The Choir in the Echo Chamber: Social Media’s Narrow Vision

JMIR just published a paper “Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership” by Harris, Choucair, Maier, et. al. The authors note that only 61% of local health departments meet standards for information and educating constituents. There is a gap in current and best practices. The objective of this study was to examine local health departments Twitter followers and their relationship with local health departments and their followers characteristics. The sample size was 4,779 Twitter followers from 59 random health departments. 

Results, local health department Twitter accounts were followed by organizations in greater numbers and were health focused located out of state. They most comprised education, government, and non-profits. Surprising was the finding that individuals were more likely to be local and not health focused. And when the health department has a public information officer on staff and tweeting they were likely to have higher percentage of local followers. 

The gross anatomy of this study is that we tend to talk to ourselves. This can be seen in Twitter chats such as #hcsm #dwdchat. Generally participation are made up of the same faces. Though the discussions provide great new information it remains in the echo chamber and is not driving greater participation or broad based learning though I will say the outside chats posts using the # are many times retwitted and reach a wider audience but still limited to those who share similar characteristics. 

I have long said we need to understand who we are speaking with and what are their characteristics to better target them. The authors note 

…we identified the characteristics (eg, jurisdiction population size, employing a public information officer) and practices (eg, tweet frequency) associated with local health department Twitter follower characteristics. This information could inform strategic planning for local health departments using or considering using Twitter. For example, if a goal of a local health department is to reach greater numbers of individuals rather than organizations, their Twitter strategy could include a regular daily or weekly tweeting schedule.

Second, understanding who the Twitter followers are could help local health departments better target tweets to diverse audiences. For example, local media and policymakers may be important followers for a local health department. Standard strategies (eg, tweeting more, developing an easy-to-find user profile ) for increasing the number of followers may bring in more media and policymakers. However, additional research into how media and policymakers on Twitter select specific information sources may help to identify strategies for local health departments in increasing the presence of these followers. As another example, out-of-state organizations are less likely to be interested in tweets focused at the individual, as well as locally focused or locally relevant tweets about health and health-related events. However, these followers may be interested in learning about innovative or successful local health department programs and best practices. Local health departments wishing to connect and engage more with this existing audience might program their Twitter accounts as dissemination platforms to reach these organizations with relevant information about successful strategies and programs.

Bottom line, we need to use social media the way we’ve always approached communications, advertising, marketing, and sales. Know our audience, know where they are, know what they want to learn, and speak to them frequently. They want to solve their healthcare problems. Know what those problems are specific to their learning needs. 

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