Monthly Archives: January 2013

Fighting Influenza: Web 2.0 Tools for Public Health Professionals and the Public

Post by: Kim Stephens

The Boston Mayor has declared a public health emergency due to the deadly flu outbreak that has killed 18 people to date.  Public Health organizations are pulling out the stops to communicate protective action information to the public and social media is just one of the tools in the toolbox. The public, however, is also using social media to talk about the flu. They state such things as whether or not they are sick; whether or not they had a shot; and “Google” what they should do after they become ill, just to name a few of the topics of conversation. People can even download a new Facebook app titled “Help, My Friend Gave me the Flu” to figure out who they need to blame for feeling miserable. (As an aside the app is actually quite cool. After you give it permission to access your newsfeed it looks for key words from friends that have posted content related to feeling sick. From a public health standpoint, if people know some of their friends are ill they might be spurred to get a flu shot, or at a minimum keep their distance. I’m happy to report all of my friends are healthy!)

All of this web and social data, in turn, is being “mined” by public health organizations and researchers in order to determine both the geographic spread of the virus, as well as the rate of infection. Some organizations are also asking the public to self-report how they are feeling. Below I outline five tools that are interesting aggregators of social flu data.

flunearyou1. FluNearYou is a tool that allows the public to participate in tracking the spread of flu by filling out a survey each week. The survey is quite simple and asks the respondent if they have had any symptoms during the past week and whether or not they have had the flu shot either this year or last year. Respondents can include family members and the questions are asked about each person individually. This user contributed data is then aggregated and displayed on a map with pins that are either green for no symptoms, yellow for some  and red for “at least one person with Influenza-like” symptoms. The pins are clickable and display the number of users in that zipcode that have reported their condition, but no personal information whatsoever. The number of participants in the state is displayed (1294 in Massachusetts) as well as locations and addresses where people can get vaccinated. Links to local public health agencies are also provided. People can also sign up to receive location-based disease alerts via email. Social sharing of the site and its content is encouraged by the addition of prominently social media buttons.

This site is administered by Healthmap of Boston Children’s Hospital in partnership with the American Public Health Association and the Skoll Global Threats Fund.

2. Google Flu Trends is another site that provides geographically based information about the spread of the influenza virus. Their data is aggregated from the search terms people are using versus self-reporting. In fact, the graph of the tracked searches (see below) related to the flu compared to the actual reported cases of the virus is so close that they almost overlap.

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Google explains how this works:

Each week, millions of users around the world search for health information online. As you might expect, there are more flu-related searches during flu season… You can explore all of these phenomena using Google Insights for Search. But can search query trends provide the basis for an accurate, reliable model of real-world phenomena?

We have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Of course, not every person who searches for “flu” is actually sick, but a pattern emerges when all the flu-related search queries are added together. We compared our query counts with traditional flu surveillance systems and found that many search queries tend to be popular exactly when flu season is happening. By counting how often we see these search queries, we can estimate how much flu is circulating in different countries and regions around the world. Our results have been published in the journal Nature.

In fact, the current flu trend data for Massachusetts reflects the declared state of emergency.

google

3.  MappyHealth is another tool that tracks keywords related to health but instead of using data from searches in Google, this system utilizes the Twitter data stream. Their stated reason for the site: “It is hypothesized that social data could be a predictor to outbreaks of disease. We track disease terms and associated qualifiers to present these social trends.” Although this blog post is focused on influenza, the MappyHealth site tracks 27 different categories of illness. They explain how all of this is done on their FAQ page.

The graph below displays Tweets by the hour and day that are related to influenza. The last full day on the chart is January 9, which shows a significant spike in the number of tweets on the topic.

mappyhealth

What is everyone talking about? The user can actually see the individual Tweets by clicking on any point on the graph. The associated Tweets then populate a table beneath the graph (profanity and all). The table includes the time, tweeter, complete text of the tweet, location (if available) condition match and qualifier match. The last two terms need a little bit of explanation. If someone states “I don’t have the flu” the condition match will state “flu” but the qualifier will state “don’t.” Location data is not included in all Tweets, however, MappyHealth does provide a sorting mechanism by location and this content is displayed on a map.

