Abstract
The Web 2.0 digital environment is revolutionizing how users communicate and relate to each other, and how information is shared, created, and recreated within user communities. The social media technologies in the Web 2.0 digital ecosystem are fundamentally changing the opportunities and dangers in disseminating qualitative health research. The social changes influenced by digital innovations shift dissemination from passive consumption to user-centered, apomediated cooperative approaches, the features of which are underutilized by many qualitative researchers. We identify opportunities new digital media presents for knowledge dissemination activities including access to wider audiences with few gatekeeper constraints, new perspectives, and symbiotic relationships between researchers and users. We also address some of the challenges in embracing these technologies including lack of control, potential for unethical co-optation of work, and cyberbullying. Finally, we offer solutions to enhance research dissemination in sustainable, ethical, and effective strategies.
The new Web 2.0 media landscape created in the past 10 years allows qualitative researchers to integrate a range of interactive media into their research communications. There is unprecedented potential to create extensive networks of stakeholders to collaborate to support research processes and research dissemination. The new Web environment is rapid, global, and facilitates information exchange and engagement of potential users. It can effectively expedite movement of scientific findings into the public sphere to an extent unimaginable two decades ago (Brossard, 2013). The emergence of digitally networked media has exploded assumptions about who should be the producers and publishers of information, because end users of these technologies often fully participate in decisions about how this information should be shaped and shared (Bruns, 2008; Lewis, 2012). In fact, the term environments in this context is reframed as “digital ecosystems” (Goldstein et al., 2013, p. 365) to recognize the interactive and interdependent nature of engagement.
There is growing pressure for qualitative health researchers to move beyond journal articles or conference abstracts in their dissemination activities and to embrace Web 2.0 communication channels as a means of disseminating research findings to augment impact on practice, policy, or people (Keen & Todres, 2007; Shearer & Birdsall, 2005). The wide-spread popularity of social media possible in Web 2.0 technologies makes these forums ideal for health research communication (Bottorff et al., 2014). As with any social change influenced by technological innovations, there are both opportunities and pitfalls regarding its use. While researchers agree that the technology has the potential to transform qualitative research knowledge dissemination (KD), it also presents significant ethical and pragmatic issues as well as a fundamental challenge to the assumed power relationship between researchers and public audiences (Brossard, 2013; Grajales, Sheps, Ho, Novak-Lauscher, & Eysenbach, 2014).
Little exists in the qualitative literature regarding the impact of digital technologies on the communication context of qualitative research outside of formal repositories for scientific purposes. There is a burgeoning body of work on conducting research in online environments (e.g., see netnography by Kozinets, 2012; McElhinney, Cheater, & Kidd, 2014), use of social media as an intervention (such as the study by Bottorff et al., 2014), as resource for recruiting participants and gathering data (Koskan et al., 2014), and a growing number of examples of nontraditional dissemination (see Gadanidis & Borba, 2013; Stockley et al., 2009). However, there is little empirical research on online science communication processes in general (Brossard, 2013) and even less on the implications, best practices, or pitfalls in translating qualitative research findings within the Web 2.0 context. There are emerging best practice guidelines for utilizing social media for public health communication and marketing campaigns that focus on the appropriate selection of social media sites, needs assessment, tailoring, and targeting of information for maximum impact (Bornkessel, Furberg, & Lefebvre, 2014; Centers for Disease Control and Prevention [CDC], 2012; Tobey & Manore, 2014). There are also guidelines for professionals’ use of social media (e.g., see American Medical Association, 2012). There is increasing focus on how to address safety concerns for health consumers (Lau, Gabarron, Fernandez-Luque, & Armayones, 2012), but there is a significant gap addressing safety concerns of researchers. Although this is an issue relevant to all forms of research, it is a particular concern to qualitative researchers because qualitative results are prone to assumptions of generalizability, and qualitative data may easily be taken out of context. Pink (2007) argues that user reediting and representing of hypermedia texts “might produce negative or harmful meanings or consequences for the people represented in it” (p. 33). Ethically sound, theoretically informed, KD activities based on collaborative work between researchers and stakeholders represent best standards (Wilson, Petticrew, Calnan, & Nazareth, 2010). Some agencies recommend dissemination occurs via face-to-face communication (see Canadian Foundation for Healthcare Improvement, n.d.). In our experience, there are increasing numbers of novice researchers who are excited and motivated by the potentials inherent in Web 2.0 who may not be fully conversant with the associated challenges.
In this article, digital media is understood as digitized content (i.e., text, audio, or video) that is transmitted via Web 2.0 Internet or online platforms or channels in which users can interface with each other and/or the person(s) who posted the information. We will draw on literature in research and other fields such as journalism and science communication to identify the benefits of Web 2.0 digital media as a vehicle for qualitative research KD. We will identify the challenges qualitative researchers face as they embrace these technologies in the dissemination of research findings. We propose that the solutions to these challenges arise in acknowledging that the use of digital media for KD provides a cultural tension for qualitative researchers. Furthermore, we indicate ways in which qualitative researchers can embrace and address this cultural tension to foster the ethical and meaningful use of digital media in the KD of qualitative health research.
