Journal of Nursing Education

Syllabus Selections: Innovative Learning Activities Free

Analyzing Social Media Imagery for Health Messages

Karen D. Groller, PhD, RN-BC, CMSRN

Social media has become a routine part of daily living. Sixty-nine percent of Americans engage in social media activities at least once per day (Pew Research Center, 2017). Social media facilitates the exchange of news, information, and entertainment with others through online Web-based platforms such as Facebook®, Twitter®, Pinterest®, Instagram®, and LinkedIn®. Information transfers through various visual forms with social media networks. Personal pictures and videos are shared with friends and family, whereas other visual messages are created and gain global popularity as memes, infographics, videos, or blog posts. The exchange of digital information combines text with visual images to communicate a message to the target audience. This visual narrative often persuades users based on personal interest and level of engagement (Dahlstrom, 2014).

Society's reliance on social media and other digital technology for knowledge acquisition makes examination of health message construction necessary in collegiate health care education. Health message design factors—aesthetics, functionality, and deterrents—influence how information found on social media is used or valued (Prybutok & Ryan, 2015). Research by Prybutok and Ryan (2015) concluded that Internet and social media venues serve as a primary source for young adults to gain health information about illness and wellness topics. The impact of exchanged health messages posted on social media is unknown. Exploring health message influence on individual social media users' behavior and its subsequent effect on members within their community should be examined.

Setting and Assigned Activity

First-year college students enrolled in a writing-intensive course improved collegiate writing skills by analyzing health and wellness concepts seen on social media from a personal and community perspective. Types of health and wellness information exchanged through social media, the perceived health message, and its impact on the individual and their local community were explored.

Students were assigned a visual rhetoric analysis as their first graded writing assignment. This assignment required students to select a media image and analyze its perceived health message. As students drafted the paper, concepts about visual rhetoric were applied. The final paper resulted in a persuasive argument about the analyzed image.

Assignment Preparation and Classroom Exposure

Students engaged in the writing process by being empowered to write on a health topic that was of interest to them. Students selected a community health concern they were interested in exploring over the course of the semester. Classroom exposure to topics and objectives from Healthy People 2020 (U.S. Department of Health and Human Services, 2017) and millennial development goals (United Nations, 2015) stimulated health concern topic selections. Student selected health concerns ranged from acute, chronic, and communicable diseases (e.g., concussion, obesity, Zika virus) to wellness topics reaching mental, reproductive or sexual, environmental, or psychosocial health (e.g., anxiety, human trafficking, sleep deprivation, texting while driving, or cultural violence).

Next, students searched the Internet and social media sites for visual health messages on their chosen topic. The selected media image was then analyzed as a visual text to understand the message it portrayed (visual rhetoric). Initially, analysis began by assessing the rhetorical situation—audience, context, and purpose of the visual text (Sheffield, n.d.). Additional criteria such as tone, text, item arrangement, use of typography, and color were considered.

In preparation for this assignment, students engaged in classroom discussions about types of social media, ways information is exchanged, and personal reflections on how information is used in their daily lives. The course instructor initially facilitated student exploration about the concept of health and media influences through a classroom discussion focusing on personal use, perceived benefits, and drawbacks to social media. Prior to class, students were assigned to read a peer-reviewed study by Liu and Yu (2013) that explored the influence of Facebook® on personal well-being. Next, students summarized the main points (i.e., study purpose, methods, and results) of a publication and shared personal impressions (i.e., What surprised you? Do you agree or disagree with the results?) through an in-class reflective writing prompt. The instructor provided examples of visual text and discussed elements (i.e., design and presentation of words and images, relationship between visual elements, design appeal, rhetorical situation, and perceived or intended impact) to consider for analysis. Students worked in small groups to apply newly learned skills to other visual text samples for their selected health concern on a subsequent class day.

Student Reactions and Lessons Learned

A review of student comments about the assignment revealed students were engaged in the course topic as they felt it was relevant to life; “This was my favorite class, I loved the digital conversation aspect of the course [and] how it can be a useful tool…as it is something I can related to.” Another student shared, “This assignment opened my mind to different writing styles and made me feel better about my flaws and how they are fixable.”

Although a class period emphasized analysis of visual rhetorical situation with a media image, some student papers lacked a detailed analysis of the media image and perceived health message and instead discuss the community health concern in detail. Revising the assignment directive and rubric to include necessary visual rhetoric concepts is advised.


Today's technology empowers individuals to access health information quickly through Web-based sources such as social media. Teaching students who are current health care consumers and potential health care colleagues how to evaluate the rhetorical situation of visual texts, may assist individuals in recognizing the intent and accuracy of the health message. Appropriately understanding the health message may influence individual and community health behaviors. In addition, analysis of visual rhetoric may aid health care professionals in developing visual health messages that can assist with health promotion and disease management.

Karen D. Groller, PhD, RN-BC, CMSRN

Helen S. Breidegam School of Nursing

Moravian College


  • Dahlstrom, M.F. (2014). Using narratives and storytelling to communicate science with nonexpert audiences. Proceedings of the National Academy of Sciences of the United States of America, 111, 13614–13620. doi:10.1073/pnas.1320645111 [CrossRef]
  • Liu, C. & Yu, C. (2013). Can Facebook® use induce well-being?Cyberpsychology, Behavior, and Social Networking, 16, 674–678. doi:10.1089/cyber.2012.0301 [CrossRef]
  • Pew Research Center. (2017). Social media fact sheet. Retrieved from
  • Prybutok, G. & Ryan, S. (2015). Social media—The key to health information access for 18 to 30-year-old college students. Computers, Informatics, Nursing, 33, 132–141. doi:10.1097/CIN.0000000000000147 [CrossRef]
  • Sheffield, J.P. (n.d.). Breaking down an image. Retrieved from
  • U.S. Department of Health and Human Services. (2017). Healthy people 2020. Retrieved from
  • United Nations. (2015). Millennium development goals. Retrieved from

The author has disclosed no potential conflicts of interest, financial or otherwise.


Sign up to receive

Journal E-contents