Abstract
Breastfeeding is one of many health practices known to support the survival and health of mother and infant, yet low breastfeeding rates persist globally. These rates may be influenced by limited diffusion of evidence-based research and guidelines from the scientific community (SC). As recently highlighted by the National Academy of Sciences, there is a need for the SC to diffuse its findings to the public more effectively online, as means to counteract the spread of misinformation. In response to this call, we gathered data from Twitter for one month from major breastfeeding hashtags resulting in an interconnected social network (n = 3,798 users). We then identified 59 influencers who disproportionately influenced information flow using social network analysis. These influencers were from the SC (e.g. academics, researchers, health care practitioners), as well as interested citizens (IC) and companies. We then conducted an ego-network analysis of influencer networks, developed ego maps, and compared diffusion metrics across the SC, IC and company influencers. We also qualitatively analyzed their tweets (n = 711) to understand the type of information being diffused. SC influencers were the least efficient communicators. Although having the highest tweeting activity (80% of tweets), they did not reach more individuals compared to IC and companies (two-step ego size: 220± 99, 188 ± 124, 169 ± 97 respectively, P = 0.28). Content analysis of tweets suggest IC are more active than the SC in diffusing evidence-based breastfeeding knowledge, with 35% of their tweets around recent research findings compared to only 12% by the SC. Nonetheless, in terms of outreach to the general public, the two-step networks of SC influences were more heterogenous than ICs (55.7 ± 5.07, 50.9 ± 12.0, respectively, P<0.001). Collectively, these findings suggest SC influencers may possess latent potential to diffuse research and evidence- based practices. However, the research suggests specific ways to enhance diffusion.
Highlights
Breastfeeding is one of many health practices which have been shown to support the survival and health of both mother and infant, and yet low breastfeeding rates persist around the world [1,2,3]
Whether women follow breastfeeding guidelines depends on a complex range of sociocultural factors which include for example: how well parents and their social groups are informed about the research findings and skills related to breastfeeding; how positive a community’s attitude is towards breastfeeding; and how well supported parents are to initiate and continue breastfeeding within the health care system, at the workplace, and in public [2,5,6,7]
This study was conducted to expand understanding around whether, by whom, and how efficiently and effectively evidence-based breastfeeding information is diffused on Twitter based on the analysis of influencer ego networks with a focus on the scientific community (SC)
Summary
Breastfeeding is one of many health practices which have been shown to support the survival and health of both mother and infant, and yet low breastfeeding rates persist around the world [1,2,3]. From a public health standpoint, ensuring parents are well-informed and well-supported requires large-scale breastfeeding promotion efforts which strategically target members of society who can influence parents directly or indirectly through their words and actions (i.e., mother’s family and friends, providers of healthcare and childcare, employers and co-workers, policy makers) [8]. As shown in other health areas such chronic disease prevention, and more recently for breastfeeding promotion, social media may be a promising platform to execute such efforts at scale [9,10,11]. To adequately do so, theory-grounded analytic approaches are required to identify networks (groups of people who interact together), recognize influencers (leaders in these networks), and understand message diffusion pathways
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