Web 2.0
Web 2.0 has introduced a paradigmatic social transformation in the way the digital media are used (Qvortrup, 2006). The traditional Web/Internet platform allowed for passive unidirectional information dissemination such as posted journal articles that can be viewed or downloaded (Neiger, Thackeray, Burton, Giraud-Carrier, & Fagen, 2013). Web 2.0 is radically different: It is a decentralized, multidirectional, user-centered cooperative activity that would have seemed science fiction rather than science fact 20 years ago (Wei, 2009; Yzer & Southwell, 2008). Any user can create, edit, revise, or even reimagine content and has extensive control over how to share that content. Once shared, other users can personalize the content and share it within their networks. Information can be instantly distributed and social media platforms allow for discussion and networking on a global scale (Andersen & Söderqvist, 2012). Users and communities can now directly participate in knowledge distribution, sharing, evaluation, and recreation of information within social networks in a horizontal manner rather than relying on information disseminated by experts (Bernhardt, Mays, & Kreuter, 2011; Brossard, 2013).
Smart phones and mobile tablets have institutionalized Web 2.0 and applications for social networking, email, chat rooms, and instant messaging as integral to our daily social lives (Andersen & Söderqvist, 2012). Information can be cocreated through wikis such as Wikipedia, blogs, micro-blogs such as Twitter, and multimedia sharing sites, such as Flickr, Pinterest, and YouTube. The pervasiveness of Web 2.0 digital technologies within global and regional populations continues to increase with estimates of 40% of the global population using Internet that contains more than a billion websites and more than 1.2 trillion Google searches at the end of 2014 (Internet Live Stats, 2014), and 1.317 million monthly active Facebook users (Facebook, 2014). A scant 10 years after their introduction, Web and mobile-based social media are now an integral part of society (Andersen & Söderqvist, 2012).
People are no longer passive receivers of information distributed by experts but are actively using the Internet to find information and create or strengthen peer networks on a daily basis (Martland & Rothbaum, 2007). In the health context, more individuals are sharing their experiences through forums such as blogging, as a way to decrease isolation, promoting connections with others with similar experiences and as a means to share personal stories, which is increasingly a vehicle to foster meaning making and gain insights from the experience of others as well as understanding of their illness (Ressler, Bradshaw, Gualtieri, & Chui, 2012). Social media can foster more intense and engaged discussion in both formal and informal networks. However, information users critically evaluate and interpret the information they access based on their own perspective and context, irrespective of the intent of those who posted the information (Weigold, Treise, & Rausch, 2007).
The active, participatory, and multidirectional information exchange in the new Web 2.0 environment is not fully harnessed by science as a whole (Brossard, 2013), nor by qualitative researchers in particular. The traditional approach of posting information online in an engaging and accessible format for passive reception is successful. For example, “Hearing Our Voices” is a website for a participatory research project on housing for people with schizophrenia (Schneider, 2012). The site contains extensive information about the participants, engagement, and research process to contextualize the Photo Voice findings, as well as a dramatic presentation of the narratives, a graphic novel, and a documentary film about the project. The site is well presented with remarkable design and graphics and contains linking documents (available at http://callhome.ucalgary.ca/; also see Schneider, 2012). However, there is no capacity for direct communication, discussion, or engagement with end users, only unidirectional interaction via a “send message” function. Web 2.0 can transform KD processes not only to allow users to determine what information they need but also to help them decide how and when they need this information, in an ongoing interactive process (Bernhardt et al., 2011).
The Benefits of Digital Media and KD
Different facets of Web 2.0 technologies are gradually permeating qualitative researchers’ dissemination repertoires as they adopt tools that facilitate the specific needs and goals in their research (Acord & Harley, 2013). In the following sections, we outline the dominant advantages and challenges these technologies present for qualitative researchers.
Wider audiences and new perspectives
The appeal of digital media as means for KD is easily appreciated when one considers the advantages of these technologies that offer tools that, if used judiciously, are likely to be beneficial to the research community and facilitate positive connections with other communities of media users (Kolmes, 2012). A considerable benefit not realized by traditional means (e.g., journal articles or conference abstracts) or Web 1.0 is that it significantly widens the audiences that have ready access to the research findings (Gattone, 2012; Weigold et al., 2007). Put concisely, the best strategy to reach large numbers of people is through an online item that goes viral. Strategic viral marketing by publishers and research groups and institutions attempt to guide and prescribe optional promotion. For example, Pfeiffer (2013) produced films during a participatory research project with adolescents in Tanzania on reproductive health realities, and disseminated the films via DVD promoted by local television stations as well as by posting on YouTube. However, many individual researchers’ dissemination efforts are more organic. One of the key drivers is spreadability or “the extent to which a viewer likes the content and is motivated to share it” (Bal, Archer-Brown, Robson, & Hall, 2013, p. 204). Social networking sites such as Facebook expose people to information sources they may never have seen before (Brossard, 2013).
