Can social media encourage diabetes self-screenings? A randomized controlled trial with Indonesian Facebook users

Nudging individuals without obvious symptoms of non-communicable diseases (NCDs) to undergo a health screening remains a challenge, especially in middle-income countries, where NCD awareness is low but incidence is high. This study assesses whether a Facebook awareness campaign can encourage individuals in Indonesia to undergo an online diabetes self-screening. Using Facebook’s advertisement function, the authors randomly distributed graphical ads related to diabetes risk and consequences. Based on their risk score, participants received a recommendation to undergo a professional screening. The campaign reached almost 300,000 individuals in three weeks; more than 1,400 completed the screening at a cost of about US$0.75 per person. Two loss-framed ads labeled “diabetes consequences” and “shock” outperformed others. A follow-up survey indicated many high-risk respondents scheduled a professional screening. A cost-effectiveness analysis suggests the campaign could diagnose an additional person with diabetes for about US$9.