The Influence of Social Media on Intrapartum Decision Making: A Scoping Review

Examining Healthcare Professionals' Communication Around Decision-Making with Internet-Informed Patients

In the last ten years the use of the internet as a health resource has transformed, and while patients increasingly consult online resources for health decision-making, less is known about how healthcare professionals (HCPs) currently discuss decision-making with internet informed patients (IIPs). In this paper we examine how HCPs perceive IIPs and specifically how bringing online information into appointments can prompt different communicative strategies around decision-making. Ten HCPs with experience working across different healthcare roles, took part in semi-structured interviews and discussed their interactions with IIPs around decision-making. Vignettes based on descriptions of real patients bringing online health information to their HCPs were used to prompt further discussion. The analysis identified two themes in relation to communication: (i) being honest about information sources and (ii) from compliance to co-construction: improving communication around decision-making. HCPs were overwhelmingly positive toward IIPs and encouraged patients to be transparent about their online searching to understand their motivations, priorities, and concerns. Although compliance remains part of the narrative, HCPs recognized practical ways in which discussing online health information could improve HCP-patient communication around shared decision-making. We discuss the findings in relation to early work on communicative strategies between HCP's and patients bringing resources to their consultations. We argue that for HCPs the concept of the internet as a provider of health information is no longer seen as inherently damaging or risky. There is growing acceptance of pre-consultation internet searching with the caveat that any information sourced online should inform rather than dictate decision-making with HCPs.

Evaluating Messaging on Prenatal Health Behaviors Using Social Media Data: Systematic Review

BACKGROUND

Social media platforms are increasingly being used to disseminate messages about prenatal health. However, to date, we lack a systematic assessment of how to evaluate the impact of official prenatal health messaging and campaigns using social media data.

OBJECTIVE

This study aims to review both the published and gray literature on how official prenatal health messaging and campaigns have been evaluated to date in terms of impact, acceptability, effectiveness, and unintended consequences, using social media data.

METHODS

A total of 6 electronic databases were searched and supplemented with the hand-searching of reference lists. Both published and gray literature were eligible for review. Data were analyzed using content analysis for descriptive data and a thematic synthesis approach to summarize qualitative evidence. A quality appraisal tool, designed especially for use with social media data, was used to assess the quality of the included articles.

RESULTS

A total of 11 studies were eligible for the review. The results showed that the most common prenatal health behavior targeted was alcohol consumption, and Facebook was the most commonly used source of social media data. The majority (n=6) of articles used social media data for descriptive purposes only. The results also showed that there was a lack of evaluation of the effectiveness, acceptability, and unintended consequences of the prenatal health message or campaign.

CONCLUSIONS

Social media is a widely used and potentially valuable resource for communicating and evaluating prenatal health messaging. However, this review suggests that there is a need to develop and adopt sound methodology on how to evaluate prenatal health messaging using social media data, for the benefit of future research and to inform public health practice.

"At the End of the Day, My Goal is to Help People Feed Their Babies Human Milk": A Qualitative Exploration of the Pumping Attitudes of Lactation Care Providers

BACKGROUND

Parents who express milk by pumping often feel this is judged as inferior to direct breastfeeding by healthcare providers, leaving parents feeling unsupported. Healthcare provider attitudes can influence decisions about human milk feeding directly at the chest. Yet, there is a gap in knowledge regarding lactation care provider attitudes about pumping.

RESEARCH AIM

To explore the attitudes and feelings of lactation care providers about pumping.

METHOD

A qualitative descriptive design was utilized. Researchers conducted semi-structured interviews with a convenience sample of 15 lactation care providers in the United States, recruited via social media. Data were analyzed using thematic analysis.

RESULTS

Four themes emerged: (1) I Support You, (2) But It's Not the Same, (3) Frustration with Social Media, and (4) Changing Perspectives. Participants held positive attitudes toward pumping as a tool to meet human milk feeding goals. They strived to provide judgement-free support but stressed the importance of setting realistic expectations and sharing the difference in benefits and work between direct breastfeeding and pumping. Providers held negative attitudes about the portrayal of pumping on social media. The participants' perspectives were that, while there has been stigma surrounding pumping in the past, views are changing.

CONCLUSION

Lactation care providers strive to provide judgement-free support for pumping, but communicating challenges about pumping may be perceived negatively by parents. More research is needed on lactation care provider education on pumping, interventions to reduce bias, and how these affect providers' pumping beliefs, attitudes, and provision of judgement-free delivery of care.

The impact of social media influencers on pregnancy, birth, and early parenting experiences: A systematic review

BACKGROUND

Pregnant and new parents are increasingly engaging with social media. The impacts of engaging with social media 'influencers' and 'bloggers' during a time of heightened vulnerability to influence, in particular, merits exploration.

AIM

To systematically review the literature to identify what is known about how following social media 'influencers' and 'bloggers' impacts pregnant and new parents' experiences and decision-making.

METHODS

A search of CINAHL, World of Science, Medline, EMBASE and Google Scholar databases was undertaken in January 2023 to identify the literature focusing on the impacts of engaging with influencers or bloggers as pregnant or new parents. The reference lists of the included papers were hand-searched. Data were extracted from each paper, tabulated, and thematically analysed. The review was reported using the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

FINDINGS

Seventeen papers met the inclusion criteria and were included in the final synthesis. Thematic analysis revealed four overarching themes, which were 'sharing information', 'support', 'identity', and 'monetisation'.

DISCUSSION

Social media influencers provide a network of peers amongst whom discussions, supportive behaviours, and information sharing take place. However, concern arises around the potential for combative interactions, the risk for transmission of misinformation, and the potential impacts of following influencers who are also qualified health professionals.

