METACOMMUNICATION AND MULTIMODALITY STRATEGIES IN ENGLISH AND SPANISH MEDFLUENCERS ON INSTAGRAM
Estrategias metacomunicativas y de multimodalidad en inglés y en español de los medinfluencers en Instagram
Alexandra Santamaría Urbieta [1]: Universidad Internacional de la Rioja. Spain. alexandra.santamaria@unir.net
Elena Alcalde Peñalver: University of Alcala. Spain.
Peter Bannister: Universidad Internacional de la Rioja. Spain.
How to cite this article:
Santamaría Urbieta, Alexandra; Alcalde Peñalver, Elena, & Bannister, Peter (2024). Metacommunication and Multimodality Strategies in English and Spanish Medfluencers on Instagram [Estrategias metacomunicativas y de multimodalidad en inglés y en español de los medinfluencers en Instagram]. Vivat Academia, 157, 1-25. http://doi.org/10.15178/va.2024.157.e1520
ABSTRACT
Introduction: Social media has become a means of communication that citizens frequently turn to not only for entertainment purposes but also to obtain updated information on a specific topic. Medinfluencers, individuals dedicated to disseminating health and wellness-related topics, often appear on worldwide social platforms. Methodology: In order to discern the discourse, both written and spoken, used by these individuals in both Spanish and English language, a total of 200 posts from Instagram have been analyzed, comprising 100 posts in Spanish and 100 posts in English. Results: The results indicate that there are differences between the two languages, as posts in the Spanish language tends to be more detailed, while in English, there is a preference for being more direct and less exhaustive in the information provided to the audience. Discussion: Studies like the ones presented here, as well as their findings, are not intended to be a mere data describing exercise of a specific type of discourse. Instead, the purpose here is to be valuable foar the pedagogy of specific fields of knowledge, such as translation, interpreting, linguistics, text editing, or communication. Conclusions: Some of the main conclusions drawn from this study include the trend of the Spanish language to be more didactic in its explanations, while the English language is more direct and concise. Likewise, regarding multimodal elements, once again, the Spanish language uses them more frequently than the English language. All of this demonstrates that the Spanish-speaking medfluencer aims to be didactic and educate, while in English, their primary goal is simply to provide information.
Keywords: metacommunicative elements, medfluencers, English, Spanish, multimodality, didactic applications.
1. INTRODUCTION
Social networks are part of our daily lives and have become a way of accessing information and interacting with the published content, unlike traditional media such as television or radio, which have always determined as one-way communication (Moreno-Cabanillas and Castillero-Ostio, 2023). The study of the language used in social networks for communication purposes presents a series of challenges and opportunities for research (Rüdiger and Dayter, 2020), since it provides insight into the characteristics that determine the success of communication in specialized fields such as tourism, marketing, economics or health science. Specifically, in medical informative communication, on which this study will focus, it is necessary to point out that medinfluencers, i.e., medical specialists who use social networks to communicate health information to users, have been gaining in importance especially since the arrival of the pandemic (Imed, 2022). This trend of consulting information via our phone or tablet, following specialist accounts that attract an increasing number of followers, continues today, as attested to by the 4th Health and Life Study by the insurer AEGON (2023). Among the conclusions of this study, it is worth noting that 52.1% of those surveyed go to the Internet to look for information on symptoms that can guide them towards a diagnosis and that 70.6% of young people between 18 and 25 years of age use it for self-diaognosis and consult information on health and wellbeing. Likewise, according to data from the FAD Youth Foundation (Zaragozá et al., 2023), 52% follow accounts and profiles of health professionals or specialists and the most frequently searched topics, in order of frequency, are physical activity, mental health and food and diets.
Despite the growing relevance of social networks in the communication of informative communication of this type, there are no studies to date that analyze their characteristics and, specifically, that study the metacommunicative elements used in this type of communication, nor have any studies been found that consider the didactic applications based on the conclusions of this type of studies (Hennecke, 2019; Chmiel et al., 2020). However, studies analyzing the communication management of pharmaceutical influencers on Instagram during the coronavirus crisis, such as that of González and Iriarte (2020), or communication on Instagram for electoral purposes, such as that of Moreno-Cabanillas and Castillero-Ostio (2023) or on Twitter (Pano, 2020), are known, but neither do they have specific didactic applications. On the other hand, multimodal communicative analysis has been the subject of numerous research studies for years (Machin, 2016; Kress, 2010; Kress and van Leeuwen, 1990; 2001), in which the act of communication is taken into account not only from a written or oral perspective but also by analyzing the elements included in it, such as images, videos or other types of effects.
Specifically, in this study we focus on Instagram social network accounts, which provide the user with the possibility of combining the publication of images, videos (reels) and text. Spanish-speaking and English-speaking medinfluencers' accounts will be taken into account in order to understand the discourse of this type of influencers on social networks in two languages and, therefore, in different cultures.
2. OBJECTIVES
All in all, this research aims to establish a general radiography of the communicative characteristics of English and Spanish medinfluencers on Instagram. In order to achieve this general objective, the following specific objectives are proposed:
- SO1. To analyze the metacommunicative and multimodal elements in the compiled corpus in English and Spanish.
- SO2. To compare the results in English and Spanish to determine the similarities and differences in each of them.
- SO3. To reflect on the didactic applications derived from the results obtained.
