Skip to main content

Users' passivity in accessing digested scientific evidence through social media: cross-sectional insights

Abstract

Objectives

This manuscript provides novel insights about the potential use of social media (a Facebook page, the first strategic attempt by EviDent initiative) to share evidence-based dentistry content and empowerment strategies for professionals, using quantifiable usage metrics, besides exposing the strengths and weaknesses of this knowledge translation strategy. One year-long gathered metrics were analyzed to understand information about usage patterns.

Results

Publications were potentially exposed to 4784 users, and subsequent interaction with the page occurred in 18% of cases. Users' involvement with page content was associated with the number of page visitors (P = .005). However, users' interaction with the page was not associated with the potential number of users that could have seen the page (P = .25). Even considering the users that approved the posts, only 7%, on average, interacted with the post's links. Although social media has effectively disseminated scientific content, our experience revealed the user's passivity in interacting with the content. We expect to overcome these barriers by developing a mobile app to offer a more interactive and dynamic interface associated with a more attractive format for posting, including images and infographics.

Introduction

Social media has been shown as a feasible strategy to disseminate scientific evidence to professionals [1,2,3]. Nevertheless, its use for this purpose is still limited. Credibility seems to be the critical factor when obtaining any information on the internet, including scientific evidence [4,5,6]. High-quality information has been sought in social media through professional communities [3, 7] or experts or renowned organizations [8].

The EviDent initiative (https://evident.fo.usp.br) to offer digested scientific content based on reliable evidence in Pediatric Dentistry has been proposed in the end of 2013 by researchers from the Dental School, University of São Paulo [9]. This initiative's primary purpose was to spread reliable and "digested" scientific content, usually found in scientific publications, to dentists and dental professionals [10].

Besides, the page pioneered in its field due to innovations in the translational process. A systematic process of scientifically digesting the evidence was created to avoid the potential inclusion of bias [11]. Since autonomy is also of utmost importance to evidence-based practice, an additional long-term purpose is to empower users to deeply understand the scientific methodology and analyze future evidence autonomously [10].

Health professionals have been already using social media to be updated and interact with scientific evidence [2, 3, 12]. Although some studies have suggested some users' passive interaction with social media [13,14,15,16], the health professionals' patterns of interaction with scientific digested contents are still underexplored.

This manuscript provides novel insights about the potential use of social media to share evidence-based dentistry content and empowerment strategies for professionals, using quantifiable usage metrics, besides exposing the strengths and weaknesses of this knowledge translation strategy.

Main text

Methods

This is a cross-sectional analytical study investigating 1-year data of users' interaction with digested scientific content posted on a Facebook page. The topics and dissemination of the page focused on Pediatric Dentistry; however, the page was open to any user.

Digested content and users' empowerment—study setting

The EviDent initiative is affiliated with the Pediatric Dentistry Department, Dental School, University of São Paulo and is led by Pediatric Dentistry researchers willing to disseminate evidence-based practice. These researchers manage a group of graduate and undergraduate students responsible for scientific and technical support for the products derived from this initiative. The Facebook Page named: "Odontopediatria: Evidências para você!" (Pediatric Dentistry: evidence for you!) was created in 2013 [10] as the first milestone in the history of EviDent. The page was initially available in Brazilian Portuguese and Facebook was chosen as the social media to disseminate the idea since, on that occasion, it was the most used one among Brazilians.

The EviDent staff met periodically to choose relevant topics for dentists' clinical practice (Additional file 1). Afterwards, the staff prepared a brief digested content related to a piece of evidence and additional content to stimulate professionals' awareness [17] and empowerment for digesting evidence by themselves. For that, researchers created a systematic process to avoid a biased report and permit reproducibility of the strategy [10].

A standard structure for the posts was also defined for the page (Additional file 2), including symbols to help clinicians understand digested evidence's relevance (Additional file 3, Fig. 1).

Fig. 1
figure 1

Symbols used to help in the digestion of evidence to clinicians. A Thermometer symbol illustrates the strength of study design; B representation of available evidence regarding other possible designs (weighing what is possible to do or design and what is currently available). For a more detailed explanation, see Additional file 2

Time frame

We consider the first topics available on the page (a pilot cycle) for the present assessments (Additional file 1). This cycle began in March 2015, and posts were, on average, biweekly published. The page and posts were initially promoted by the EviDent team and members of the proponent department, and then, the spread was organic, and no paid tools were used to promote them.