Many leading peer-reviewed journals have used multiple Web 2.0 domains such as Twitter and Facebook to actively disseminate findings (Bernhardt et al., 2011). This exposes research findings to a wide array of audiences who may be interested in the research in various social and geographical contexts and who in turn may generate new perspectives and applications of the findings (Gattone, 2012). For example, Twitter can engage a number of users in discussions about the veracity and applicability of research findings. When people are able to express their thoughts and opinions about research findings using these forums, they are more likely to learn more about the findings and to experience attitudinal change than if they simply read research reports or attended scholarly presentations (Prislin et al., 2011). It is not only completed research that benefits from this, but there is also a growing number of articles-in-draft posted in wikis and blogs whereby readers can contribute to the development of the ideas or discuss the implications of the findings as they emerge (Brossard, 2013; Colson, 2011; Zivkovic, 2008). This formative feedback during the process of development can be constructively informative compared with the usual process of peer review of completed journal manuscripts.
Symbiosis between traditional and digital
Much of the literature to date presents digital media as an alternative to conventional forms of KD, particularly as a way to circumvent increasing barriers to publishing in traditional format (Houghton, Steel, & Henty, 2004). However, this view does not highlight the symbiotic relationship between the traditional and nontraditional. The most obvious is the ability to disseminate empirical research knowledge through nontext formats, such as the ethnographic video articles in the open-access Journal of Video Ethnography, established in late 2014 (http://www.videoethno.com). Dissemination is also facilitated through links to articles, abstracts, and presentations on social networking sites (Andersen & Söderqvist, 2012). This can draw attention to work that might otherwise be inaccessible to nonacademics. Web links can be posted on flyers and posters about the research, directing anyone interested to blogs and other forms of digital messaging in which users can dialogue with the researcher and others about the research (Terras, 2012). Often, this occurs through special QR (Quick Response Codes) graphical icons that, when photographed by a smartphone, will immediately bring up a Web page without the user having to enter the Web address. Using social media to market or promote articles formally or informally can increase downloads, citations, and presumably create a wider impact (Andersen & Söderqvist, 2012). For example, Terras (2012) discovered that her research articles were downloaded significantly more often after she discussed them using digital media than when she relied only on journal publications. One published article had been downloaded twice in 1 year, but after using digital media to bring the article to prominence, 140 users across the globe downloaded it. Social media can also provide a platform to share background information that is not easily published elsewhere. Qualitative researchers recognize the constraints in comprehensively describing research process in traditional journal articles. Hyperlinks to blogs in which this reflective experience is shared complement more focused reports.
Tracking usage
Several forms of digital media include features that permit the tracking of use so that researcher can identify which messages about their research are capturing users’ attention. Twitter, for example, is “a real-time information network” (Twitter, n.d.) in which users share “tweets” of 140 characters or less and tag messages using a “hashtag.” The hashtag feature of Twitter enables researchers to determine which groups of users attend to particular messages about the research and to track interest in the message among users as an aggregate and among specific user groups (Hermida, 2012). This can help researchers develop networks of people with similar research interests.
Transformation of gatekeeper roles
Scholarly publishing is adapting quickly to take advantage of the Web 2.0 interactive features. Crowd-sourced review, in which member of the public may post comments to a posted article with, or without editorial mediation, is an emerging option in open peer review (Ford, 2013). Informal forums in which researchers can post complete or in-progress research findings no longer require a middleperson or a gatekeeper in the same way peer-reviewed journals require (Martland & Rothbaum, 2007). Issues such as journal preferences, peer review, and editorial decisions become less influential as Web-based dissemination increases by individual researchers establishing their own forums and vehicles for communicating their research. This permits researchers to present their “message” in different ways and in different forms, appealing to a wide variety of potential audiences with different tastes and interests, the hope being that interested readers will pull the information directly (Hanson, Thackeray, Barnes, Neiger, & McIntyre, 2008). It is challenging to determine the extent of this approach, although Boydell, Gladstone, Volpe, Allemang, and Stasiulis (2012) offer a review of arts-based health research, and Gonzalez de Armas, Archidald, and Scott (2014) has initiated an inventory tracking in-progress arts-based projects.
The Challenges of Digital Media and KD
One of the most significant challenges facing qualitative researchers using digital media in KD is that researchers have traditionally interpreted KD as a top–down approach in which the audience is informed about the research findings. Digital technologies have created a fundamental power shift in which participatory users can create, tag, share, and remix information at will, an apomediated environment (Eysenbach, 2008). This has reshaped the way that producers and audiences of research information have traditionally been conceptualized because issues of quality, personal relevance, interpretation, and contextualization are fundamentally altered (Lewis, 2012).