3. THEORETICAL FRAMEWORK
3.1. Metacommunicative elements in English and Spanish in oral and written discourse
The training of any student in the field of communication sciences, translation, interpreting, or even linguistic correction requires, in order for them to be able to perform their work professionally that they know how to adapt the texts or speeches they produce to the communicative guidelines of the field in which they are working. This, in turn, is also in order to achieve success in the transmission of the message from the sender to the receiver, the ultimate goal of any communicative act (Peñalver, 2009). It is here where the metacommunicative elements come to play a fundamental role given that they "serve to clarify the intention of the author of the text, guarantee the success of the communication and facilitate the recipient's reception of the information transmitted in the text" (Mayor, 2003, p.91). Gläser (1995, p.85) explains its function as follows:
[...] metacommunicative strategies as a rule refer to a particular spoken or written text and accentuate the speaker’s or writer’s intention when he or she gradually elaborates a topic as a written text or takes part in a face-to-face dialogue. A metacommunicative strategy is always directed at the communicative partner, in that the speaker or writer tries to ensure on the part of the addressee the adequate reception of the information conveyed in the text.
Despite their importance, these have not been studied in depth in multimodal discourse such as the one that is the subject of this study. However, the studies by Mayor Serrano on metacommunicative elements in health brochures (2008) and in medical dissemination articles (2008), to which this study has added their corresponding equivalents in English and adapted according to their applicability in written or oral discourse, serve as a basis for the subsequent analysis that will be conducted. These elements include the following (Table 1):
Table 1
Metacommunicative elements for the analysis of written and oral discourse.
|
Explanation |
|
Input of new terms |
|
Information on specific names |
|
Name |
Source: Elaborated by the authors.
The following is a description of each of these elements and includes, for each of them, several examples taken from the corpus compiled in the two languages:
- Explanation. These are occasions in which the medical term is first introduced and then explained. In Spanish, this is formulated through the use of the conjunction “o” (or) and explanatory reformulators (“es decir” (that is to say), “por ejemplo” (for example), “o sea” (in other words), “del tipo” (of the type), “esto es”(that is)), which would be applicable to oral and written discourse, or through punctuation or auxiliary signs, such as parentheses, brackets or dashes (applicable only to written discourse). For example:
[...] pasado un par de meses ahí recomendamos lo contrario: que le dé un poquito de sol para que no se queden blanquecinas, es decir, para favorecer la repigmentación de la cicatriz. (SP44)
[...] otras tienen una inteligencia más kinestésica, es decir, comprenden las cosas si se mueven, no si están estáticas [...]. (SP46)
It should be remembered that there are also cases in oral discourse in which it is not necessary for the sender to introduce any of these reformulators or conjunctions to introduce the explanation, since they are understood and introduced after a comma.
Este tipo de parches, que además son de color piel, son opacos, no dejan pasar el sol, y lo que hacen es que la cicatriz no se vuelva o sea hacen como un tope y los [...]. (SP41)
In English, connectors such as “or” and explanatory reformulators such as “that is”, “that's”, “meaning", “in other words” are used to introduce clarifications. In oral communication, more concise formulations such as “or”, “meaning” are preferred, while in written communication there is more variation and formality with options such as "that is to say".
[...] “if you have a lot of rem sleep that’s typically when your saliva glands shut down and stop producing saliva.” (EN28).
[...] “you use your topical steroids or anti-inflammatory medications [...].” (EN35)
Punctuation marks such as parentheses and dashes are characteristic of written discourse to encapsulate clarifications, while in oral speech, pauses and vocal inflections are used more frequently. Likewise, markers such as "specifically" and "particularly" are more frequent in academic and technical writing. Finally, writing allows greater precision by incorporating explanatory verbs such as "refer to", "signify", while oral conversation prefers simpler options such as "mean" or "which is" or "that". In the corpus there are several related examples:
[...] “to discover how gum chewing, with a special ingredient called xylitol which can improve oral health.” (EN43_Des)
“I will apply a vitamin C serum which is an antioxidant serum that will fight radical damage like from sunlight and pollution [...].” (EN31)
It is interesting to note that in English, there is no attempt to delve into the definition of the medical term used since what is resorted to is the practicality of social networks to explain to the user what consequences it will have on his or her body.
