#RoyalBaby Offers Public Health A Unique Opportunity To Advocate For Maternal and Child Health

As Catherine, Duchess of Cambridge, went into labor early yesterday morning, public health organizations and advocates took advantage of the opportunity to talk about maternal and child health.  Since much of the world was following the #RoyalBaby story, it made sense to make the connection to public health work.

Here are some of my favorite tweets and topics:

VACCINATIONS

 

 NEWBORN SCREENING

BREASTFEEDING

Andy's tweet was in response to this image from Oreo:

PRENATAL SMOKING

SUPPORT FOR NEW PARENTS

As I've noted in related posts, I hope these organizations are evaluating their communication strategies!

• Have they seen an increase in traffic to their websites and resources?
• Have they engaged a new audience by aligning with the #RoyalBaby news?
• What organizational resources are needed to develop communication plans that coordinate with timely global and pop culture news?
• What lessons learned can be applied to future communication efforts? 

What do you think?

• Are these types of communication strategies effective in reaching a broader audience?
• Are there other relevant public health tweets that you felt were creative and engaging?  Please share!!

Pinning Public Health: A Spotlight on Hamilton County Public Health

On June 18, 2013 "How and Why Should We Pin Public Health?" became one of Pop Health's most popular blog posts.  So you can imagine my excitement to share a follow-up piece that spotlights the Pinterest work at the Hamilton County, Ohio Public Health Department! 

Today's post is written by Christy Cauley, M.Ed., an Electronic Communications Specialist, who is responsible for the department's social media strategy.  Hamilton County Public Health (HamCoHealth) was established in 1919 to serve more than 460,000 Hamilton County residents living outside the cities of Cincinnati, Norwood, Sharonville and Springdale. With a staff of more than 80, including sanitarians, plumbers, health educators, nurses and epidemiologists, Hamilton County Public Health strives to prevent disease and injury, promote wellness, and protect people from environmental hazards.  

I am very fortunate to work for a local public health department that understands the value of a strong social media presence. Hamilton County Public Health  has a strong presence on Facebook, Twitter and YouTube and now we’re expanding our presence on Google+ and Pinterest. The latter’s image-centered format poses many challenges to public health entities. After all, who wants to look at pictures of syphilis?

That simply means we have to get creative. Rather than pinning a picture of syphilis, I’ll pin a picture of a cute stuffed amoeba that represents syphilis. The photo still links to an article that lets everyone know there is a syphilis epidemic in Cincinnati and what they can do about it, but they are spared the sometimes graphic images that are associated with public health.

We also have to consider our audience. Our Pinterest audience is quite different from other social media outlets. For starters, there is a much stronger female presence on Pinterest. In fact, the vast majority of our followers are women. That affects our pins and our boards – we have a Women’s Health board for example. Our pins have much more to do with family health and safety than our other social media pages. We tend to focus on health, nutrition and fitness, things that matter more to women than men. We have many pins on Pinterest that do not make it to our Facebook or Google+ pages because the audience just isn’t right for it.

Growing our audience has been challenging on Pinterest. Few people outside the profession are really interested in public health until there is a reason to be interested – like an outbreak of West Nile Virus, for example. We take the usual steps – following others’ boards, liking, commenting and repinning when possible. But what we really want is interaction with our stakeholders on our own boards. We want to get our messages out and know that our audience is hearing them.

To help with that goal, we have “public” boards where we allow others to post to our boards (and we have been invited to do the same). This creates boards with people of similar interests who can share pins more easily. We are careful to include a disclaimer on these boards however, and we do monitor outside pins. Our public health and safety boards can only be pinned on by us, but our recipe and fitness boards are open for our followers to share their favorite pins and they do. We pin to a public board called Health Communication & Social Media from Raed Mansour, where social media and communications professionals can share their ideas. Before, our only interaction with these professionals was on Twitter.

