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ISDS 2012 Conference Abstracts

Framing the Use of Social Media Tools in Public Health
Jennifer Stoll*, Richard Quartarone and Miguel Torres-Urquidy

Centers for Disease Control and Prevention, Atlanta, GA, USA

Objective
Recent scholarship has focused on using social media (e.g., Twit-

ter, Facebook) as a secondary data stream for disease event detection.
However, reported implementations such as (4) underscore where the
real value may lie in using social media for surveillance. We provide
a framework to illuminate uses of social media beyond passive ob-
servation, and towards improving active responses to public health
threats.

Introduction
User-generated content enabled by social media tools provide a

stream of data that augment surveillance data. Current use of social
media data focuses on identification of disease events. However, once
identification occurs, the leveraging of social media in monitoring
disease events remains unclear (2, 3). To clarify this, we constructed
a framework mapped to the surveillance cycle, to understand how so-
cial media can improve public health actions.

Methods
This framework builds on extant literature on surveillance and so-

cial media found in PubMed, Science Direct, and Web of Science,
using keywords: “public health”, “surveillance”, “outbreak”, and “so-
cial media”. We excluded articles on online tools that were not inter-
active e.g., aggregated web-search results. Of 2,064 articles, 23
articles were specifically on the use of social media in surveillance
work. Our review yielded five categories of social media use within
the surveillance cycle (Table 1). This framing within surveillance il-
luminates a range of roles for social media tools beyond disease event
detection. [Insert Image #1 here]

Finally, we used the 1918 Influenza Pandemic to illustrate an ap-
plication of this framework (Fig 1), if it were part of the public health
toolkit. In 1918, America was already becoming a “mass media” so-
ciety. Yet a key difference in mass communications today is the en-
abling of public health to be more adaptive through the interactivity
of social media.

Results
We used this “pre-social media” disease event to underscore where

the real value of social media may lie in the surveillance cycle. Thus
for 1918, early detection of disease could have occurred with many,
e.g., sailors aboard ships in New York City’s port sharing their “sta-
tus updates” with the world. [Insert Image #2 here]

After detection, social media use could have shifted to help con-
nect and inform. In 1918, this could include identifying and advising
the infected on current hygiene practices and how to protect them-
selves. Social media would have enabled the rapid sharing of this in-
formation to friends and family, allowing public health officials to
monitor the response. Then, to support multiple intervention efforts,
public health officials could have rapidly messaged on local school
closures; they could also have encouraged peer behavior by posting
via Twitter or by “Pinning” handkerchiefs on Pinterest to encourage
respiratory etiquette, and then monitored responses to these inter-
ventions, adjusting messaging accordingly.

Conclusions
The interactivity of social media moves us beyond using these tools

solely as uni-directional, mass-broadcast channels. Beyond messaging
about disease events, these tools can simultaneously help inform, con-
nect, and intervene because of the user-generated feedback. These
tools enable richer use beyond a noisy data stream for detection.

Table 1. Social media use in supporting information for action

Fig. 1. Social media mapping to 1918 epi curves for NY State (1).

Keywords
Surveillance; Public Health; Social Media

References

1. Goldstein E. et al. Reconstructing influenza incidence by deconvolu-
tion of daily mortality time series. Natl Acad Sci U S A. 2009 Dec
22;106(51):21825-9

2. Heaivilin N. et al. Public health surveillance of dental pain via Twit-
ter. J Dent Res. 2011 Sep;90(9):1047-51

3. Luck, J. et al. Using Local Health Information to Promote Public
Health. Health Affairs 2006;25(4): 979-991

4. Napolitano MA. et al. Using Facebook and Text Messaging to De-
liver a Weight Loss Program to College Students. Obesity 2012

*Jennifer Stoll
E-mail: jstoll@cdc.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e67, 2013