they conceptualize digital communication. The diversity in studied applications and forms of digital communication also suggests that effects are most likely bidirectional. Passive digital communication (e.g., browsing and lurking) is more likely to result in negative effects on well-being. Active and purposeful digital communication (e.g., posting, liking, conversating), by contrast, is more likely to result in positive effects. Future research should therefore investigate how the various levels of digital communication (including differences in devices, applications, features, interactions, and messages) interact in shaping individuals’ well-being. Instead of expecting long-term effects on comparatively stable cognitive indicators such as life satisfaction, scholars should rather study and identify the spatial and temporal boundaries of digital communication effects on the more fluctuating affective components of well-being.

Risk is a social construction, and its understanding by information consumers is shaped through interaction with messages, opinions, shared and learned experiences, and interpretations of the characteristics of risk. Social actors and information flows can provide heuristic cues about risks, their relative importance and unimportance, and the attention that an information consumer ought to pay to a particular risk. Social cues can also accentuate particular characteristics of risk, further amplifying or attenuating attention to it and shaping behaviors. This, in turn, can generate secondary and tertiary effects resultant from the public’s reaction to risk. The process of social amplification of risk, therefore, has structural components that include the social elements that get enacted in the process of the translation of risk information. Risk amplification is also affected by message factors, which can dramatize information, increase attention and uncertainty, and generate shared signals and symbols. And finally, social amplification of risks results in reactions that can shape pathways for risk assessment and management, frame views, fuel intergroup dynamics in response to risk, contribute to the accumulation of experiential knowledge and signals of different risk situations, and label and stigmatize some groups or outcomes as undesirable.

The widespread diffusion of social media in recent years has created a number of opportunities and challenges for health and risk communication. Blogs and microblogs are specific forms of social media that appear to be particularly important. Blogs are webpages authored by an individual or group in which entries are published in reverse chronological order; microblogs are largely similar, but limited in the total number of characters that may be published per entry. Researchers have begun exploring the use and consequences of blogs and microblogs among individuals coping with illness as well as for health promotion. Much of this work has focused on better understanding people’s motivations for blogging about illness and the content of illness blogs. Coping with the challenges of illness and connecting with others are two primary motivations for authoring an illness blog, and blogs typically address medical issues (e.g., treatment options) and the author’s thoughts and feelings about experiencing illness. Although less prevalent, there is also evidence that illness blogging can be a resource for social support and facilitate coping efforts. Researchers studying the implications of blogs and microblogs for health promotion and risk communication have tended to focus on the use of these technologies by health professionals and for medical surveillance. Medical professionals appear to compose a noteworthy proportion of all health bloggers. Moreover, blogs and microblogs have been shown to serve a range of surveillance functions. In addition to being used to follow illness outbreaks in real-time, blogs and microblogs have offered a means for understanding public perceptions of health and risk-related issues including medical controversies. Taken as whole, contemporary research on health blogs and microblogs underscores the varied and important functions of these forms of social media for health and risk communication.

During the past few decades we have witnessed increased academic attention on resistance to persuasion. This comes as no surprise, as people are often persuaded by external forces when making important decisions that may affect their health. Public health professionals, scholars, and other concerned parties have developed numerous trainings, interventions, and regulations to teach or assist people to resist unwanted persuasion, deriving from media exposure (e.g., advertising) or social pressure. The extant literature on resistance induction encompasses strategies such as inoculation, media literacy interventions, trainings on specific persuasive techniques, warnings, and social influence interventions. Although the research findings of the discussed strategies vary in how straightforward they are, they do offer promising avenues for policymakers and health communication professionals. Furthermore, several avenues worthy of further study can be identified.

Public service announcements (PSAs) emerged after World War II in the United States as a promising strategy for increasing awareness of important social issues and changing beliefs, attitudes, and behavior. Research at that time showed that PSA campaigns had limited success in changing attitudes and behavior. Even so, both in the U.S. and internationally, sponsoring agencies and organizations continued to produce PSAs, hoping they would create significant behavior change. In the 1980s, a more informed view of what PSAs can achieve began to emerge as practitioners of social marketing demonstrated that media campaigns can produce behavior change when they are designed and executed according to the principles and best practices followed by the advertising industry. Beginning in the 1990s, PSA-based campaigns to promote public action through programs and policy change became more common. Research has shown that such campaigns can play a key role in shaping the public agenda, changing perceptions of social norms, reinforcing school- and community-based programs, and building support for and then publicizing changes in public policy, all of which can foster individual behavior change. PSAs and other media executions are best designed using a planning scheme that is grounded in advertising best practices and behavior change theory and that uses those media executions as part of a broader intervention effort. These various elements can be brought together by using a media planning guide that outlines how the campaign will work in sync with other intervention activities and what its key messages will be. In the United States, federal regulations that outlined broadcasters’ public service obligations were loosened in the 1980s, making it increasingly difficult to get donated time for PSAs and other public service messages. More broadly, the increased focus of broadcasters, cable networks, and print publications on generating revenue has magnified this problem. Faced with strong competition, campaign planners need a strategy for convincing media gatekeepers to give priority to their messaging. The rise of social media (e.g., Facebook, Instagram, Twitter) has opened up a new means of putting PSAs before the public. For example, once a message is posted on a video-sharing website such as YouTube, it can be linked to the sponsoring organization’s website, where additional intervention-related material can be found, as well as to websites hosted by other groups. Promotional efforts through national, state, and community organizations can draw an initial audience, with the hope that they will share the link with their social media and email contacts and that eventually the message will “go viral.” PSAs remain a viable media alternative for public communication campaigns, despite the fact that major media outlets do not often provide donated time or space for such advertising. In some cases, a PSA-driven campaign will be supported by a large budget, but while such campaigns have a better chance of success, the resources required are seldom available. The emergence of social media has created a new way to build an audience. Successful examples of social media campaigns are emerging, but why some campaigns take off and others do not requires additional study.