- Input of new terms. In contrast, ed with the previous metacommunicative element, the medical term is introduced after the more informative explanation. As far as Spanish is concerned, the metacommunicative elements used are applicable to oral and written discourse and are materialized, primarily, through the use of the conjunction "o" (or), as shown in the following example:
Pues la acetilcolina es un mensajero o neurotransmisor encargado de enviarle la señal a tus glándulas sudoríporas para que se activen y liberen sudor. (SP6)
Parentheses could be used for this purpose only in the case of written discourse:
El ácido retinoico (AR) es un metabolito multifuncional de la vitamina A que ha sido conocido como el maestro detrás de varias funciones de la vitamina A. El AR tiene tres variantes (isómeros) naturales, que han demostrado diferentes capacidades para modular la diferenciación y proliferación celular. (SP11_Des)
In English, the metacommunicative elements for introducing new terms include some differences in their use between oral and written discourse. In both oral and written discourse, the conjunction "or" is used to introduce the term together with its explanation. Likewise, verbs such as "call", "term", "refer to" are used in both modalities to define concepts, for example:
“do not just think or do things - we have the ability to analyze and evaluate our own thoughts and actions. This ability is called metacognition.” (EN49)
In written discourse, however, it is more common to use parentheses and dashes to encapsulate definitions, for example:
"This has been the focus of my work over the past few years on longevity— understanding and dissecting the latest research and science on living longer and applying the principles to myself and my patients.” (EN2_Des)
More formal defining markers such as "known as", "denoted as", "dubbed", characteristic of written discourse, are also frequent. In contrast, in oral conversation, more dynamic and less precise formulations such as "called", "known as" are preferred. From the corpus we found several examples of this mode. For example:
“Medication prescribed by doctors to lower high blood pressure are known as statins [...].” (EN13)
- Information on specific names. Although the use of this element is frequent in textbooks and textbooks (Mayor, 2008), its presence in posts on social networks dedicated to health and wellness is very common due to their educational nature. One of the strategies used by medinfluencers to introduce this information is by posing questions. In the case of the example below, both in the description of the publication and in the reel, the pediatrician frequently asks questions to introduce technical terms:
Pues vamos a resolver este misterio que casi cada día preguntáis en consulta: ¿qué diferencia hay entre bronquiolitis, bronquitis y broncoespasmo? (SP1_Des)
[...] se deposita en las paredes del bronquio y el bronquio se inflama y ¿qué pasa cuando se inflama? Que se cierra, se obstruye, broncoespasmo, hace un espasmo con lo cual la luz del bronquio [...]. (SP1)
Bueno, pero vamos al grano: ¿cuál es mejor de los dos? A ver la fermentación del kéfir la producen bacterias y levaduras y la del yogur solo bacterias. (SP9)
Another technique used to include this type of information in the case of Spanish is through the direct use of the term in English, which forces the medinfluencer to add the explanation in Spanish. For example: default network.
Cuando yo estoy utilizando juicios, cuando yo estoy trayéndome el pasado al presente hay una red que se activa que se llama la red neuronal por defecto, default network, la red neuronal por defecto no te permite captar [...]. (SP48)
Several cases have also been found in which the medinfluencer accompanies the publication of the image in English with a brief description in Spanish (Figure 1). They are even seen in the video talking about a scientific topic in what is supposed to be a congress, and, to accompany their speech, they use graphs and data in English.
Figure 1.
Example of the use of English in a publication written in Spanish.
Source: @sergiovanog (SP20), February 15, 2023.
In the case of English, no equivalent example has been found.
- Name This is the most frequent metacommunicative element in health brochures (Mayor Serrano, 2008) and has also been detected in this corpus. This author describes the following three definition models as the most common:
- A [term, name] is/are B that C
- B that C (is/are referred to as, is/are known as, is named as, is/are named after) A
- Definitions beginning with "If...", "When...", "By...".
It can be done simply by using the verb "means" or "is". For example:
[...] productos de glicación avanzada que son como villanos que destruyen el colágeno y la elastina de nuestra piel que aquí hemos aprendido que son los cimientos, lo que le da la firmeza, la estructura, incluso la elasticidad a la piel por eso es muy importante huir de [...]. (SP7)
It is also possible to opt for a substitution, i.e., using a synonym or antonym (oral and written discourse) or even a more informal equivalent or comparative that the receiver will understand more clearly. This is the case, for example, of the "villain" in the previous example (SP7) that has been personified so that the receiver understands that advanced glycation products are harmful to health. Another example would be the following:
No, en realidad, lo que hacen es ocupar el receptor donde va la acetilcolina, como si estuvieran jugando al juego de las sillas, pero sin dar la orden de que se sude. (SP8)
On the other hand, you can resort to a paraphrase, that is, opt for a sentence with the same or similar meaning to the term, such as: "as I explained, it is about..." or "I don't know if you will remember when I told you about...". This is the case in example SP7 in which the influencer indicates that the concept has been explained before ("that we have learned here").
In English, they tend to express simple definitions with verbs such as "mean" or "signify" and substitutions with synonyms, antonyms and abbreviations, without the need to go into detail. The conjunction "when" is also used in English. For example:
One of the most common environmental toxins is bisphenol A, known as BPA, this chemical is found in some plastics and food packaging. When BPA leaches out [...]. (EN49)
3.2. The elements of multimodal communication in English and Spanish
Multimodal communication involves the use of multiple communicative modes such as the use of gestures, figures, texts, and dialogues (Mayerhofer, 2013). In this regard, meaning is constructed with an interaction of different communicative modes (Lemke, 1998). In a multimodal text in social networks, the elements of orality combined with the use of images and videos is what determines the success of the communication. As Yus (2011) points out, when the user uses videos to communicate a message on social networks, a conversational, interactive, and colloquial style predominates. Likewise, the language is usually close to immediacy, so the use of imperative or, interrogative or exclamatory statements in the second person is used with the aim of eliciting some kind of comment among recipients (García Aguiar, 2019). Another way of showing closeness to the receiver is through the use of a colloquial register (Hernández Toribio, 2006) so that the transmission of the message does not encounter any impediment to understanding and, in turn, shows close and enthusiastic communication with the user. Likewise, the communication usually has a humorous tone related to the young audience, characterized as the main group that resorts to social networks to search for information (García, 2023). On the other hand, in this type of multimodal communication in social networks, the image is intended to interact with the verbal mode to construct a meaning that goes beyond the individual contribution of a single mode (Duque, 2020). In this way, the image becomes a complementary element that promotes comments among message recipients since it favors user interaction and involvement (Fernández-Gómez and Martín-Quevedo, 2018). For the purposes of this study, since it has didactic implications, in addition to the variables indicated, the variable of subtitles in the video has also been added, which is another complement to take into account in the work to be done. Likewise, a reference is made to the use of emoticons in written discourse, which contributes to providing visual elements to achieve greater communicative clarity (Sampietro, 2016). Table 2 shows the characteristics that will be analyzed below.
