Influence of social media on health-related decision making among caregivers attending an outpatient department in a tertiary care hospital, Bengaluru

INTRODUCTION

The rapid proliferation of social media platforms over the past two decades has fundamentally changed the way in which people seek, share, and act upon health-related information. Platforms such as Facebook, Google, YouTube, Instagram, Telegram, chat GPT and WhatsApp have become a major hub of receiving this information. As per the latest reports, there are an estimated 5.79 billion social media users globally, while India alone accounts for about 500 million users.^1,2 This unprecedented reach has positioned social media as one of the most influential tools of health behaviour, operating alongside conventional healthcare delivery systems. Evidence from literature shows that patients rely on information from social media platforms before visiting clinics, and after their clinical interactions with physicians. The information attained from these platforms influences their decisions regarding the choice of healthcare provider, initiation or discontinuation of medications, and any adoption of lifestyle changes.^3,4 While access to health information can promote patient empowerment and engagement, the unregulated nature of social media content raises serious concerns about the accuracy, completeness, and safety of information being disseminated. A systematic review of 69 studies emphasized on the misinformation being spread by social media platforms.⁵ This study found that Twitter/other AI platforms was the predominant source of inaccurate healthcare content, particularly about the use of smoking products and drugs. Health misinformation regarding vaccines accounted for 43% of the identified content, followed by diseases such as cancer (40%) and dietary misinformation (36%).⁵ The World Health Organization has warned about “infodemics,” wherein large volumes of unverified digital information may cause confusion, promote harmful practices, and delay appropriate care.⁶ A further dimension of concern is the role of social media influencers in shaping health-related decisions. The use of social media in healthcare communication and medical education is currently growing. However, this space is simultaneously being occupied by social media influencers, who are promoting different health products and dietary supplements without any formal knowledge and medical education, influencing people to buy them. The distinction between a real expert and someone who is credible has become diminished.⁷ One well-known example of the dangers of putting your confidence in unfit celebrities is the widespread anti-vaccination movement spearheaded by former model and actress Jenny McCarthy.⁸

Tertiary care hospitals and their outpatient departments (OPDs) are critical intersections of the healthcare system where patients presenting with diverse clinical conditions interact with specialists across multiple disciplines. In metropolitan cities like Bengaluru, where digital literacy is high, patients frequently arrive at OPDs with preconceived health-related notions shaped by online information.⁹ Such reliance may influence the choice of doctors, the adoption of lifestyle modifications, and even treatment preferences.¹⁰ This context highlights the importance of studying how adults perceive and use social media for health-related decision-making in tertiary care hospital settings. The socio-demographic predictors of social media-influenced health decisions remain incompletely characterised in the Indian urban hospital context. The present study was conducted to assess the pattern of social media usage among Indian population. The study also determined the extent to which social media influences specific health-related decisions.

Objectives

The objectives of the study are to assess the pattern of social media usage among the study participants and to determine the extent to which social media influences specific health related decisions.

METHODS

The study was a hospital-based cross-sectional study was conducted at a tertiary care hospital in Bengaluru, India, over a period of one month from 9th May 2026 to 10th June 2026. The study included 130 participants. The same size was calculated by taking a prevalence of 70.4% from a study by Rehman et al who found that, the prevalence of health-related decision making based on social media messages.³ With an absolute precision of 8.1%, the final sample size was 130.

Before initiation of data collection for this study, clearance was obtained from the Ethics Committee of the institute of Rajarajeswari medical college and hospital, Bengaluru. The ethical clearance certificate number was RRMCH-IEC/137/2026. All participants were provided detailed explanation of the study’s purpose and procedure in their native language before being included in the study. A written informed consent was obtained from the study participants. Confidentiality of study participants was strictly maintained. Adult participants of ≥18 years of age who were active users of at least one social media platform and who attended OPD during the study period were enrolled in the study. A purposive sampling method was used to recruit participants. Healthcare professionals accompanying patients and those who did not provide informed consent were excluded from this study.

