IT & Social Media
Room: Blackberry Lilly
Tuesday, April 21, 2015, 2:00 to 3:30 PM
Moderator: Anna Goodman Hoover, PhD, MA
Roger Wong, BS
Local Health Departments Tweeting About Ebola: Characteristics and Messaging
Co-Investigator(s): Jenine Harris, PhD; Mackenzie Staub, BS; & Jay Bernhardt, PhD, MPH
Background: In August 2014, the World Health Organization (WHO) declared the Ebola outbreak in West Africa to be an international public health emergency. Shortly after, the Centers for Disease Control and Prevention (CDC) confirmed the first U.S. case of Ebola on September 30, 2014. These events contributed to a rise in Ebola-related messaging across the nation through numerous forms of social media, such as Twitter. One of the 10 essential services provided by local health departments (LHD) nationwide is to inform, educate, and empower constituents about health issues. Health departments are increasingly using social media as one communication tool. Research Objective: The purpose of our study was to examine the messages and characteristics of LHDs sending Ebola tweets. Data Sets and Sources: We collected all tweets sent by 287 LHDs using Twitter included in the Twitter list (https://twitter.com/jenineharris/lists/local-health-departments) nationwide between September 5, 2014 and October 31, 2014. We merged the Twitter data with the 2013 NACCHO Profile study data for all LHDs that had sent at least one tweet (n=226) during the data collection period. Study Design: We used quantitative and qualitative methods to analyze tweets sent by LHDs. Drawing on prior research related to social media use by LHDs, we built a logistic regression model including population size, employment of public information specialists, leadership education level, and number of tweets sent by each health department into the model. Since Ebola is an infectious disease, we also entered epidemiology staffing and communicable disease surveillance in the model. In addition, we classified the 1648 Ebola-related tweets into one of four broad categories: information-sharing, updates, events, or preparedness. We also identified tweets including research evidence and mobilizing information. Analysis: We conducted a content analysis of Ebola tweets to identify common themes and features in addition to using descriptive statistics to understand the characteristics of LHDs tweeting about Ebola. Principal Findings: Of the 226 LHDs that sent at least one tweet during the data collection period, 176 had complete data in the Profile study and were included in quantitative analyses. LHDs employing public information specialists (PIS) were 2.78 (95% CI: 1.19-6.52) times more likely to tweet about Ebola. Population within LHD jurisdiction, total number of tweets sent in September and October, whether the top executive attained an MPH degree, presence of an epidemiologist, and whether communicable disease surveillance is conducted were not significant predictors of tweeting about Ebola. Qualitative coding is underway for the 1648 tweets. Conclusions: Our findings may assist public health organizations in using social media campaigns to prepare for and respond to emergency outbreaks. Implications for Public Health Practice and Policy: Social media has been important in public health emergencies, such as Hurricane Sandy, and may also play a crucial role for outbreaks such as Ebola, which requires time-sensitive transmission of information in order to contain the spread of the disease and ease public anxiety. Having the staff capacity and knowledge to utilize social media within public health organizations would be necessary to effectively disseminate information during outbreak incidents.
Rakhi Trivedi, MPH
Use of Facebook by Local Health Departments: Activity and Focus Areas
Co-Investigator(s): Gulzar Shah, PhD & Ankit Bangar, MPH
Background: The use of online social media like Facebook, Twitter etc., is not confined to personal use. There is a great potential for public health professionals at local health departments (LHDs) to utilize this popular platform to promote health, and provide updates to the people in their jurisdictions about current health issues. Research Objective: Assess the usage of Facebook by LHDs, their level of activity, and to identify the areas in which LHDs are focusing through Facebook. Data Sets and Sources: We used NACCHO’s 2013 National Profile of LHDs, and primary data collected for this study from Facebook profiles of LHDs that indicated in the Profile study that they used Facebook. Using NACCHO’s 2013 Profile of LHD study, for which a module was administered to a sample of 625 LHDs, we determined that 167 LHDs used Facebook. We then followed the Facebook profiles of these 167 LHDs over a period of 4 months and transcribed the content information. Finally we performed analysis on the transcripts for this study. Study Design: This is an observational study, based on cross-sectional survey data as well as content analysis of Face Book over a four-month time period. Analysis: We performed qualitative analysis of the Facebook contents using the Atlas.ti. We recorded the hermeneutics based on focus area codes. We then quantified the occurrences of these codes to get our results. Quantitative analysis of the Profile study data included descriptive and bivariate statistics on use of social media. Principal Findings: Results from the 2013 Profile study show that independent of the purpose of use, Facebook and Twitter are the two most commonly used social media being used by 43.3% and 18% LHDs respectively. The descriptive analysis showed that popularity and use of social media platforms by local health departments is increasing. Health departments governed locally, and those serving larger populations tend to use social media to reach out to people in their communities. Out of the 167 LHDs indicating they used Facebook, 101 were identified with an active profile. The content analysis of the Facebook accounts showed that, , in terms of content-information, we found that tobacco usage and its effects were the most popular topic followed by inclement weather/emergency preparedness and maternal and child health issues. Surprisingly, Ebola was the least mentioned topic by LHDs on Facebook. Conclusion: This analysis reflected the current status of LHDs in using social media platforms in increasing awareness about many public health issues. Despite the extended reach of social media, LHDs are not completely utilizing this platform in health promotion. Moreover, LHDs can exploit social media to communicate with their communities regarding emergency planning, outbreaks, health education, and other issues of requiring urgent communications. Implications: Since online social media has a promising potential in disseminating important information for health promotion and announcements about important events, it is imperative to evaluate its current status. This research will help in creating strategies to utilize popular social media like Facebook for disseminating important health information to communities served by LHDs.
