Twitter for Public Health

Twitter bird holding red AIDS ribbon in its beak.Even if you don’t tweet, you’ve seen the blue bird and you’ve heard it Twitter. The popular microblogging service enables people to share 140 character messages (tweets), spread each other’s messages (retweets), and participate in online conversations using hashtags (#).

That familiar blue bird is carrying a lot of public health messages these days. Twitter is a potent tool for health communicators for several reasons, including its open nature, which allows us to follow and respond to anyone’s tweets; and the character limit, which helps us spread our message in concise and plain language.

Under a contract with the Centers for Disease Control and Prevention’s (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Danya has been tweeting for the National Prevention Information Network (NPIN) since 2009. In that time, we have watched many state and local health departments and health service organizations turn to Twitter to spread health information.

As Danya evaluation expert Michael Fitzpatrick points out in his recent post on the next frontier of measurement, public health’s social media challenge is successful engagement. Research out of Brigham Young University notes that many public health departments and organizations use Twitter and other social media as one more channel to push out content. The focus tends to be on the “media” aspect—pushing out information—and organizations miss out on the “social” engagement aspect of social media.

Within government, public health organizations face difficulties that include making the social media case to leadership, allocating enough staff resources to allow for social media engagement, and creating engaging content. Other challenges include developing voice and tone, striking a balance with approval processes so the fast response needed on Twitter is not inhibited, and managing reputation concerns.

Ways Forward

Despite the challenges, a number of health departments and organizations are using Twitter to creatively and effectively engage the public. Here are several success stories we explored in detail in the February 19 “Twitter for Public Health” webcast, the first in a series of In the Know: Social Media for Public Health webcasts that Danya is producing for NPIN.

Program Improvement

Philadelphia Office of HIV Planning (@hivphilly) uses Twitter to extend the reach of community workshops, enabling more people in their large service area to participate. They live tweet from workshops, ask for feedback on Twitter, and use the responses to further develop their programs.

Multi-Channel Campaign

CDC Emergency Preparedness and Response (@CDCemergency) took advantage of the popular culture zombie trend to create a multi-channel “Zombie Apocalypse” campaign on emergency preparedness. It morphed from a blog post into everything from a graphic novel to an educator’s Web site. CDC was as relentless as a zombie in spreading the campaign through every available channel, including Twitter.

Close-up of female zombie peering through window blinds.


Increase Media Coverage

Shelby County Health Department in Tennessee (@ShelbyTNHealth) uses Twitter in their press strategy. They follow and tweet to local reporters and disseminate highlights from their press releases. Twitter is enabled on staff smartphones so they can tweet whenever they have a minute during their busy days.

Use of Popular Culture for Public Health Messages

The American Public Health Association (@PublicHealth) took advantage of the Super Bowl to promote related health messages using the #SuperBowl hashtag. They tweeted about healthy snacks, drinking and driving, and flu vaccination. When the half-hour blackout hit, they took advantage of the unexpected opportunity with the tweet below, which was widely retweeted. Check out the response on Storify.

Screen capture of American Public Health Association tweet, “Power outages can disrupt more than football games. Know how to be prepared with our Get Ready fact sheet.”

Respond to Disease Outbreaks/Emergencies

Philadelphia Department of Health (@PHLPublicHealth, @PDPHFlu) tweeted information about H1N1 and monitored responses. A local mother tweeted to them that she was told by one of their clinics that her child could not be vaccinated. The health department reached out to her, identified the clinic, and had the staff retrained by the end of the day.

Community of Practice

CDC NPIN (@CDCNPIN) hosts a monthly Twitter chat, #NPINchat, which brings the public health community together to discuss topics such as the latest news, research and resources, and observances. NPIN has held regular chats since its June 2010 Twitter Town Hall for National HIV Testing Day, and over time they have developed into a community of practice where people exchange information and experiences.

Innovative Applications

New applications are turning Twitter into a supplemental surveillance system, enabling health departments to monitor local diseases and illnesses in real time.

MappyHealth uses Twitter data to track and analyze disease terms, reporting on them by condition and location. It won the “Now Trending: #Health in My Community” developer’s challenge sponsored by the U.S. Department of Health and Human Services. It also owes its existence to Twitter—the app’s two co-founders met via a tweet.

In January, Johns Hopkins University announced a new algorithm to track influenza cases via Twitter. “When you look at Twitter posts, you can see people talking about being afraid of catching the flu or asking friends if they should get a flu shot or mentioning a public figure who seems to be ill,” explained Mark Dredze, an assistant research professor in the Department of Computer Science. “But posts like this don’t measure how many people have actually contracted the flu. We wanted to separate hype about the flu from messages from people who truly become ill.”

Consumer-oriented applications also are being developed such as Sickweather, which tracks social media posts that reference illnesses and displays trends by location. Sickweather also shows illness patterns over time and allows members to report their illness directly and share information with friends through social networks.

Public health use of Twitter is evolving rapidly, especially regarding message distribution, behavior surveillance and monitoring, and evaluating health-focused initiatives. We’ll continue to blog as new trends emerge, but please leave a comment if you have Twitter for public health success stories, lessons learned, or resources to share.

If you missed February’s Twitter for Public Health webcast, you can view it as a recording or a slide deck. We invite you to join the next NPIN webcast, “LinkedIn and SlideShare for Public Health,” on Tuesday, March 12 from 2:00 to 3:00 p.m. eastern time. Get more information and register today!

By Cynthia J. Newcomer


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