“A New Dimension of Health Care: Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication”

Based on 98 original research studies the authors have set out to review published literature on social media for health communication in order to identify the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals. Secondly, they aim to identify current gaps in the literature and provide recommendations for future health communication research.

The paper gives a comprehensive overview of the topic and the reference section is a great resource list.

If you’re not up for reading the paper in its entirety, three of the tables gives a great summary of the findings. Follow the link to the paper above or check out the tables at the end of this post.

What about science communication?

One thing that strikes me is that if you take a look at table 3, which lists the different uses of social media for health communication, the use of social media for communicating science and research in health is not on it. Neither when it comes to research communication between health professionals nor communicating health related research to the public is mentioned. An interesting and slightly surprising find I would say. Granted, it could to some extend figure under the categories ‘Providing health information’, ‘Proving answers to medical questions’ and ‘Facilitate dialogue between patients and health professionals’, but none the less it is not a category in it self. Whether this is because it has not be the focus of any research studies, or doesn’t take place at all is hard to tell. I believe (and hope) however, that it is the later.

None the less, the article underscores the growing role and importance of social media in health and in health communication, and shows that it cannot and should not be ignored.

Table 3 - Uses of social media for health communication 

Table 4 - Benefits of using social media for health communication -

Table 5 - Limitations of social media for health communication

There are already lots of great blog posts, Twitter discussions etc. about the role social media played (and is still playing) in the events related to the Boston bombings, so I won’t try myself to replicate those. A post that gives a good overview and is written by a public health professional is Leah Roman’s blog post on the blog Pop Health. She goes through some of the key themes of social media in the emergency response, ranging from Immediate Public Safety Concerns and Instructions over Investigation, Reconnecting people, to the functioning of social media as a Resource for Journalists, and it’s role in Mental Health & Support Resources.

Another good post about the social media in the boston bombing is on the blog iDisaster 2.0 that shares links to other great articles about the role social media played during the horrific aftermath and presents three observation on use of social networks, particularly Twitter, by the Boston Police Department. Also worth a read.

New media challenges old media

In the last couple of days, old media and new media are both reporting of how the later beat the first during the Boston events. Especially CNNs failure to keep up with social networks in being first with the news is being covered and discussed (among other places in this article in the NY Times and in Danish in this article in Politiken). The dynamic between the traditional media and new social media is interesting, and the relationship between the two will certainly continue to evolve. Without knowing the details of the discussion back in time when radio and later on TV came into being I’m sure that there were similar discussions on the then new media challenging the old ones. I look forward to seeing how it develops, and how emergency management manages to make use of what is still categorized as ‘new media’ and its relation with traditional media.

This is what happened to me recently. I agreed to act as a ‘case’ for a journalist writing an article about the opportunities in Denmark to get government support for taking additional education. When I chose to do a one-year degree in Journalism, I was so lucky to be approved for SVU (the State’s Adult Education Support) which meant a monthly allowance during my studies equal to 80% of unemployment support.

The article was published this week in the magazine of the The Association of Danish Lawyers and Economists (and lots of other academics, including people with degrees in Public Health Sciences). Its in Danish, which may prevent lots of my readers to read it, but none the less: below is the article (you can also read it on page 26-27 in DJØFbladet).

What was pleasant for me to read was that the journalist, based on our talk actually assessed that I had created a niche for myself:

“Today, Nina has created a niche for herself where she mixes the methodologies from both of her tool boxes [public health sciences and journalism & communication, edit], when she communicates in her field or teaches at the Faculty of Health [at University of Copenhagen]“.

A field of Public Health Sciences and communication, or Public Health Science Communication. The sound of it feels right to me, and I guess its time to embrace and articulate the niche more to myself and in my introduction of myself to others. I guess it also shows that I wasn’t completely off, when I some time back chose the to name this blog Public Health Science Communication 2.0.

The website is called The Australian Emergency Management Knowledge Hub and is still a BETA version of the Knowledge Hub, but a good BETA version. It provides easy access to evidence-based research and other research as wells as news relevant to emergency management, including statistics and information, photos, video and media about past disaster events. You can read more about the rational and the organisations behind the website on their ‘about’ page.

The website has lots of well thought out search tools. You can search for information about specific emergencies through a combined map and timeline. It will provide you with basic data about the event and links to resources related to the event in the research database.

You can also go directly to the research database and search here on the topic you seek information. You can even filter or sort it by the kind of document (case study, website, report, journal article, blog, wiki etc.), date and disaster category.

