








































This is an open access article under the terms of a license that permits non-commercial use, provided the original work is properly cited.  
© 2023 The Authors. Société Internationale d'Urologie Journal, published by the Société Internationale d'Urologie, Canada.

Key Words Competing Interests Article Information

Social media-based surveys, health care, 
survey fraud, survey dissemination

None declared. Received on October 10, 2022 
Accepted on December 10, 2022 
This article has been peer reviewed.

Soc Int Urol J. 2023;4(2):118–124

DOI: 10.48083/PERG3137

Tips and Pitfalls in Using Social Media Platforms  
for Survey Dissemination

William Ong Lay Keat,1 Vineet Gauhar,2 Daniele Castellani,3 Jeremy Yuen-Chun Teoh4

1 Department of Urology, Penang General Hospital, Penang, Malaysia 2 Department of Urology, Ng Teng Fong General Hospital, NUHS, Singapore  
3 Urology Unit, Azienda Ospedaliero Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy 4 S.H. Ho Urology Centre,  
Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China

Abstract

Introduction Social media has become a prevalent platform for survey dissemination, despite the paucity of 
literature on this topic. The purpose of this paper is to outline the benefits and drawbacks of and best practices for 
social media-based surveys.

Methods We performed a scoping review of this topic and explored different strategies commonly employed for 
conducting efficient health care surveys via social media platforms.

Results The main advantages of social media-based surveys are the convenience and flexibility of survey design, 
their relatively low cost, the anonymity of responders, and the ability to reach a broader population of responders 
across geographical boundaries. Several measures can be adopted to avoid issues inherent in this approach, such 
as data disruption and response duplication, as well as to enhance ethical behaviors and consent compliance. We 
discuss limitations associated with unclear distribution of survey respondents and outline survey fraud as a major 
impediment to the online propagation of surveys on various social media platforms.

Discussion The use of social media to disseminate surveys on various medical specialty topics has garnered 
global participation, particularly during the COVID-19 pandemic. Ethical codes of conduct emphasize the need for 
professionalism and truthfulness, and disclosure of potential conflicts of interest on the part of respondents, and 
high-quality survey research on the part of researchers.

Conclusion We advocate for the novel use of social media to promote large and diverse health care surveys. 
Additional studies should further explore the use of emerging social media platforms for survey dissemination and 
their impact on health care research.

Introduction

Surveys represent a study design commonly used in health care research. They are simple to perform and aim to 
collect impartial information from a population of interest. Traditional survey recruitment strategies, such as in-
person interviews, postal mail, and telephone calls, are indeed time-consuming and labor intensive[1,2]. During 
the COVID-19 pandemic, the world witnessed a dramatic surge in daily use of social media for communicating 
electronically[3]. The World Health Organization (WHO) implementation of social distancing policies and public 
health measures made onsite, in-person health care research a challenging endeavor[4].

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https://orcid.org/0000-0002-3048-1170
https://orcid.org/0000-0002-3740-7141
https://orcid.org/0000-0001-7354-9190
https://orcid.org/0000-0002-9361-2342
mailto:jeremyteoh%40surgery.cuhk.edu.hk?subject=SIUJ
http://SIUJ.org


Social media acts as an electronic communication 
online platform that enables its users to instantly share 
thoughts, information, and personal content. Accord-
ing to Datareportal 2022, there are already 4.62 billion 
people around the world using social media, with indi-
viduals spending on average approximately 2 hours and 
27 minutes each day communicating on social media 
platforms[5]. Health care professionals are increas-
ingly using social media channels, such as Facebook, 
YouTube, Twitter, Instagram, TikTok, and LinkedIn, as 
well as streaming audio applications, such as Spotify and 
Podcast, to reach a vast audience[6]. Emerging as one 
of the rapidly expanding online tools, social media has 
been adopted by many health care specialties, including 
medicine and urology[7]. We have observed an expo-
nential rise in the number of publications on urolog-
ical subjects through analysis of social media over the 
past decade. With impactful knowledge exchange and 
educational information provision, social media offers 
an opportunity for clinicians worldwide to connect with 
their peers and exchange knowledge and best practices 
in real time or near real time. For example, Twitter 
allows its users to compose brief 140-character messages 
and share them almost instantly with only a few 
clicks[8]. This not only reduces the amount of time spent 
waiting for a small group of in-person discussions but 
also allows medical professionals to reach more people 
across more geographical areas. Instagram, for example, 
is one of the tools used most frequently by the WHO to 
aid in disseminating health information and educational 
messages[9]. Jason Frank, MD, from the Royal College of 
Physicians and Surgeons of Canada has stated, “Within 
the next decade, you won’t be able to be a successful 
scholar without having some activities on social media,” 
emphasizing the implications of social media within 
our modern technological era[8]. As a result, the use of 
social media as a recruitment technique for surveys has 
become prevalent and has garnered tremendous popu-
larity in recent years. In the present study, we explore 
and evaluate best practices and pitfalls of survey distri-
bution via social media platforms.