Table 2
Characteristics of multimodal communication in social networks.
|
Does it use video (reel) or images? |
|
In case of reel, is the style conversational, interactive and colloquial? |
|
Personal pronouns and types of utterances |
|
Is the written register colloquial? |
|
Does the speech show a humorous key? |
|
Do subtitles appear in the reel? |
|
Is there anything characteristic in the attire used by the medinfluencer? |
|
Does he/she use emoticons in the written text? |
Source: Elaborated by the authors.
3.3. Challenges of multimodal communication in the field of didactics.
Today it can be stated, as Taylor did in 2013, that the concept of multimodality transcends all disciplines, hence its importance. In this regard, the elements that we propose to analyze in this study allow us to obtain an overview of the type of discourse used in the medical informative field in social networks in order to extract a series of guidelines and recommendations that, for example, future translators, interpreters, proofreaders or linguists can incorporate into their work methodology. Thus, as Alcalde and Santamaría (2019) pointed out in a previous study, the use of studies based on a corpus methodology has a series of didactic applications that we list below and that allow the development of the four competencies identified by Cabré (1993), including cognitive, linguistic, socio-functional and methodological:
- Thematic update through information provided by specialists.
- Approach to a specific type of communication, through real examples.
- Assimilation of terminology and phraseology of a given field, which will allow its subsequent use in a correct and contextualized manner, as well as the analysis of its evolution. In the case of the use of terms in English, this may also allow knowing whether the Spanish translation is preferred in Spanish or whether the specialist uses the English term more, providing an explanation.
- Acceptance of a type of methodology (corpus) that allows them to systematically have the type of information they need as professionals.
4. METHODOLOGY
In order to achieve the proposed objectives, we proceeded to compile a corpus of 200 Instagram posts (100 in Spanish and 100 in English). For this purpose, a selection of possible related profiles has been carried out following the following previously defined inclusion and exclusion criteria:
Table 3
Inclusion and exclusion criteria.
|
|
Inclusion Criteria |
Exclusion Criteria |
|
Profile and experience |
Influencers with demonstrable experience or knowledge in the healthcare field, who can be credited through their education, work experience or relevant certifications. |
Influencers without demonstrable experience or knowledge in the health field, who can be credited through their education, work experience or relevant certifications. |
|
Language |
The profile includes posts in Spanish or English language. |
The profile includes posts in languages other than Spanish or English. |
|
Subject |
The profile includes posts related to topics of health, wellness, fitness, nutrition, medicine, etc. |
The profile includes posts unrelated to health, wellness, fitness, nutrition, medicine, etc. |
|
Recent activity |
Profile includes posts less than 2 months old. |
Profile includes posts older than 2 months. |
|
Content |
Profile includes posts that consistently display health information. Content posted is reliable. |
Profile includes posts that display health information sporadically (e.g., personal or non-health related travel accounts). The content posted is misleading or deceptive. |
|
Number of followers |
The profile has more than 50,000 followers. |
The profile has less than 50,000 followers. |
|
Type of posts |
The post is not limited to promoting products or services without providing valuable health information. It includes written explanations to the accompanying image (or video [reel]). |
The post is limited to promoting products or services without providing valuable health information. Any accounts that appear to be fake or bots are discarded. |
Source: Elaborated by the authors.
After applying the inclusion and exclusion criteria in Table 3, the following medinfluencer profiles were selected. Below is the compendium of users, number of followers and medical specialty of each of them, which also corresponds to the most searched topics (physical activity, mental health and nutrition) as previously noted by Zaragozá Marquina et al. (2023).
Table 4
Medfluencers analyzed in Spanish and English.
|
Spanish language |
Number of followers |
English language |
Number of followers |
|
Lucía Galán (pediatrician) |
885.000,00 |
Mark Hyman (médico de familia) |
2.6 M |
|
Boticaria García (pharmacy and nutrition) |
536.000,00 |
Hazel Wallace (physician and nutritionist) |
635.000,00 |
|
Silvia Gómez Senent (digestive physician) |
553.00,00 |
Mike Natter (endocrinologist) |
117.000,00 |
|
Sergio Vañó (dermatologist) |
512.00,00 |
Chris Kesser (specialist in integrative and functional medicine) |
114.000,00 |
|
Patri Psicóloga (psychologist) |
578.000,00 |
Joel Fuhrman (family physician and nutritionist) |
136.000,00 |
|
Sergio Peinado (sports and nutrition) |
1.6 M |
Mark Burhenne (dentist) |
228.000,00 |
|
Iñaky García (sports and nutrition) |
200.000,00 |
Daniel Sugai (dermatologist) |
328.000,00 |
|
Aitor Sánchez (dietician-nutritionist) |
314.000,00 |
Faye Begeti (neurologist and neuroscientist) |
135.000,00 |
|
Ana Molina (dermatologist) |
188.000,00 |
Nicole LePera (psychologist) |
7.2 M |
|
Mario Alonso Puig (surgeon) |
1.7 M |
Jolene Brighten (endocrinologist) |
484.000,00 |
*M refers to millions of followers. The number of followers indicated is the number of followers the users had at the time this study was carried aout.