Although I haven’t yet tried it out, there is also a community forum space where people working with emergency management can register to discuss ideas and issues affecting the emergency sector.

As the name of the knowledge hub implies, the majority of the resources relates to Australia and its closest surrounding countries, but it is no way exclusive. I have mostly been looking at things related to social media and it seems to me that Australia is first-mover country when it comes to integrating social media into emergency management.

The Knowledge Hub also provides access to resources in the Australian Emergency Management Library.

Users of the hub can contribute to the hub’s continuous development, by recommending additional resources, share upcoming events, photos, videos and join in on the discussions.

The Australian Emergency Management Knowledge Hub is of course also on Twitter (@AEMKH), which they use very actively.

Having a bachelor and masters degree in public health sciences from University of Copenhagen, I know for a fact that at least in a Danish context public health science communication has not been part of the curriculum for public health students in the later part of the 20th or the first part of the 21st century. None the less, when I saw the headline of Martin McKee’s article, I was hoping that science communication would be an ambition for modern public health training.

Unfortunately, I was to be a bit disappointed. The article starts out well, stating the need to “prepare people to engage actively in a complex and changing world in ways that improve the health of the population”. So how do you prepare people to engage actively in ways that improves their health? Well, in my world that will require that you as a public health professional and public health scholar can actually communicate what you are doing, what your theories are and what findings come out of your hard work. And that you can engage into conversation and discussion with the public and subgroups of the public (e.g. policy makers, researchers in other fields). In short, that you can communicate public health sciences.

Public health science communication is not mentioned directly as one of the 7 goals. In short that goals Martin McKee lists are:

1. Stimulate curiosity
2. Encourage social entrepreneurs who are willing to take the initiative
3. Make epidemiological connections and understand the biological mechanisms behind
4. Convey the big picture, expanding Koch’s postulates or Bradford Hill’s criteria of causality with mathematical models to provide evidence of links
5. Make public health students literate about what (and who) they are up against
6. Engage with key decision makers at all levels and be confident to speak up.
7. Ground human rights into public health approaches

For all seven goals, science communication plays a key role, but is only partly mentioned under goal 6, articulating the need for public health people to be confident to speak up and share their knowledge. The only other time communication is touched upon is as an encouragement for public health professionals to not just stay updated on public health news but go beyond the scientific literature:

“More than ever, the public health professional needs to read the Economist, the Financial Times and the Wall Street Journal.”

No suggestion is however broad forward about also contributing and communicating public health through these channels. Shouldn’t public health people aim to let their voice, knowledge and opinions be heard outside the ‘traditional’ public health media?

Another element missing in Martin McKee’s list is the IT reality of the 21st century and how Web2.0 already have and is still changing public health research and practice. He mentions the need for public health people to acquire a great deal more self-confidence and points out how:

“with a fast internet connection, most students could do a much better job of understanding the topics they [politicians and social commentators] addressed”.

But the potential for new ways of communicating and engaging with the public broad forward by social media and other technologies is not mentioned at all.

Make public health science communication the 8th goal

Communication is almost a precondition for all other 7 goals, which is why I would argue that it deserves to be a goal in itself. Public health students should be given competences in communicating what they do, why they do it and taught how communication can benefit not only the people they are trying to help but also their own work (which then again will come to the benefit of the public). Public health is, as Martin McKee opens the article, not just a collection of different disciplines or the goals it seeks to attain. It is much more. Exactly this ‘much more’ however requires communication. Public health science cannot (meaningfully) exist in its own little universe. It only comes to life when it steps out of the public health sphere and meets the rest of the world. This, however, requires that we as public health people are dressed to meet the world and to communicate with it. Let’s make public health science communication skills the 8th goal of public health training in the 21st century.

The article by Martin McKee is unfortunately hidden behind a pay wall, but you read an extract here: Seven goals for public health training in the 21st century.

Both preparing for the lecture and teaching was a good experience, and I feel I managed in the 3×45 minutes available to get around the topic in a comprehensive way – although with that time frame it can only be an introduction. In addition, I got great feedback from the students who, coming from all over the world, had different experiences with dealing with disasters, which they could contribute with in the discussions.

Since I couldn’t assume students to be familiar with social media for other than private purposes, I chose to allocate some time to introduce social media before going into examples of its use in disaster and emergency situations. For those interested, I thought I’d just share the programme with you:

More than communicating a message

Social Media & Crisis Comm: A Whole New Game

In my experience the first (and sometimes only) thing that comes people’s mind when they think of what social media can be used for in emergency settings is dissemination of information and messages to the public. Social media are simply categorized as yet another communication channel equal to radio, tv etc. But as it is well illustrated in the YouTube video on the right (click the picture) it is much more than that.

