Social Media Health Information Formats and Endometriosis Treatment-Seeking Intentions: A Randomized Controlled Trial

Background Despite many women learning about endometriosis on social media, posts about the condition often fail to reflect current evidence. With the content and credibility of online health messages being found to influence behavioral intentions in other areas, this study aimed to explore how the format of endometriosis-related social media posts affects women’s intentions to get a laparoscopy for the diagnosis and treatment of endometriosis. Design In this 2 × 2 × (2) online randomized controlled trial, Australian women aged 18 to 45 y who had no prior endometriosis diagnosis were randomly assigned to view 1 of 4 mock Instagram posts. Post content (personal anecdote v. nonnarrative, factual information) and source (high-credibility “World Health Organization†(WHO) account v. low credibility layperson account) varied across conditions. A within-subjects component investigated change in intention when participants were informed of new treatment guidelines. Results A total of 1,473 women were included in the analysis. Instagram posts featuring an anecdote produced higher treatment-seeking intentions (mean difference [MD] = 0.22, 95% confidence interval [CI] = 0.04–0.39) and more favorable attitudes toward getting a laparoscopy compared with posts containing nonnarrative information (MD = 0.13, 95% CI = 0.01–0.25). While the WHO account was perceived as more credible (MD = 0.29, 95% CI = 0.17–0.41), there were no differences in intentions, perceived norms, or self-efficacy toward laparoscopy compared with the layperson account. Advising participants of new evidence regarding the limitations of laparoscopy reduced intentions to get the procedure (MD = 0.29, 95% CI = 0.21–0.37), irrespective of condition. Conclusions Findings demonstrate the power of anecdotes in shaping treatment preferences. Supplementing evidence-based information with personal anecdotes may ensure accurate yet engaging health information is used by online endometriosis communities to seek appropriate care. Trial registration. Australian New Zealand Clinical Trials Registry ( https://www.anzctr.org.au/ ; ACTRN12624000767505p) Highlights Framing health information on Instagram as a personal anecdote increased women’s intentions to get a laparoscopy for the diagnosis and treatment of endometriosis. We found few differences between high- and low-credibility sources. Informing participants of new evidence and clinical guidelines reduced intentions across all conditions, potentially reflecting more informed decision making.