CONCLUSION

Existing research suggests that engaging with social media influencers can be both beneficial and harmful for pregnant and new parents. At the current time, it is unclear how exposure to the benefits or harm impacts personal experiences and decision-making.

Sources of information used by women during pregnancy and the perceived quality

Background

Access to reliable information is critical to women’s experience and wellbeing during pregnancy and childbirth. In our information-rich society, women are exposed to a wide range of information sources. The primary objective of this study was to explore women’s use of information sources during pregnancy and to examine the perceived usefulness and trustworthiness of these sources.

Method

A quantitative cross-sectional study of Dutch women's experiences with various information sources during pregnancy, including professional (e.g. healthcare system), and informal sources, divided into conventional (e.g. family or peers) and digital sources (e.g. websites or apps). Exploratory backward stepwise multiple regression was performed to identify associations between the perceived quality of information sources and personal characteristics.

Results

A total of 1922 pregnant women were included in this study. The most commonly used information sources were midwives (91.5%), family or friends (79.3%), websites (77.9%), and apps (61%). More than 80% of women found professional information sources trustworthy and useful, while digital sources were perceived as less trustworthy and useful. Personal factors explain only a small part of the variation in the perceived quality of information sources.

Conclusion

Even though digital sources are perceived as less trustworthy and useful than professional and conventional sources, they are among the most commonly used sources of information for pregnant women. To meet the information needs of the contemporary generation of pregnant women it is essential that professionals help in the development of digital information sources.

Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women

Background: Digital health literacy (DHL) increases the self-efficacy and empowerment of pregnant and lactating women (PLW) in using the Internet for health issues. The European project IC-Health aimed to improve DHL among PLW, through the co-creation of Massive Open Online Courses (MOOCs). Methods: The co-creation of the MOOCs included focus groups and the creation of communities of practice (CoPs) with PLW and healthcare professionals aimed to co-design the MOOCs. The quantitative measures of MOOCs’ acceptability, experience in the co-creation process and increase in DHL (dimensions of finding, understanding and appraisal) were assessed. Results: 17 PLW participated in focus groups, 113 participants were included in CoPs and 68 participants evaluated the acceptability of MOOCs. A total of 6 MOOCs aimed at improving PLW’s DHL were co-designed. There was a significant improvement in self-perceived DHL after using MOOCs (p-value < 0.001). The acceptability of MOOCs and co-creation experience were positively valued. Conclusions: The preliminary results of the quantitative assessment showed a higher self-perceived DHL after the IC-Health MOOCs. These results suggest that IC-Health MOOCs and the co-creation methodology appear to be a viable process to carry out an intervention aimed to improve DHL levels in European PLW.

Undergraduate Nursing Students' Stress and Fear of Missing Out

BACKGROUND

This descriptive study analyzed the stress in nursing education and the fear of missing out.

METHOD

This study was conducted at a public university in eastern Turkey and included 1,119 undergraduate nursing students.

RESULT

Findings indicated there was no statistically significant relationship between the levels of stress experienced by students during their nursing education and their fears of missing out.

CONCLUSION

In light of these findings, recommendations include identifying the factors leading to stress and fear of missing out for undergraduate nursing students and then developing potential strategies to help allay nursing students' stress and fears. [J Nurs Educ. 2021;60(10):559-565.].

Validating a framework of women's experience of the perinatal period; a scoping review

OBJECTIVE

The aim of this paper is to identify and explain the factors that make up a woman's experience of the perinatal period. We accomplish this by validating a framework, described in an earlier study, that identifies the distinct dimensions of the perinatal experience.

DESIGN

We conducted a scoping review, using five online databases, to identify and categorize studies that investigate women's experience of the perinatal period.

FINDINGS

We found 251 publications that focused on the experience of the perinatal period. Our review confirmed the seven dimensions of our framework describing women's experiences of the perinatal period - the woman as unique individual, the woman as active participant in care, the responsiveness of maternity care and health services, the lived experience of being pregnant, giving birth and the postpartum period, communication and relationships with care providers, information and childbirth education, and support from social environment. One new dimension emerged from the studies we identified: societal influence. The resulting eight dimensions provide a comprehensive overview of the important aspects of women's experience of the perinatal period. While each dimension is distinct, there are significant overlaps and close relationships between them.

CONCLUSION

The framework is a useful guide for healthcare providers, researchers, and policy makers who wish to improve the experience of the perinatal period. It is important to remember, however, that the current framework is dynamic, open to new insights and further development and refinement.

Social Media and the Mediation of Childbirth: So, What for Mothers, Maternity, and Midwifery Practice?

Social media is fast becoming a global phenomenon with recent research providing insight into the complex inter-weaving relationship between the media and women and families over the childbirth continuum. Additionally, a growing body of evidence demonstrates a major cultural shift in the agency and information-seeking practices of women through social media. This perhaps suggests that services fall short of providing real and lived value to the women navigating through maternity systems in the United Kingdom, due to changes in culture and society. A deeper understanding of this phenomenon may help providers and practitioners offer care which better supports women's needs and enable them to develop innovative new approaches for future service provision. The aim of this article is to examine the literature and develop a deeper understanding of how social media may impact upon women, childbearing and midwifery practice via six domains. In conclusion, informational, experimental, and relational needs of women could be enhanced with funding and investment into the role of new expert tech-midwives using social media initiatives within maternity systems. Thus, supporting the demands of modern technology use by woman to elevate midwifery care provision and satisfaction and protect against the technocratic and patriarchal influence of childbirth. This synthesis of the literature through a western cultural lens may also be relevant to an international audience.