Experts' Goals and Constraints When Discussing Vaccines With Laypeople on a Facebook Group

The scholarly community has dedicated increasing attention to the ways science literacy (SL) manifests itself in everyday life. This paper explores dialogue on a controversial, everyday personal health issue in an online community of scientific experts and non-experts, from the perspective of scientific insiders. Specifically, it characterises the considerations guiding participation of experts in science and health in a question and answer (Q&A) Facebook group dedicated to vaccines.

The authors begin by offering a literature review that covers: (i) public communication of scientific experts and health professionals with laypeople; (ii) motivations and objectives of answerers on online Q&A services; and (iii) vaccine hesitancy. One example they cite is a content analysis of the Israeli Facebook group "Parents Talk about the Polio Vaccine", which indicated that experts tended to base their claims on ideas relating to the nature of science and to methods of scientific inquiry more often than non-experts. In addition, claims, even those made by experts, were seldom supported by evidence.

The researchers conducted the present study on the Hebrew-language Facebook group Medabbrim Al H_issunim ("Talking about Vaccines"; hereafter TaV), founded in October 2013. It is operated by a small, volunteer-based Israeli non-profit organisation named MiDa'at (derived from the Hebrew term Haskama MiDa'at, "informed consent"). MiDa'at and TaV were founded in the wake of Israel's 2013 Polio crisis, continuing and expanding the activity that took place in a previously established pro-vaccine Facebook group, described elsewhere (see, e.g., Related Summaries, below). Members of TaV may pose vaccine-related questions and receive answers from community members at no cost. Most askers are mothers of infants. Answerers are often, but not always, experts in science and medicine; non-experts in science and medicine are permitted to answer, too, but only if their answers reflect "the evidence-based scientific consensus". Hence, the group can be considered a hybrid between a "community-based" Q&A service and an "expert-based" Q&A service. (TaV has a "public" privacy setting, meaning that its content is visible to non-members.)

As part of a larger case study, 30- to 60-minute-long interviews were conducted with 10 TaV answerers, using a 2-part protocol. Two answerers were physicians; one specialised in family medicine and the other was a paediatrician. Another answerer was a physician-in-training. Two answerers were nurses, and 5 had completed graduate-level research training in biological or medical sciences, or were currently in such training.

The researchers found that experts used a diverse set of considerations in their online communication about vaccines. Goals included disseminating knowledge about the vaccines and the diseases they help prevent, defending science against unfounded rumours and conspiracy theories, and calming fears of parents. At the same time, answerers were mindful of 2 salient constraints: maintaining collegiality with their health professional peers and avoiding provision of medical advice for individuals, even though askers' questions are often phrased in individual terms. (See Table 2 in the paper, which includes example quotations.)

Upon reflection, the researchers suggest that, in some ways, findings evoke previous research on public communication of science by scientific experts; in other ways, they diverge from the literature. For example, answerers report taking a defensive stance against anti-vax activists, yet they exhibit a caring and nurturing form of science communication, offering health information and social support for vaccine-hesitant parents who specifically ask for it. TaV can be considered a community for on-demand dissemination of scientific information. This communication is a modified form of the deficit model, characterised by being guided by the public's genuine information needs. However, the researchers assert, even the most well-intentioned experts are bounded by their own knowledge (including knowledge of the askers' specific context) and by social constraints, such as the relationships that experts must maintain with their peers.

Further research on co-construction of scientific and health knowledge in online communities can take several directions, according to the researchers:

• Whether answerers achieve their goals vis-à-vis askers remains to be examined. Do dissemination efforts result in knowledge gains? Do answerers' efforts to calm askers truly work?
• Further research could characterise the competencies needed for experts for meaningful dialogue with laypeople. Do experts learn these competencies "on the job", or do they draw on skills learned beforehand? To what extent can these competencies be taught, and what are some effective ways to do so?
• The concept of experts' "bounded engagement with the public" raises questions about the nature of that engagement. What kind of lay questions do experts think they can reasonably answer, and how does that compare with laypeople's expectations?

The researchers conclude that further investigation into these questions could advance understanding of SL on the community level, both within technologically-enhanced environments and outside of them. It might also enhance understanding of co-construction of knowledge in online communities.