Another feature on the site includes a link to a “Realtime Twitter Search.” This link takes the user to an advanced search MappyHealth has already created that includes many different keywords Tweeters  might use when talking about influenza, including: flu, influenza, h1n1, h5n1, H3N2, adenovirus, etc. This search is available for every illness category. This feature alone is worthy of a bookmark.

cdcapp4. Not to be outdone, the Center for Disease Control has released a Influenza smartphone application. The intended audience is clinicians and other health care professionals, with a stated purpose of making it easier to find CDC’s latest recommendations and influenza activity updates. Some of the reviews, however, point to a few problems, such as dated information on flu activity.

5. HealthMap.org was involved in the design and development of “FluNearYou” and therefore has a similar look and feel to it. However, the site does have a very different process for gathering data. HealthMap states that they
photo-8

“…bring together disparate data sources, including online news aggregators, eyewitness reports, expert-curated discussions and validated official reports, to achieve a unified and comprehensive view of the current global state of infectious diseases and their effect on human and animal health. Through an automated process, updating 24/7/365, the system monitors, organizes, integrates, filters, visualizes and disseminates online information about emerging diseases in nine languages, facilitating early detection of global public health threats.”

HealthMap.org also has a mobile application that includes all of the features found on their website, but I actually find the app easier to use. Using the smartphone’s touch screen zooming capability it is easy to hone in on specific locations and view all of the associated alerts. The alert content, however, is a bit heavy with information from traditional media.

+1. #FluChat: News organizations are not only providing the public with information about the effects of the influenza virus this year, some are also providing a public health awareness function via their presence on social networks. On Thursday, January 10th, for example, a #FluChat was sponsored by @USATodayHealth.

Health based Twitter chats offer the public the opportunity to post questions that are addressed by healthcare professionals or researchers. The CDC, for instance, has conducted many chats on a wide variety of topics. Watching the questions that are posted in these chats offers local public health organizations an opportunity to “hear” the concerns of the public. Knowing this information can help with message formulation and coordination. Here are a few questions posted to the #fluchat:

https://twitter.com/SellOrElse/status/289423264302895104

https://twitter.com/sgt1917/status/289424324937527296

Bonus: Reviewing the #fluchat stream I found “A Flu With a View” from Sickweather.com. This visualization of flu data comes from a process they use to filter Tweets, Facebook updates and self-reporting on their website. They state: “This amount of real-time data, combined with historical data from the CDC and Google Flu Trends, is what gave us a crystal-ball-like view of the flu this year. In fact, our data of flu season to date shows that we are still near the peak of flu season, but possibly (hopefully) starting to level off.”

See this visualization:

None of these tools will help people feel better once they are already stricken with the virus, but they might alert the public to how prevalent the virus is in their community and possibly persuade folks to take preventive measures. Tell me what you think. How could your agency put this information to use?

Content Strategies: What do I Post?

Post by: Kim Stephens

MC900442000It is easy for emergency managers to learn   social media in terms of the purely technical aspects–these platforms are pretty straightforward to use. However, one of the complaints I often hear, is “Now what?” Never before has the EM community been expected to communicate with the public on an almost daily basis. Once an emergency manager has a Twitter feed and a Facebook page they  understand that they have to post something so that it doesn’t look like a ghost town, but what?

Deciding what to post is not usually a problem during an emergency or a disaster situation, but social communication during the preparedness phase can be  challenging (even after an organization has determined they will invest time and resources to the effort). There are several inter-related issues to consider:

  1. Coordination with response partners. 
  2. Managing Public Expectations.
  3. Being creative enough to get the public’s attention.

COORDINATION WITH RESPONSE PARTNERS

In bigger communities it is increasingly common for almost every department or agency to have their own social media account.  The Department of Transportation is likely to be posting information road closures, traffic problems, and real-time road conditions during storms:

Police Departments tend to post content about  a wide range of activities from car crashes, to arrests, to the weather, as well as safety tips.

Fire Departments often provide updates about where they are responding, fire prevention tips, and general safety information as well.

So, where does that leave the Office of Emergency Management?  If all of the “sexy” up-to-the minute content is being reported by other agencies, what’s left to be said? Even once your agency decides what “lane” you should be posting in, it’s still possible that other city or county agencies will infringe on your territory. I have heard statements from some annoyed EMs such as: Why did the Fire Department post emergency preparedness content? That’s my job!

