title: How U.S. children's hospitals use social media: A mixed methods study.
abstract: BACKGROUND
  Social media provide new channels for hospitals to engage with communities, a goal of increasing importance as non-profit hospitals face stricter definitions of community benefit under the Affordable Care Act. We describe the variability in social media presence among US children's hospitals and the distribution of their Facebook content curation.
  
  
  METHODS
  Social media data from freestanding children's hospitals were extracted from September-November 2013. Social media adoption was reviewed for each hospital-generated Facebook, Twitter, YouTube, Google+ and Pinterest platform. Facebook page (number of Likes) and Twitter account (number of followers) engagement were examined by hospital characteristics. Facebook posts from each hospital over a 6-week period were thematically characterized.
  
  
  RESULTS
  We reviewed 5 social media platforms attributed to 45 children's hospitals and 2004 associated Facebook posts. All hospitals maintained Facebook and Twitter accounts and most used YouTube (82%), Google+ (53%) and Pinterest (69%). Larger hospitals were more often high performers for Facebook (67% versus 10%, p<0.01) and Twitter (75% versus 17%, p<0.05) engagement than small hospitals. The most common Facebook post-themes were hospital promotion 35% (706), education and information 35% (694), community partnership or benefit 24% (474), fundraising 21% (426), and narratives 12% (241). Of health education posts, 73% (509) provided pediatric health supervision and anticipatory guidance.
  
  
  CONCLUSIONS
  Social media adoption by US children's hospitals was widespread.
  
  
  CONCLUSIONS
  Beyond its traditional marketing role, social media can serve as a conduit for health education, engagement with communities, including community benefit.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: charwong@upenn.edu.
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Wong
authors.affiliation: Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Ostapovich
authors.affiliation: Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Kramer-Golinkoff
authors.affiliation: Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Griffis
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA; Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Health Equity Research and Promotion, The Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Penn Medicine Social Media and Health Innovation Lab, Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA; Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Raina M
authors.initials: RM
authors.lastname: Merchant
mesh_terms: D002648:Child; D006293:Health Promotion; D006761:Hospitals; D006776:Hospitals, Pediatric; D006801:Humans; D020407:Internet; D040541:Marketing; D058991:Patient Protection and Affordable Care Act; D040241:Social Marketing; D061108:Social Media; D060756:Social Networking; D014481:United States