Promoting health online: surviving the revolution

WHEN we use social and new media (which usually refers to anything that came after television), we only occasionally pause to reflect on the huge paradigm shifts that have occurred in the ways that we consume information.

But perhaps one of the most important paradigm shifts in information use and dissemination has occurred in public engagement in and with health care.

New media, scientific discourse and education

Health practitioners are using a variety of online platforms (including blogs associated with academic journals, specialty blogs, university blogs, newsletters, social media and others) to educate, debate and interact with colleagues and the public.

Alongside continuing and successful use of traditional media (eg, television advertisements about smoking and lung cancer), use of social media has become an intrinsic part of health advocacy.

The element of hypermediacy is pronounced, and awareness campaigns are sometimes meticulously constructed to be fit-for-purpose for their intended medium.

The bold image and laconic caption have come into their own, and meld seamlessly with televisual-connective-interactive media’s “iconic” mode of discourse.

The World Health Organisation, for instance, has shown a preference for a visually focused strategy in its awareness campaigns. Its Antibiotic Awareness Week (12–18 November, 2018) posters, a centrepiece of its work on antimicrobial resistance, tend to make an arresting image the focus, usually accompanied by a short declaration.

This works well on social media.

Arguably, the “social” dimension of health research is coming into its own.

New discoveries about potentially significant epidemiological links pertinent to infectious diseases management and infection control, for example, can quickly reach wider audiences and potentially quickly influence public behaviour.

This is to not suggest that consumption of information about health operates in a unilateral and uncontested manner. Social media can be contentious too.

In fact, opinions on issues of public interest (e.g., suggestions about the need for behaviour change for the management of infectious diseases in household pets) can provoke significant debate and pushback.

Twitter and other online platforms facilitate this and contribute to what may be characterised as the rapid churning of scientific discourse. The proliferation of scientific discussions and interactions online has been accompanied by a shift towards rapid consumption and interaction – in terms of rapid circulation of data, dissemination of new research and engagement with “controversies”.

In these seemingly unmediated and often unmoderated spaces, the regular processes and rules of peer-reviewed engagement with and contention of arguments do not necessarily apply. Alternative perspectives on issues and approaches to data, for instance, can be postulated and proffered without mediation or delay. The acceleration of the dissemination of new information and potentially clinically impactful opinions has been accompanied by a concomitant acceleration of the spread of contending perspectives.

This poses unique challenges for researchers and educators, who have traditionally prioritised the dissemination of structured, authenticated and curated information. The pace at which new information circulates makes it difficult for educators to focus solely on structured, well constructed and curated modules for teaching and learning purposes.

Educators find themselves needing to constructively grapple with the challenges of fast-paced online engagement with research and educational material, as well as needing to encourage students to do the same. This trend also necessitates substantial self-directed engagement with scientific content online on the part of the public.

Online training and professional development

In addition to the use of new and social media for purposes of engagement, we have seen the rise of online training and professional development.

In areas of critical need, such as educational content for antimicrobial stewardship (the promotion of improved antimicrobial prescribing in various health care sectors), large and well resourced institutions have delivered content online by curating the expertise of international experts and then facilitated dissemination by making the content freely accessible.

The benefits of using online training and professional development platforms to disseminate research include the rapid pace of dissemination that is afforded by new media, potentially quicker translation of research and policy, and increased public engagement. Training platforms, which may be associated with university centres of research, allow educators to curate the content and delivery of information in a manner that would accord with traditional approaches.

Needless to say, online engagement does not supplant or replace but actually reinforces the importance of traditional research activities. Online platforms act as “force multipliers” or amplifiers of traditional activities, serving to broaden the reach of publications, specialist presentations and submissions to government, including directly to the public. Occasionally, online engagement may offer opportunities for quicker clinical and policy translation, or facilitate behaviour change.

However, researchers and content developers also need to consider the sustainability of their engagement. Engagement plans (particularly expectations of open access to content) need to adequately account for the fiscal sustainability of ongoing research and educational delivery.

Research institutions are attempting to enhance public engagement through researcher training, infrastructure support and other means. Clearly, institutions believe that engagement is a sine qua non of research activity.

While engagement continues apace, it may be useful to retrospectively examine the kinds of engagement that might have emerged in specific areas of health care research (and to what effect) and prospectively consider how engagement can be enhanced.

Dr Arjun Rajkhowa is centre manager of the National Centre for Antimicrobial Stewardship, at the Department of Medicine, University of Melbourne, the Doherty Institute, and Royal Melbourne Hospital.

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or MJA InSight unless that is so stated.

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