title: Should health organizations use web 2.0 media in times of an infectious disease crisis? An in-depth qualitative study of citizens' information behavior during an EHEC outbreak.
abstract: BACKGROUND
  Web 2.0 media (eg, Facebook, Wikipedia) are considered very valuable for communicating with citizens in times of crisis. However, in the case of infectious disease outbreaks, their value has not been determined empirically. In order to be able to take full advantage of Web 2.0 media in such a situation, the link between these media, citizens' information behavior, and citizens' information needs has to be investigated.
  
  
  OBJECTIVE
  The goal of our study was to assess citizens' Web 2.0 media use during an infectious disease outbreak and to determine which Web 2.0 medium is used for which goal. With this information, we wanted to formulate recommendations for health organizations that consider using Web 2.0 media as part of their communication strategy during an infectious disease outbreak.
  
  
  METHODS
  A total of 18 student participants kept an information diary for 4 weeks during the 2011 enterohemorrhagic E. coli (EHEC) outbreak in Germany. Of them, 9 lived at the epicenter of the outbreak and 9 of them at some distance. The diaries were supplemented by a qualitative pre-survey (demographics) and postsurvey (questioning their satisfaction with information provision during the outbreak).
  
  
  RESULTS
  The Internet appeared to be the most popular medium for passively receiving EHEC-related information, with news websites and websites of newspapers as the most consulted sources. Twitter was used for receiving information to a small degree, while Facebook played virtually no role. Participants indicated that they thought information posted on Twitter or Facebook was not reliable or was out of place. When actively seeking information, online newspapers and wikis were important sources. Several causes for (dis)satisfaction with information provision were uncovered: source credibility, contradicting messages, and a need for closure.
  
  
  CONCLUSIONS
  During an infectious disease outbreak, our small sample of students did not see social media (like Facebook and Twitter) as suitable or reliable sources for communicating information, but primarily viewed them as a tool for communicating with friends. Wikis, however, did fill several information needs, especially when citizens are actively searching for information. For many, source credibility is an important asset of information usefulness. Finally, we provide several general recommendations for communicating with citizens during an infectious disease outbreak.
authors.affiliation: National Coordination Centre for Outbreak Management, National Institute for Public Health and the Environment, Bilthoven, Netherlands. l.s.vanvelsen@utwente.nl
authors.forename: Lex
authors.initials: L
authors.lastname: van Velsen
authors.forename: Julia E W C
authors.initials: JE
authors.lastname: van Gemert-Pijnen
authors.forename: Desirée J M A
authors.initials: DJ
authors.lastname: Beaujean
authors.forename: Jobke
authors.initials: J
authors.lastname: Wentzel
authors.forename: Jim E
authors.initials: JE
authors.lastname: van Steenbergen
mesh_terms: D004196:Disease Outbreaks; D006801:Humans; D020407:Internet; D036301:Qualitative Research