With this experience it was important for me in my lecture to highlight some of the other key functions of social media in disasters. Below are 4 broad categories for the potential use of social media in emergency situations. There are surely other ways social media can be used and as said the four below are quite broad and thus covers lots of sub-functions.

1. Disseminate disaster information to the public by governments, emergency management organisations, and disaster responders
2. Share disaster information with the aim of having journalists and others pick it up so that it can be further disseminated to the affected members of the public
3. Communicate and enter into dialogue with the public, other institutions etc.
4. Gather information about the emergency by monitoring the situation, identifying areas of need and picking up rumours and misunderstandings.

Safe & Well

One advantage of teaching (and of blogging) is that you get so much feedback and suggestions for new things to read, websites to visit etc. I thought I’d share two of these tips with you. The first is a website that a student in the class recommended. It is called Safe & Well and is provided by the American Red Cross. The idea is that after a disaster, people in the affected area can through this website let their family and friends know that they are safe and well. By clicking the button “List Myself as Safe and Well” you register on the site. Relatives can then search the list of those who have registered themselves as “safe and well” by clicking on the “Search Registrants” button. The results of a successful search will display a loved one’s first name, last name and a brief message.

Facebook and extreme weather events

The posts on this blog are double-posted on the Medical Museion’s website and there my previous post on social media and disaster management was commented by a researcher from Aarhus University, Andreas Birkbak, who had authored an interesting article about the use of Facebook for informal emergency collaboration during a snow blizzard on the Island of Bornholm in Denmark. A very interesting article that I might use next time I teach. Read the article your self: Crystallizations in the Blizzard: Contrasting Informal Emergency Collaboration In Facebook Group. Thanks for sharing it on the blog, Andreas!

Take home messages

It has been exiting to dig into a new field and to experience how social media really presents great new opportunities, but of course also new challenges. Since I haven’t previously worked specifically with disaster management, I choose a few weeks ago to ask my Twitter followers for help on finding good literature and resource people in the field. And once again, Twitter didn’t let me down.

Blogs, website and hashtags

I got a lot of great inputs to blogs, websites, Twitter chats, hashtags and people to follow and hook up with on Twitter (a big thank you to all of you who responded!).

The blogs are a good starting point, especially since most of them offer great links to other resources. The most helpful so far have been the website/blog Social Media 4 Emergency Management. From here there is access to wikis, archives of Twitter chats (#smemchat), videos, blogs etc. on social media and emergency management. The only ‘problem’ with the website is that there is almost too much information.

Another super helpful resource is the blog idisaster2.0 (primarily run by @kim26stephens). It have lots of informative blog posts as well as a good bibliography of selected academic and government resources on social media and emergency management.

Own experiences with disasters and social media?

When I was asked to give the lecture, I hesitated for a moment, because what did I know about emergencies and disasters? Apart from my solid knowledge of social media in public health, including some superficial insight into its role in disasters, I had never had anything to do with disasters or least of all experienced it… However, the later is not true, I quickly realised. I have actually to some extend been in an emergency setting and I have in fact experienced the role of social media in a disaster situation.

Earthquake in Japan in 2011

I was in Japan, when the big earthquake, subsequent tsunami and finally the Fukushima nuclear plant crisis occurred in March 2011. Being relatively far from the epicenter of the disaster (I was based in Kobe in the Kansai region), I wasn’t directly surrounded by flooded buildings, elevated radiation risks or other immediate danger. But I was surrounded by potential danger, by worried friends and family in Denmark and by Japanese friends and colleagues with close relatives in the affected areas.

Looking back on my Facebook timeline, I can now see how social media actually played an important role for me during the emergency. I used Facebook to assure others that I was okay and kept them updated on my situation. I started following the Danish Embassy in Japan’s Facebook page through which they several times daily shared information about risks, advice on how to act and the organisation of potential evacuation. I encourage the mobilization of emotionally and financial support to Japan by sharing links and QR-codes. And I experienced how a Japanese colleague of mine after days of no contact with her sister living in Sendai where the tsunami hit, finally through Facebook got in contact and found out that her and her were safe…

So yes, I have actually experienced a disaster, and experienced how social media can be used in this kind of situation. I plan to share my experiences as a case with the students next week and hope that this real life experience can contribute to the understanding and some discussions.