Source: Elaborated by the authors.
For the compilation of the corpus, information on each of the users was collected in an Excel table in order to have as much data as possible on each of them. In addition to their specialty and the number of users, it was recorded whether they were verified accounts. The verification badge, or blue tick, allows users of public interest to verify their Instagram account and this, as SocialBlasts (2023) points out, "has become a symbol of authenticity and prestige." Regarding the selected accounts, 90% of the Spanish-language accounts selected have the verification denoted by the blue tick and 100% of the English-language accounts chosen have this symbol.
For each of the posts, on the one hand, the written description was copied and, on the other hand, in cases where the post consisted of a video or reel, oral speech was transcribed into written text in order to be able to perform a quantitative analysis of the results in both languages. Likewise, posts that included images or infographics with embedded text were also transcribed. It should be noted that for the purpose of this study we did not analyze Instagram stories (videos or images that last 24 hours and then disappear) of the users, only their posts.
Once the corpus was compiled, we used the methodology of Pano-German (2020) to analyze the use of the most common metacommunicative elements by medinfluencers in English and Spanish (SO1), taking into account the classification established in the previous section and adapted from the studies of Mayor Serrano (2003 and 2008). To this end, Sketch Engine was used, which is one of the main tools currently available for these purposes (Kováล et al., 2016). Its functions include matching search (to see examples of use of terms or phraseological units in context), word sketch (to obtain an overview of the behavior of a word in combination with others) or word frequency determination (for frequency lists generation).
Similarly, multimodal elements were analyzed, following the criteria of section 3.2. This was done for both languages, which subsequently allowed us to obtain results on the similarities and differences between the two languages and their applications for didactics and thus fulfill the remaining specific objectives (SO2 and SO3). Table 3 provides a summary of the criteria used:
Table 5
Elements of analysis.
|
Metacommunicative elements for the analysis of written and oral discourse |
Characteristics of multimodal communication in social networks |
|
Explanation |
Does it use video (reel) or images? |
|
Input of new terms |
In the case of the reel, is the style conversational, interactive and colloquial? |
|
Information on specific names |
Verb form used and person (imperative, interrogative, exclamatory statements) |
|
Name |
Is the written register colloquial? |
|
Does the speech show a humorous key? |
|
|
Do subtitles appear in the reel? |
|
|
Is there anything characteristic in the attire used by the medinfluencer? |
|
|
Does he/she use emoticons in the written text? |
Source: Elaborated by the authors.
5. RESULTS
The 200 posts that have been analyzed are of two types: (1) those in which the medinfluencer includes one or more images accompanied by a brief description and (2) others in which a video is used also accompanied by a brief text. The breakdown of the posts is shown below:
Table 6
Type of analyzed posts.
|
Typology |
Spanish language |
English language |
Total corpus |
|
Image or images + text |
32 |
61 |
93 |
|
Video + text |
68 |
39 |
107 |
|
Total |
100 |
100 |
200 |
Source: Elaborated by the authors.
What these data show is that Spanish-speaking medinfluencers tend more frequently to use reels or videos in their posts, while English-speakers opt more often for the use of images.
In general, those posts that include video are accompanied by a shorter description than those that use one or more images, both in Spanish and English. This could be due to the fact that, from the medinfluencer's perspective, video is a more informative medium for their followers, so that going into more detail in writing could become redundant, bore the social network user and, in short, move away from the main objective of the issuer, which is to entertain.
This trend can also be seen in the following data shown in Table 7:
Table 7
Number of words in the corpus in Spanish and English.
|
|
Spanish language |
English language |
|
Transcribed text |
17,478 words |
9,204 words |
|
Written text |
10,692 words |
10,264 words |
|
Total |
28,170 words |
19,468 words |
Source: Elaborated by the authors.
What is striking about the data when comparing the Spanish-language component and the English-language component is that despite having practically half as many image + text posts in Spanish as in English, the number of words used in the descriptions are very similar. This could suggest that Spanish-speaking medinfluencers tend to explain in greater depth the topics they cover, while English-speakers, on the other hand, assume that their followers have a broader e base of previous knowledge or are less inclined to stop and explain.
The results of the metacommunicative elements, both in written and oral discourse, of medinfluencers on Instagram in two languages are presented below. The characteristics of multimodal communication detected in both languages in the field of health and wellness influencers are also presented.
5.1. Metacommunicative elements for the analysis of written and oral discourse
In order to analyze the metacommunicative elements, both in oral and written discourse, the first step was to count the words that make up the elements found in written discourse, both in Spanish and English. The empirical breakdown of the classification detailed above in the theoretical framework is shown below:
Table 8
Metacommunicative elements in Spanish and English: written discourse.
|
Metacommunicative elements |
Spanish |
% |
English |
% |
|
Explanation |
95 words |
5.92% |
582 words |
55.9% |
|
Input of new terms |
166 |
10.33% |
127 |
12.2% |
|
Information on specific terms |
966 |
60.15% |
76 |
7.3% |
|
Term |
379 |
23.6% |
256 |
24.6% |
|
Total |
1,606 words |
100% |
1,041 words |
100% |
Source: Elaborated by the authors.
