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Twitter is the most popular form of microblogging that is being utilized in public health to engage audiences and to communicate health-related information. Although there is some research showing the various forms of Twitter use in public health, little is known about how individual public health professionals are using their personal Twitter accounts to disseminate health information.
The purpose of this research was to categorize public health professionals’ tweets to evaluate how individual public health professionals are furthering the mission of public health.
Twitter accounts held by public health professionals were identified, and researchers proceeded to record 6 months’ worth of each individual’s Twitter feed. During the 6-month period, a total of 15,236 tweets were collected and analyzed using the constant comparison method.
A total of 23 tweet categories among the 15,236 tweets were initially identified. Some of the most common topics among the 23 categories included the following: health nutrition (n=2008), conferences (n=815), Ebola (n=789), Affordable Care Act (ACA)/health care (n=627), and social justice (n=626). Each of these categories were then stratified into one of four themes: (1) informing and educating, (2) monitoring health statuses and trends, (3) social justice, and (4) professional development.
Using Twitter, public health professionals are helping dispel misinformation through education and by translating technical research into lay terms, advocating for health inequalities, and using it as a means to promote professional development.
In a recent paper published in JPHS we described how public health professionals use Twitter for professional development [
The most popular form of microblogging, with 313 million active users, occurs through Twitter [
Public health organizations disseminate information and education by tweeting about various health-related topics [
Health organizations are also beginning to use Twitter as a source of professional development by tweeting updates while at a conference or an important meeting, thereby allowing other organizations and health professionals to receive updates on the current work and research being conducted [
When examining the implementation of new technology, Roger’s diffusion of innovation model is commonly used. Although Twitter was founded in 2006 and has gone through the full diffusion of innovation cycle (innovators, early adopters, early majority, late majority, and laggards), the diffusion of innovation model can be used to examine how new ideas and uses of Twitter spread throughout the population or a subpopulation/group. For example, public health organizations did not start using Twitter until more recently because of network filter blocks, but they created new uses for Twitter such as syndromic surveillance [
Participants were chosen through Twitter’s search function using the terms “public health practitioner,” “MPH” (master’s in public health), “public health,” and “APHA” (American Public Health Association). After individuals were identified as public health professionals, participants were chosen based on a set of inclusion and exclusion criteria. Inclusion criteria were as follows: the individual was a public health professional and had to have a minimum of 300 followers. Exclusion criteria were as follows: the individual could not be a part of an academic institution, and it could not be an organization’s Twitter page (eg, CDC, local health departments, and NIH). Overall, 220 public health professionals were chosen to examine their tweets during a 6-month period from October 1, 2014 to March 31, 2015. A total of 15,236 tweets were collected and then analyzed using the constant comparison method.
The constant comparison method was used to analyze the tweets to reduce the data into manageable units and coded information [
The constant comparison method initially revealed 23 different tweet categories among the 15,236 tweets analyzed, as displayed in
Tweet categories of public health professionals.
Tweet category | Tweets, n |
Non-public health–related | 4032 |
Health nutrition | 2008 |
Other | 1885 |
Conference/Forum/APHAa | 815 |
Ebola | 789 |
Noninfectious diseases | 728 |
ACAb/Health care | 627 |
Violence/Safety/Social justice | 626 |
Health law and policy | 567 |
Technology/Innovation | 553 |
Environmental health/Factors | 380 |
Charity/Organizations/NPOc | 346 |
Vaccines | 250 |
Education and literacy | 233 |
Global famine/Water | 196 |
Emergency/Emergency preparedness | 176 |
Global poverty/Homelessness | 170 |
Infectious diseases | 158 |
Mental health | 156 |
HIVd/AIDSe | 143 |
Smoking/Tobacco/Marijuana | 143 |
Medications/Drugs and alcohol | 143 |
Influenza | 112 |
Total | 15,236 |
aAPHA: American Public Health Association.
bACA: Affordable Care Act.
cNPO: nonprofit organization.
dHIV: human immunodeficiency virus.
eAIDS: acquired immunodeficiency syndrome.