Metrics for analysis

Usability metrics (how the page works to users) were collected from Facebook and analyzed to evaluate the initiative's impact 1 year later than its initial exposure to the users. As the pilot cycle was initiated in March 2015, data gathered by Facebook was then collected in March 2016.

As posts on social media could effectively be seen or just exposed to the user, we used different metrics provided by Facebook to assess these different behaviours. The estimated reach means the number of users potentially exposed to the post [18]. Reactions and clicks informed the users' involvement with the page and were used to proxy users' actual access to the posts. As different posts were delivered on different occasions according to the page schedule, the actual exposure time for each post was registered and considered.

Based on these primary metrics, we estimated the user's involvement with the posted content (percentage obtained when dividing the involvement registered during the page use by those users that the page potentially could reach). Finally, we also estimated the percentage of interaction with posted content (clicks in figure and links) by dividing the number of clicks into links or figures by the number of approvals per post. Each one of these metrics will be detailed in Additional file 4.

Analysis

Univariate bootstrapped quantile regression analyses (×10,000 and 50% quantile estimation) tested the relationship between the reach and different users' involvement with this content. The order among posts was also tested as an independent variable. The significance level was set as 5%.

Results

The Facebook page followers reached 1347 up to April 6, 2016, mainly composed of women (88%). Different nationalities were reached, comprising a majority of Brazilian users. The posts exposure time was approximately 11 months (335 days). The estimated average reach was 4784 users per publication (Table 1). The hottest topic received more than 700 reactions and almost 40 accesses on the provided links. The posts order did not impact on user's reach (P = 0.99) or involvement (P = 0.90). The same trend was observed for the exposure time (P = 0.98 and 0.88, respectively).

Table 1 Facebook page usage metrics in chronological order of the posts

Users’ involvement with page content (Coef = 0.16; 95% CI 0.08–0.23, P = 0.003) and clicks on the post (P = 0.048; Coef = 0.13; 95% CI 0.001–0.27) were associated with the reach magnitude. The user's interaction/post corresponded, on average, to 18%. Besides, very few clicks to the original article or explanations about the study's relevance were observed. These specific links available in the posts were accessed, on average, 16 times per post.

The reactions to the posts reached approximately 300 marks/publications. On average, 6% of reached users approved (clicked on the "like" button) or shared the post, and the estimated reach of the page was not associated with their users' reaction (P = 0.25; Coef = 0.04; 95%; CI − 0.03 to 0.12). Even considering the users that effectively reacted to the posts (likes), only 7%, on average, interacted with the links available in the post to go more in-depth to the topic. Conversely, the actual interaction with figures related to posts reached approximately 60% per post.

Discussion

One year-long gathered metric indicates that using a Facebook page may have been an interesting way of disseminating digested scientific content rapidly and globally [16, 19]. Similar initiatives also recognize social media as an effective approach for sharing health evidence (increase in followers and/or traffic) among a geographically diverse audience [16, 19,20,21]. The number of followers of our Facebook reached more than 1300 followers in 1 year of follow-up, reinforcing their interest in receiving the content. Even being an estimated metric, the potential reach observed corroborates the potential of digested scientific evidence as offered to be significantly spread among social media users. However, the users' involvement was lower than expected.

The users' reactions were not associated with the reach metric. Being exposed to more people does not seem to make more people automatically interact with the post content. Indeed, the impact of sharing scientific evidence using social media may not be related to the social media reach [22]. The reactions to the post might be more related to users' preferences and not necessarily to its acknowledged utility [19, 23]. Randomized controlled studies also do not show page access differences between articles promoted through social media, independently of the frequency of dissemination promotion [24, 25].

A low interaction with the posted contents was observed. The interaction with the content posted on our initiative occurred mainly through the approval and endorsement of the page to other potential users. Despite the variations between similar initiatives, different studies [16, 19,20,21] observed a great reach of the post/tweet and a low interaction with the content disseminated. It is still unclear how social media posts should be structured to optimize their uptake among the target audience [20]. Using other content formats than text (video, infographics, figures) could increase the user interaction with the post [5, 20, 21, 26]. Indeed, 60% of our users interact with figures.