Grassroots/lack of control
There is a rapidly expanding grassroots empowerment movement in which “users are learning how to master these media technologies to bring the flow of media more fully under their control and to interact (and cocreate) with other users” (Jenkins & Deuze, 2008, p. 6). Users of digital media in these virtual ecosystems can write over, amend, add to, and then recirculate the information posted by the researcher. Although the science literacy of the general public is increasing, there may still remain relatively poor understanding of the goals, nature, strengths, and limitations of research in general (Weigold et al., 2007) and qualitative research in particular. There is considerable risk that users may produce amateur versions of the content, rather than the versions that are published by expert researchers who are culturally and ethically responsive (Keen & Todres, 2007). That viewers have interpreted qualitative representations is acknowledged, but the speed in which this hypermedia can be distributed, recreated, and applied has significant implications when those interpretations were not intended by the researchers (Pfeiffer, 2013). Specifically, there is a risk that even when hypermedia contains multiple forms of data representations (e.g., narratives, films, photographs) to represent multilinear texts, users may use them to create their own narrower narratives (Pink, 2007). Pink further argues that the dynamic between visual representations and users continues to be largely neglected and there is a worrying gap in knowledge about hypermedia user’s experiences.
Co-opted work
Qualitative researchers posting research findings in digital media are faced with the possibility of someone usurping the findings for their own purposes (Scanlon, 2014). For example, people with commercial or other vested interests may highlight certain research findings as more prominent than they actually were. Any individual may stretch the significance of particular findings to make a point. Corporations and individuals with agendas can use the freely available and participatory nature of digital technologies to promote targeted messages or to influence particular populations. Examples of this practice exist on YouTube in the arena of smoking cessation messaging by health promotion advocates as well as pro-smoking marketing by the tobacco industry (Bottorff et al., 2014; Paek, Kim, Hove, & Huh, 2014). Adding to this is the challenge of presenting research findings in abbreviated format, such as videos posted to YouTube. While it is essential to provide links to the original work, there is no guarantee that users will use these links and researchers can place few controls on viewers’ ability to selectively use and adapt whichever findings meet their needs regardless of the context. Professional academic plagiarism is of concern to many academics, as Lupton’s (2014) survey of 711 academics’ use of social media discovered. One participant in this study commented, “How much can/should you share of your research via social media before it’s published, and who, if anyone, cites pre-article material?” (p. 29). While traditional, professional, and academic cultural norms enforce reputation and citation to ensure honesty (Acord & Harley, 2013), the extent to which this will remain effective in the global environment is unclear.
Central to these issues are values about the interpretation of research findings by researcher versus user. Findings can be used to support individual, group, or corporate agendas. Emergence of “citizen researchers” or “people who have no social science qualifications or experience and who want to do research for purposes other than adding to academic knowledge” (Fielding, 2012, para. 4) raise the possibility of users selectively extracting findings for their own purposes. In Lupton’s survey, there was considerable concern about the potential for research findings to be misrepresented, taken out of context, stretched or distorted, and overlooked (Lupton, 2014). When these incidents occur, the individuals involved generally do not discuss limits of transferability of the research findings they are using. For example, research reported by Dr. Barbara Paterson on a Facebook site was used by members of an advocacy group as evidence to support a public campaign of free transportation for all urban citizens to receive health care, despite the fact that the research pertained only to rural people who lived in poverty. The difficulties for consumers in establishing the quality of information, issues in determining authorship in the absence of source citation, and dangers inherent in users posting personal opinion as fact (Vance, Howe, & Dellavalle, 2009) result in urgent calls to critically reflect on the dynamics in Web 2.0 modalities and responsibilities of researchers. Although such challenges may certainly occur when individuals attend a scholarly presentation or read a journal article, the viral nature of digital media and its emphasis on brevity makes this an issue of even greater import. This is particularly concerning to researchers who open their professional work to public scrutiny when they post thoughts and ideas about their research; they risk being attacked by digital media users as lacking credibility or relevance (Carr, 2010; Lupton, 2014).
Web searches on governmental sites and direct enquiries to agencies by the authors provide many examples of handbooks and posted guidelines for creating effective messages to various publics using various kinds of media (e.g., see CDC, 2013). Direct enquiry to the U.S. CDC, however, returned the response that CDC had no protocol to guide researchers in considering how their messages might be used by various members of the public (email CDC Acting Social Media Team Lead, July 24, 2014). In fact, CDC’s (2012) handbook on creating social media messages mandates an approval process determined—by guidelines that are unclear even to the CDC—within each office or center. The only formalized evaluation tool for messages produced by CDC is the agency’s “Clear Communication Index” (CDC, 2013), which attempts to measure whether a message is comprehensible to the intended audience, without considering what the audience might do with the information once it has been understood.
