Obstetricians deliver TikTok truths with a dose of humour

Melbourne: Misinformation and "fake news" are by no means new, but the speed at which it can spread through social media makes responding to it particularly challenging. When it involves healthcare, those stakes become even higher.  But a community of obstetrician gynaecologists have broken through in the fight against misinformation, helping educate followers using an approach that balances compassion with expertise.

Social media's rapid dissemination can be a double-edged sword: it benefits us learning about global events quickly, but raises problems when incorrect information finds millions of people very quickly.  For example, there are over  500 hours of video footage uploaded to YouTube every minute. By the time a video has been flagged as misleading and reviewed, then removed, it may have reached millions of people and been reposted on other platforms.

During the COVID-19 pandemic, misinformation about the virus and the vaccine proliferated, with researchers noting it had a significant impact on discouraging vaccine uptake.  The impacts of misinformation more generally, while hard to measure, have been connected to increasing social distrust and political polarisation.

Social media companies have responded to the spread of misinformation on their platforms by showing pop-ups when users share an article prompting you to read it first (seen on X, formerly known as Twitter), or an info box directing them to an official source of information when searching a term like "COVID", as is done on platforms like Instagram, TikTok and Facebook.  At the same time, many platforms benefit and profit from the circulation of information — irrespective of its quality — so it's unsurprising that many of these strategies have had a limited impact on containing misinformation.

Research suggests that "confirmation bias" — our propensity to believe information that affirms beliefs we already hold — plays a big role in the spread of misinformation, especially on social media.  A 2018 US study which examined how well social media users can detect misinformation showed that flagging fake news as such had no impact on how trustworthy participants rated it.

The same study reported that social media users were much more likely to believe a news headline that aligned with their beliefs than one that did not.

To get a better understanding of how misinformation works and why it works, it’s helpful to first understand why people seek information — particularly about their health —  from social media.

Recently, we’ve been studying how young people access information about menstruation and sexual health. We’re trying to understand how they think about social media and content creators as part of the range of perspectives and sources of information available to them.

In our pilot study, we interviewed nine young Canadians about their experiences learning about menstruation and found that many used social media as a more personalised source of information, where they could follow creators whose experiences felt more closely aligned with their own.  When it comes to sensitive topics such as sexual health, feeling like the source of the information understands your experience was identified as very important, perhaps even more important than qualifications or expertise.

Given some participants described having had negative experiences with healthcare providers, finding very supportive and helpful content on social media further validated these beliefs.

These findings align with the earlier US research on confirmation bias on social media, given participants sought out perspectives that aligned with their own. However, there’s more to be explored that can tell us about how we can respond to misinformation.  Another study emphasised the important role intimacy plays in building trust between content creators and their audiences, rather than expertise.

We analysed content created by obstetrician gynaecologists on TikTok to understand the educational strategies they use, as well as the way they respond to misinformation. There is a substantial community of healthcare workers on the platform who create content about their work and lives.

In this case, even when focused specifically on expert creators (all the creators studied were qualified practising obstetrician gynaecologists), we found they employed strategies that fostered intimacy with their audience.  While they did draw on their specialist expertise and qualifications to demonstrate their legitimacy, this was done in tandem with strategies that attempted to break down the formalities usually established in medical practice.  They used humour to convey their messages, offered "behind the scenes" insights into their work lives and even their personal lives to establish a relationship with their audiences.

This approach extended to how they critically responded to health misinformation on the platform. It was common to see obstetrician gynaecologist creators "stitch" (a TikTok video format that pairs their video alongside another video, allowing them to comment on it) with videos containing misinformation in order to speak back to or clarify the claim(s) being made.

They often used humour to debunk myths they came across, frequently drawing on popular in-jokes circulating on TikTok at the time, demonstrating their membership in the community.  Their content was also compassionate and non-judgemental, even when debunking misinformation. They did not shame those who fell for misinformation, but rather created a supportive space to redirect them.  These practices align with research on shame in the healthcare setting, which concludes that, while shame can be a powerful motivator, it can also lead to serious harms such as avoiding treatment.

The videos also often acknowledged the problems within the medical industry, such as sexism or racism — further establishing trust with followers who may have had difficulty with healthcare providers in the past.

Obstetrician gynaecologist creators on TikTok developed a strong connection with their audience using strategies that would be familiar to any social media influencer, and they leveraged these strategies to combat health misinformation.  Rather than focusing only on removing misinformation from the platform, they used this content to create a productive dialogue with their audiences.  Though this strategy has limited applications and is not going to be a silver bullet when it comes to tackling misinformation, it models how debunking can be part of a supportive, rather than shame-based, approach. (360info.org)