Data were collected using a pretested, semi-structured questionnaire administered through patient interviews. The questionnaire was divided into four sections socio-demographic characteristics including age, sex, educational qualification, socioeconomic status; social media usage encompassing the type of platform, frequency and duration of use; perceived reliability of online health content, influence of social media on health-related decision making such as choices related to doctors, lifestyle, and treatments. Data was collected by interview method using this questionnaire. Data were collected among eligible participants attending OPD. Participants were selected using a purposive sampling method based on inclusion and exclusion criteria. Participants who were seated in the OPD lobby area during the study period were approached and informed about the purpose of the study. After obtaining written informed consent, data were collected through face-to-face interview using pretested semi structured questionnaire.

Data entry and analysis was performed using MS Excel. Descriptive statistics was used to summarize data as frequency and percentage for categorical variables. The chi-square tests were applied for assessing the association between categorical variables. P value of <0.05 was considered significant.

RESULTS

A total of 130 participants took part in this study. The mean age of participants was 36.96±16.12 years with a majority of female participants (65.4%). Subject who lived in urban location (70%) and had nuclear families (76.9%) reported higher usage of social media platforms. In terms of educational status, the subjects were relatively well educated, with 46.2% being postgraduates and 43.1% graduates. Detailed demographics and socioeconomic characteristics are depicted in Table 1. Among 130 participants, daily social media usage was reported in 43%, followed by 22% using it 2–3 times/week while only 16% used it rarely. In terms of duration, the majority of participants spent considerable time on social media. Around 37% users spent around 1–2 hrs daily on these social media platforms and 36.2% spending more than 2 hours daily.

The most common platforms being used were Google, YouTube, WhatsApp in 76.9%, 69.2%, and 63.8% of subjects, respectively. The study participants used WhatsApp, YouTube, Instagram and Google together (Table 2). Figure 1 shows participant responses regarding the influence of social media on health-related decisions. Overall, participants demonstrated neutral influence of social media when checking the information before doctor consultation (32.3%) or getting influenced by social media to visit a doctor (32.3%). However, there was a high tendency of getting influenced by social media and trying remedies or medicines recommended by these platforms. About 47.7% of participants agreed to trying remedies or medications from social media, compared with 30.0% who disagreed. On the contrary, majority of participants reported that they did not purchase health-related products seen online. The impact of social media on health behaviours varied across different domains (Figure 2).

A large majority of participants (84.6%) reported that they did not start a new treatment after reading online about it. Similarly, most participants (69.2%) indicated that they did not choose a doctor based on social media reviews, whereas 30.8% of respondents reported choosing their doctor based on social media reviews. About 73.8% of participants did not discuss the advice they received from social media with their doctors. Nearly half of the participants (49.2%) reported encountering misleading health information on social media. Although only a small portion (7.7%) delayed or avoided a doctor visit and 12.3% initiated new treatment based on online information.

This study also assessed the association between educational qualification and the influence of social media on the healthcare behaviours. Authors reported non statistically significant association between educational qualification and delaying or avoiding doctor visits due to social media information (p=0.376) or discussing health advice gained from social media platforms with a doctor (p=0.636). However, a statistically significant association was found between educational qualification and starting a new treatment after reading about it online (p=0.001) (Table 3).

*Statistically significance

DISCUSSION

This hospital-based cross-sectional study evaluated the influence of social media on specific health-related decisions. The study further added to the growing body of evidence on digital health behaviour, where penetration of smart phones and accessibility to social media have exploded among urban and rural Indian populations. Social media users in the study were working-age adults aged 36.96±16.12 years. There was a predisposition of female social media (65.4%) users in our study. These findings are consistent with the evidence from the literature. Rehman et al conducted a study at a tertiary care centre in West Bengal and reported a mean age of 34.4±10.2 years among social media users with 43.2% females.³ Higher proportion of females in the study may be due to the demographic composition of the OPD attendees at the study centre and the tendency of women to engage more actively with health-related content on social media platforms. The findings are also consistent with behavioural evidence suggesting that women are more proactive health information seekers.¹¹ Another study from Saudi Arabia further supports our observations, with a mean age of 35.4±11.5 years and a predominance of females (71.9%) among social media users.¹²

The most frequently accessed social media platform for health-related information in the study was Google, followed by YouTube, WhatsApp and Instagram, with 43% of participants using it daily. This is consistent with findings reported by Moorhead et al and subsequent studies from South Asia which have identified messaging applications like WhatsApp and video-sharing platforms like Facebook as dominant channels for health information seeking among adults in low- and middle-income countries.^3,12,13 The high prevalence of daily usage observed in our cohort underscores the degree to which social media has become embedded in everyday health information practices. High level of social media usage that authors saw is especially important because, by being exposed to health information daily, even if not always accurate, there is an accumulative effect that cannot necessarily be reversed through one consultation.