Tweet theme: Informing/Education
Categories
Ebola
Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)
Affordable Care Act (ACA)/Health care
Health law and policy
Emergency/Emergency preparedness
Environmental health factors
Health and nutrition
Tweet theme: Monitoring health status/Trends
Categories
HIV/AIDS
Health and nutrition
Influenza
Smoking/Tobacco/Marijuana
Technology/Innovation
Infectious diseases
Noninfectious diseases
Tweet theme: Social justice
Categories
Global poverty/Homelessness
Global famine/Water
Charity/Organizations/American Public Health Association (APHA)
Education and literacy
Mental health
Violence/Safety/Social
Non-public health–related
Tweet theme: Professional development
Categories
Conference/Forum/APHA
Informing and education tweets centered around informing and educating the public on various aspects and updates in public health. Within the theme, there were seven major topic areas covered: Ebola; human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS); Affordable Care Act (ACA)/health care; health law and policy; emergency/emergency preparedness; environmental health factors; and health and nutrition (
Another area where public health professionals tweeted information to dispel misinformation was about the ACA (see
Although social media has drastically changed the way of communication, it has also created a way to spread misinformation quickly. As public health professionals have the credentials/authority tied with their Twitter accounts, they can dispel misinformation as well as spread other important health information to the public at a rapid rate.
Public health professional dispels panic and myths during Ebola panic.
Public health professional dispels misinformation about the Affordable Care Act.
Public health professional disseminates information about flu epidemic.
Public health professional shares a study about cigarettes with followers.
Tweets identified as monitoring health status and trends were not using surveillance techniques, instead they were informing the public of updates on specific health statuses and trends (see
Through the word limit function in Twitter, public health professionals are forced to condense important information into 140 characters, making these important updates on specific health statuses and trends more relatable to the lay population.
Social justice tweets focused on raising awareness and support for various public health issues (see
Twitter provides a space for public health professionals to share items they are passionate about, within or outside, their field. This platform also allows them to connect and collaborate with other professionals who are interested in the same social justice issues.
Public health professional speaks about US poverty.
Public health professional shows support for an organization.
Professional development occurred when health professionals tweeted new public health information obtained at conferences and forums, as well as with the exchange of sources of scientific literature back and forth between other public health professionals and the general public (see
Twitter provides a unique platform for professional development as budget cuts decrease the opportunity to connect and collaborate with other public health professionals.
Public health professional shares his/herconference experience.
Public health professional shares a photo of a conference.
Similar to public health organizations, public health professionals are also using Twitter to inform and educate the public. These results are not surprising, as one of the main tenets of public health is to “educate and inform” [
Public health organizations use Twitter to monitor health status and trends through syndromic surveillance [
The most visible tenet of public health is the concept of social justice [
Finally, akin to public health organizations, public health professionals are also using Twitter as a means of professional development. Over the years, many states have seen significant decreases in funding for public health, severely limiting resources available to the public as well as to the public health professionals (eg, continuing education and conferences). Twitter provides public health professionals with a unique platform, to still engage with local conferences, as individuals attending tweet about sessions while they are occurring. Twitter also provides a way for public health professionals to connect and collaborate with other public health professionals in real time, despite being limited in funding for travel.
The scope of the tweets examined was during a 6-month window and was limited to that specific time frame. Although limited throughout the 6 months, the tweets reached saturation before 6 months, ensuring that tweets collected were representative of public health professionals’ Twitter activity. A second limitation was that the individuals analyzed only had to have a minimum of 300 followers. Although this is a small number of followers, because public health professionals are early adopters, they will not have a large following yet. The final limitation was that the category “non-public health–related” was the most common tweet category. Looking at the categories as a whole makes it appear that public health professionals are not talking about public health the majority of the time, but when one looks at the tweets (see
For more adoption to occur among public health professionals, public health organizations should consider removing social media filters, specifically from Twitter. The removal of social media filters would eliminate the barrier of public health professionals only being able to tweet during after work hours, thereby encouraging increased adoption of the social media platform among public health professionals as well as enabling them to rapidly spread critical health information to the public as it occurs “in real time.” Unlike the majority of health organizations, public health professionals’ individual Twitter accounts outside organizations are not monitored by the government, and they are able to disseminate important information to colleagues and the lay population, such as how climate change affects public health, that organizations may not be able to disseminate, despite how critical that information is to the overall public health in the United States.
Affordable Care Act
acquired immunodeficiency syndrome
American Public Health Association
Centers for Disease Control and Prevention
human immunodeficiency virus
master’s in public health
National Institutes of Health
social networking site
None declared.