The Effect of Social Media Content Exposure on the Health Literacy of Followers @halodoc

ABSTRACT


Introduction
The presence of technology is an important and very influential component in human life, especially in communication.(McLuhan, 1999) suggests "Technology has been changed the way we communicate" (Saefudin, 2008), which means that we (humans) communicate influenced by technology.Therefore technology cannot be avoided, The Effect of Social Media Content Exposure on the Health Literacy of Followers @halodoc humans are required to adapt and adapt to new technologies.The technology of the 4.0 era is seen with a series of technologies that are growing, there is a change that was originally analog to all-digital.In today's digital era, almost all walks of life have smartphones or gadgets, it is because of the shape and size when held and carried everywhere can be easily.Smartphones have the advantage of being able to access information such as health information when connected to the internet.Based on data in 2017 according to the Indonesian Internet Service Providers Association (APJII) stated, 51.06% of Indonesian internet users use the internet to find health information and 14.05% use the internet to consult with health workers.
Indonesia is the country with the largest population in the world, therefore the use of digital technology including social media increases significantly every year.Basically, social media is a useful tool in life also has many forms, types, and uses that vary according to needs.There are various types of social media that are currently being consumed by the public including Instagram and TikTok.Therefore, based on observations made by Hootsuite (We are Social) stated, Instagram is the second largest social media platform in Indonesia with a percentage of 86.5%.Social media platform TikTok followed in fourth position, covering 70.8% of all internet users in Indonesia.The high number of active users on Instagram and Tiktok social media platforms in Indonesia, this is because both applications offer advantages to socialize, get entertainment, and become a place so that they can find out information.
Currently, there have been many accounts created specifically to disseminate information, one of which is health information through content.The significant development of social media is also used by the world of health to disseminate information about health.The increasing amount of public awareness of health changes one's lifestyle for the better.A healthy lifestyle has begun to become a lifestyle by Instagram and TikTok social media users lately.Entering the era of utilizing the development of social media with other sectors, such as the economic sector or businesses that utilize social media called E-commerce, the world of health has also entered the era, known as Electronic-health or Telemedicine.The purpose of using social media in Ehealth is to convey health information to persuade someone to practice a healthy lifestyle, according to Dr. Ayu Cornelia (UGM Lecturer) mentioned, for example, public health campaigns such as how to wash hands well and then applied with interesting and interactive videos.
Content about health is interesting on Instagram and Tiktok social media, because in addition to entertaining it is also information.Interactions can also be made between users and account owners regarding health questions.In Indonesia, there are already quite a lot of social media owners who are specifically made to provide health information, by having their own services.One of them is @halodoc social media account.This social media account is managed by a start-up company with the same name, Halodoc.A pharmaceutical service established in April 2016 by PT Media Dokter Investama through its application and website.Halodoc users can decide which doctor to choose so that it suits their needs.The service function that allows users to consult directly with trusted doctors owned by Halodoc is via chat, voice, and video call.In addition to having a high number of followers on social media Instagram and TiktTok, released from The Healthcare Technology Report states that of the 100 health services in the world, Halodoc was appointed as the best health service by being ranked 60th and being the only company from Indonesia.Halodoc became the leading digital health service in Indonesia within three months, Halodoc won several awards, namely Marketeers Youth Choice (YCA) Source : Processed Author Taken on October 24, 2023 Based on observations, there are several social media platforms that Halodoc uses to convey health information.Based on the data above, Instagram has the most followers compared to other social media.Health communication is widely shared on @halodoc Instagram account.The account has 1 million followers and is marked with a blue checkmark.Instagram Halodoc plays an active role in routinely communicating health information to its users.The average content of Halodoc's Instagram uploads is to convey messages related to public health.The Twitter application also has a pretty good following, but Halodoc itself is not very active on the application.Through one of its social media accounts, Halodoc's Instagram provides interesting and informative information content about health.According to Kean Shihab in the title of his article Reconcept Halodoc's Instagram Content, mentioning the content of Halodoc's Instagram content is divided into four pillars, namely first, the product knowledge pillar which contains information about the development of Halodoc feature products or collaboration announcements.Second, pillar tips and tricks that provide information tips and tricks about daily activities to be more aware of health.Third, pillars of health facts in the form of basic knowledge about health that are more practical.And fourth, the Inspirational pillar that focuses on Halodoc's trust as one of the health solutions.The Effect of Social Media Content Exposure on the Health Literacy of Followers @halodoc campaign titled #infoKesehatan to make it easier for people to access and read accurate and reliable health information.Currently on TikTok social media, the author also sees that there is a lot of discussion or FYP video reviews using Halodoc regarding consultation on skin problems or acne, the content is by telling the experience of using Halodoc.One of Halodoc's social media, TikTok is also active in providing content about health involving general practitioners and specialists so that it has a video like of up to 2 million.The content provided by social media accounts is @halodoc very attached to health information, so that it can be an encouragement for people to carry out health literacy activities easily.Currently, Indonesian people are more interested in finding information through Instagram social media because the information uploaded on Instagram is up to date and easy for users to understand (Fajari & Khuntari, 2023).From the data obtained by the author through Instagram @halodoc the content provided is very varied to support the health literacy of its users, such as the impact of often staying up late which is feared to aggravate acne, the benefits of sago worms as a unique food rich in nutrients, mask tips during acne, health terms, to how to deal with colic in infants as well as stomach acid and much more.
It is undeniable that consuming too much social media content has an impact on its users.Regardless of whether it has a positive or negative impact on a person's perspective, mindset, and information literacy.Continuous exposure to a mass media has influenced him.The activity of listening, viewing, or reading media messages, or the experience and attention to those messages that may occur between individuals or groups is referred to as exposure or exposure.(Elvinaro, Op.cit,).Added by Jalaludin Rakhmat, said media exposure was caused by media exposure.The presence of the media is a link between the mass media, its audience, and its influence.To meet the needs of health information, a person can access and read information sources to answer questions from problems and can increase knowledge about health or called health literacy.Health literacy is important because it is necessary to make accurate health decisions for oneself.This is based on cultivation theory (Junaidi, 2018) explained that mass media is believed to have a great influence on the attitudes, perceptions, and behavior of its followers.Based on the background, this study was conducted to find out how much influence exposure to social media content has on the health literacy of @halodoc followers.