The influence of social media on healthcare provider selection was a prominent finding in the study, with participants reporting that they checked information online before visiting the doctor and being influenced to visit the clinician. This behaviour, which can also be described as "pre-consultation information seeking," is well documented throughout various healthcare contexts and demonstrates how patients' roles have transformed from recipients of advice into consumers of digital information about their health needs.¹⁴ In a cross-sectional study, 80.1% of participants reported that they had actively searched for a healthcare professional on social media platforms, with Instagram being the dominant platform used for this purpose (85.3%).¹⁵ In another study, majority of the participants believed that it was easier to reach doctors online, however, only 12.2% reported that advertisement on social media platforms influenced their decision to visit a particular doctor.¹¹ The numbers imply that increasingly, the presence on social media acts as an effective replacement for traditional referral networks based on word-of-mouth recommendations and hospital reputation when it comes to deciding upon which healthcare professionals to consult.

The influence of social media in the study further extended to clinical decision-making with 47.7% of participants agreed that they tried remedies/medicines by relying on information provided by social media. Studies have demonstrated that platforms like Facebook and Twitter influence patient decision-making, particularly in selecting healthcare providers and seeking lifestyle advice.^3,16 Social media platforms today are flooded with information and misinformation that it becomes difficult to filter out what is right and what is wrong. In the present study, we observed that nearly half of the participants (49.2%) reported encountering misleading health information on social media which underscores the extent of the infodemic challenge. More concerning, however, was the finding that only 25% of participants discussed the advice they received from social media with their doctors.

This suggests that the majority of people act on unverified information without professional validation, highlighting a gap in the communication between a patient and healthcare provider. Moorhead et al emphasized that while social media enhances communication and health promotion, it also carries risk of spread of misinformation and reduced trust among physicians.¹³ During COVID-19 pandemic there was an alarming rise in the information circulated on the social media platforms about the disease and its treatment. The literature stands divided on the positive and negative impact it had in terms of right and wrong information.^17,18 The association analysis in our study revealed that participants with lower educational qualification were more likely to initiate treatment influenced by information available on social media, whereas post-graduates demonstrated more cautious behaviour. This inverse relationship between educational qualification and influence of social media influence is well-established in the literature.

Individuals with lower health literacy may lack the critical appraisal skills needed to evaluate the credibility of online health claims, making them vulnerable to act on information being circulated online and get influenced to make health-related decisions. Participants with secondary education were considerably 40% (95% CI 1.01–1.94) more affected in the adjusted analysis, and those who used both media instead of only WhatsApp were significantly 31% (95% CI 1.09–1.58) more likely to be influenced.³ Participants who were uneducated tend to get influenced by social media (75%) compared with participants who had postgraduate degrees and above (22.7%). In contrast, participants with postgraduate education showed a greater tendency toward moderate or low social media influence, indicating a more critical approach toward treatment-related information available online.¹¹

Limitations

The study has certain limitations. The results of our study were based on self-reported questionnaire which may be prone to recall or social desirability bias. Data were collected from one tertiary care hospital in Bengaluru, which serves a specific urban population. Authors used purposive sampling method which was appropriate for this study but it may introduce the risk of selection bias.

CONCLUSION

The study demonstrated that social media platforms influence health-related decisions. Their frequent use to gather health information combined with the perceived reliability, influences health-related decisions based on information that may not be evidence-based or clinically verified. The findings of this study carry important public health implications. Social media impacts health decision-making in choosing the doctors and hospitals, creating lifestyle modifications, and treatment-related decisions. The OPDs are an important place for patient education and healthcare providers should counsel patients on critically evaluating information they obtain online. The study emphasizes the need to improve digital health literacy and create awareness about credible online sources for seeking health-related information.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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