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Comment on: Archibald M.M. & Clark A.M. (2014) Twitter and nursing research: How diffusion of innovation theory can help uptake. Journal of Advanced Nursing 70(3), e3-5. Doi: 10.1111/jan.12343

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Comment on: Archibald M.M. & Clark A.M. (2014) Twitter and nursing research: how diffusion of
innovation theory can help uptake. Journal of Advanced Nursing 70(3), e35. doi:10.1111/jan.12343
In Archibald and Clark’s (2014) editorial, they provide an inter-
esting and intriguing examination of Twitter’s adoption by
nurses and researchers into the profession through the lens of
Rogers’ (2003) Diffusion of Innovations Theory. Although the
authors outline a variety of reasons as to why Twitter has failed
to take hold in nursing academic circles, we believe that their
editorial misses a few important considerations when exploring
the adoption of social media platforms such as Twitter.
Foremost, Twitter is a social technology. Correspondingly,
the modality of communication that Twitter enables is a trait
of the technology, and also co-created through the role and
value its users have inscribed onto the technology. In other
words, Twitter as an innovation is exceedingly mouldable, scal-
able and non-static. In this vein, both the innovation (i.e. Twit-
ter) and its users help to generate the current dynamic that is
the Twittersphere, and the inherent culture, attitudes and eti-
quette that are allowed to exist and operate on Twitter. As a
by-product of this continuously evolving relationship, some
nursing researchers have found value in using Twitter as a
means to distribute information related to research. Just as
Facebook is an ‘accidental health platform’ (Fox 2014), Twit-
ter too has become an accidental mechanism for distributing
information of all genres, including nursing research. There-
fore, as an accidental platform for nursing research dissemina-
tion, it is important to appreciate that the platform likely only
resonates with potential users (and nurses) who are able to
internalize both the technical competencies required to use the
platform, but more importantly, to also appreciate the larger
social implications and value of this communication modality.
From an ontological perspective, the Diffusion of Innova-
tion approach typically privileges the innovation in question
(i.e. Twitter), conceptualizing the innovation as an entity that
compels other elements in the surroundings to conform
around its presence. As outlined by Archibald and Clark, the
adoption of Twitter by nursing has not been comparable to
the adoption rates of adults in the general population, leading
them to question this ‘inertia’ from the perspective of the
profession (p. e3). As Twitter is an innovation that holds the
potential to exponentially amplify the social abilities of its
users, any person wishing to adopt and use Twitter in a sus-
tained fashion is subject to an array of complex socio-techni-
cal considerations, which may not be present in other types of
technical innovations that are less socially mediated. In an
effort to outline how social platforms (and their users) are
shaped by the networked nature of social media, Kietzmann
et al. (2011) outlined a ‘social media ecology’ (p. 241) as a
means of understanding a user’s audience and needs within
situations involving social technology. In this ecology, the
elements of presence, sharing, conversations, groups, relation-
ships, reputation and identity are outlined as potential factors
that influence engagement in social media dynamics. There-
fore, depending on the context, role and responsibilities of a
nurse (or researcher), the need or value of Twitter may not
resonate enough to support adoption, or sustain use. Inso-
much, the presence of the innovation itself is not sufficient to
drive adoption; rather, the depth of understanding of Twitter
and need of the potential user to undertake elements like iden-
tity building, maintenance of reputation, and sharing of infor-
mation in the user’s role and life are likely more important
predictors of adoption and sustained use in the postadoptive
phase.
Subsequently, it is not surprising that nursing researchers
have largely ignored Twitter, particularly those established in
their careers who have found sufficient translation of their
body of work through other, traditional platforms, and who
find limited utility for social media platforms in other facets of
their daily lives. As clearly outlined by MacVaugh and Schiav-
one (2010), the ‘[u]tility [of an innovation], regardless of its
nature or source, has never been a complete explanation for
the behaviour of humans’ (p. 204). Therefore, a more fruitful
area of exploration of Twitter within the profession would be
to explore postadoptive behaviours of the platform, and how
certain cross-sections of nurses utilize the platform, to what
intensity, and for what purpose.
2406 ©2014 John Wiley & Sons Ltd
One area of adoption that we have anecdotally observed
(not the least in our own neophyte careers) is the use of social
platforms by researchers who are early in their academic jour-
neys. Twitter adopters may find the technology to be a means
to increase their visibility and clout amongst fellow researchers
and other academic centres, community partners or traditional
media outlets. Given the contraction in research funding, it is
becoming increasingly difficult for new researchers to obtain
research grants to assist in the development of their academic
careers. Subsequently, Twitter may offer a competitive advan-
tage to these novice researchers as a mechanism that helps
build career momentum in asymmetric fashions, alongside tra-
ditional academic requirements like publications and grants. It
is now possible for a new researcher to leverage their existing
expertise through the amplifying nature of Twitter and its glo-
bal reach (e.g. tweeting recent publications, attendance at con-
ferences and other scholarship-related material on a regular
basis to followers). That said, the basic adoption of Twitter
does not yield even these sorts of returns immediately. As out-
lined by Archibald and Clark, time and effort is required to
build followers to establish oneself as a valuable Twitter con-
tributor who should be followed for their insights. Only nurses
who have this information/communication ‘push-pull’ desire
will use Twitter to its fullest capabilities, and likely already
possess insights of their presence online similar to the Kietz-
mann et al. (2011) ecology framework.
In this way, we agree with Archibald and Clark’s interpreta-
tion of the potential value of Twitter for nursing research.
Regardless, we offer the caveat that any individual proposing
the adoption of social technology to others should reflect upon,
and be cognizant of, the deeper socio-technical forces that are
at play. Twitter uptake and adoption, like all other social
media platforms, likely does not conform to traditional innova-
tion diffusion logic.
Disclaimer: RB originally discovered Archibald and Clark’s
article via a Twitter feed
Richard Booth PhD RN
Assistant Professor
Arthur Labatt Family School of Nursing, Western University,
London, Ontario, Canada
E-mail: rbooth5@uwo.ca
@rbooth5
Abram Oudshoorn PhD RN
Assistant Professor
Arthur Labatt Family School of Nursing, Western University,
London, Ontario, Canada
E-mail: aoudsho@uwo.ca
@AbeOudshoorn
References
Archibald M. & Clark A. (2014) Twitter and nursing research:
How diffusion of innovation theory can help uptake. Journal of
Advanced Nursing 70,e3e5.
Fox S. (2014) Facebook is an accidental health platform. Read the
comments: http://susannahfox.com/2014/02/01/evolution-of-online-
patient-communities/ [Twitter]. 1 February 2014. Retrieved from
https://twitter.com/SusannahFox/status/429729065335943168 on
1 February 2014.
Kietzmann J., Hermkens K., McCarthy I. & Silvestre B. (2011)
Social media? Get serious!Understanding the functional building
blocks of social media. Business Horizons 54, 241251.
MacVaugh J. & Schiavone F. (2010) Limits to the diffusion of
innovation: a literature review and integrative model. European
Journal of Innovation Management 13, 197221.
Rogers E. (2003) Diffusion of Innovations, 5th edn. Free Press,
New York.
©2014 John Wiley & Sons Ltd 2407
JAN: JAN FORUM JAN Forum
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  • S Fox
Facebook is an accidental health platform
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Fox S. (2014) Facebook is an accidental health platform. Read the comments: http://susannahfox.com/2014/02/01/evolution-of-onlinepatient-communities/ [Twitter]. 1 February 2014. Retrieved from https://twitter.com/SusannahFox/status/429729065335943168 on 1 February 2014.