Methods

Literature review
With the potential to effectively solicit the distinctive 
experience of health professionals, surveys distributed 
on social media have salient implications for researchers. 
The benefits of social media-based surveys include 
enhanced recruitment and increased anonymity, 
which may be advantageous when conducting research.  
At present, there are no clear recommendations for 
using social media to circulate health care surveys. We 
performed a scoping review on this topic and searched 
for key words and MeSH terms, including (urology) and 
(survey) and (social media). We determined that most 

data are qualitative in nature, therefore, we presented the 
results in narrative format.

Conflicts of online methodologies
Email-based surveys containing the survey within 
the body of the email or as an attachment are sent by 
email directly to target participants, who are invited 
to complete the questionnaire and email it back to the 
researchers. While email-based survey responses may 
be slightly better distributed among the population of 
interest, the response rate of this traditional survey 
distribution is sometimes very low. In a project approved 
by the University of Miami and conducted by Dubin 
et al. in 2020, a total of 4519 surveys were emailed to 
urologists worldwide but only 537 (11.9%) responses 
from 29 countries were received[10]. This low response 
rate raises doubt on whether email invitation is the 
preferred method of survey dissemination.

In contrast to traditional surveying methods, social 
media-based surveys entail the use of a well-designed 
online software system for posting the survey on the 
selected social media platform, through which partici-
pants can submit their responses. The data are captured 
immediately by the online software[6,11]—a feature that 
may allow for more accurate measurement of attrition, 
which is nearly impossible with email-based surveys. 
Furthermore, networking on social media, largely 
driven by capital, fosters more social connections than 
email invitations. Instead of relying on passive delayed 
interaction via email, social media platforms offer 
instantaneous and active engagement with the targeted 
audience. Platforms such as Twitter, Facebook, and 
Instagram provide their users with insights on content 
engagement, and as such, survey analytics metrics can be 
used to recognize patterns of engagement and improve 
outcomes[12]. Social media-based surveys, by offering 
versatility and affording great utility, have opened a new 
approach for conducting surveys—what may be coined 
by some as a social network survey strategy.

Tips and tricks, strength of social media-
based surveys
Design flexibility, cost-effectiveness, 
convenience, and real-time access
Complex health care surveys can be constructed fast 
and with ease using common survey-building software 
technologies such as SurveyMonkey, Google Forms, 
Jotform, and Typeform. The layout and question-and-
answer options can be created without hassle. Once 
the survey has been created, it can be uploaded onto 
the social media platform and shared effortlessly, 
within seconds, on tablets, desktop computers, and 
smartphones. The ease of use of smartphones has 
contributed to the ever-increasing share of respondents 
participating in social media-based surveys via their 

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mobile devices from anywhere and at any time[13]. 
Additiona l ly, adver tising sur veys on t he socia l 
media sites to garner more participation is relatively 
inexpensive compared with advertisements on print 
newspapers or billboards and pop-ups and banners on 
websites[14]. Surveys on social media platforms prove 
to be a low-cost alternative for researchers seeking to 
create posts that can be tailored to the study population. 
Another benefit of disseminating surveys in this manner 
is that respondents can complete the survey at a time 
that is most convenient for them. Survey responses are 
stored automatically by the software system, allowing 
investigators access to the results through any mobile-
friendly device. In turn, this renders the data analysis 
process seamless.