According to the table, there are notable differences in the distribution of metacommunicative elements between Spanish and English in the written discourse analyzed. In Spanish, the category of information about certain terms represents the substantial majority with 60.15% of the total number of words. This suggests an emphasis in Spanish for launching questions in the description of posts to attract the attention of the receiver. Meanwhile, in English, the dominant category is explanation, constituting 55.9% of the total, implying a higher focus in English on introducing the medical term first and expanding it in writing. New term entries have similar distributions in both languages, with percentages around 10-12%.
Table 9
Metacommunicative elements in Spanish and English: oral discourse.
|
Metacommunicative elements |
Spanish |
% |
English |
% |
|
Explanation |
373 words |
14.24% |
460 words |
39.69% |
|
Input of new terms |
398 |
15.19% |
248 |
21.40% |
|
Information on specific names |
1202 |
45.9% |
169 |
14.58% |
|
Name |
646 |
24.67% |
282 |
24.33% |
|
Total |
2619 words |
100% |
1159 words |
100% |
Source: Elaborated by the authors.
As in the results of the written discourse analysis, there are differences in the distribution of metacommunicative categories between the two languages in oral discourse. In the Spanish reels, information about certain terms predominates, once again, with 45.9% of the total number of words. This suggests that the medinfluencer again resorts to questions in order, in this case, not only to attract the attention of the receiver, but also to organize the discourse. In contrast, in the English videos the explanation category again makes up the largest proportion with 39.69%. This points to a higher trend in English to introduce the medical term and, subsequently, to expand it. The new term and name entries have more balanced distributions between the two languages.
After the analysis of the metacommunicative elements, both written and oral, a total of 4,225 words have been identified in Spanish (15% of the total corpus in Spanish). As for the English language, this figure amounts to 2,200 words (11.3% of the total corpus in English).
Table 10
Summary of the metacommunicative elements in Spanish and English (oral discourse).
|
Metacommunicative elements |
Spanish |
% |
English |
% |
|
Explanation |
468 words |
11.08% |
1042 words |
47.36% |
|
Input of new terms |
564 |
13.35% |
375 |
17.05% |
|
Information on specific terms |
2168 |
51.31% |
245 |
11.14% |
|
Term |
1,025 |
24.26% |
538 |
24.45% |
|
Total |
4225 words |
100% |
2200 words |
100% |
Source: Elaborated by the authors.
In this comparative table, there is a trend for English, in written discourse, to include communicative elements such as the explanation in which the medical term is first introduced and then explained (albeit briefly). In oral discourse, the medinfluencer does not spend too much time introducing more scientific terms. This is in contrast to the Spanish language, which goes on at length in its explanations and definitions.
On the other hand, in Spanish there is a tendency to educate users through metacommunicative elements that include information about certain terms, mainly through rhetorical questions. This trend is observed in both oral and written discourse.
In both languages, naming is used as a very frequent strategy, as we have already seen in the health brochures analyzed by Mayor (2008).
In a more graphic way, the holistic comparison of these elements in both languages is presented below.
Figure 2.
Holistic comparison of the metacommunicative elements in Spanish and English (oral discourse).
Source: Elaborated by the authors.
Visualizing the data in this way, both similarities and clear differences can be perceived between the oral and written discourse used by both Spanish and English medinfluencers. Here it is perceived that Spanish-speaking medifluencers tend to use metacommunication more for explanatory purposes and to contextualize terms and names for the audience. English speakers prefer metadiscourse that emphasizes direct explanation of concepts. But there are also similarities between the two groups in terms of their use for bringing in new terminology and naming discourse elements.
5.2. Characteristics of multimodal communication in social networks
One of the reasons for the success of the Instagram is that it allows users to communicate in a multimodal way, combining images, text, emoticons, video, audio and other multimedia elements. This type of communication is key to expressing ideas and emotions in a much richer and more complete way than written text alone would. Images and videos allow recipients to understand the message in a much simpler way, since the sender extends the message more, uses a fluent language, uses non-verbal elements that facilitate the understanding of complex concepts and his/her speech could be similar to the one that the recipient could get from his/her family doctor or specialist. Likewise, and with regard to multimodal written communication, social networks allow the use of emoticons that help in the understanding of certain concepts and, in addition, allow the discourse to be conversationalized, bringing it closer to the receiver.
The data analyzed from the 200 studied posts indicate that, on the one hand, 53.5% of these are posts that include a video accompanied by a brief description, and 46.5%, on the other hand, resort to images and text. In terms of languages, the differences in our corpus are evident in that Spanish-language medinfluencers resort more frequently to videos and text (68%) in their posts, while English-language medinfluencers do the same, but with images and text (61%). This may be directly related to the results obtained in the section on metacommunicative elements, since the English language tends, unlike Spanish, to be more direct in terms of its explanations, so its function would not be so much to educate in terms of health and wellness through Instagram, but simply to inform. To do so, it is more direct (and probably easier) to resort to the use of images rather than videos.