Literature Review
One theory that discusses the impact of mass communication is the Cultivation Theory, which was first introduced in the early 1960s by George Gerbner in his early research, the Cultural Indicators Project to investigate the impact of television.In this theory Gerbner stated that one of the dominant forces influencing the time was television.According to Gerbner (Junaidi, 2018), stated that television has a long-term impact that occurs gradually, indirectly, but cumulatively and can definitely determine a person's behavior.Based on Signorielli and Morgan (Junaidi, 2018), states that the decomposition of cultivation is the next step of media content production, images or impressions of media content, and in the relationship between exposure to messages, beliefs, and public behavior.Wood interprets the word 'cultivation' to refer to a cumulative process in which television cultivates beliefs about social reality to its audience.According to Gerbner, in cultivation theory there are 2 types of television viewers, namely: Heavy viewers, people who access also watch media > 4 hours a day, while Light viewers, people who watch media <2 hours a day.Heavy viewers can be said to have become addicted to television thinking that something that happens on television is real life.After watching media content, it is interpreted in the cultivation of examining that mass media communication can predict and shape long-term perceptions, understandings, and beliefs about the world.
The cultivation theory is connected with the concept of media exposure, media exposure is the level of the audience's state when exposed to messages broadcast by a media.media exposure, or media use.It consists of time spent on various mediums, types of media content, media used, or media as a whole.Based on Rosengren in (Jalaludin, 2009), media exposure can be known from 3 dimensions, namely Frequency, Duration, and Attention.The frequency dimension represents routine, which is how often a person accesses and uses media and how often to consume news content from that media.The duration dimension is a dimension that refers to the length of time a person uses media.And this attentional dimension refers to the level of attention or mental processes of a person when listening to the content of the program message.This includes watching while doing other activities, watching without doing other activities, and discussing while watching.According to Andersen, the formation of one's perception is related to one's attention in watching media, exposure is related to attention related to the formation of one's perception.
Social media is one of the media classified as new media or new media.According to (Nasrullah, 2015), social media is defined as an internet network medium that allows users to express themselves and establish online social relationships by interacting, collaborating, and sharing with other users.So it can be interpreted that social media is a group of applications that allow users to create personal web pages and connect with friends to share information and communicate, and currently the most social media applications include Instagram and TikTok.Instagram allows users to directly capture life moments in the form of photos and videos).Any content shared can be given and receive a response, with a heart sign which means liking the Instagram content and comments if you want to interact more with others.In addition, through the Instagram application can establish social networking or make friends with 'follow', 'following', and 'followers' features.Instagram social media is currently used by its users as a communication medium that attracts attention so that they can communicate with each other virtually.Meanwhile, TikTok is a simple but fun and easy-to-use application because it provides tools for taking pictures and various video editing features with several effects, filters, music and much more so that they are combined into a content.The TikTok application is currently not only a place of entertainment for the community, but its benefits increase to spread influential messages or information to followers or fellow users.Content messages can be health, food, fashion, accommodation, and more.
According to the Joint Committee on National Health Education Stzrds (1995), the term health literacy or so-called 'health literacy' is the ability of individuals to acquire, interpret, try to understand basic health information and services, and use them to improve their health.According to (Sørensen et al., 2013), health literacy has four dimensions or health indicators, namely first, access, namely the ability to search, find, and obtain relevant information.Second is understanding, or the ability to understand the health information accessed.Third, evaluation, which is interpreting, filtering, and evaluating the health information obtained.The fourth is to apply, namely the ability to interact and use health information accessed.Every individual is important to have health literacy in order to manage and control their health condition properly.According to (Redhana, 2019), health literacy is one of the interdisciplinary themes in the 21st century.According to Kwan et al. (Fiveriati, 2023), stated that everyone, including patients, health workers, and the general public, needs to have health literacy.Individuals who understand health The Effect of Social Media Content Exposure on the Health Literacy of Followers @halodoc information can use that knowledge to make informed decisions, reduce health risks, and improve their quality of life.
The study entitled "The Effect of Social Media Content Exposure on the Health Literacy of Followers @halodoc" uses cultivation theory, the concept of media exposure, and the concept of health literacy where both are in accordance with the phenomena contained in this study.Researchers tried to see how the influence and how much influence variable X had on variable Y.In variable X used in this study, there are 3 dimensions of sub-variables, namely frequency (X1), duration (X2), attention (X3).The three sub-variable dimensions will be associated with the sub-variable dimension Y, namely Access to information relevance (Y1), Understanding information about health (Y2), Assessing or observing information related to health (Y3), Applying or applying information about health (Y4).Hypothesis is very crucial in a study, therefore the author proposes the following hypothesis: H1 : "There is an influence of exposure to social media content on the health literacy of followers @halodoc" H0 : "There is no effect of exposure to social media content on the health literacy of followers @halodoc"

