A Game of Telephone: Pro-CWF vs Anti-CWF Information Online
There’s good and bad news for fluoridation advocates in a new study on how information on community water fluoridation (CWF) spreads online, both with important lessons.
The authors of Community water fluoridation online: an analysis of the digital media ecosystem collected stories on fluoridation and then categorized the sources they came from, ultimately identifying nine types of media, from academic to user-generated. Another layer of analysis was applied to identify the sentiment of each article: pro-fluoridation, anti-, or neutral.
Not surprisingly, of the scientific sources (defined as recognized scientific associations providing peer-reviewed content), 78% of what was published during the study period was pro-fluoride and 15% was neutral. Unfortunately, these sources made up only a little over 8% of the total. Fully 80% of what was published on government websites was pro-fluoride and 16% neutral but, again, this authoritative source comprised only about 8% of the total.
Mainstream media accounts for the largest portion, at 44%, and appears neutral about 85% of the time. Advocacy organizations, of which the Campaign for Dental Health is one, are also represented. Fluoride opponents are more numerous (22 versus 15) and therefore take up more bandwidth. In this category, 44% of the online information is anti-fluoride; 30% is pro; and 26% is neutral.
Pro-fluoridation sources had the highest number of inlinks, and that is good news. Yet, as the authors point out, “anti-fluoridation sentiment maintains influence online.” One explanation is that, although they misrepresent the content, anti-fluoridation websites link to the same scientific sources as pro-fluoridation sites. What happens next is that the misrepresentation is actively shared – without a link to the scientific source – and takes on a social authority of its own. Alas, pro-fluoridation information does not have the same kind of momentum.
Public health information is very different than public health communications. At least one of these researchers has demonstrated in other work that, when it comes to online communities, we tend to speak more to ourselves than to the audiences we would like to reach. Although we are pleased to see this study affirm the presence of authoritative pro-fluoridation information online, it’s findings also point to areas where advocates need to improve the style, spread, and impact of our messages.