Your help

Although I already got great tips from people on Twitter, I am still the happy receiver of inputs on social media and emergencies/disaster management. Suggestions on discussion topics, assignments or any other ideas on how to involve the students are more than welcome as are links to guidelines, scientific articles etc.

So how did it go? Did the students find it useful? What went well? Would I repeat a course like this again? And if so, what would I do differently? There are lots of questions to answer, so I thought I’d go through them one by one.

How did it go?

Overall, I think it went quite well. At least all students passed and it wasn’t criticized apart by the students. I’d even like to think that the students learned something new and useful. And just as important: I learned a lot! Both about science communication in relation to public health and about teaching public health science communication.

Did the students find the course useful?

It is very often difficult to get a clear impression of whether students found a course useful or not, and the fact that only few students filled in the online evaluation questionnaire and that only about half of the class attended the last module, where we did a short oral evaluation of the course, makes it even more difficult. However, based on the students who did participate in the evaluation I think it would be alright to conclude that the students on the whole were happy with the course. From the online evaluation most of them indicated that the study objectives of the course were met (and I assume they to some extend joined the course on the basis of these), and they rated their overall study-relevant benefit as ‘very good’ or ‘good’. I was also very happy to see that a most of the students who filled in the online evaluation found the course very relevant to their general Public Health education.

From the oral evaluation the comments were also in general positive. The students expressed that it had in many ways been a very different course, with much less hardcore theory than many of their other graduate courses. Some also mentioned that the fact that the centre of attention to a much higher degree than in other courses had been on themselves as individuals and researchers, had been interesting but at the same time a challenge. They expressed that they were more used to focus on the objective of Public Health, which is usually the public and not so much on their own role in this. I found this interesting, and recalling my own time as a Public Health student it is true that it was rarely about ourselves and our current and future roles in public health (one could talk about our subjective role), but much more about all the other players in public health, of course including the public itself.

Another thing I found interesting, was that when asked about the syllabus, the students in general seemed happy with the selected literature, except many of them expressed that they found the blog posts too chatty and recommend them taken out in future courses. I myself had put a lot of thought into allowing different kinds of literature. In part to illustrate that science communication is not just about text books and peer-reviewed journals. I guess they as university student have by now just been a little brainwashed to prefer good old scholarly texts over the more ‘chatty’ and personal writing styles…

What went well?

In my own opinion, many things went well. The balance between having myself as the main lecturer and having great guest lectures (thank you to them!) was good (I taught about half of the modules). It also worked well and was a good change to get out of the class room and go on field trips. One to Videnskab.dk, a Danish popular science news website, and to Medical Museion.

I’m happy also that I chose to make a compendium rather than assigning a textbook. Partly due to the fact that there isn’t yet a book out there on Public Health Science Communication, but also because it was good to be able to through different kinds of texts to illustrate the many forms of science communication.

Another things I found was successful was trying to use as many real life examples. Ranging from case studies (although it would have been nice to have more), to YouTube clips, podcasts, blogs etc.

Despite some worrying comments from some of the participants prior to finishing the exam, I also think that the task of writing an introductory chapter on Public Health Science Communication worked well. Some students expressed that they found that an exam more focused on actually trying to communicate a specific public health challenge would have been more appropriate and useful instead of what they regarded being an assignment to refer theory of science communication. I (of course) tend to disagree. Writing an introductory chapter on Public Health Science Communication is also an example of communicating a scientific field – it just happened to be a field (and a way of thinking) that was new to them.

What would I do differently? 

It is funny what time does. Looking back at the course now, with some months having passed, I have a hard time recalling all the things I would have changed. Because at one point I thought there were many. However, some do come to mind:

I think I would have tried to include more real life examples of science communication – both good and bad examples, and perhaps have challenged the students to analyse both and suggest why they worked and why the didn’t.

Despite having the primary focus on the communicator (the public health professional) rather than looking at the receiver, I think I would in a future course try to incorporate a little more on how publics benefits from public health science communication, and perhaps try to allocate some more time to going through how one can become better at understanding and writing to a specific target group. This will present a different challenge, because the course is not a writing course.

Actually, I found the that finding a balance between being a course on principles, trends and theories in science communication and a writing, hands-on course quite difficult. I am sure that in a repetition of the course, this would again be a difficult balance to get right.

It’s always difficult to get students to discuss, but in a future course I’d try to make room for more discussion and student involvement. My own take-home message from teaching this course, is that I should keep in mind, that science communication is not an exact science and that I, despite being the teacher, does not have all the answers…

Would I repeat a course like this again?