One central differential of our initiative is encouraging clinicians to become protagonists in their evidence-based decisions, which require reading in detail and critically appraisal of the original evidence. The passivity may be seen as a user's proof of reliance on the available content or the clinician's restriction of their learning and decision-making to information digested by others. This last aspect may be an outstanding deal, especially considering the importance of professionals' autonomy and awareness in judging evidence [17]. Despite the timeframe and occasion of data collection, we believe these findings reflect the social media users' interaction profile, and it may be interpreted as an atemporal finding. Policies stimulating such professional behaviour can be created and implemented during professional formation and practice, endorsed by universities, class entities, employers, and different government spheres.

Based on the barriers above, we have also explored a more proximal alternative to minimize gaps observed when implementing the studied strategy. We have been working on a more interactive and dynamic platform with more engaging content to overcome users' passivity observed. Mobile applications (mApp) are feasible, with high acceptability for health professionals' routines [18, 19] and may permit exploration of different content presentations. The EviDent mApp has been developed (Fig. 2) [27] and will soon be compared to this first initiative. Furthermore, presenting the digested evidence through infographics makes the content user-friendlier than just textual content [21, 26].

Fig. 2
figure 2

Prototype mApp design development. A Splash screen (initial screen of the mApp); B main topic menu screen; C topic post screen; D brief digested content screen. VERSION 0.0 (prototype). The app has been developed in partnership with the Institute of Mathematics and Statistics at the XP Laboratory Course

In conclusion, although social media has effectively disseminated scientific content, our experience revealed the user's passivity in interacting with the content. This finding seems to be a social media users' pattern, which we expect to overcome by developing a more interactive and attractive interface.

Limitations

The initiative was designed by pediatric dentists who planned to disseminate the best available evidence in Pediatric Dentistry. Due to this published content, we believe our target audience is dentists and dental professionals. Nevertheless, since our data was collected from organic engagement from an open Facebook page, we cannot assure that. Therefore, we avoid addressing our conclusions focused specifically on dentists.

On the other hand, we do not believe we have reached all Brazilian pediatric dentists. Even if all users are pediatric dentists, our reach would still be lower than those found in Brazil (3540 pediatric—source: Brazilian Federal Dental Council). Therefore, we reinforce we could not generalize our findings to all pediatric dentists, and this is a preliminary appraisal of how the proposed initiative may work on social media.

We opted to use Facebook metrics. Then, some limitations were pointed out to metrics interpretations. Although reactions and clicks proxied the users' involvement with the page, several users could have effectively seen the post but not interacted with it. We adopted a more conservative approach considering the users' involvement as those actions that the page provider could measure during the page use.

As approval is a single interaction metric (signal the user, at least, saw the post), we used it as a reference to create the "actual interactions" metrics. However, this metric may be interpreted cautiously since some users may have explored page content and did not necessarily approve it. It is also essential to address that the actual interaction with figures may be overestimated since users could access the page by clicking on the figure, regardless of the approval.

Social media strategies' effectiveness has been assessed by the number of clicks/impressions on posts, frequency of viewed posts, volume of comments, and replies [28], validating the choice of the used metrics, despite their possible limitations discussed above. These metrics seem more "natural" since users did not acknowledge they were being assessed, minimizing possible "forced" behaviours. Therefore, we may trace initial impressions about the use patterns related to the initiative and permit further initiative development.

Availability of data and materials

The datasets regarding Facebook metrics used and/or analyzed during the current study are included in this published article and found in Table 1. The datasets regarding users' profiles (age, sex, nationality, language) are available from the corresponding author on reasonable request.

Abbreviations

mApp:

Mobile applications

References

  1. Hamm MP, Chisholm A, Shulhan J, Milne A, Scott SD, Klassen TP, et al. Social media use by health care professionals and trainees: a scoping review. Acad Med. 2013;88(9):1376–83.

    Article  Google Scholar 

  2. McGowan BS, Wasko M, Vartabedian BS, Miller RS, Freiherr DD, Abdolrasulnia M. Understanding the factors that influence the adoption and meaningful use of social media by physicians to share medical information. J Med Internet Res. 2012;14(5): e117.

