I agree that social networks can have positive, life-changing effects on people, but have watched with great frustration as a culture of swiping and sliding has taken over the way people behave both at home and in public.

It was this misuse of what I saw as a powerful tool for social impact that motivated me to start On The Mend in 2017.

After ditching FB many years ago (when I was blogging in my own clumsy way), I went through knee surgery in 2016 and looked online for support from health social networks like HealthUnlocked, PatientsLikeMe, or more recently, Wizdo.

I could see these sites all had the same problem: they were all about the other person and not about me. It was not difficult to see why these sites take such an approach: growth. The more people join, the more other people are likely to join as well.

However, this strategy of user adoption can leave many lacking the support they sought from such networks in the first place, namely motivation for positive behaviour change.

That's why we are taking the approach to create a health social network that is closed (requiring onboarding from a health professional) and anonymous (giving people the confidence to share their experience with others without feeling conscious of others knowing about it).

I was lucky to have found a leading academic in the US who is willing to work with us in the design of the community aspects of our rehab tech platform. He has spent more than a decade showing how we can harnesses the potential of network dynamics to spread the positive impact of behaviour change (e.g. encouraging people to quit smoking, exercise more etc).

As with most things health tech, it has taken us a lot longer to get our project off the ground, but that hasn't stopped us in persevering towards our goal of designing a platform to make physical rehab more rewarding for anyone with a musculoskeletal (MSK) disorder.

While our original plan was to start running early pilot studies with people being treated for any MSK disorder, we're now focusing on patients discharged from day case knee and hip replacement surgery (long story but it gets us to working with lots of patients quickly and we are first to market in the UK with this approach to treating patients this way).

What is interesting is that in designing our social network in the way we describe, it shouldn't put off people who are 65+ from engaging with the platform. They like joining in group-based exercises just as much as anyone else (maybe even more so) but are wary of sharing their personal details with people they don't know.

Preserving an anonymous system should ensure wider adoption, greater retention and better health outcomes. People will be engaging in behaviour that is good for their health while feeling less lonely in the process. That is what I believe social networks, for health or anything else, should be all about.

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