One of the characteristics shared by both corpora is the conversational, interactive and even colloquial style. Both the English and Spanish languages use a colloquial register and humor is presented as a useful and effective strategy to convey the message. The use of this informality and closeness has been detected in both oral and written discourse, although it is even more evident when the discourse is oral. It should also be noted that in 90% of the discourses analyzed, the Spanish language shows a high degree of informality, while English does not seem to demonstrate such closeness to the receiver. Two of the corpus posts, one in English and the other in Spanish, are shown below, in their oral and written forms:
Table 11
Informal, colloquial and humorous examples in Spanish and English (oral discourse and written text).
|
|
Spanish |
English |
|
Oral discourse |
Personaje 1: Vamos a ver, el sudor está compuesto en un 99 % de agua y después en ese pequeñico 1 % hay algunas sales, minerales como cloro, sodio, potasio, urea, amoniaco, ácido láctico, pero eso no huele. Personaje 2: Ya, y entonces, ¿por qué me canta a mí el alerón? [...]. (SP6 |
One of the most effective ways to reduce environmental toxins in your home is to take off your shoes as soon as you arrive. (EN47)
|
|
Written text |
¡El sudor no huele! ¡Son los gases que emiten las bacterias que se lo zampan! โก๏ธ Y si le damos menos comida a esas bacterias, sus “flatulencias” ๐ serán menores. #NoEsNormal que el sudor condicione tu vida. Consulta a tu profesional sanitario para encontrar la solución que mejor se adapte a ti ๐๐ป. (SP6_Des) |
What you track in can mess with your hormones! Not to mention the potential carcinogens that hitch a ride on the trainers! We’ve been talking breast cancer prevention the last couple of days. Definitely check out the other posts. But environmental toxins cannot be ignored. Let me know if you’re team: ๐ซNo shoes in the house ๐ Shoes in the house ๐Gonna take them off starting today โ๐ผ Here’s to creating your best health with simple steps. (EN47_Des) |
Source: Elaborated by the authors.
In the case included in Table 11, there is a tendency in Spanish to resort to humor and informality to convey, both in oral and written discourse, a health message through the use of terms and expressions such as "zampar” (to scarf down), "cantar el alerón” (to smell like old gym socks) or "pequeñico” (teeny weeny). It should be noted that the same could have been done the same with "flatulencias” (flatulence) but the speaker chose this term and not another more abrupt (or inappropriate) one, which shows that informality is used, but always within certain limits. On the other hand, in English language is used with certain informality and closeness, but much more in the description of the text and not so much in oral discourse, which may be due to what was previously indicated about the use of more direct explanations and without so many descriptions, similes, or metaphors.
Language, as the above example demonstrates, is key to determining the informality of a text. The rapprochement between sender and receiver are also visible through the use made by the sender of certain statements (interrogative and exclamatory) and personal pronouns (first and second person singular and plural) (Santamaría, 2014). In the case at hand, and with the aim of highlighting in an approximate way the informal nature of the medinfluencers' discourses in both languages, the first person singular ("yo") (I) and plural ("nosotros/as") (we) pronouns in Spanish are used in 11.78% of the total pronouns counted in the corpus. On the other hand, the second person singular ("tú") (you) and plural ("vosotros/as") (you) appear in 12.9% of the pronouns. As for the English corpus, the first person singular ("I") and plural ("we") appear in 26.5% of the pronouns, while the second person plural ("you") appears in 20.1%. These figures, albeit cautiously, indicate informality and closeness between sender and receiver in the discourse of medinfluencers on Instagram. This, moreover, is reinforced by the presence of, mainly, enunciative and interrogative sentences. As previously indicated, the inclusion of rhetorical questions (information about certain names), both in oral and written discourse, is very frequent, although it is more so in Spanish than in English.
Another recurrent technique in both languages that demonstrates closeness and informality is the use of emojis in written discourse. Table 11 shows two examples in which emojis help the sender to complete the message and, mainly, to add another visual component to it. These are the most frequent cases in which emoticons are used. Likewise, the use of these resources is not limited to providing colloquialism to the speech, since on some occasions they have been used to explain concepts that may be complicated to understand for some readers. In the example below of a speech written in Spanish by one of the medinfluencers (SP16), emojis are included to explain what "oral therapies" and "microinjections" are.
En varones jóvenes con #alopecia androgénica puede conseguirse no solo estabilizar la pérdida de pelo, sino incluso mejorar la densidad capilar, con la combinación de dosis bajas de terapias orales ๐ (3 días/sem) junto con alguna terapia de 2ª línea, como las microinyecciones ๐ de dutasteride / bicalutamida. (SP16_Des)
Accessibility is not only limited to websites and more and more social media users, especially those with a large number of followers, are choosing to add captions to their videos on Instagram in order to "remove barriers and provide a more inclusive experience for all users" (Moreno, 2023), as well as to achieve a higher number of views. The analyzed medinfluencers use subtitles in their videos on almost all occasions. In Spanish, 87.5% of the videos include subtitles, while in English this percentage is 71.4%. In all other cases, the medinfluencer does not embed subtitles or only partially embeds them and only includes some key terms in the video.
Another aspect that should be analyzed in this section has to do with the attire used by medinfluencers in the vast majority of their videos. This is owing to the fact that in both languages they use medical gowns or other related elements, which contribute to their image and credibility and help them to establish themselves as reliable and trustworthy sources of information related, in this case, to medicine and health. The medical gown, in these cases, is used as a recognized symbol of the medical profession and, therefore, by wearing it, they clearly identify themselves as health professionals and their audience understands that the information they are receiving comes from reliable sources.
Finally, another interesting issue worth mentioning has to do with the use of elements such as toys and medical material used by medinfluencers only in Spanish to explain a concept.
