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Digital Strategies for Health Communication

Social MediaLisa Gualtieri, PhD, ScM, Course Director

Tufts University School of MedicineJuly 24, 2014

Quiz 1

• What is the most important change in recent years?

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Demographics• Non-whites: Among those who use their phone to go online,

6 in 10 Hispanics and 43% of African-Americans are cell-mostly internet users, compared with 27% of whites. 

• Young adults: 1/2 of cell internet users ages 18-29 mostly use their cell phone to go online. 

• The less-educated: Some 45% of cell internet users with a high school diploma or less mostly use their phone to go online, compared with 21% of those with a college degree.

• The less-affluent: Similarly, 45% of cell internet users living in households with an annual income of less than $30,000 mostly use their phone to go online, compared with 27% of those living in households with an annual income of $75,000 or more.

Quiz 2

• What are the 10 most popular types of social media in the US?

http://www.experian.com/marketing-services/online-trends-social-media.html

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Formerly #10, Reddit was replaced by IMVU

People are using social media a lot!

• 95% of Facebook users log in daily• 73% access Facebook through mobile

device• Some organizations use Facebook instead

of a website• And people are using multiple devices and

multiple types of social media…• Don’t repeat the same messages exactly

Quiz 3

• Who uses social media here – Personally– Professionally

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• Why is it important to know the popularity of social media?

• What else might you want to know?

Quiz 4

• Together, black, Hispanic and Asian-American users account for 41% of Twitter's 54 million U.S. users, compared with 34% of the users of rival

• http://online.wsj.com/news/articles/SB10001424052702304419104579323442346646168?mod=e2tw

Demographics of social media

Is social media the best way to reach people?

• Don’t toss the traditional approaches but understand how social media enables inbound marketing

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How to think about social media

• Each type of social media is unique• Nothing is static

– More work?– More fun?

• Much more than marketing: learning about employers, connecting with colleagues, getting answers to research questions, and more

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How Social Media Can Be Used

1. Listen and learn – find out what people are saying about you or a topic of interest and find out what your “competitors” are doing for what NOT to do as well as what to emulate

2. Speak – connect with people in new ways and reach new people but don’t push information

3. Energize – get people to evangelize and promote for you4. Support – solve problems and help people solve their

own and each other’s problems5. Embrace – work with your online community to

improve your products and “marketing” of product

Humor andspontaneity

• When the power went out during the 2013 Super Bowl

• Oreo's message, which was retweeted 10,000 times in 1 hour

Quiz 5

• What was one of the most heavily tweeted non-sports events ever?

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Pope-related social media• Cute animals

– Early Wednesday, @SistineSeagull captured the spotlight by landing on the Sistine Chapel smokestack where cameras were trained in anticipation of the afternoon vote.

– The creation of an account for any animal that ends up in the spotlight has become a Twitter staple.

• Names– In the crowd several held a banner that read "We'll follow you @pontifex."

The @pontifex account had been used by Pope Benedict XVI but was wiped clean when he retired at the end of February.

– The account @JMBergoglio, believed to be previous tweets from the new pontiff, was fake.

• Popular tweets– "HABEMUS PAPAM FRANCISCUM" was the first tweet under Pope Francis.

Habemus Papam translates to "We have a pope”, with 54,000 retweets, 10% of the all-time record of 500,000 for @BarackObama's re-election photo.

– About 130,000 tweets per minute were posted about the new pope. By early Wednesday afternoon, about 2 million tweets had been sent.

• Hashtags– #habemuspapam (Latin: we have a pope)– #Bergoglio (name)– #LosArgentinosDominamosElMundo (Spanish: Argentines rule the world)

The latest from Pope Francis

• Pope Francis declared the Internet was a "gift from God" that can break barriers between different groups of people by giving them a platform to discuss their differences– http://mashable.com/2014/01/23/pope-internet-gift-

god/

• Lots of guides, but my advice is…• Learn from successes

– Popular non-health – Isaiah Mustafa– The Pope!

• Learn from failures– Domino’s

The most popular uses of social media are generally politics, sports, entertainment

High touch

• Lots of anger about cold, late pizzas… but

• Response to– “Best Pizza Ever!”… “Keep up

the good work guys!” with a smiley face emoticon

• Domino’s bot– “So sorry about that! Please

share some additional information with us at bit.ly/dpz_care and please mention reference# 1409193 so we can have this addressed.”

Select goals•Patient education•Crisis communication•Community outreach•Customer service•Public relations

Decide which social media technologies to use•Who are you trying to reach?•What do they use?•What do your competitors use?

Use social media•How to use appropriately?•How to integrate?•What content?•Who manages/participates?•How much time?

Evaluate social media effectiveness•What are meaningful metrics?•How can they be measured?

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How to engage patients

with social media

How to engage patients with social media

• Select goals– In support of organization’s mission

• Decide which social media technologies to use– Who are you trying to reach? What do they use?– What do your competitors use? What do they do well? What do they do poorly or not do?

• Select and use social media– How to use appropriately? – How to develop messages and content?– How to integrate different social media technologies and a website?– Who manages/participates? How much time? How resource-intensive?

• Evaluate social media effectiveness– How can engagement be measured? – What are meaningful metrics? Example…

• Iterate– There are always upgrades, evolving risks, changing popularity and use

Why Iterate?

• Internal– Your needs and expertise change

• External– Social media technologies change

• Facebook profiles and privacy

– How people use social media changes– Which are popular and demographics of use change

• Second Life and MySpace

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Social Media Technologies May Be Free But…

• You need to learn– How to use them– When to use them– How to measure their effectiveness

• You need to keep up with the changes• You need to be conversant with their language• You need to mitigate risks without diluting the

entire purpose

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CDC Social Media Toolkit

• Provides guidelines

• Limitations: selection, integration

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http://knowem.com

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Meaningful metric!