Anonymity
Email responses might reveal respondents’ identity 
and in conventional in-person interviews, it is even 
possible that interviewers can inf luence responses. 
The anonymity of social media-based surveys may be 
appealing to both researchers and participants, leading 
the latter to perhaps feel more secure and to have fewer 
inhibitions in truthfully answering the questions. 
The majority of survey respondents tend to answer 
“socially or emotionally sensitive” questions more 
honestly on online platforms because they know their 
responses are confidential. This also helps to mitigate 
the desirability bias, a potential drawback in research. 
In addition, online social media-based surveys are 
better utilized in recruitment of marginalized, hard-
to-access lesbian, gay, bisexual, transgender, and 
queer (LGBTQ) young individuals, who may prefer a 
relatively safe and anonymous atmosphere over face-
to-face interactions[15]. It has been documented in the 
literature that anonymized social media-based surveys 
are successful in procuring in-depth data from this 
population[16], which might not otherwise be possible 
through face-to-face interviews.

Distribution and sampling
The link to the survey is typically publicized and shared 
or re-shared by both researchers and participants alike 
on social media channels, allowing for increased survey 
exposure and hence more likelihood for participation[6]. 
Researchers are usually not able to determine who 
has engaged in the survey because they don’t have a 
master list of intended respondents. Nonetheless, this 
methodology often generates convenience samples, 
encouraging recruitment through viewers’ engagement 
with the survey. It is of the utmost importance that 
researchers obser ve basic online etiquette while 
studying online communities. Spamming, excessive 
contacting, or reposting the survey repeatedly on social 
media platforms should be avoided. In addition, survey 
participants should be reminded that they are expected 

to answer all the survey questions truthfully and to the 
best of their abilities. Surveys may include preliminary 
screening questions that do not rely excessively on 
advertisement during recruitment. The main study 
objective, general information, and intended audience 
should all be clearly mentioned at the outset of the 
survey.

It is quintessential to ensure the sampling method can 
gather a representative sample of the targeted population 
for a given survey. Careful consideration should be given 
to the survey recruitment approach. Today, as most 
health care professional bodies and organizations have 
social media profiles, it would not be difficult to reach 
out and recruit them for survey research. For instance, 
researchers can use social media to recruit a target popu-
lation via Facebook groups or Facebook pages. Also, the 
ability for social media users to repost content promotes 
an exponential rate of engagement, which can culminate 
in the snowball sampling phenomenon[17,18]. This type 
of chain referral helps ensure surveys are posted regu-
larly and multiply simultaneously. This is not observed 
in the case of survey by email distribution. Addition-
ally, social media may offer multiple interactive formats 
that can incorporate audiovisual content and valuable 
resources[19]. Another potential of social media-based 
surveys is that by accurately estimating the numbers of 
social media connections or followers as the denomina-
tor, the results of polls may likely be predicted. The use of 
“hashtags” may also substantially increase the number 
of people who can engage and complete the survey[20].

Broader outreach and better response
While the identity of respondents in social media-
driven surveys stays concealed, the intent is to reach a 
broader audience where social media is ubiquitous for 
maximizing survey outcomes. The availability of the 
internet and widespread use of social media across 
continents and many countries allow for overcoming 
geographical barriers.  A recent publication by the 
UroSoMe team titled “A Global Survey of the Impact 
of COVID-19 on Urological Ser vices” described 
the significant impact the pandemic has had on the 
urology community[21]. The Twitter platform was 
used to garner urologists from several continents to 
address COVID-19–related urology issues. The survey 
questionnaire was distributed primarily to urology 
health care professionals via UroSoMe Twitter. The 
authors received an overwhelming response from a 
total of 1004 participants from Asia, the United States, 
Europe, Africa, Australia, and New Zealand. This social 
media-based survey, which delivered high-quality 
scientific content in a short period of time, was a good 
example of timely global collaborative outcomes fostered 
by urologists[20,22].

