use Internet-based social media sites to share their treat- ment-related ... the most popular. ... relatively young age (typically younger than 10 years). All.
Report
Peer-reviewed paper. Submitted May 2013; accepted August 2013
Social Media Use by Orthodontic Patients Henzell M, Knight A, Antoun JS, Farella M abstract Internet-based social media sites have recently surged in popularity and are often used to share thoughts and seek support about health issues. Objectives: The aim of this study was to investigate how orthodontic patients use Internet-based social media sites to share their treatment-related experiences and attitudes towards braces. A secondary objective was to investigate whether an online or mobile application would be considered helpful in improving co-operation with the use of orthodontic appliances. Method: Patients visiting the orthodontic clinic at the University of Otago were asked to participate in a cross–sectional survey that sought details of their Internet-based social media use and their thoughts about the development of a reminder application. Results: The sample comprised 130 orthodontic patients, with a mean age of 17.2 (SD 6.9) and a nearly equal sex distribution (52.3% were female). Internet-based social media sites were used by 80.8%, with Facebook being the most popular. Some 13.3% of the sample had posted comments about braces on these social media sites. Only 6.7% had considered obtaining information about orthodontic treatment from Internet-based social media sites, with the majority (81%) preferring to seek this information directly from their orthodontist. Nearly twothirds of those who had difficulty remembering to wear their orthodontic appliances reported that a reminder application on their phone would be beneficial. Conclusions: A large proportion of orthodontic patients use Internet-based social media sites, although only a few currently use them to post about treatment-related topics. Social media sites may provide a useful channel of communication for patients seeking support. Further research is needed to evaluate the use of phone reminder applications in orthodontics.
These sites have recently been used to evaluate the experiences of dental patients. Heaivillin and colleagues (2011) found that nearly 14% of Internet-based social media users sought advice on dental pain from the Twitter community, with 15% describing its impact on their daily lives. Others have used these Internet-based social media sites to investigate public opinion on topics such as immunisation (Keelan et al., 2010), and to evaluate the type of health-related information shared online (Greene et al., 2010). Such studies are likely to increase dramatically as Internet-based social media sites continue to surge in popularity, with a reported one billion people logging onto Facebook each month worldwide1. With such a wide breadth of users and an informationrich database, could these sites provide the dental profession with insight into the problems and issues experienced by orthodontic patients? The use of Internet-based social media sites to investigate the experiences and attitudes of orthodontic patients seems rather appealing, since teenagers and adolescents have abundant access to the Internet (Pfeil et al., 2009; Maczewski, 2002). Moreover, it has been reported that people feel less restricted online and are able to express themselves more freely (Maczewski, 2002). To the best of our knowledge, however, there have been no studies investigating how orthodontic patients use Internet-based social media sites, or whether they utilise it to convey treatment-related experiences, and/or seek braces-related information. This type of information is needed if Internet-based social media sites are to be used as a data source in future research. Orthodontists may also use this information to improve patient motivation and co-operation. The aim of this cross-sectional pilot study was to investigate how orthodontic patients use Internet-based social media sites to share treatment-related experiences and attitudes. In addition, we investigated whether patients used these sites to search for treatment-related information. A secondary objective was to determine whether orthodontic patients would prefer using online or mobile applications to help improve cooperation with appliance use.
Methods INTRODUCTION The majority of orthodontic treatments are dependent upon patient co-operation and motivation, and yet very little is known about how patients perceive and experience braces in their daily lives. Cross-sectional surveys may be useful for evaluating treatment effects, although using them to record and evaluate day-to-day experiences with braces can be impractical. The past few years, however, have seen the rise of a considerable revolution in the form of social media sites on the Internet. These sites—which include the ever-popular Facebook and Twitter—provide forums for people to share their photos, thoughts, ideas and information (Paul and Dredze, 2011), as well as their views on health services.
