Where Evidence-Based Health Experts Fit on Social Media

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Social media is a powerful force. From politics to promotion, finance to fashion, social media impacts the world we live in today. Social media, defined as websites or applications that allow interaction and social networking, includes platforms such as Twitter, Facebook and Instagram. According the Pew Research Center, in 2015, social media was used by 74 percent of internet-connected adults including a range of sociodemographic groups. Social media may present a unique method for disseminating evidence-based practice guidelines to professionals and related health behavior information to patients. However, little is known about the extent to which social media is used as a dissemination tool, and the quality of the information which is provided.

That's why, in 2013, the Academy's research team received a three-year grant from the Agency for Healthcare Research and Quality to explore the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline for Heart Failure, or EBNPG for HF. The goal of the study was to identify the content, source and target audience of Twitter messages related to heart failure, and to identify gaps and opportunities for using this and other social media platforms for dissemination in the future.

The first part of the project involved conducting a content analysis of tweets related to heart failure. Tweets and posting data were downloaded from Twitter via Twittonomy.com, a Twitter analytics tool. In May 2015, nine consecutive days of tweets (a total of 298 original tweets and 325 re-tweets) with the hashtag "#heartfailure" were downloaded. The research team coded the content, source and target audience of each tweet. Content themes included heart failure symptoms, medication, exercise, general nutrition information and specific recommendations from the Academy of Nutrition and Dietetics EBNPG for HF. Source and target audience groups included patients, professional organizations and individual providers.

The analysis of these tweets related to heart failure showed that messages mostly come from patients and families, not from health care providers or professional organizations as might be expected. Accordingly, content overwhelmingly focused on awareness and patient support rather than dietary recommendations such as those included in the Academy's EBNPG for HF. Detailed content was rare (likely due to Twitter's 140-character limit), but many posts included pictures or links as a means of sharing more information.

The public frequently obtains health information online, increasingly via social media. However, results from this study show that content on nutrition information and evidence-based guidelines is rare, at least for heart failure. Social media messaging is often dominated by lay people rather than trained experts. Health care providers such as RDNs and NDTRs and professional organizations such as the Academy can fill this gap by disseminating evidenced-based information to patients via social media. Authors likely need to focus on cultivating followers and establishing a consistent audience to tailor their messages for maximum impact.

Additionally, the interactive component of social media raises ethical questions that must be considered with future research and practical use as a dissemination tool.

Jenica Abram
Jenica K. Abram, MPH, RDN, LDN, is a dietitian, researcher an educator in Boston.