Analysis of the purpose of state health departments' tweets: information sharing, engagement, and action.
BACKGROUND
Public health agencies are actively using social media, including Twitter. In the public health and nonprofit sectors, Twitter has been limited to one-way communication. Two-way, interactive communication on Twitter has the potential to enhance organizational relationships with followers and help organizations achieve their goals by increasing communication and dialog between the organization and its followers. Research shows that nonprofit organizations use Twitter for three main functions: information sharing, community building, and action.


OBJECTIVE
It is not known whether state health departments are using Twitter primarily for one-way information sharing or if they are trying to engage followers to build relationships and promote action. The purpose of this research was to discover what the primary function of Twitter use is among state health departments in the United States and whether this is similar to or different from nonprofit organizations.


METHODS
A complete list of "tweets" made by each state health department account was obtained using the Twitter application programming interface. We randomly sampled 10% of each state health department's tweets. Four research assistants hand-coded the tweets' primary focus (organization centric or personal health information centric) and then the subcategories of information dissemination, engagement, or action. Research assistants coded each tweet for interactivity, sophistication, and redirects to another website. Data were analyzed using SPSS version 20.


RESULTS
There were 4221 tweets from 39 state health departments. There was no statistically significant difference in the number of tweets made by a state health department and the state population density (P=.25). The majority of tweets focused on personal health topics (69.37%, 2928/4221) while one-third were tweets about the organization (29.14% , 1230/4221). The main function of organization-based tweets was engagement through conversations to build community (65.77%, 809/1236). These engagement-related tweets were primarily recognition of other organizations' events (43.6%, 353/809) and giving thanks and recognition (21.4%, 173/809). Nearly all of the personal health information-centric tweets involved general public health information (92.10%, 1399/1519) and 79.03% (3336/4221) of tweets directed followers to another link for more information.


CONCLUSIONS
This is the first study to assess the purpose of public health tweets among state health departments. State health departments are using Twitter as a one-way communication tool, with tweets focused primarily on personal health. A state health department Twitter account may not be the primary health information source for individuals. Therefore, state health departments should reconsider their focus on personal health tweets and envision how they can use Twitter to develop relationships with community agencies and partners. In order to realize the potential of Twitter to establish relationships and develop connections, more two-way communication and interaction are essential.
Brigham Young University, Department of Health Science, Provo, UT, United States. rosemary_thackeray@byu.edu.
Rosemary
R
Thackeray
Brad L
BL
Neiger
Scott H
SH
Burton
Callie R
CR
Thackeray
D033181:Information Dissemination; D020407:Internet; D011635:Public Health Administration; D013219:State Government; D014481:United States
engagement; public health; social media