Brian Dixon, PhD, MPA, BA
Improving Population Health through Targeted Decision Support
Co-Investiagor(s): Zuoyi Zhang, PhD; P. Joe Gibson, PhD, MPH; Xiaochun Li, PhD; Patrick Lai, MPH; Uzay Kirbiyik, MD, MPH; Jennifer Williams, MPH, BS; Rebecca Hills, PhD; Debra Revere, MS; & Shaun Grannis, MD, MS
Background: Surveillance is the cornerstone of public health practice. Traditionally, health departments have relied on passive, manual reporting of communicable diseases by hospitals, laboratories and clinics. Yet passive approaches can be burdensome for reporters, producing incomplete, delayed reports which impede follow-up and delay recognition of community disease patterns and outbreaks. Research Objective: We seek to understand the various sources and methods by which hospitals, labs, and clinics report communicable disease information to public health authorities. Data Sets and Sources: The Indiana Health Information Exchange (IHIE) is a large, robust HIE network in which clinical messages (such as laboratory results) are electronically delivered to over 25,000 physicians. In addition, the HIE network reports positive laboratory results for communicable and infectious notifiable diseases to the Marion County Public Health Department (MCPHD), which is responsible for communicable disease surveillance for its jurisdiction. Study Design: We are evaluating an intervention designed to pre-populate the official communicable disease reporting form with patient demographics, lab results, and provider information available from the IHIE electronic health record system. The pre-populated form is delivered electronically to providers. Prior to deploying the intervention, we gathered baseline reporting information from fax, paper, and electronic reports that constitute a reported case and were submitted by both providers and labs to MCPHD. Analysis: Key data required to investigate and close cases were manually abstracted from each report. We measured the completeness of reporting data elements separately for paper, fax, and electronic reports, stratifying by report type. We also calculated reporting rates and examined the results stratified by clinical source, disease and report type. Principal Findings: We collected 11,997 reports submitted to public health for 8,754 unique cases across seven conditions (chlamydia, gonorrhea, syphilis, Hepatitis C, Acute Hepatitis B, Salmonella, and Histoplasmosis). Completeness of data elements varied by report type: lab report completeness averaged 73% with a range from 2.3% to 100% while provider report completeness averaged 64% with a range from 18.6% to 100%. Lab report completeness was higher than corresponding provider report fields for 12 of 15 critical fields. Lab reporting rates also matched or exceeded the rates for provider reports across all conditions. Conclusions: The rise of ELR capacity among health departments and the superior completeness of lab reports may improve disease reporting to public health agencies and decrease the amount of information collected from providers. Yet lab report completeness remains problematic in many cases. Health information exchanges may help support more complete capture and synthesis of multiple reports from labs and providers in support of surveillance practice. Implications for Public Health Practice and Policy PHSSR: Contributes to PH practice by exploring not only which interventions are effective but also why they are effective. Our intervention seeks to streamline clinical and public health workflow related to notifiable condition reporting. Moving forward, we will analyze the impact of pre-populated forms on report completeness, clinical staff burden, reporting rates, and timeliness to further understand how HIE networks can support notifiable disease reporting.
Justeen Hyde, PhD
Community Engagement Games: A Strategy for Expanding Local Stakeholders in Community Health Planning Processes
Co-Investigator(s): Ranjani Paradise, PhD; Reann Gibson, BA; Shirma Pierre; & Michelle Keenan
Background: This paper presents findings from an innovative strategy employed by Brigham and Women’s Hospital (BWH) in Boston, MA to engage community residents and other local stakeholders in a community health planning process. Using an existing game platform (Community Planit) created by Engagement Labs at Emerson College, the Institute for Community Health worked in collaboration with BWH to develop What Matters for Health, an online, multiplayer game (https://communityplanit.org/healthmatters). Research Objective: The purpose of the game was to gather input from local residents and stakeholders in five Boston neighborhoods regarding investments that they believe are important to improve individual and community health. Study Design: Over a three-week period, individuals were asked to play the game by completing a series of challenges that prompted players to answer open- and close-ended questions, contribute media, or solve problems based upon their personal values and experiences. Each week represented a different mission, focusing on individual, neighborhood, and city priorities. The game culminated in a final community forum where findings were presented and used as a springboard for additional discussion. Data Sets and Analysis: Player included a mix of qualitative and quantitative data. Data were exported into Excel. Quantitative data was analyzed in SAS, with responses examined by demographic characteristics. Qualitative data were imported into Dedoose and analyzed for primary and secondary themes. Principal Findings: Approximately 900 people registered to play What Matters for Health and 489 individuals played the game. Players were predominately female (74%), White (45%) and African American (24%), and between the ages of 25 and 54 (54%). More than half of participants had never participated in a community planning process. With respect to priorities for individual health improvements, players identified six areas that are important. In order of frequency, these include physical fitness, healthy eating, managing stress and mental health, sleep, financial stability, and managing health conditions. At the neighborhood level, participants identified seven areas in need of improvement: opportunities for physical activity, access to healthy food, changes in the built environment, activities that promote social connection and cohesion, improved safety, economic development, and equitable public transportation. Many of these same themes appeared again in questions focused on the city, with additional priorities including racial equity, quality affordable housing, safer communities, cleaner and safer streets, and improved public education. Conclusions: Use of an online game for community health planning processes was effective in engaging individuals who are often not reached through traditional approaches. There were a number of lessons learned with respect to game curation, literacy, and outreach. Although not an effective strategy for reaching every linguistic and age group in a diverse urban setting, those who participated provided positive feedback on the approach. Implications for Public Health Practice and Policy: Community health needs assessments and community health improvement planning processes are rapidly becoming common practices for many health and public health organizations in the United States. The use of online engagement games hold promise for helping these organizations include a broader range of local stakeholders in setting health priorities.