Despite clear direction from governmental agencies like CDC, some social media organizations are alert to these concerns. “Reddit” is a site where users known as “Redditors” post user-generated content and links to other online content. Areas of the site that are dedicated to specific interests are known as “subreddits” and include nearly any topic imaginable. Recently, Reddit’s Science subreddit instituted a verification system for scientists posting information there. Users can now verify a poster’s scientific background—or that they are a science journalist—using a “flair” or text/images that accompany the redditor’s name in comments (http://www.reddit.com/r/science/comments/1s6410/subreddit_announcement_nature_partnership_with/).
The line between science and opinion is blurring. Online sources including wikis and blogs often do not separate science and opinion. There is increasing popularity of YouTube to share personal narratives by, for example, cancer survivors. These narratives are characterized by dramatic tension and emotional engagement, which makes them powerful storytelling communication devices (Chou, Hunt, Folkers, & Augustson, 2011). On the other hand, potential users may not have the knowledge background to determine credible sources, or to notice when research findings have been utilized, re-represented, or misapplied out of context, or indeed, are not research based (Brossard, 2013). There is growing concern in communication science over the documented habits of online surfers, who, with the aid of mobile devices such as tablets and smart phones, tend to frequently but briefly surf for information with little critical evaluation. Online information is embedded in a format that contains a number of cues about accuracy, importance, or popularity accompanied by numbers that imply significance, importance, or uptake (such as Facebook “likes,” twitter mentions, or number of readers’ comments) provided by third party, end-user peer apomediators. These seemingly statistical numbers that are essentially a popularity contest (Acord & Harley, 2013) can potentially affect the reader’s interpretation of the information (Brossard, 2013). This has significant implications for how qualitative researchers represent complex findings in brief form or for how such comments may add additional layers of meaning that the researcher did not intend.
Anonymization and bullying
Digital media relies on speed of messaging and the candid sharing messages among a wide audience; these features increase the potential for harm. Because digital media does not require that people identify themselves with their real names, users may feel unencumbered to make harmful or inappropriate comments or engage in cyberbullying, and this concerns many academic researchers (Lupton, 2014). There are times, particularly when the focus of the study is on a marginalized population, when users misinterpreting and conveying inappropriate messaging might lead to untoward consequences. As an example, Langford, Litts, and Pearson (2013) write of the danger of users engaging in digital discussions about military suicides; their concern was that users might convey a sense of hopelessness or the notion that suicides are more prevalent than they are in reality.
Variable user search skills
Web search engine functions can give access to limitless information (Brossard, 2013), and the user can tailor the search to personal preferences and needs. While at first glance, this feature may appear beneficial, it can pose significant challenges because not all users are equally skilled at searching. Users search for information on the Web using their own words, not necessarily the search terms deemed by researchers to be representative of the research. Users unfamiliar with search engines may not locate the research because they limit their search domain, use too-specific search terms, or are unaware how to refine their search terms to allow for a broader range of results (Martland & Rothbaum, 2007). As there may be significant variation of user demographic characteristics across Web 2 applications, researchers may need to use multiple tools to achieve their dissemination goals (Bik & Goldstein, 2013).
Researcher skills and resources
Unfortunately, academic institutions are only slowly creating infrastructure to meet the challenges of Web 2.0 KD. Dissemination and promotion of research beyond journals and conferences are subject to institutional controls, and universities often rely on specialized communication and marketing departments that have institutional branding and identity formation on their agendas. For many qualitative researchers, however, KD needs may go beyond the mission and capacity of such departments (Andersen & Söderqvist, 2012).
KD is a task for individual researchers. Many qualitative researchers feel more prepared and skilled in the traditional forms of KD, such as writing journal articles or presenting at conferences. Developing proficiency in the Web 2.0 environment is not widely part of many professional or disciplinary research preparation programs (Hanson et al., 2008). In addition, applying research to practice is often regarded as beyond the boundaries of the research process, and thus, investigators are less motivated to actively disseminate transformed and tailored information for targeted audiences, or to engage in discussion of the meaning or application of the findings (Keen & Todres, 2007).
Researchers can perceive KD by digital media as being more time-consuming and labor-intensive than more traditional formats (Hammond & Cooper, 2011). Even those researchers who are familiar with the technology may find the time required to sustain an interesting blog or to tweet about research overwhelming (Terras, 2012). Carr (2010) suggests that researchers who engage in KD in digital media may find their work/life balance compromised because of the time investment required for digital media.
The new Web 2.0 media landscape provides a wide range of communicative formats to fit researchers’ purposes, should they be willing and able to use them. To date, there is little evidence that younger researchers are utilizing these approaches to any great extent, despite a possibly greater level of comfort with the technologies (Harley, Acord, Earl-Novell, Lawrence, & King, 2010). This may be related to concerns about requirements for career advancement. Many academic researchers may not regard novel approaches to active dissemination of research as meritable activity. Dominant cultural norms within disciplines greatly influence the valuing of traditional peer-reviewed publication over opportunities afforded by new technologies. While more creative approaches to judging quality or success in scholarship are evolving, the gold standard remains formal publication (Acord & Harley, 2013). At the present time, it is unclear whether active dissemination using Web 2.0 is rewarded or impedes career progression within traditional academia (Bernhardt et al., 2011), although there seems to be little to no recognition of social media contributions, in that a recent survey indicates that only 8% of 367 social scientists surveyed in Canada, the United States, and the United Kingdom stated that social media activities contributed to their tenure of promotion reviews (Gruzd, Goertzen, & Mai, 2012).