    Article  Google Scholar 

  3. Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res. 2013;15(4): e85.

    Article  Google Scholar 

  4. Haustein S, Costas R, Lariviere V. Correction: Characterizing social media metrics of scholarly papers: the effect of document properties and collaboration patterns. PLoS ONE. 2015;10(5): e0127830.

    Article  Google Scholar 

  5. Oska S, Lerma E, Topf J. A picture is worth a thousand views: a triple crossover trial of visual abstracts to examine their impact on research dissemination. J Med Internet Res. 2020;22(12): e22327.

    Article  Google Scholar 

  6. Tunnecliff J, Ilic D, Morgan P, Keating J, Gaida JE, Clearihan L, et al. The acceptability among health researchers and clinicians of social media to translate research evidence to clinical practice: mixed-methods survey and interview study. J Med Internet Res. 2015;17(5): e119.

    Article  Google Scholar 

  7. Rolls K, Hansen M, Jackson D, Elliott D. How health care professionals use social media to create virtual communities: an integrative review. J Med Internet Res. 2016;18(6): e166.

    Article  Google Scholar 

  8. Hand RK, Kenne D, Wolfram TM, Abram JK, Fleming M. Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of Twitter messages and health professional interviews: an observational study. J Med Internet Res. 2016;18(11): e295.

    Article  Google Scholar 

  9. EviDent - FOUSP Site Iniciativa EviDent. https://evident.fo.usp.br/.

  10. Machado GM, Pereira RAC, Pereira JML, Ferreira FR, Reyes AMSJ, Braga MM. Utilizar o Facebook para levar evidências científicas para o clínico: qual o real alcance dessa estratégia? (Abstract). Brazilian Oral Res. 2016;30:98.

    Google Scholar 

  11. EviDent - FOUSP Final content production - EviDent WebPage 2022 [Available from: https://evident.fo.usp.br/producao-de-conteudo/final-content-production/.

  12. Bahabri RH, Zaidan AB. The impact of social media on dental practice promotion and professionalism amongst general dental practitioners and specialists in KSA. J Taibah Univ Med Sci. 2021;16(3):456–60.

    PubMed  PubMed Central  Google Scholar 

  13. National Academies of Sciences EM, Division HM, Health BG, Education GFIHP, Forstag EH, Cuff PA. Improving Health Professional Education and Practice Through Technology: Proceedings of a Workshop: National Academies Press; 2018.

  14. Romero DM, Galuba W, Asur S, Huberman BA, editors. Influence and Passivity in Social Media2011; Berlin, Heidelberg: Springer Berlin Heidelberg.

  15. Chen W, Fan C-Y, Liu Q-X, Zhou Z-K, Xie X-C. Passive social network site use and subjective well-being: a moderated mediation model. Comput Hum Behav. 2016;64:507–14.

    Article  Google Scholar 

  16. Dyson MP, Newton AS, Shave K, Featherstone RM, Thomson D, Wingert A, et al. Social Media for the Dissemination of Cochrane Child Health Evidence: Evaluation Study. J Med Internet Res. 2017;19(9): e308.

    Article  Google Scholar 

  17. Pathman DE, Konrad TR, Freed GL, Freeman VA, Koch GG. The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations. Med Care. 1996;34(9):873–89.

  18. Facebook. About Data Sampling Facebook for Business [Available from: https://www.facebook.com/business/help/1691983057707189?id=354406972049255.

  19. Puljak L. Using social media for knowledge translation, promotion of evidence-based medicine and high-quality information on health. J Evid Based Med. 2016;9(1):4–7.

    Article  Google Scholar 

  20. Gates A, Featherstone R, Shave K, Scott SD, Hartling L. Dissemination of evidence in paediatric emergency medicine: a quantitative descriptive evaluation of a 16-week social media promotion. BMJ Open. 2018;8(6):e022298.

    Article  Google Scholar 

  21. Thoma B, Murray H, Huang SYM, Milne WK, Martin LJ, Bond CM, et al. The impact of social media promotion with infographics and podcasts on research dissemination and readership. CJEM. 2018;20(2):300–6.