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Incentivisation has been used for survey participation 
and can vary from as simple as providing visibility to 
selected authors to monetary rewards including coupons 
and lucky-draw chances in commercially sponsored 
surveys to promote active participation and minimize 
dropouts[23,24]. In another recent global survey led by 
Tan et al. on the psychological health of surgeons during 
COVID-19, a variety of URLs to the same survey were 
generated and sent to the participants who wished to 
promote the survey within their network[25]. Once the 
participants ascertained a target number of completed 
respondents, which were tracked by SurveyMonkey, 
they were listed as PubMed-indexed collaborators to the 
study. This would eventually be reflected in the active 
responses by the survey software to determine the effi-
cacy of their promotion. Offering this type of co-author-
ship opportunity could optimize the reach of the social 
network and improve respondents’ engagement with the 
survey.

Preventing duplication
A potential drawback of social media-based surveys 
concerns duplicate responses. It is possible that the 
same respondent might participate in a specific survey 
more than once. To mitigate this, surveys may limit 
survey participation of each individual to only one IP 
address. Like other online survey software systems, 
SurveyMonkey and Google Forms have the ability 
to collect IP addresses. Once the survey responses 
have been obtained from a specific IP address, that 
address is then blocked from further participating 
in the survey[26]. However, this method may raise 
concerns regarding compromising the anonymity of the 
respondents.

Measures to avoid missing data
In contrast to the traditional in-person approach 
or telephone survey, surveys on social media have 
the potential downside of respondents intentionally 
or inadvertently opting not to answer (ie, sk ip) 
intricate questions. To avoid this, the survey software 
employs logic and skip patterns to generate questions 
that participants are required to answer[27] before 
proceeding to the next question. If the question remains 
unanswered, it will be marked, and participants will 
receive an automatic reminder to answer the question 
and proceed to complete the survey within a stipulated 
time. To prevent invalid responses, surveys may include 
“do not know” or “others” as a response option.

Ethics and consent
All standard elements of the consent process should 
be adhered to in online investigations, including 
the provision of information about the research 
inquiry and clarification of the procedures in place 
to safeguard confidentiality, anonymity, and privacy. 

An introduction to the survey, including the survey’s 
purpose and eligibility of the respondents, should be 
listed on the landing page of the survey, prior to the 
first question. Survey participants are presumed to 
have read and understood said statements and given 
their implied consent prior to proceeding to answer 
the questions[28,29]. Anyone who does not wish to 
participate in the questionnaire is expected not to 
proceed to the next page. Alternatively, the survey 
landing page can be designed with a button “I agree 
to participate” that respondents must click in order to 
proceed to the questions.

Pitfalls of social media-based surveys
While the recruitment of survey participants using 
social media sounds impressive, the distribution of 
participants across different sites cannot be clearly 
determined. This is partly due to the limiting factors 
of not adopting sponsored advertising, resulting in 
limited sampling and respondent availability. Variations 
in digital and technology capabilities may impact 
the representativeness of the sampling population 
and hence the generalizability of the results. Certain 
rural populations are inevitably deprived of access 
to the internet, resulting in a lower response rate to 
social media-based surveys. However, with health care 
professionals' contemporary active online social media 
involvement, this pitfall is nearly trivial.

Survey fraud is one of the greatest obstacles when it 
comes to the online propagation of social media. Many 
concerns exist regarding the methodological quality 
and equivalence, access challenges, and technologi-
cal drawbacks of social media-based approaches. As 
dissemination of health care surveys via social media is 
in its infancy, the lack of regulatory guidance is cause for 
concern[7]. Additionally, it is challenging to accurately 
measure nonresponse and attrition rates among social 
media users. The number of respondents who view 
the research opportunity but choose not to participate 
cannot be accurately determined. Concerns also exist 
regarding anonymity and data security (for example, 
secure online transmission and storage of participant 
data) and digital delivery difficulties[30].