Ethical challenges
There are ethical challenges in the digital KD of qualitative research that are not yet clearly addressed. Qualitative researchers are charged with the responsibility to preserve the depth and richness of the data they have collected, while accurately depicting the thematic structuring, processes of case comparison, and typology of data within the data analysis. Decontextualized data presented through channels such as micro-blogs (e.g., Twitter) present a significant challenge in this regard. Some media such as Twitter or short YouTube videos provide only “sound bites” of research reports, and information may be taken out of context or distorted, that is, messages that decontextualize and sensationalize parts but not the whole of the research findings. Including clear links to the original research report does not guarantee that those “surfing” for information may extract information based on a brief and superficial view (Brossard, 2013). In addition, science communication researchers have identified concerns with the extent to which seemingly innocuous contextual information, such as specific wording choices in media such as Twitter, or search terms, can prime readers to view information in particular ways. Such inadvertent contextual information may act either to encourage or discourage further dissemination (Brossard, 2013). Most researchers may focus on content and may not have the communication background necessary to be cognizant of these subtle but influential factors.
Confidentiality
Confidentiality may be difficult to ensure when research data such as images and voices are posted, or when research participants request a copy of their data and post it themselves. For example, discovery of a participant’s information on the Internet can occur when shared or overlapping friend networks are identified on media sites such as Facebook (Kolmes & Taube, 2011). This is a particular concern for participants who share a similar social identity, such as cultural affiliation or sexual orientation, or when the researcher posts quotes of a participant speaking about someone else who has not provided informed consent for the study. Posting of actual participant images and voices may also be tracked more easily than if it were confined to a journal with restricted access to subscribers. It may also be a concern for the researcher who may be tracked by a Web user and perhaps stalked (Kolmes, 2012). There is increasing concern of traceability of quotes used from online data sources as search engine techniques advance so that “all comments are traceable,” which can lead to usernames, profiles (Henderson, Johnson, & Auld, 2013). These authors warn that if researchers are not aware of the metadata included in embedded digital media, such as photos taken by smart phones and tablets, viewers online can trace location, time, and author. These concerns are exacerbated because digital media is accessible by everyone, unless specific restrictions are placed on its access. Participants in a qualitative research study about addiction may not think ahead, when completing the informed consent for the study, about the potential impact they may face if their colleagues or employer read about their addiction.
Harassment of research participants whose personal information is revealed in the Web environment is particularly concerning because of the ongoing and viral nature of digital media. As most online information remains available for years, there is a potential for viewers to discover a person’s identity by searching across multiple media. What is of most concern in this scenario is the ability of the harasser to remain anonymous. This potential to create harm is illustrated in the case of an online poster using the name of Nerdy Apple Bottom, who wrote a blog titled “My Son Is Gay.” The blog described how her 5-year-old son wanted to dress as a female cartoon character for Halloween. The blog went viral, resulting in several media reports and interviews. Many commentators berated the blogger for being an unfit mother and speculated about her son’s sexual orientation. Although the blogger later closed down the blog to comments, a recent Google search for this item revealed 100,000 entries (Kolmes, 2012). We could find no empirical research on the incidence of harassment although we have anecdotal accounts related by delegates during conferences.
Directions for the Future
For researchers, the lure of Web 2.0 is that it will assist in adopting a consumer-centered approach to research dissemination with the end goal of maximizing rapid utilization (Bernhardt et al., 2011). This article is a beginning effort to develop a practical and ethical framework for the KD of qualitative research in digital media; however, there are many questions yet to be explored. In general, ethical review boards or researchers do not tend to consider the ethical issues specific to the Web 2.0 ecosystems in the development of informed consent for qualitative research. Until recently, the ethics review boards of one of the authors (J. Spiers) explicitly determined that participants sign a consent form that included the statement that the participant was not permitted to post online the video they had produced of their experience. Given that a copy of their own video was an appropriate exchange for the weeks they spent making it for the researcher, it seemed unreasonable not only to tell them what they were not permitted to do with the fruits of their labors but also to attempt to regulate participants’ actions after the study was complete. Someone who signs an informed consent to share his or her interview data for teaching or other scholarly purposes may not consider the implications of having these data available in digital forms, presented in sound bites, and readily accessible to a variety of audiences. Informed consent for research that will use such media in KD should make these plans clear (e.g., images or voices will be permanently posted, or, we plan to have a weekly online blog in which we will discuss the research findings one at a time and invite people to comment).