Interestingly enough, the place where we receive the most interaction on Pinterest is one of the public boards we were invited to pin to – Cat World, a board by Joyce Egoodman. Yep, you read that right, Cat World. What does that have to do with public health, you ask? Not a lot, although we can connect pets to our emergency preparedness and heat safety topics quite easily. But, people who love cats are our stakeholders. Public health affects everyone, even our pets. And who doesn’t like cute cat pictures?

How it works is we will find the cutest cat picture on our following boards in the morning and repin it to Cat World with a message about public health or safety. That pin then gets repinned by anyone who likes the picture – not necessarily the message. In turn, our message gets disseminated all over Pinterest and it only took a few seconds of our time. Our Cat World pins get commented on, liked and repinned much more often than our other pins because that board has a wider audience (for now).

One of the Social Media for Public Health (#SM4PH) Twitter chat participants (@AmandaMPH) mentioned that there is a LOT of unhealthy dieting information on Pinterest and we have also found that to be the case. That’s one of the reasons it’s so important for health departments to have a presence on Pinterest, so we can put out accurate information that people can trust.

We’ve found that the image is as important as the message. As a result, we keep our messages short and sweet and we keep our pictures creative. For example, did you know Ryan Gosling is the poster boy for public health? There are hundreds, maybe even thousands of Ryan Gosling memes and many of them are public health centered. We try to utilize them on “Fun Friday” as much as possible.

Another small thing we do is change our board covers often. When new stakeholders visit our page, we want them to see a captivating image that makes them want to view the board, but we also want to make sure that the pin in question is toward the top of the board. I can’t tell you how many pages I’ve visited where I wanted to repin the board cover image, but once I clicked the board, it went on forever and the cover photo was nowhere to be found. We want our stakeholders to find things easily. It’s a small thing, but don’t underestimate its importance to the aesthetics of your page. And don’t neglect the description and category areas either.

We have also taken advantage of @PinGraphy, which allows us to schedule pins for certain times and days. When interaction matters so much and we do not have someone on social media on the weekends, this tool is invaluable. (We use HootSuite for scheduling our other social media sites.)

Getting our feet wet in Pinterest has been challenging. We have made a lot of changes to our boards since we started in response to feedback from users. We’re still learning, but we hope that Pinterest will be a valuable tool in spreading our messages about public health and safety issues in Hamilton County, Ohio and throughout the world.

Instagram It! Using Instagram for Public Health

This week's guest post for Pop Health was written by Alyssa Anderson.  She is a Community Health Education graduate student focusing on health promotion and work site wellness. Originally, she thought employee wellness was her niche but soon discovered that social media took 1st place in her heart. Finding ways to weave health promotion, marketing, and communication with social media is her main focus these days. She currently lives on Pensacola Beach, FL, enjoying her slice of paradise on the Gulf Coast. 

Follow Alyssa on Twitter, Instagram, and pin with her here!

There is certainly a wide range of social media channels discussed on Pop Health. However, as I was browsing and chatting with Leah about this guest post, we discovered that Instagram had not yet been covered. I jumped at the opportunity to highlight some public health organizations using this channel. And with the revealing of Instagram Video, the timing just seemed perfect.

A quick search of Instagram revealed that a number of public health organizations are actively using this photo-sharing application.

• Chicago Department of Public Health (By the way, congratulations to the Blackhawks!)
• American Public Health Association
• Austin, TX Department of Health and Human Services (what they did is really great, more to come!)
• The Red Pump Project (Hey, National HIV Testing Day is June 27!)
• American Cancer Society
• The list continues…

While there are quite a few public health organizations on Instagram, their usage differs. For example, Chicago Department of Public Health is sharing mostly promotional messages, such as

It may seem simple and a no-brainer, but these posts have received little engagement. A "like" here, a comment there, but no real involvement from other followers.  In fact, Chicago Department of Public Health only has 195 followers. In a city of 2.7 million, their Instagram is having very little reach.