    Article  Google Scholar 

  22. Allen HG, Stanton TR, Di Pietro F, Moseley GL. Social media release increases dissemination of original articles in the clinical pain sciences. PLoS ONE. 2013;8(7): e68914.

    Article  CAS  Google Scholar 

  23. Recuero R. Like, share, comment: facework, conversation and social networks on Facebook. Verso e Reverso - revista da comunicação. 2014;28:117–27.

    Google Scholar 

  24. Fox CS, Bonaca MA, Ryan JJ, Massaro JM, Barry K, Loscalzo J. A randomized trial of social media from circulation. Circulation. 2015;131(1):28–33.

    Article  Google Scholar 

  25. Fox CS, Gurary EB, Ryan J, Bonaca M, Barry K, Loscalzo J, et al. Randomized controlled trial of social media: effect of increased intensity of the intervention. J Am Heart Assoc. 2016;5(5): e003088.

    Article  Google Scholar 

  26. Ibrahim AM, Lillemoe KD, Klingensmith ME, Dimick JB. Visual abstracts to disseminate research on social media: a prospective, case-control crossover study. Ann Surg. 2017;266(6):e46–8.

    Article  Google Scholar 

  27. Goldman A, Santos VA. Continuous Improvement of an XP Laboratory Course: An 18 year History. Agile 2019 Conference; Washington, D.C2019.

  28. Sivaratnam S, Hwang K, Chee ATA, Ren L, Fang G, Jibb L. Using social media to engage knowledge users in health research priority setting: scoping review. J Med Internet Res. 2022;24(2): e29821.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the computer science students at the Institute of Mathematics and Statistics at the University of São Paulo (IMEUSP), especially Prof. Dr. Alfredo Goldman, responsible for the Extreme Programming Lab (LabXP) for the first version of EviDent. We thank Professors in the Pediatric Dentistry Department, University of São Paulo, for their support to our Facebook page and mApp development. We are also thankful to the student team that contributed to developing and reviewing the topics posted on the Facebook page: Alessandra Reyes, Juliana Mattos-Silveira, Fernanda Rosche Ferreira, Raissa Andujas, Juliana Carvalho, Mirela Barros, and Caroline Rodrigues. Finally, we would like to thank the Facebook page users for making this study possible.

Funding

This work was supported by the Technological Initiation Scholarship [156511/2018-5], Ph.D. Scholarship [142109/2020-7] and research productivity scholarship [304319/2018-0] from the Brazilian National Council for Scientific and Technological Development (CNPq).

Author information

Authors and Affiliations

Authors

Contributions

MMB is the initiative coordinator and contributed to the conception, design, and analysis of the cross-sectional study. GMM monitored and collected the metrics, contributing to the content production and drafting of the manuscript. All authors critically reviewed manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mariana M. Braga.

Ethics declarations

Ethics approval and consent to participate

According to the Brazilian resolution 510/2016 for guide Ethics in Human and Social Research (National Health Council, 2016), since the database used comprises unidentified participants and aggregated data, as the Facebook page records, the submission to the Research Ethics Committee is not necessary. Besides, no identification or individualization of participants was possible; the individual consent to participate was not needed.

Consent for publication

The written consent was obtained from the guardians of those children (or even parts of them as teeth or smiles) posted on the EviDent Facebook page and other initiatives. Additionally, the written consent for being used in publications was obtained for the patient's guardian, whose teeth are presented in Additional file 2 (a print screen of the mentioned page).

Competing interests

The authors participated in the conceptualization and development of the Facebook page. However, there is no intention to make this a commercial initiative.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Additional file 1.

EviDent Facebook Page—Topic selection process and those topics selected for the pilot cycle.

Additional file 2.

EviDent Facebook post structure.

Additional file 3.

EviDent symbols to the "digestion" of scientific contents on its Facebook page.

Additional file 4.

Detailed metrics used for assessing Facebook page usability and users' interaction with the contents.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Machado, G.M., Braga, M.M. Users' passivity in accessing digested scientific evidence through social media: cross-sectional insights. BMC Res Notes 15, 218 (2022). https://0-doi-org.brum.beds.ac.uk/10.1186/s13104-022-06089-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://0-doi-org.brum.beds.ac.uk/10.1186/s13104-022-06089-x

Keywords