J. Med. Internet Res. - Use of twitter among local health departments: an analysis of information sharing, engagement, and action.


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CKGROUND: Social media offers unprecedented opportunities for public health to engage audiences in conversations and collaboration that could potentially lead to improved health conditions. While there is some evidence that local health departments (LHDs) are using social media and Twitter in particular, little is known about how Twitter is used by LHDs and how they use it to engage followers versus disseminating one-way information.OBJECTIVE: To examine how LHDs use Twitter to share information, engage with followers, and promote action, as well as to discover differences in Twitter use among LHDs by size of population served.METHODS: The Twitter accounts for 210 LHDs were stratified into three groups based on size of population served (n=69 for less than 100,000; n=89 for 100,000-499,999; n=52 for 500,000 or greater). A sample of 1000 tweets was obtained for each stratum and coded as being either about the organization or about personal-health topics. Subcategories for organization included information, engagement, and action. Subcategories for personal health included information and action.RESULTS: Of all LHD tweets (n=3000), 56.1% (1682/3000) related to personal health compared with 39.5% (1186/3000) that were about the organization. Of the personal-health tweets, 58.5% (984/1682) involved factual information and 41.4% (697/1682) encouraged action. Of the organization-related tweets, 51.9% (615/1186) represented one-way communication about the organization and its events and services, 35.0% (416/1186) tried to engage followers in conversation, and 13.3% (158/1186) encouraged action to benefit the organization (eg, attend events). Compared with large LHDs, small LHDs were more likely to post tweets about their organization (Cramer's V=0.06) but were less likely to acknowledge events and accomplishments of other organizations (?=12.83, P=.02, Cramer's V=0.18). Small LHDs were also less likely to post personal health-related tweets (Cramer's V=0.08) and were less likely to post tweets containing suggestions to take action to modify their lifestyle. While large LHDs were more likely to post engagement-related tweets about the organization (Cramer's V=0.12), they were less likely to ask followers to take action that would benefit the organization (?=7.59, P=.02. Cramer's V=0.08). While certain associations were statistically significant, the Cramer's V statistic revealed weak associations.CONCLUSIONS: Twitter is being adopted by LHDs, but its primary use involves one-way communication on personal-health topics as well as organization-related information. There is also evidence that LHDs are starting to use Twitter to engage their audiences in conversations. As public health transitions to more dialogic conversation and engagement, Twitter's potential to help form partnerships with audiences and involve them as program participants may lead to action for improved health.

Resumo Limpo

ckground social media offer unpreced opportun public health engag audienc convers collabor potenti lead improv health condit evid local health depart lhds use social media twitter particular littl known twitter use lhds use engag follow versus dissemin oneway informationobject examin lhds use twitter share inform engag follow promot action well discov differ twitter use among lhds size popul servedmethod twitter account lhds stratifi three group base size popul serv n less n n greater sampl tweet obtain stratum code either organ personalhealth topic subcategori organ includ inform engag action subcategori person health includ inform actionresult lhd tweet n relat person health compar organ personalhealth tweet involv factual inform encourag action organizationrel tweet repres oneway communic organ event servic tri engag follow convers encourag action benefit organ eg attend event compar larg lhds small lhds like post tweet organ cramer v less like acknowledg event accomplish organ p cramer v small lhds also less like post person healthrel tweet cramer v less like post tweet contain suggest take action modifi lifestyl larg lhds like post engagementrel tweet organ cramer v less like ask follow take action benefit organ p cramer v certain associ statist signific cramer v statist reveal weak associationsconclus twitter adopt lhds primari use involv oneway communic personalhealth topic well organizationrel inform also evid lhds start use twitter engag audienc convers public health transit dialog convers engag twitter potenti help form partnership audienc involv program particip may lead action improv health

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