Breastfeeding Communication Strategies, Challenges and Opportunities in the Twitter-Verse: Perspectives of Influencers and Social Network Analysis
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Influencers Had Diverse Backgrounds within and Beyond the Scientific Health Community
3.2. Influencers Use Twitter for Dissemination, Advocacy, and Community Building
3.3. Influencers Seek Career Opportunities, Community Support, and Impact on Breastfeeding Practices via Twitter
“I see it [Twitter] as like not only a place to share information, but also for people to know who I am. It’s helpful to have people know your name, whether it’s domestic for grants or internationally for speaking engagements.”(Academic clinical researcher and nurse, North America)
“I think when you work in breastfeeding, it can be a very isolated profession, particularly if you work in an area where you have a very strong bottle feeding culture…And because you’re always working where things are atypical for your population, you know, you need to reach out and find your tribe, that’s very much the people that think the same as you, people that don’t think you’re mad because you happen to believe that this [breastfeeding] is really important…When you find people that think the same as you, it can be very supportive…it can feel very collaborative.”
and“We want to provide hopefully neutral and fact-based statements that are easy to understand as [much as] possible, and then let people make their own decisions based on that…Advocacy is something that we [as an organization] really can’t participate in. That’s just not something that we’re allowed to do [due to an organizational policy]…We work really closely with them [national advocacy organizations] to promote and support breastfeeding. We support them through technical assistance and advice... But it’s really difficult for us to be able to retweet their content or to be able to highlight them in our social media content because of that advocacy piece.”(Governmental health-related organization, North America)
“With Twitter, we’re able to reach some of our partners that maybe aren’t as invested in breastfeeding as we are, like [names of federal departments involved in labor and commerce]. So [our focus on Twitter] is on organization-to-organization advocacy.”(State-wide breastfeeding coalition, North America)
3.4. Influencers Use Specific Brand Messaging Techniques That They Believe Resonate with Their Target Audiences
“There are many controversial topics in the breastfeeding [science] world, including real and perceived conflicts of interest. It’s easy to get into heated online conversations about these issues, but I personally don’t have the energy for extensive debating on Twitter.”(Academic researcher)
“Sometimes I’m retweeting some scientific publications or research funded by companies [related to breastfeeding] because I think that it would be interesting for other people and even for mothers. But it’s true that in the breast milk feeding or breast milk [research and practice] area, the WHO code has huge relevance. I accept the rules [in the code] and I’m agree with them. But the point that I hate is when people use these rules to put on a fire [create a hostile environment on Twitter] and maybe to create a society that is divided into yes or no [you either agree with all aspects of the WHO code or with none]. At the end of the day, we [should] have a lot of grace. This is not a black-or-white situation. And I don’t want people who may view that rules simplistically to pressure other people [who don’t]. I mean I am part of different lactation working groups [to promote breastfeeding] but also believe sometimes research done or funded by companies provide interesting scientific evidence [innovations related to breast milk research]. I don’t want to be part of this war between companies and breastfeeding advocates. I think in equilibrium, we can find good things.”(Academic biomedical researcher from Europe)
3.5. Influencers Face Technical and Communication Challenges
“The other thing [barrier] in the breastfeeding sphere especially, is understanding the tech barrier that many of our most passionate advocates face. Because when you can only access your clients’ community or your peers’ community through your antiquated work technology, and because you work at a state agency that’s not well-funded, then you start to think there aren’t a lot of options [to make an impact on Twitter].”
“I have noticed when I post tweets about breastfeeding, that occasionally you’ll get the women who write “ Don’t make me feel worse. And I already feel that I can’t breastfeed.” I understand where they’re coming from. It’s sad, and I respect it. But, I can’t deal with everybody’s sensitivities for the greater good.”
“We get trained from day one about listening, about communication skills. We never say to the mother, “you’re doing things wrong.” We listen, and we can always find something positive, and then we build on that connection. And so I’m very, very careful about how I phrase things. I never want to make someone feel guilty or bad by what I say. But I want to say what’s actually scientifically correct. Now some people will take offense at the scientific evidence, and I can’t change their minds. All in all, this really informs my messages and my tone and my language which can be tricky on Twitter.”
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Type of Influencer, n = 813 | n | Percent |
---|---|---|
Scientific health community | 347 | 42.7 |
clinician | 125 | 15.4 |
health-related NGO | 77 | 9.47 |
researcher without clinical duties | 32 | 3.94 |
researcher with clinical duties | 31 | 3.81 |
academic journals or conferences | 17 | 2.09 |
public health employee | 14 | 1.72 |
university | 12 | 1.48 |
hospital or clinic | 12 | 1.48 |
health-related gov. agency | 12 | 1.48 |
professional association | 6 | 0.74 |
others 1 | 9 | 1.11 |
General community | 445 | 54.7 |
individual from general public | 315 | 38.8 |
non-gov. non-health celebrity | 85 | 10.5 |
non-health-related news | 15 | 1.85 |
non-health-related NGO | 11 | 1.35 |
elected government official | 8 | 0.98 |
non-health-related gov. agency and programs | 3 | 0.37 |
others 2 | 8 | 0.98 |
Companies | 21 | 2.59 |
selling products unrelated to BF | 15 | 1.85 |
selling products related to BF | 6 | 0.74 |
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Moukarzel, S.; Caduff, A.; Rehm, M.; del Fresno, M.; Pérez-Escamilla, R.; Daly, A.J. Breastfeeding Communication Strategies, Challenges and Opportunities in the Twitter-Verse: Perspectives of Influencers and Social Network Analysis. Int. J. Environ. Res. Public Health 2021, 18, 6181. https://doi.org/10.3390/ijerph18126181
Moukarzel S, Caduff A, Rehm M, del Fresno M, Pérez-Escamilla R, Daly AJ. Breastfeeding Communication Strategies, Challenges and Opportunities in the Twitter-Verse: Perspectives of Influencers and Social Network Analysis. International Journal of Environmental Research and Public Health. 2021; 18(12):6181. https://doi.org/10.3390/ijerph18126181
Chicago/Turabian StyleMoukarzel, Sara, Anita Caduff, Martin Rehm, Miguel del Fresno, Rafael Pérez-Escamilla, and Alan J. Daly. 2021. "Breastfeeding Communication Strategies, Challenges and Opportunities in the Twitter-Verse: Perspectives of Influencers and Social Network Analysis" International Journal of Environmental Research and Public Health 18, no. 12: 6181. https://doi.org/10.3390/ijerph18126181
APA StyleMoukarzel, S., Caduff, A., Rehm, M., del Fresno, M., Pérez-Escamilla, R., & Daly, A. J. (2021). Breastfeeding Communication Strategies, Challenges and Opportunities in the Twitter-Verse: Perspectives of Influencers and Social Network Analysis. International Journal of Environmental Research and Public Health, 18(12), 6181. https://doi.org/10.3390/ijerph18126181