Research Methods
Based on the background, problem identification, and theory that has been described, this research method uses quantitative methods to test theories and relationships between variables in this study.This quantitative method is used to find out or examine populations and samples by obtaining random samples or random sampling.Quantitative data is a means of research based on positivism or is valid data obtained from certain populations and samples.This research data is in the form of indicators that use statistics as a measuring tool and conclusions can be drawn (Sugiyono, 2018).This study uses a survey method, which helps researchers easily obtain data in the form of numbers to be analyzed systematically (Bungin, 2005).
This type of research is causality, which will explain how much influence exposure to halodoc social media content has on the health literacy of followers or followers.This type of causality research is a research design used to determine whether there is a possibility of cause-and-effect relationships between variables, where researchers have insight into causation, to be able to classify independent variables and which are dependent variables (Sanusi, 2011).Researchers have classified independent or independent and dependent or bound variables in this study using Social Media Content Exposure as variable x (Free) and Health Literacy as variable y (Bound).Social Media Content Exposure consists of 3 dimensions, namely frequency, duration, and attention.While health literacy consists of 4 dimensions, namely access to the relevance of information, understanding information, assessing information, and applying information.
The population in this study used Halodoc's social media accounts, including @halodoc Instagram accounts that have 1,000,000 followers and TikTok @halodocid accounts that have 613,000 followers (data October 24, 2023 by researchers through searches on Instagram and TikTok).While the sample determination uses the Slovin formula so as to obtain a sample of 100 respondents, with a data collection technique, namely a questionnaire distributed online via Google Form to 100 respondents consisting of followers of @halodoc social media accounts.
An instrument is said to be valid if it can measure the value of an object (Sugiyono, 2021).In this study, the validity test serves to assess how far the measurement of the object of research so that it can be scientifically accounted for.The validity of the instrument in this study was measured using the SPSS 25 application by comparing rcalculate and rtabel.Meanwhile, to measure questionnaires / variables, reliability tests are used.This study tested reliability using Cronbach's alpha.The questionnaire is considered reliable if Cronbach's alpha score > 0.70, if Cronbach's alpha score < 0.70 means reliability is rejected.Data analysis in this study consisted of several tests, including: 1) Normality test using the Kolmogorov-Smirnov test to determine the distribution of X and Y variable scores; 2) Pearson correlation test to determine whether there is a relationship between the two variables; 3).Simple linear regression test to evaluate the impact of a variable on a particular outcome; 4) Test the coefficient of determination to determine the intensity of the relationship between variables; and 5) Test the hypothesis to find out the presence / absence of significant influences between variables.