On the other hand, the Red Pump Project has 905 followers. They promote awareness and education for women and girls about HIV/AIDS using the red shoe as their symbol. Users can tag their pictures with #RockTheRedPump to show their support. Typical posts are from events, putting faces to their movement, and event promotion. Here are a few snapshots:

The images are more colorful and vibrant than those posted by the Chicago Department of Public Health. And some image descriptions have a call to action…asking followers to like and share, comment below, etc. The second picture has 47 likes and most have over 20 likes with comments.

On social media, using calls to action or cues inspires people to do just that. Regardless of the message or reason for using social media, engaging with your target audience is key and helps to expand your reach.

Now, the city of Austin tried something this past April during National Public Health Week. They tasked their audience, the citizens in the city to help them answer a question: What is public health? Instagram users were to snap a picture of what public health means to them in Austin with the unique tag #austinpublichealth.

Such a great idea! Think about it, a photo journey from your target audience about what public health means to them. You could almost use these as unfocused focus groups and see what your audience does with the resources you have provided.

Unfortunately, only 17 pictures were tagged with #austinpublichealth. Bummer.
Here’s what I think could have gone better:

• Promote, promote, promote! If these pictures were to be part of a larger campaign, creative marketing strategies to get the word out could have been used.
• Incentives. As much as we want to believe everyone cares about public health, you sometimes have to lead people with a carrot. There could possibly be red tape with giving away prizes to the best picture, but perhaps an award or certificate could have been used.
• Engage. No other users engaged with the 17 pictures, no one championed the program from the department.

So we’ve seen the good (The Red Pump Project), the bad (Stanley Cup winning Chicago…I’ve got to throw my hometown a bone!), and the different (#austinPublicHealth). The biggest take-away from this would be inviting engagement.

• Tell people what you want them to do, kindly. Share this post! Double-tap if you think #vaccines rock! 
• Take interesting pictures. We see your event posters all over town and we’re just as blind to them online as we are in real life. Snap a shot of a child wearing a bike helmet and elbow pads instead of a flyer with Bike Safety Tips listed. 
• Be a real person. People want to engage with other people, not ambiguous brands or images.
• Test NEW things. Don’t be afraid to try things out and don’t feel bad if they fall flat! 

And since we are discussing trying new things, have you tried Instagram Video? How do you like it compared to Vine? I think the length is going to be great for public health professionals, much better than a 6 second loop. What sorts of videos would you like to see for #publichealth?

(P.S. Comment below and share this with your friends!)

How and Why Should We "Pin" Public Health?

I regularly participate in the social media for public health (#sm4ph) twitterchat.  The chat (sponsored by the Public Health Management Corporation and hosted by Jim Garrow) explores various forms of social media use and how they impact (or could impact!) public health.  Back in March, the following question was posed to twitterchat participants:

At the time, I took note that several participants (including me) thought that Pinterest could be "the next big thing" (FYI: Pinterest is an online pinboard that allows users to create and share image collections):

Then this week, Nicole Ghanie-Opondo posed an important question to the field:  "Is Public Health Pinnable?"  She does a great job of breaking down all the "stuff" public health people want to pin (i.e., campaign posters, event information, staff photos) and analyzing why or why not it is a good fit for this particular communication channel.  She also emphasizes the key principle we need to remember and revisit in health communication:  

Think About Your Audience!  

When exploring any new communication channel, we need to review available data regarding the demographics and online behaviors of those users (whether it be Pinterest or Facebook or Twitter) and then tailor our content/strategies to those users.  The Pew Research Center's Internet & American Life Project is a great resource for social media user data.

In preparation for this post, I followed up with Nicole to see if she had received any feedback from public health colleagues on her post.  She shared the major theme from her (informal) feedback so far:  

Public health is not creating content to optimize pins.