6. DISCUSSION
After analyzing the metacommunicative and multimodal elements of the discourse of medinfluencers on Instagram, it can be affirmed that the Spanish language provides the user of this social network with a greater amount of information and detail on a specific topic when he or she turns to the profiles of influencers who are dedicated to the dissemination of this type of information. On the other hand, the English language is much more direct and opts mainly for images and not so much for videos to explain medical concepts. In both cases, the discourse is informal (Yus, 2011) and humorous (Hernández, 2006; García, 2023), with the aim of capturing the reader's attention and gaining his or her trust. Not only through the language with the use of certain personal pronouns that provide closeness (García, 2019), but also through multimodal elements such as the medical gown or didactic elements during their video explanations.
Among the objectives of this study was to reflect on the didactic applications derived from the results obtained, since we believe that multimodal communication in medical outreach in social networks does not only benefit health professionals and the general public, but offers valuable opportunities for the development of competencies and skills in a variety of fields related to communication and linguistics. The following are some of the didactic applications of studies such as those conducted here:
- Medical communication training: since studies such as this one could be used to describe doctor-patient communication, as well as and to improve it so that it is done in the most effective and understandable way possible.
- Medical translation courses: the findings of studies such as this one would help future translators to understand and keep up to date on specific medical terminology and communication strategies.
- Writing and digital content education: the results of this study could be included as a basis for writing and digital content courses to learn how to create persuasive and reliable content online and using multimodal elements effectively and efficiently.
7. CONCLUSIONS
Although it would be interesting and necessary to expand the study corpus in order to study a larger number of profiles, th findings here area good starting point for understanding the language of medical specialists who disseminate information through social networks. Due to the importance of the topics they deal with for society, the study of these accounts is beneficial not only to know what they say but also to know how they say it (metacommunicative elements) and what techniques and strategies they use (multimodal discourse). Future lines of research could focus on how users receive this information through, for example, the study of their comments or interactions with a given communicator.
As far as the present study is concerned, there are both similarities and significant disparities in the way medinfluencers express themselves, either orally or in writing, in Spanish and English. In this analysis, Spanish-speaking medinfluencers tend to use metacommunication more frequently in order to offer detailed explanations and contextualize terms and concepts for their audience. On the other hand, English-speaking medinfluencers show a preference for metadiscourse that focuses on providing direct explanations of concepts. However, similarities are identified in both groups in terms of their use of metacommunication to introduce new terminology and name key elements of the discourse. In terms of multimodality, the Spanish language is much more didactic than the English language since it resorts more frequently to elements such as books and toys, among others, to explain concepts. In short, Spanish medinfluencers seek to teach the receiver and give them the necessary tools to learn about health and wellness, while the English language seeks only to inform, and its objectives do not include education.
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AUTHORS’ CONTRIBUTIONS, FUNDING AND ACKNOWLEDGMENTS
Authors’ contributions:
Conceptualization: Santamaría Urbieta, Alexandra; Alcalde Peñalver, Elena and Bannister, Peter. Methodology: Santamaría Urbieta, Alexandra and Bannister, Peter. Drafting-Preparation of the original draft: Alcalde Peñalver, Elena and Santamaría Urbieta, Alexandra. Drafting-Revision and Editing: Santamaría Urbieta, Alexandra and Bannister, Peter. All authors have read and accepted the published version of the manuscript: Santamaría Urbieta, Alexandra; Alcalde Peñalver, Elena and Bannister, Peter.
Funding: This research received no external funding.
AUTHORS:
Alexandra Santamaría Urbieta: Alexandra Santamaría is a Full Professor at Universidad Internacional de la Rioja (UNIR, Spain) and she teaches in the Translation and Interpreting Undergraduate Degree. Her research interests focus on translation didactics, technological innovation, translator professionalization and corpus study and analysis, among others. She has published several books, articles and book chapters, as well as presented the results of her research at national and international congresses. She is a member of the PRODIGI research group.
Orcid ID: https://orcid.org/0000-0003-0935-0616
Google Scholar: https://scholar.google.es/citations?user=Em8ZzYUAAAAJ&hl=es
ResearchGate: https://www.researchgate.net/profile/Alexandra-Santamaria-Urbieta
Elena Alcalde Peñalver: Elena Alcalde Peñalver is Full Professor at the University of Alcalá (Spain). Her main lines of research focus on specialized translation and foreign language teaching, about which she has numerous publications. She holds a PhD from the University of Granada and has participated in several national and international congresses.
Orcid ID: https://orcid.org/0000-0002-1606-4792
Google Scholar: https://scholar.google.es/citations?user=Pp4ONR8AAAAJ&hl=es&oi=ao
ResearchGate: https://www.researchgate.net/profile/Elena-Alcalde-Penalver
Peter Bannister: Peter Bannister is a researcher at Universidad Internacional de La Rioja (UNIR, Spain) and he is a member of the PRODIGI research group. His thesis addresses the role of artificial intelligence in the field of higher education. He has published articles and book chapters in prestigious national and international publishers. He has also shared his research findings at national and international conferences. In addition to the subject of his thesis, he has published and presented on gamification in university education, the internationalization of education, and the teaching, learning and evaluation of L2 listening comprehension, among others.
Orcid ID: https://orcid.org/0000-0002-7216-3912
Google Scholar: https://scholar.google.es/citations?hl=es&user=eKkQ3AkAAAAJ
ResearchGate: https://www.researchgate.net/profile/Peter-Bannister-5