Results and Discussion
This study was conducted with the aim of finding out how influential the exposure of social media content is to the health literacy of @halodoc followers.Researchers used a sample of 100 respondents who were followers or followers of Halodoc social media, and distributed questionnaires online using a google form containing statements for respondents.The percentage of responses that researchers received or called the response rate in taking this study data amounted to 66.4%.The characteristics of respondents that have been obtained include based on age with the highest results in the age range of 17-25 years with the highest sex respondents, namely women, the rest are men, it can be assumed that the age of 17-25 years is female more interested in Halodoc.The highest results of respondents educated Bachelor S1 / S2 / S3 with the highest duration using social media with results of >2 hours.

The Amount of Influence of Social Media Content Exposure on the Health Literacy of Followers @halodoc
Based on the results of data processing that has been obtained by researchers, it can be seen that exposure to social media content affects the health literacy of @halodoc followers.This can be proven by processing data on the normality test using the Kolmogorov-Smirnov method which produces a normal distribution and significance values also show normal results.In this study, the results of partial hypothesis testing of the t test showed that the value of exposure to social media content on the health literacy of followers @halodoc.This is in line with previous research by Rosita regarding the relationship between self-disclosure content and mental health literacy of @menjadimanusia.idfollowers in 2021, which found that overall self-disclosure content on Instagram @menjadimanusia.idhas a significant influence on the mental health literacy of followers.
In the results of the recapitulation of respondents' responses regarding media exposure variables that have been carried out in descriptive analysis on dimensions that are in media exposure variables are included in the high category.With there are dimensions that get a very high category, namely being in the attentional dimension.In addition, descriptive analysis results were obtained on dimensions that are in the health literacy variable which is included in the very high category.With the dimension of understanding health information that obtained the highest amount and entered into the very high category.So it can be known that attention or focus on the content of interesting and trendy content presented by Halodoc on its social media can provide an understanding of health information to its followers.This is in accordance with cultivation theory, which can be interpreted that the use of media will provide understanding and predict the results of a mass communication process.
In this study, the results of the analysis have been obtained that are in line with the concept of media exposure and the fundamental assumptions of cultivation theory, according to (Shore & Kane, 2005) that media exposure is the activity of listening, seeing, and reading mass media messages so as to experience experience and attention to these messages, and continuous media exposure will provide an overview and influence on the perception of the seeing.Therefore, Halodoc's social media content has played a role and hit well in delivering health content so that it gets the attention or attention of its followers.In addition, this is in line with previous research by Dara Navilla Rainisa regarding the exposure of @Drprasdja account educational content to sleep health in 2023 which found that the content has a significant influence on the sleep health awareness of its followers.
In the results of the study, processed data showed the magnitude of the influence of exposure to social media content on the health literacy of @halodoc followers, which when measured through the level of relationship can be interpreted as a moderate influence.Furthermore, in simultaneous hypothesis testing, the f test conducted by researchers showed that there was a significant influence simultaneously between variable X (media exposure) and variable Y (health literacy).Therefore, exposure to social media content has a significant effect simultaneously on the health literacy of @halodoc followers .The following is the magnitude of the influence of the variable dimension of media exposure (X) on health literacy (Y).
Based on the results of research that has been obtained, the frequency dimension has a moderate influence on health literacy.Frequency according to Rosengren (Jalaludin, 2009) refers to routine or how often a person engages in media activities and consumes content from the media.It is assumed that the majority of respondents quite often see Halodoc content uploads on their main social media pages.Through the results of this study, it shows that the exposure of Halodoc media content that provides health education is in accordance with the frequency according to Rorengren (Jalaludin, 2009), so that Halodoc's social media, especially Instagram and Tiktok, are quite capable of actively interacting with their followers.This is also in accordance with the results of previous research conducted by (Budhi & Pratiwi, 2021) considering the interactivity of @Rintiksedu Instagram account to be one of the keys in influencing interest in listening to the Rintik sedu podcast.
Based on the results of research that has been obtained, the duration dimension has a low influence on health literacy.The duration or length of time according to Rosengren (Jalaludin, 2009) refers to the time spent by the audience in accessing and following information through the media during a certain period of time.It is assumed that the majority of respondents have seen less @halodoc posts several times or for a long time.Through the results of this study, it shows that the exposure to media content that provides Halodoc health education is not in accordance with the duration according to Rosengren, so respondents can be said to be new followers who spend less time on Halodoc social media and the duration that is too long such as Tiktok video content makes respondents bored.This is also in accordance with the results of previous research conducted by (Budhi & Pratiwi, 2021) where audiences consider Instagram @Rintiksedu interesting because of its duration so it doesn't get bored and can be watched several times.
Based on the results of research that has been obtained, the attentional dimension has a strong influence on health literacy.Attention according to Rosengren (Jalaludin, 2009) refers to the extent of audience attention when they consume content from the media they use.It is assumed that the majority of respondents pay attention and like the content uploaded by @halodoc social media accounts.Through this research, it shows that the exposure of Halodoc media content that provides health education is in accordance with Rosengren's attention, which gets full attention and curiosity from the audience so that the use of media does not carry out other activities.This is in line with the concept of media exposure according to Andersen, the formation of one's perception is related to one's attention in watching media, exposure is related to attention related to the formation of one's perception.Also, in accordance with the results of previous research conducted by Kurnia Hayuning Budhi and Aprilianti Pratiwi (2021), it shows that the content that is liked and received full attention is very important to be an attraction for listening to the Rintik sedu podcast.

