The past decade has witnessed a rapid increase in the use of Social Networking Sites (SNSs) in health communication campaigns seeking to achieve an ambitious range of health-related impacts. This article provides a review of 40 studies and research protocols, with a focus on two key factors that differentiate SNSs from more traditional health communication approaches of the past. The first is the potential dualism between message sender and receiver, in which receivers become receiver-sources who forward and amplify the content and reach of health messages. The second is the potential dualism between message and message impact, in which the act of forwarding and modifying messages by receiver-sources itself becomes a measure of message impact. Each of these dualisms has implications for the design and evaluation of contemporary health communication campaigns. The review concludes with a series of observations and recommendations for future health communication research.

This study uses the influence of presumed media influence model as the theoretical framework to examine how perceived social norms (i.e., descriptive, subjective, and injunctive norms) will mediate the influence of pro- and antidrinking media messages on adolescents' intention to consume alcohol in rural Thailand. Data collected from 1,028 high school students indicate that different mechanisms underlie drinking intentions between nondrinkers and those who have consumed alcohol or currently drink. Among nondrinkers, perceived peer attention to prodrinking messages indirectly influenced adolescents' prodrinking attitudes and intentions to consume alcohol through all three types of perceived social norms. Among drinkers, perceived peer attention to pro- and antidrinking messages indirectly influenced adolescents' prodrinking attitudes and intentions to drink alcohol through perceived subjective norm. The findings provide support for the extended influence of presumed media influence model and have practical implications for how antidrinking campaigns targeted at teenagers in Thailand might be designed.

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