DiStaso, Marcia Watson, Vafeiadis, Michail, & Amaral, Chelsea (2014). Managing a health crisis on Facebook: How the response strategies of apology, sympathy, and information influence public relations. Public Relations Review, 41(1), 222-231.


This study investigated what response strategies are the most effective on Facebook in the wake of a health crisis. Overall, it was found that posting messages of sympathy on Facebook resulted in lower post-crisis reputation evaluations and trust toward the affected hospital, whereas they also elicited higher secondary crisis reactions (negative word-of-mouth). Conversely, information Facebook posts resulted in higher evaluations of message credibility. In addition, stakeholders are more likely to share information messages as opposed to sympathy ones, thus contributing themselves in the propagation of authoritative crisis-related information in social media. Taking into consideration the looming fear of lawsuits apology messages may trigger, in conjunction with the negative implications associated with sympathy messages, it is suggested that posting information posts on an organization’s Facebook page is perceived more favorably by stakeholders during a health crisis. In sum, the findings indicate that the voluntary and early sharing of negative information with stakeholders may prove advantageous to health organizations.


An experimental study was conducted through an online survey where a total of 517 participants were randomly exposed to one condition (i.e. apology, sympathy, information). A fictitious hospital was selected to control for possible confounding effects of prior attitudes toward the hospital on participant’s responses. The post in the survey resembled an actual Facebook page by illustrating a blue banner with the Facebook logo, an H logo referring to the fictitious hospital, a time stamp indicating the time of the post (“Yesterday”), and a bottom banner displaying the words “Like,” “Comment,” and “Share.”

Key Findings

  • The sympathy message produced the lowest post-crisis reputation and the lowest trust evaluations.
  • The information message generated the highest perception of message credibility.
  • Respondents were more prone to share the information message, but they were most likely to comment on Facebook and talk offline about the sympathy message.
  • Those who were exposed to the sympathy condition were less likely to visit the hospital in the future than respondents who viewed the information or apology messages.

Implications for Practice

This research found that messages of sympathy on Facebook backfire in a healthcare crisis and should be avoided. Instead, the best approach is to use Facebook posts to provide informative messages. Since crisis situations breed uncertainty, panic and rumors, it is important to provide information in a format that is easily shared on social media so stakeholders can be quickly and directly updated.

Article Location

The full article is available at:


Heidy Modarelli handles Growth & Marketing for IPR. She has previously written for Entrepreneur, TechCrunch, The Next Web, and VentureBeat.
Follow on Twitter

Leave a Reply