I thought that was really interesting and it changes the conversation for me.  The question is not: "Should we use Pinterest- yes or no?"  There seems to be enough evidence that Pinterest is a promising communication strategy.  For instance we have: (1) strong interest in Pinterest from the field (as seen above), (2) available data on its users, (3) key audiences represented among users (e.g., women), and (4) colleagues that are successfully integrating this channel into their social media plans (e.g., CDC and Hamilton County Public Health).

Therefore, the question should become:  "How can we use Pinterest strategically in public health?"  This approach would require a discussion of the following questions:

• What audience/s should we be engaging on Pinterest?
• What kinds of content/images are most likely to be re-pinned or shared?
• How can we optimize our content for pinning?
• How are we evaluating our Pinterest efforts? (*Note that CDC's National Prevention Information Network (NPIN) recently had a wonderful webcast on social media evaluation. While Pinterest was not one of the featured channels, many of the concepts and resources would still be applicable.  The slides are available here).

Tell Me What You Think:

• Why (or why not) should we "pin" public health?
• How should we "pin" public health?
• What other planning questions should be considered?
• Please share examples of Pinterest being used successfully (or unsuccessfully) in public health!

Emergency Response to the Boston Marathon Bombings: Looking to Social Media for Information, Resources, and Connections

Boston is my second home.  I lived there for 6 years.  I went to school there.  I made some of the best friends of my life there.  I got married there.  I spent many Marathon Mondays along the race route cheering for friends, colleagues, and absolute strangers.  As many have reported on the news, Marathon Monday is the best day of the year in Boston and you have to experience it to truly understand its excitement and feeling of community.

I am absolutely heartbroken about yesterday's bombing at the Marathon.  In tears, I sat and watched the news alone in my home.  However, I did not feel alone.  As news broke, I quickly connected with Boston friends via text and social media to make sure they were okay.  Many had been watching at various points along the route.  I also connected with public health colleagues to follow the news and to catalog resources and information being deployed to my friends in Boston and also to those of us watching from home.

As with Hurricane Sandy last November, I think it is important to document all the ways that social media is being used to disseminate information and support public health and emergency management.  Here are the key themes that I saw:

Immediate Public Safety Concerns and Instructions

With the #tweetfromthebeat hashtag, Boston Police communicated regularly with twitter followers, instructing marathon spectators to clear the area around the finish line and refrain from congregating in large crowds.

Investigation

To assist with the investigation, Boston Police and FBI are asking all spectators and eyewitnesses to submit video and photos taken at the finish line.  This message has been widely disseminated via social media.

Reconnecting Runners, Spectators, and Resources

As we have seen with emergency management of natural disasters, social media and technology play a critical role in reconnecting victims with their families and friends.  For example, the following resources were quickly deployed on social media:

• American Red Cross: Safe and Well
• Google: Person Finder
• Google document: Local Boston residents offering shelter to displaced runners/friends/families

Resources for Journalists

Along with tweets from respected news organizations and reporters reminding each other not to speculate early on in the investigation, there were also formal resources circulated regarding how to effectively cover such a story.  For example, the Dart Center for Journalism & Trauma offers comprehensive resources on the reporting of disasters and terrorist attacks.  A resource focusing specifically on the Boston Marathon bombings was tweeted out:

Mental Health & Support Resources

Many public health professionals linked to resources to support those in distress following the bombings and/or those who needed help communicating about the events (e.g., discussing it with children).

HHS Secretary Sebelius tweeted about federal disaster resources:

Philadelphia (like many other cities) tweeted about local disaster resources:

Massachusetts General Hospital and other organizations tweeted out tips for discussing the Boston Marathon bombings with children:

As I discussed in my coverage of Sandy, the power of social media also brings challenges to public health and emergency management.  We have seen some early postings about the lessons learned from this event- which does include a discussion of concerns such as rumors spreading rapidly on social media.  For example, it was first reported that cell coverage in Boston was being turned off so that additional bombs could not be detonated remotely.  We later learned that information was not true.  The cell service was slow or not operational due to the extreme overload of users trying to communicate simultaneously.  There was also a lot of concern about very disturbing images of the crime scene and victims being shared on social media.