Social media used for communication purposes within healthcare contexts is increasing and becoming more acceptable. The users of social media for healthcare communication include members of the general public, patients, health professionals, and health organizations. The uses of social media for healthcare communication are various and include providing health information on a range of conditions; providing answers to medical questions; facilitating dialogue between patients and between patients and health professionals; collecting data on patient experiences and opinions used for health intervention, health promotion, and health education; reducing stigma; and providing online consultations. With emerging advances over time, including new platforms and purposes, these uses will change and expand, increasing usability and thus providing more opportunities to use social media in connection to healthcare in the future. However, both patients and health professionals may require training to fully maximize the uses of using social media in healthcare. Social media has numerous benefits for healthcare communication, including increased interactions with others; more available, shared, and tailored information; increased accessibility and widening access; and increased peer/social/emotional support. While there may be further benefits of using social media in healthcare, there are many limitations of social media for healthcare communication as well. The main reported limitations include a lack of reliability; quality concerns; and lack of confidentiality and privacy. From the available evidence, it is clear that maintaining patient privacy as well as the security and integrity of information shared are concerns when using social media. As patients and members of the general public use social media widely, some may expect it in healthcare, thus it important for health professionals and organizations to manage expectations of social media in healthcare communication. This results in challenges ranging from encouraging staff to use social media to dealing with user problems and complaints. It is recommended that organizations embrace social media but have a specific purpose for each activity and platform while continually monitoring traffic. Regardless of the nature or size of the healthcare organization, it is time to adopt appropriate guidelines for the use of the social media in healthcare communication to address the challenges and the growing expectations of using social media, especially within healthcare contexts. The key message is that social media has the potential to supplement and complement but not replace other methods to improve communication and interaction among members of the general public, patients, health professionals, and healthcare organizations.

Using pictures (also called images) in health and risk messages increases attention to messages and facilitates increased retention of message content, especially in low-literate populations. In risk communication, researchers have found that pictorial warnings stimulate communication and that images without text can communicate risk information as effectively (or, in some cases, more effectively) than text. However, little empirically based guidance exists for designing images for health and risk messages because most studies use an absence-presence model and compare visual communication to textual communication, rather than compare different types of visual communication. In addition, visual communication theories focus on describing the “how” aspect of communication instead of offering proscriptive guidance for message design. Further complicating the design of visual messages is that the number of possibilities for a visual message is, like text-based messages, almost infinite. Choices include colors, shapes, arrangement, and the inclusion of text, logos, icons, and so on. As a result, best practices on visual messages often draw on design recommendations. Before the widespread advent of Internet use and the adoption of social networking sites like Facebook and Twitter, using images—especially color images—could be cost prohibitive. However, these online platforms facilitate the distribution of visual content, and many public health organizations use these platforms to distribute visual messages. The need for guidance and research on using pictures effectively is growing. Although there has been increasing focus on images in health messages, many questions still exist about how visual messages should be composed and what their effect is. The existing evidence suggests that visual information can improve persuasive and, on social networking sites, diffusion outcomes. However, visual information may be prone to misinterpretation. Researchers should also evaluate ethical considerations when choosing pictures. Message testing is highly recommended.

The spiral of silence theory provides insight into the ways in which perceptions of public opinion can lead to changes in opinion expression behavior. Conceptualized in a political communication context, the central claim of the theory is that individuals’ fear of social isolation motivates them to continuously evaluate the climate of opinion through both experiences with the media and interpersonal communication. Upon assessment, individuals either find themselves in a situation where their opinion aligns with the majority or minority. Accordingly, those who find their opinion does not align with the dominant opinion are likely to conceal their opinions while those who find their opinion aligns with the majority are more likely to express them. Empirical research testing the spiral of silence theory has predominately focused on measurement of focal variables and methods of empirical testing. Advances have been made in regard to micro-level factors, such as creating universally applicable measures of psychological attributes. However, limited work has explored macro-level factors, such as appropriateness of issues, application to computer-mediated communication environments, and tools used to identify circumstances vulnerable to spiral of silence effects. Nonetheless, the practical value of the spiral of silence theory for health and risk communicators can be utilized by modifying campaign efforts to anticipate and counteract fluxes in public opinion.