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Social media use by orthodontic patients
The study was approved by the Ethics Committee of the University of Otago. A survey of 134 orthodontic patients attending the School of Dentistry orthodontic clinic at the University of Otago was carried out during July and August 2012, over a period of 5 days. Patients being assessed for orthodontic treatment need were excluded because of their relatively young age (typically younger than 10 years). All other patients attending the orthodontic clinic on these days were approached by the clinic’s receptionist and invited to participate in the survey. Owing to the fluctuating workload of the clinic’s staff, not all patients were approached, and these 1 Kiss J (2012). Facebook hits 1 billion users a month. The Guardian Oct 4th. Sect. UK News. p5.
New Zealand Dental Journal – December 2013
formed the “non-responder” group. The questionnaire was anonymously completed in the clinic’s waiting room, usually before the patient’s scheduled appointment. Basic sociodemographic information (including age, gender, and ethnicity) was collected. Sociodemographic information was also recorded for patients who did not participate in the survey in order to compare them to respondents, and evaluate whether those who participated differed systematically from those who did not. Each patient’s treatment stage was recorded as either ‘before’, ‘during’ or ‘after’ treatment. The questionnaire was developed based on discussions among qualified orthodontists and postgraduate and undergraduate students. It focused on how orthodontic patients conveyed their treatment experiences and attitudes through Internet-based social media websites such as Facebook. In particular, information was sought as to whether participants or their friends had posted comments or photos on these websites about braces, and whether they would use these Internet-based social media networks to look for information about orthodontic treatment. Information was also collected on whether participants believed that online/mobile applications (or “apps”) would be useful to remind them about treatmentrelated tasks such as wearing intra-oral elastics. Data were analysed using the Statistical Package for the Social Sciences (SPSS Inc, Chicago, IL). Bivariate analyses (such as the Chi-Square test, Fisher’s Exact test and One-Way ANOVA) were used to test for statistically significant associations, with the alpha level set at 0.05.
Results Of the 266 people eligible to participate, 130 (48.9%) returned completed questionnaires. There were no statistically significant differences between responders and non-responders with respect to sociodemographic characteristics (Table 1). The sample was predominantly of New Zealand European origin (85.6%), had a mean age of 17.2 (SD 6.9) years, and 52.3% were female. Table 1. Comparison of sociodemographic characteristics of respondents and non-respondents (brackets contain column percentages) Respondents (n = 130)
Non-Respondents (n = 136)a
Male
62 (47.7)
72 (52.9)
Female
68 (52.3)
64 (47.1)
34 (26.2)
45 (33.1)
Gender
Age Group Under 13 14 to 17
60 (46.2)
64 (47.1)
18 and over
36 (27.7)
27 (19.9)
108 (83.1)
107 (88.4)
Ethnicitya
a
NZ European/Pa¯keha¯
Ma¯ori
9 (6.9)
3 (2.5)
Pacific Island
2 (1.5)
3 (2.5)
Asian
5 (3.8)
2 (1.7)
Other
6 (4.6)
6 (5.0)
Ethnicity data missing for 15 non-respondent cases
New Zealand Dental Journal – December 2013
The majority (70.8%) of the participants were under treatment, although no significant differences were apparent between them and those who had either not received treatment yet, or completed treatment (Table 2). Some 80.8% (n=105) of respondents reported using Internet-based social media sites, with nearly all of those using Facebook (96.2%; 101/105). Twitter was the second most commonly used Internet-based social media site (21.9%; 23/105), whereas other sites (such as Tumbler and Bebo) were used by fewer than one in ten. Most respondents (83.8%) reported accessing these Internet-based social media sites from home, although 60.0% (63/105) also visited these sites using their mobile phones. Over two-thirds of the participants (74/105) reported visiting Internet-based social media sites for less than 60 minutes per day, and only 28.6% accessed them for longer. Few participants (13.3%; 14/105) posted comments about their braces, with the majority of those undergoing treatment (85.7%). In contrast, a greater number of respondents had noticed friends posting about orthodontic treatment (29.5%; 31/105). Slightly under half of the participants indicated that they were likely to post photos of their teeth at the end of treatment (45.7%; 48/105), with females being more likely to do so than males (70.8% and 29.2% respectively; p