So there is much to learn about the use of social media for public health and emergency management through close examination of this event and others.  In any case, it is very clear that social media needs to be a part of every organization's disaster and response plan. 

Tell me what you think:

• What was your impression of the use of social media by federal/state/local organizations yesterday after the Boston Marathon bombings?  
• Can you share additional examples of how it was used effectively?  
• What did you see that concerned you?

Social Media: Providing Connections, Voices, Adventures to Many with Chronic Illness

I am in awe of social media.  

I am in awe of it in my professional life.  I have connected with colleagues all over the world who share my passion for public health, health communication, blogging, pop culture- you name it.

I am also in awe of it in my personal life.  As someone who lives with a chronic illness, I have connected with others who suffer from similar symptoms, offer support, advocate for patient rights, and recommend creative solutions to balancing work and life.

In the past month, I have been struck by several examples of how social media is transforming the lives of people with chronic illness.  Without the networks available within social media, many of these people may have been very isolated due to their conditions.

On March 11, 2013 NBC Nightly News with Brian Williams ran a story about Virtual Photo Walks.  The project's tagline is "Walk the walk for those who can't".  Using the social media platform Google+, Virtual Photo Walks enables people to become "interactive citizens" again.  They connect with smart phone enabled photographers to "travel" and see places and people that they used to see...or always wished that they could.  The news story profiled a woman with Lupus who could not travel due to her serious health condition.  She always wanted to go to Italy and with Google+ she did.  We watched World War II veterans no longer able to travel, "visit" the USS Arizona Memorial through the collaboration of photographers and Google +.  It was incredible to watch.    

On April 5, 2013 CNN Tech ran a story called "On Twitter, Roger Ebert Found a New Voice".  The story describes how Roger became an avid twitter user in 2010, years after cancer had silenced his voice.  He wrote, 

"Twitter for me performs the function of a running conversation. For someone who cannot speak, it allows a way to unload my zingers and one-liners".

As someone growing up in the 80's, I regularly watched "Siskel and Ebert and the Movies".  Keeping up with Roger through twitter and his blog "Roger Ebert's Journal" in recent years has been a seamless transition.  I felt like the show never ended.  I kept up with his running commentary and of course- his movie reviews.

Sustaining your presence in the world is important with a chronic illness.  I felt that point strongly when reading his final blog post, "A Leave of Presence".  

"What in the world is a leave of presence?  It means I am not going away".  

Please Share:

• What creative ways do you see social media being used to support those with chronic (or acute) illnesses?
• Why do you think these communication channels are so effective in "sustaining your presence"?

Using Twitter to Track Disease: Weighing the Advantages and Challenges

A few weeks ago I participated in a fantastic twitter chat on the use of social media for public health.  During the event, our moderators posed the following question: "Are there any other diseases (besides the flu) that we could track on social media?"

The question generated a very lively discussion that I was inspired to revisit on Storify this morning after reading the Washington Post's article, "Twitter becomes a tool for tracking flu epidemics and other public health issues." 

The WP article highlights several advantages and challenges of monitoring public health diseases and/or conditions on twitter.  My twitter chat colleagues brought up many other important issues for us to consider, so I'm including these expanded lists:

Advantages:

• Offers real time data on health or behavior (Government data can often take weeks or months to be released)
• There is so much available data! 
• It could capture cases that would not otherwise be formally documented at a physician's office or hospital.
• It has proved helpful in tracking time sensitive disease outbreaks (e.g., Novovirus).  *Check out this article about how twitter was used to track Norovirus activity during a journalism conference.

