April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Social Media Messages on Nutrition and Physical Activity During Pregnancy
Background: Health behaviors during pregnancy have a direct and lasting impact on both mother and baby. While scientific evidence and expert recommendations for nutrition and exercise during pregnancy exist, a majority of women do not consistently comply with these recommendations. Lay recommendations abound, particularly on social media. However, few studies address the content of nutrition and exercise messages within these applications, despite the proliferation of use and persuasion on these platforms. The present study explores the characteristics and accuracy of prenatal nutritional and exercise messaging on TikTok.
Methods: In a quantitative content analysis, researchers first identified leading pregnancy hashtags, then sampled the top posts in a given month from 20 hashtags related to pregnancy, nutrition, fitness, and/or general prenatal health (e.g., #pregnancyworkout, #fitpregnancy, #healthypregnancy). The selected hashtags yielded 800 TikTok posts, of which 656 posts included prenatal exercise and/or nutrition content.
Two research assistants served as coders. Once all codes of individual posts met sufficient reliability in a pilot test, coders completed their randomly assigned codes with a 10% overlap reliability sample. Coders reached intercoder reliability sufficient for an exploratory study for all codes (Cohen’s kappa ≥ .74). Coders addressed the following variables for all posts: popularity, general and specific topic, stated credentials, promotional content, and congruence with professional guidelines. For exercise posts, coders added: type and intensity of exercise, and the presence of instructional communication. For nutrition posts, coders added: nature and method of food advice, diet type, caloric intake, and weight gain recommendations.
Key Results: The majority of posts in the final sample (75.6%) were created by individuals without formal credentials. Self-identified credentialed individuals (e.g., RD, RN) created 20.8% of nutrition posts with an additional 54.4% created by individuals with self-proclaimed expertise (e.g., non-certified health coach). Nutrition posts created by credentialed individuals were 69.2% congruent with recommendations and did not provide specific calorie (97.5%) or weight gain recommendations (92.4%).
A majority of prenatal exercise posts (73.6%) came from posters that did not identify as any form of trained exercise specialist. Content created by an exercise specialist focused on strength training (67.1%) over aerobic training. Content was unlikely to include instructional or cautionary information whether posted by an exercise specialist (18%) or not (9%). When all exercise types and intensities were grouped, 40.6% fully adhered to and 59.4% deviated from the guidelines. Chi-Square test revealed a significant association between type of exercise (aerobic v. strength training) and congruence to exercise guidelines (𝛘2=35.2, df=1, p<0.01), such that content on strength training was significantly less likely to adhere to the guidelines compared to content on aerobic exercise.
Conclusion: The study indicated irregular compliance with professional guidelines related to both nutrition and exercise. Content creators with professional specialties were more compliant than those without specialties. Strength-training posts were particularly non-compliant and should signal recommending organizations to attend to the apparent demand for such exercise during pregnancy.
Methods: In a quantitative content analysis, researchers first identified leading pregnancy hashtags, then sampled the top posts in a given month from 20 hashtags related to pregnancy, nutrition, fitness, and/or general prenatal health (e.g., #pregnancyworkout, #fitpregnancy, #healthypregnancy). The selected hashtags yielded 800 TikTok posts, of which 656 posts included prenatal exercise and/or nutrition content.
Two research assistants served as coders. Once all codes of individual posts met sufficient reliability in a pilot test, coders completed their randomly assigned codes with a 10% overlap reliability sample. Coders reached intercoder reliability sufficient for an exploratory study for all codes (Cohen’s kappa ≥ .74). Coders addressed the following variables for all posts: popularity, general and specific topic, stated credentials, promotional content, and congruence with professional guidelines. For exercise posts, coders added: type and intensity of exercise, and the presence of instructional communication. For nutrition posts, coders added: nature and method of food advice, diet type, caloric intake, and weight gain recommendations.
Key Results: The majority of posts in the final sample (75.6%) were created by individuals without formal credentials. Self-identified credentialed individuals (e.g., RD, RN) created 20.8% of nutrition posts with an additional 54.4% created by individuals with self-proclaimed expertise (e.g., non-certified health coach). Nutrition posts created by credentialed individuals were 69.2% congruent with recommendations and did not provide specific calorie (97.5%) or weight gain recommendations (92.4%).
A majority of prenatal exercise posts (73.6%) came from posters that did not identify as any form of trained exercise specialist. Content created by an exercise specialist focused on strength training (67.1%) over aerobic training. Content was unlikely to include instructional or cautionary information whether posted by an exercise specialist (18%) or not (9%). When all exercise types and intensities were grouped, 40.6% fully adhered to and 59.4% deviated from the guidelines. Chi-Square test revealed a significant association between type of exercise (aerobic v. strength training) and congruence to exercise guidelines (𝛘2=35.2, df=1, p<0.01), such that content on strength training was significantly less likely to adhere to the guidelines compared to content on aerobic exercise.
Conclusion: The study indicated irregular compliance with professional guidelines related to both nutrition and exercise. Content creators with professional specialties were more compliant than those without specialties. Strength-training posts were particularly non-compliant and should signal recommending organizations to attend to the apparent demand for such exercise during pregnancy.