• Others are followers, RTs, fans, likes, views, etc.• Only meaningful (like above) if goal achieved• Can take time especially with SEO 33

Social media policies• 12 words from Mayo Clinic

– Don’t Lie, Don’t Pry– Don’t Cheat, Can’t Delete– Don’t Steal, Don’t Reveal– http://socialmedia.mayoclinic.org/2012/04/05/a-twelve-word-social-media-policy/

• Ed Bennett’s list: http://ebennett.org/hsnl/hsmp/• Cleveland Clinic’s policy (some legalese, but concise)

– http://my.clevelandclinic.org/about-cleveland-clinic/about-this-website/social-media-policy.aspx

• Rhode Island case– Doctor thought she de-identified patient in Facebook post, but person was re-identified– Re-identification is easier than you think, and gets easier as more data is put on internet– Fired and sanctioned by Board of Registration in Medicine– http://

healthblawg.typepad.com/healthblawg/2011/04/health-care-social-media-policies-facebook-misstep-costs-ri-physician-fine-job.html

• My advice: don’t say anything on social media you wouldn’t say on a crowded elevator

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Is the bigger risk being on social media or not being on social media?

• Worst case: stronger stance to address comments, criticisms, and concerns

Social media and interactive content1. Twitter and Twitter chat

2. Facebook

3. Google+ and Google+ Hangouts

4. Blogs

5. YouTube and video sharing

6. Podcasts and audio sharing

7. Pinterest and Infographics

8. Instagram, Flickr, and photo sharing

9. Snapchat, Secret, and other ephemeral content

10. Wikipedia

11. LinkedIn groups

12. “Like,” ratings, and reviews

13. Comments

14. Q&A or Ask the Expert

15. Webinars

16. SMS, messaging, texting, and chat

17. Buttons and badges for health campaigns

18. Virtual hugs and gifts and other indicators

19. eCards

20. Online and permission-based eNewsletters

21. Sharing icons

22. Most read, most emailed, most popular, etc.

23. Contests and challenges

24. Crowdsourcing and collective intelligence

25. Games and gamification

26. QR codes

27. Location-based

28. Holidays (day, week, or month)

29. Specialized and social search

30. Integration of social media into site with more than icons36

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eCards

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My eCards

• St Patrick’s Day – Outside: Kiss Me, I’m Irish– Inside: But first floss and brush

• And more – but don’t bore or overwhelm

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Case study:Water main break, May 1, 2010

• Twitter is global but people use #Boston and other filters

• New hashtag emerged: #aquapocalypse

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From Twitter to Megaphones: Seven Lessons Learned about Public Health Crisis Communication

Online Journal of Public Health Informatics, Vol 2, No 3 (2010), http://ojphi.org/htbin/cgiwrap/bin/ojs/index.php/ojphi/article/view/3179/0

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Boston Public Health Commission

• Before– BPHC and its partners participate in emergency preparedness exercises and

reviews to refine their coordination and response• During: How the BPHC alerted residents

– Coordinated with The Mayor’s Office who used reverse 911 phone system, set up 24-hour hotline, etc.

– Boston police officers drove up and down streets using megaphones and loudspeakers

– Set up calls with area hospitals – Sent staff to food-service establishments – Called upon faith-based organizations, schools, and businesses, to spread the

message through their own channels– Used Twitter, Facebook, and their website where they posted fact sheets

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Twitter use

• Immediacy of Twitter proved helpful• While Twitter is global, people use #Boston

hashtag and other filters for local information • New hashtag emerged: #aquapocalypse• Spread to others, pushing out timely information

and passing questions to BPHC• Could they have reached people without

Twitter?

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Best practices

1. Develop a rubric to assess the type of crisis. When the crisis is over, review, solicit feedback, and refine using what the military call an After Action Review

2. Identify and coordinate with partners in advance3. Prepare a communication plan for each type of crisis4. Carefully construct messages to convey needed information

succinctly5. Create messages that inform and allay unnecessary fears.

Think like your target audience6. Use social media which can be both fast and local7. Use crises to educate people in this case about water sources,

safety, and conservation as well as about emergency response

Learn from your examples and others

• What more could have been done to educate?• You may not have a second chance to look

good

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Think about your online presence the way others will!

Case Study: Megan Ranney

How to use social media at a conference – or in a class

• Tweet using conference hashtag (ex: #APHA14)• Offer opinions and links to related information• Mention people, they’ll see it and respond

– Ex: Great conversation with @lisagualtieri• Say hi to people you know through social media• Go to tweetups

Use social media

• Have a presence before you need it

• Let people know you’re going

• Meet presenters and attendees in advance*

• Plan onsite meetings

* Consider privacy concerns

Make it easy for them!

• Can people find you? Will they like what they see?

• Do you stand out from your “competition”?• Do you know what will attract people*?

* Depending on who you want to attract

Your next steps for using social media

1) Set goals for your online presence2) Conduct an inventory

a) Where do you currently have a presenceb) Set up Google Alerts to monitor your presence and Google analytics to see what drives people

to your site

3) Determine what works and doesn’t work about eacha) Effectiveness at reaching peopleb) Effort to set up, update, and monitor

4) Prioritize technologies to use: current and new ones5) Plan and execute

a) Different messages or the sameb) Different metrics or the same

6) Assess the impact after a month and iterate

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Conclusions

• Be where your target audience is– When they are there – which might not be 9-5

• Be creative to reach new and existing people effectively– Learn from what others do– Adapt to make appropriate – ex: seasonal information

• Be active in monitoring social media– Changes in technology and in the use of technology– What your competitors are doing – and not doing– What people are saying about your competitors– What people are saying about you!– What your professional societies are saying and doing