Yes, I think I would. For many reasons. One, I thought it was fun and inspiring to teach. Second, I was confirmed in my belief that introducing public health students to the importance of science communication is very much relevant – if not essential. And finally, I learned a lot from the process and I would love to see how a version 2.0 of the course would go about.

Did I forget to mention something important in the post? Probably – but I promise to add them (or do an additional post) if and when things come to mind. I also welcome my students to share their views and correct me if I’m wrong, and I would be happy to answer questions from anyone interested in hearing more of my experiences with teaching Public Health Science Communication.

To those who are unfamiliar with German geography

I have on previous occasions moved abroad to take on new jobs (in China, Switzerland and Japan) but this time no fixed job awaits me. Rather, I have the opportunity to explore different options, try out my freelance skills and at the same time live with the person dearest to my heart.

I must admit that I know very little about Bonn. Both in general but also when it comes to the activities in science communication and in public health. Actually, I know very little about the status of science communication in Germany in general. However, since I plan to stay in the field of Public Health Science Communication, which I find to be both super interesting and a an important topic for public health, I truly can say that look forward to exploring it.

Apart from finding out what goes on in Science Communication in Germany, I still plan to have my feet planted into Danish Public Health Science Communication – as well as into global Public Health Science Communication. One of the wonders of social media (and the internet in general) is that it really doesn’t matter where you are – you are free to  work and stay connected with the entire world.

So far I haven’t got a clear-cut plan for my Bonn life, but lots of ideas, already a few assignments and a long list of opportunities. Bonn is a UN-city with a bunch of UN agencies present, so it is likely that I can engage with them. Especially due to the fact that I have experiences working with them already. The United Nations University is located in Bonn and several German Universities are close by (Bonn University, University of Cologne to mention a few) as well as a number of international NGOs and other organisations are based in Bonn. If they are not already working on science communication and social media then there is certainly a lot of new ground to made there!

Should any reader of this blog know of relevant people to in Germany to engage with,  Institutions working on science communication and social media, University courses related to science communication etc. please don’t hold back. I’d love to hear about it.

I promise to keep you all on posted on my doings in Public Health Science Communication in Bonn and in the rest of the world. So far assignments with the Department of Public Health, Medical Museion, and the Faculty of Health and Medical Sciences at University Copenhagen will take up my time as will communication assignments with the European Regional Office of the World Health Organisation (WHO). I would also love to explore opportunities for continuing teaching Public Health Science Communication. Perhaps the course Public Health Science Communication which I taught last year at University of Copenhagen can be adapted to other universities….

Anyhow, with this first blog post of 2013 I would like to wish you all a Happy New Year where ever you are based. Bonn adventures awaits and I look forward to you being a part of them. If not in any other ways, then by following my scribbles here on this blog.

However, post number 101 can also be special and actually I think the topic is quite appropriate: A public health science blog hosted by PLOS blogs has arrived! It is simply called ‘Public Health‘ and has five contributors coming from different backgrounds but all with an interest in Public Health.

The blog looks very promising and the posts currently posted are well written and interesting. I look forward to following the blog and hope for many discussions.

Public Health 2.0

Not surprisingly, I am especially happy to see that the topic of social media and public health is discussed on the blog. In the post Public Health 2.0: Electric Boogaloo by Atif Kukaswadia of Queen’s University in Kingston, Ontario, Canada draws attention to strengths and weaknesses of social media in public health. It is clear that Atif comes to this with an epidemiologist’s perspective (being and Ph.d. candidate in Epidemiology), but he raises some important questions about acknowledging that social media exists and that regardless of whether people with scientifically founded knowledge make use of social media or not, people spreading untrue or perhaps even harmful public health information will continue to do so. This is in my opinion an important argument which needs to be made also to the social media skeptics.

The post is full of great links, so newcomers to the topic of public health 2.0 should take a look at the post and join the discussion.

Social media and science conferences

Atif Kukaswadia opens the blog post with discussing what makes a good conference, and how it not necessarily what happens during the presentations and in the conference room, but rather the discussions that continue (or perhaps first starts) in the lunch room and during the coffee breaks. This make me wonder, if Atif Kukaswadia has been to the Science Online conferences, which acknowledges exactly that. These conferences are built up following a so-called ‘non-conference’ format and brings more space for the in-between-sessions-stuff. Based on my experiences the ScienceOnline people are the most advanced users of social media before, during and after conferences. For newcomers to social media in conferences it is actually quite overwhelming and a little extreme – but none the less a great eye-opener for the power of social media in conferences.