Today, the sheer number of surveys conducted on 
social media platforms runs the risk of producing survey 
fatigue[31]. The truthfulness of the survey responses 
can be called into question, as respondents may rush 
through the surveys, particularly for lengthy or complex 
surveys. Undeniably, in certain circumstances, the 
respondents may not provide truthful responses but 
rather respond solely for promised reward for survey 
completion. However, survey questions can be framed 
in different ways to assess participants’ deception and 
random responses[32]. Another limitation is the poten-

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tial bias influencing respondents through the design of 
the response options and how they are presented in the 
survey. Last but not least, the absence of trained inter-
viewers to address participants’ questions or doubts may 
potentially lead to less reliable data.

Discussion
Future directions
Social media has been adopted by many medical 
specialties, facilitating health care survey distribution. 
Use of social media-based sur veys has increased 
due to social distancing measures brought on by the 
COVID-19 pandemic, and as a result, has provided great 
opportunities for global participation. Commercial 
software products are user friendly and designed to 
create questions and their answer options seamlessly. 
Social media platforms should exercise caution to 
identify prospects with a strong interest in the survey 
topic. Multiple social media platforms can be used to 
establish a more diversified sample to reduce sample 
composition bias. To define the target populations, an 
operational definition of the intended population should 
be developed to encourage the effective recruitment 
of respondents. Demographic variables including 
age, gender, geographic location, and specialty field of 
interest should be explicated.

Additionally, the intended sample population should 
be taken into consideration when structuring the survey 
questions. Questions should be written in an appropri-
ate tone, use standard terminologies, and be clear and 
concise. Excessively long surveys with complex and 
multistep questions should be avoided, as they promote 
attrition and poor survey completion compliance. 
Contributing to participation dropout are factors such 
as an excessive number of qualitative questions, surveys 
with multistep questions, questions without the option 
to opt out or to decline answering, and an inaccessible 
survey interface[33,34]. It is incumbent upon survey 
researchers to identify the best data model in order 
to determine the variables needed to prevent survey 
response inconsistency and redundancy. Conceptual 

modeling would enable obtaining data directly, without 
the need for any manipulation. “Third-party guarantee 
of the survey” can be provided to increase credibility 
and perceived legitimacy[35].

To allay fears and concerns regarding the use of social 
media platforms, the European Association of Urology 
(EAU), the American Urologic Association (AUA), and 
other organizations have established recommendations 
and guidelines for the appropriate use of social media 
for communication among the urologic community[36]. 
Ethical codes of conduct impart the need for profession-
alism and veracity, disclosure of any conflict of interest, 
good quality of survey research, and protection of confi-
dentiality. The formation of a social media committee 
and stakeholders ensures the delivery of guidelines in 
urology to foster good social media practices[37]. Profes-
sional standards for online conduct should be incorpo-
rated into social media education as the use of social 
media continues to proliferate in urological settings and 
beyond.

Conclusion
Our paper examined the efficacy and feasibility of social 
media as a survey dissemination tool among health 
care professionals. Researchers may find it useful to 
create study-specific social media accounts to interact 
with their study population through various accessible 
online social media platforms. While recognizing the 
limitations of social media-based surveys, we must 
move forward and overcome obstacles inherent with 
this approach. As the saying goes, “A court ought not 
to be affected by the weather of the day, but will be by 
the climate of the era.” Given that the widespread use of 
technology and social media has grown in popularity 
over the past few years, we advocate the novel use of 
social media platforms for promoting large and diverse 
survey participation. We also encourage additional 
studies to further explore the use of emerging social 
media platforms for promotion and distribution of 
health care surveys.

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TABLE 1. 

Comparison between social media-based survey and conventional-based approach

Fielding through social media 

Pros Cons

• While many people may see the survey, individual respondents may 
participate more than once

• Inability to recognize the identity of the respondents

• Lack of control over the sample size

• Inability to verify the accuracy of responses

Fielding via conventional path — eg, in-person, postal mail, telephone calls, email, survey specialists

Pros Cons

• Ability to select a specific, targeted audience • Could be costly if panel specialist is hired

• Validation of the sample • Time-consuming to wait for respondents

• Respondents meet all defined criteria • Limited numbers of respondents

• Precise numbers of respondents needed for  
proper segmentation and analysis

• Higher dropout rate

• Easy and rapid dissemination

• Extremely affordable, if not free of charge

• Ability to reach broader number of respondents

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