Researchers, institutions, and the ethics review bodies with whom they collaborate should be alert to the need to develop an informed consent process specifically addressing the concerns raised here about KD of qualitative research in Web 2.0. The risks of KD in digital media (i.e., users taking data out of context, misrepresenting or distorting data, or linking the participant to unrelated digital sources) should be clearly articulated. The consent should stipulate that participants should contact the researcher or the research team if they wish to have their data removed. Users of digital media sites that contain information about qualitative research findings should be informed, on the front page of the site and on the front page of each research report posted, of the ethical, legal, and policy frameworks that determine what information can be shared with others and whether it can be revised or expanded.
Consider User Group
The identified benefits of digital technologies highlight the accessibility of research findings to a variety of audiences; however, researchers who already understand the culture of engagement of digital media users may discover that the audiences for their research postings are limited. Qualitative researchers should take pains to identify lay terms that users might use to locate their research on the Internet; for example, “sadness” rather than “clinical depression.” Dr. Barbara Paterson brings participants in her research together at the end of the study to share the findings and to generate ideas from the group for innovative and useful means of KD. At that time, she asks the attendees to generate lists of search terms they might use to locate the research. The research team uses this list to anticipate keywords that users are likely to use when searching for the research findings. These search terms are embedded within a website’s content and key terms or phrases are located strategically throughout the website. Resources for researchers wishing to develop lay-friendly search terms are widely available. For example, the WebGuide Thesaurus of Common Keywords, a list of common keywords used in the field of child development, is available at www.cfw.tufts.edu. In addition, many communication professionals can advise on tactics for search engine optimization. When Web content is optimized to be easily discoverable, researchers may notice a significant increase in “hits” (individual visits) to their Websites.
Workload calculations for academic and industry researchers must consider the time and energy that KD through Web 2.0 media requires. If KD through digital media is an expectation, employing institutions and research funders must consider not only adequate technologic infrastructure but training, as well as any other resources (e.g., Web designer), that the researcher will need to emplace KD in the Web environment. Although many people use the Web in their personal and professional lives, a recent large study of the research behavior of 17,000 Gen Y doctoral students (born between 1982 and 1993) across 70 universities in the United Kingdom clearly indicated doctoral students are insufficiently trained or informed to be able to fully utilize the latest opportunities in the digital environment (Joint Information System Committee, Higher Education Funding Council, 2012). Specific training needs to become an integral part of knowledge translation learning in research oriented graduate programs.
Frameworks
We could not locate any definitive guidelines or frameworks to assist qualitative researchers in deciding whether and how they should use Web 2.0 digital media to translate and disseminate their research findings for rapid utilization. We likewise could not find guidance in ways in which they might maximize the benefits and mediate the challenges associated with these technologies. There is increasing interaction with, and use of conceptual frameworks from the area of social marketing and distribution. The translation processes of defining and producing specific products for specific consumers is relevant to science information consumers (Wilson et al., 2010), but no framework specifically accommodates research dissemination in a Web 2.0 environment. Wilson et al. (2010) found that among the 33 dissemination frameworks identified in their systematic review of health and social science databases, only 5 contain “more than one way communications and include genuine interaction between researchers and target audiences” (p. 13), and those contained insufficient dissemination detail. Overall, Wilson et al. note an overreliance on linear messenger-receiver models and an inadequate use of practices emerging from modern communication theory. Web-based activity is communication-as-interaction, so this is an important deficit to ameliorate.
There is an acknowledged organizational “lack of infrastructure and systems necessary to ensure that research products reach intended end users” (Bernhardt et al., 2011, p. 35). There is a similar lack in the availability of virtual environment-specific conceptual framing. That notwithstanding, there are some key elements researchers should consider before deciding to translate research via Web 2.0 channels (Brossard, 2013). First, consider how best to reach the target audience (Cann, Dimitriou, & Hooley, 2011). This is reflective of a core key principle in marketing science: target tailored information to segmented audiences (Wei, 2009). Determine the kind of information that might be appropriate for specific types of audiences, for example, the needs of people experiencing the phenomenon-of-interest as reported in the research findings will differ from the needs of professionals working within that context. Both the overall goal and the specific goal for each target audience need to be considered. Reflect on how these target audiences might be best drawn to or directed to the site, as this will influence choice of keywords, or indeed use of buttons or gadgets that might link to the research site. The researchers’ intent is to deliver useful, current information and knowledge that is easy to understand and use, so careful consideration of the strategic information messaging is just as important as considering the overall design of a website. The fundamental questions to be asked are as follows: “To what extent is the user invited to interpret information for them?” and “What persuasive strategies are required to gain the site user’s participation?”
Few qualitative researchers are as skilled in website design as they are in their research specialties, so grant applications should include expert assistance in Web 2.0 technology to assist with translation of research findings into useful products. Techniques such as smart tagging and search engine optimization are ways to strategically highlight research content based on search engine indexing procedures and commonly used search terms so that the content is more prominent during a user’s Web search (Bernhardt et al., 2011). Grant applications should outline how a specialist in Web 2.0 skills will be integrated into the research team.