Challenges:

• Accuracy and case definition (i.e., does a twitter user really have the flu or just a bad cold?)
• Tracking specific words like "sick" or "flu" can bring up a lot of content that is unrelated to the twitter user being ill themselves (e.g., "I'm so sick of this terrible weather").  *Check out how Johns Hopkins researchers are working to address this problem by better screening tweets.
• We must differentiate between tracking symptoms vs. tracking cases- they are not the same.
• Our search strategies should include various terms or slang that are used to describe the disease or behavior of interest.
• Caution: media coverage of certain illnesses can cause a spike in key words on twitter without a rise in actual cases.
• What are the privacy concerns?
• Twitter might not thoroughly capture diseases or conditions that carry stigma (e.g., mental illness) because users may be hesitant to discuss them in a public forum.
• Results could be skewed by populations who are over or under represented on twitter.
• Do we need to train "trackers" to intervene? E.g., what if they are monitoring dangerous tweets/behaviors like suicidal ideation and attempts?

While the challenges list is quite long, I hope we are not discouraged!  I think twitter is an enormous resource for public health professionals.  We just need to be thoughtful and thorough regarding how to use twitter effectively.

More Resources:

The Washington Post article and related stories shared great links to more information about research in this area:

• YouTube video on University of Rochester efforts to track influenza on twitter.  It also describes their related app: Germ Tracker (warning: it may have you hopping off your regular morning bus). 
• Johns Hopkins University article: "You Are What You Tweet: Analyzing Twitter for Public Health".
• Brigham Young University article: "'Right Time, Right Place' Health Communication on Twitter: Value and Accuracy of Location Information".
• A great article that highlights what we can learn from Google Flu (since their predictions were off this year)- emphasizes the importance of "re-calibrating" your models or algorithms each year.

What Do You Think?

• What other advantages and/or challenges should we add to the list?
• What other resources can you share?

  

Downton Abbey: A Mountain of Viewer Tears Leads to an Incredible Online Discussion about Maternal Health

Warning: if the January 27, 2013 episode of Downton is still on your DVR- this post contains spoilers!

From the looks of twitter this week, I am not the only person who was devastated by the loss of Lady Sybil on Downton Abbey.  She died of Eclampsia shortly after giving birth to her daughter.  In my house, there was complete silence while we watched Sybil convulsing and struggling to breathe.  After she died, our horror and sadness quickly turned to anger.  There were two doctors in the room (one of whom made the correct diagnosis)- how could this happen?

As I contemplated this question, I was fascinated to see how this story line impacted the public health messaging that started appearing on twitter.  I recognized a few trends:

Making the connection to current women's health issues and debates

There has been much concern about men making decisions about women's healthcare- for example, the comments in 2012 about the definition of rape and the ongoing abortion debate.  Since Sybil's death was largely the result of poor decisions about her health (made by her father and the fancy male doctor consulting on her case), I saw the following post on this topic over and over again:

 

Identifying a Teachable Moment:  Preeclampsia and Eclampsia Specifically

Like many organizations, the American Public Health Association (APHA) followed up on Monday with this message:

Identifying a Teachable Moment:  Maternal Mortality and Maternal Health Broadly  

I saw many links to organizations such as Every Mother Counts, which focuses on global maternal health advocacy:

In addition to the discussion on social media, many news outlets and foundations also took the opportunity to post information on their websites about the condition that killed Sybil.  For example, ABCNews wrote, "Eclampsia Death in 'Downton Abbey' Highlights Pregnancy's No. 1 Killer".

I would love to see some evaluation data to follow this teachable moment.  Some questions that I have:

• How many people searched for Preeclampsia and Eclampsia following the episode?  (As a side note, this episode aired months ago in the UK- was there a similar searching pattern?)
• How many physicians/midwives/clinicians received inquiries from patients following the episode?
• Beyond knowledge- did this episode change any clinician behaviors?  Did they go back and review a suspicious case after seeing a reminder of the severity of this condition?  Did they perform a more comprehensive screening?

What do you think?

What other evaluation questions should we be asking?

What other trends did you see in the discussion on social media (or in person) following this episode?