Solution:  In order to prevent “social-media envy” coordination and collaboration are key. The results of coordination could manifest in a city or county-wide written content strategy or simply in a verbal agreement regarding expectations. However, it is important to keep in mind that in the social media world, repetition of a message is NOT a bad thing. Your Tweets and Facebook updates  are never seen by everyone that follows you (see Jim Garrow’s article “The Demise of Facebook” in which he points out how few people actually do see what you are posting in their feed). Therefore, amplifying each other’s messages should be an overarching goal.  Here are two great examples of how this is done and communicated to the public in Baltimore.

MANAGING PUBLIC EXPECTATIONS

I like the Tweet immediate above this paragraph because it also denotes  the type of content OEM will provide and when. I have heard concerns from emergency managers that once they start posting something, such as road closures or the weather, the public complains when they stop. One social media admin told me “The public now thinks I’m the weather man.”  However, continuing to post the same information daily can turn your feed into a very boring presence, ultimately reducing the amount of community engagement and interactions.

Solution: There are two ideas to consider:

  1. Pre-determine your thresholds for when your office will post emergency content (e.g. not every road closure, but only major incidents; not every fire warning, but only “red-flag” events; not every day it rains, but only severe weather ). You can publicize your intentions, however, by simply staying consist, the public will learn what to expect.
  2. Make it very well known, either via your website and/or Facebook page, the types of content your response partners are posting on social networks and where people can find that information. See the National Capital Region ”News Feeds” as an example of this.

BEING CREATIVE

Whether or not we want to admit it, the ”Be Ready” message gets very little traction when there isn’t an emergency.  Posting “Are you Prepared?” along with a few tips to your Facebook page does not mean your community is now more resilient.  In fact, they are probably ignoring this message altogether. Why? Frankly, it is boring.

What works? Storytelling. Stories  do many things: reshape knowledge into something meaningful; make people care, transcend one’s current environment; motivate; and give meaning, among other things.  In a blog post titled “The Importance of Storytelling in a Digital World”  the author discusses why TED Talks (the ultimate in digital storytelling) work. His logic applies to all digital communication:

I believe that storytelling is critical for public engagement on the web. Storytelling is a fundamentally human and social practice that allows individuals to connect through mutual cooperation and shared empathy. Storytelling inspires. Storytelling moves. It is a timeless practice that is the future for public engagement on the web.

A great example of storytelling in emergency management this year was from  ”Ready Houston” with the video: “Run. Hide. Fight,” embedded below. This 5 minute video holds viewers attention and has received over 1.8 million hits. The protective action measures the public should take during a shooting incident are demonstrated via the story of an attack in an office building. It was also successful because, unfortunately, it is all too relevant for the times we live in.

In contrast, the Ready Houston Facebook page has only 208 “likes” and features typical “Be Ready” content.

ready1

Solution: What are we trying to do here? We are trying to change behavior, which is not an easy task. Posting “Get Prepared–here’s your list” is probably not going to get anyone off the couch. A little more work might have to be involved. (For some reason I’m reminded of kid in the movie The Incredibles who’s asked “What are you waiting for?” and he says, “I don’t know. Something amazing, I guess.”) See the video clip below, just for grins.

What can you do? You don’t have to invest thousands in producing slick videos, but you can find a family in Home Depot shopping for winter supplies and take a pic. Ask them why they are getting prepared and post that. Or repeat news stories (even older ones) about someone that almost died in their car during a snowstorm because they didn’t have food or blankets in their car.

Storytelling can also be short and sweet. The Brimfield Police Department, whom I’ve written about previously, tells little stories that amuse, and get people to act and engage. Below are two posts from their Facebook page. The second one had almost 1500 “Likes” and many comments.

brimdogs

brimdogs2

Let me know, are you ready to provide good content for 2013? What’s your plan to be amazing?

Bonus Video #1:
See this video which demonstrates how boring “data” can be enthralling when given meaning and context.

Bonus Video #2:

This post was also posted to iDisaster.wordpress.com.

See also: Module 9 Content Strategy Development