Cann and colleagues (2011) identify additional elements to understand before deciding to translate research in digital media. These include considering whether the KD should occur before or after the research is published and whether there are ethical or intellectual property implications if the content is publicly and freely accessible. Other factors, such as the workload for the researcher and the possibility of harm to participants, should also be included in such decision-making. There are some existing frameworks and policies (e.g., Council on Ethical and Judicial Affairs, American Medical Association, 2010, 2011) that can be used as resources to encourage an institutional discussion about how qualitative researchers might effectively and ethically use digital media for KD.
Need for Consumer Research
Many aspects of Web 2.0 applications and media can be beneficial to the qualitative researcher wishing to disseminate and translate research findings. These include the speed of delivery, its accessibility to a wide audience, and the opportunities for bidirectional communication and networking (Martland & Rothbaum, 2007). Despite these advantages, we know little about various digital media users’ needs, level of trust, uses, and preferences in regard to information about qualitative research findings. It is clear in areas such as health information, that usage of and trust in commonly used sources of online and mass media varies by ethnicity and culture, age, language, and socioeconomic status (Clayman, Manganello, Viswanath, Hesse, & Arora, 2010). Further studies of how intended audiences’ or population groups’ habits and preferences for receiving and processing KD information offered via digital media would assist qualitative researchers tailoring digital KD to specific audiences. This is a direction for future research in the field. There is some literature in fields, such as journalism and clinical psychology, in which the authors present case histories of issues that have arisen when digital media is used to transmit information. A similar set of case stories provided by qualitative researchers would further illuminate the issues and the benefits of digital media in KD, as well as inform frameworks and guidelines for qualitative researchers considering using digital media for this purpose.
Looking to the Future
The elephant in the room in the discussion of KD in the Web 2.0 universe is Facebook or its equivalent, which may be used by many people in lieu of other forms of electronic communication. Knowing how to leverage its capacity to grow social relationships and foster connections between diverse people makes understanding Facebook, as Howard Rheingold puts it, “a twenty-first-century survival skill” (Rheingold, 2012, p. 230). Facebook’s privacy and data policies call forth many serious questions about how users may protect their identity and privacy in an environment of constantly shifting services and policy changes. The looming challenges to the use of Facebook as a component of KD—or as part of the spectrum of social media used by anyone with access to data generated by research—is massive. One photograph taken at a gathering of research subjects, automatically tagged with time and geographical location, and linked to unrelated photographs by Facebook’s face-recognition technology, could at one instant stroke remove the privacy and anonymity of everyone in the photograph.
Web 2.0 enables collaborative information transfer. Current media theory recognizes that the technology merely facilitates communication: that people are at the center of the communicative process whether it is mediated or face-to-face. Media researchers are now looking at “Personal Learning Networks” (PLNs; Rheingold, 2012), which surround each connected person. The PLN contains people from whom one gathers new information as well as people to whom one disseminates information. Relationships shift and coalesce as transactional agreements to collaborate or groupthink form around matters of interest or problems to be solved. Within a PLN, new members come on board for certain tasks and may be removed once their input is no longer needed (Rheingold, 2012).
Rheingold offers a series of actions to build an effective PLN: explore, search, follow, tune, feed, engage, inquire, and respond. The same steps and their implications may integrate into the more specific discussion of disseminating research results:
Explore all kinds of media, including face-to-face interaction.
Search using keywords picked up through exploration.
Follow the data streams of those found by searching.
Tune the network by withdrawing attention from those who do not seem to contribute to the present interest.
Feed the network by sharing data as they are created.
Engage with the network by commenting, asking questions, proposing collaboration, and sharing networkers’ data outside the PLN to others.
Inquire, raising questions to get to more focused information or deeper collaboration. And finally,
Respond to inquiries, continuing the iterative process of knowledge creation, dissemination, and network building.
Conclusion
Social history is marked by the impact of pivotal changes in communication technology. In 1948, the focus was on television, FM radio, and facsimile. Sixty years later, it is new media: Twitter, blogging, chat rooms, instant texting, and hyperlinking that allow users to collaboratively create and share information. Web 2.0 is a new model of knowledge production based on values of rapid, global, user-generated, and user-controlled networking. It is exploding assumptions about who should be the producers and publishers of information, particularly because end users of these technologies may now participate fully in decisions about how this information can be shaped and shared (Bruns, 2008; Lewis, 2012). We, as qualitative health researchers, need to embrace a new era of research in which the long-standing norms of qualitative research, particularly those relating to privacy and ownership of data, and interpretation of results are evolving at a rapid rate. Until we are equipped with evidence-based frameworks to guide the ethical application of KD in Web 2.0, qualitative researchers should exercise caution in heralding the advantage, authority, and credibility of emerging digital channels as a forum for qualitative research dissemination.
Footnotes
Acknowledgements
The conversations that led to this article were initiated at the 19th International Qualitative Health Research Conference (2013), Montreal, Canada.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
