Investigating the effects of interactive social media communication on community engagement: evidence from Abu Dhabi health sector

This research examines how social media is used within the Abu Dhabi healthcare system, and how it contributes to public health communication and community engagement. The study addresses four key aims: to measure the extent to which interactive communication via social media increases individual community engagement; to assess the effectiveness of social media in content-driven public health communication; to determine the impact of engagement on health outcomes; and to identify the most common issues raised by communities on social media and to explain how the public health system responds in practice. The study is theoretically framed using the Health Belief Model (HBM) and Social Influence Theory (SIT), providing a means to examine both cognitive and sociocultural aspects of health behaviour and communication in the digital context.A qualitative approach was employed, comprising 28 semi-structured interviews (9 with public health professionals and 21 with community respondents), alongside archival data from over 200 social media interactions on platforms such as Twitter and Instagram. Data were analysed using systematic thematic analysis. Five key thematic domains emerged: Dialogic Resonance, Perceptual Cartography, Communal Ethos (defined as shared cultural values, norms, and trust influencing how communities respond to health communication), Mobilized Cognition, and Digital Reverberations. These domains, comprising 20 codes, reflect the iterative, participatory, and adaptive forms through which digital media engagement for health communication is enacted.The findings suggest that interactive social media communication enhances community engagement by fostering feedback loops, dialogic resonance, and relational trust. Social media serves both as a distribution and participatory channel, shaping perceptions and influencing behaviour through emotional content and peer dialogue. Evidence indicates that such engagement improves health outcomes, particularly in vaccination uptake and preventive behaviour. The study also identifies key community concerns, including trust, clarity, cultural relevance, emotional tone, misinformation, and accessibility, which can be addressed through live question-and-answer sessions, multilingual messaging, partnerships with trusted influencers, and empathetic, culturally attuned content.The study contributes conceptually by reconceptualising health communication as a dynamic, co-created process rather than a top-down broadcast. It integrates social and psychological theories to explain digital behaviour and introduces constructs such as Echo Governance and Discursive Pulse . It contextualises HBM and SIT within a multicultural, digitally sophisticated environment and develops a recursive communication model in which trust functions simultaneously as an input, a mediating force, and an outcome of effective engagement. Managerially, the study provides practical implications for creating culturally sensitive, emotionally intelligent, and inclusive communication strategies and emphasises the value of using real-time analytics to support adaptive and transparent public health messaging.Although the study offers valuable insights, it is limited by its regional focus, lack of longitudinal data, and absence of quantitative validation. Future research may apply the model across diverse geopolitical contexts, track long-term behavioural patterns, and employ qualitative methods designs to enhance generalisability and predictive power. Nonetheless, the research provides a holistic and theoretically grounded account of the evolving role of social media in transforming public health communication in Abu Dhabi and proposes a new framework for trust-based, community-driven digital health interventions.