Conclusion
Based on the research that has been conducted and obtained the results of the research discussion in the previous chapter related to the Effect of Social Media Content Exposure on the Health Literacy of @halodoc Followers , researchers can draw conclusions that obtained by researchers through normality tests show that this study is normally distributed.In this study, the results of partial hypothesis testing of the t test showed that there was an influence of exposure to social media content on the health literacy of followers @halodoc.Descriptive analysis that has been carried out on dimensions that are in media exposure variables is included in the high category.In addition, the dimensions that are in the health literacy variable are included in the very high category.In this study, it is also known that the amount of influence of exposure to social media content on the health literacy of followers @halodoc in this study is known to be at a moderate level.So it can be said that exposure to social media content has a moderate and significant influence simultaneously on the health literacy of followers @halodoc.Although the influence is in the medium category, there are various levels of influence of variable dimensions of media exposure.The frequency dimension has a moderate influence, because Halodoc is quite active in interacting with its followers and it can be said that followers @halodoc included in light viewers who tend to use more diverse types of media to get information sources.The duration dimension has a low influence, because boredom with a duration that is too long makes followers spend less time and the highest dimension, namely attention, has a strong influence, because the content is interesting and according to trends.Attention is also used as the main focus in media exposure, this is because as much and as often as someone watches media but if it does not have attention or attention it will be difficult to produce influence on the perception of the person.
For all the results of research that researchers have done, there are several suggestions that researchers can give, including:

Academic Advice
In the next study, researchers hope that this research can be used as a reference material and examine by replacing the object of research with social media accounts about other health and focusing more on how media content can hit so as to change or add health literacy for the better.Thus it can provide new data that can be a comparison for other studies.

Practical advice
In this study, there are correlation and regression analysis results that show that the duration dimension gets low results.It can be assumed that Halodoc social media, especially Instagram and Tiktok, need to know the duration of content that suits the needs of followers.This research also shows that the highest dimension is attention, therefore Halodoc's social media management needs to maintain interesting content and follow trends in order to continue to get high attention from its followers.Therefore, researchers hope that this research will be considered by Halodoc so that the chances of health literacy in Halodoc social media followers, especially Instagram and Tiktok, will increase.

Figure 1
Figure 1 Content @halodoc on Instagram account Source : Instagram.com/halodoc/To counteract inaccurate health information that can harm the public, in 2022 Halodoc and the TikTok digital platform collaborated by presenting an educational

Table 1 . Halodoc Social Media Accounts
Fortune Indonesia Change the World 2022, and PPKM Award 2023 from the Indonesian government.In 2022, Halodoc's total engagement index on digital platforms has increased to 86.54.For this, the healthcare platform Halodoc won the "Indonesia Most Engaging Brand 2022" award in the Healthcare Application category.One of the success factors is Halodoc's activity on digital platforms as well as social media.