INTRODUCTION TO PUBLIC HEALTH INFORMATICS THE ROLE OF TWITTER IN PUBLIC HEALTH A REPORT BY MANDEEP KAUR GILL 00262644T MASTER OF PUBLIC HEALTH

INTRODUCTION TO PUBLIC
HEALTH INFORMATICS
THE ROLE OF TWITTER IN PUBLIC HEALTH
A REPORT BY
MANDEEP KAUR GILL
00262644T
MASTER OF PUBLIC HEALTH
(ADVANCED)
TORRENS UNIVERSITY AUSTRALIA
OCTOBER 14,2018
INTRODUCTION
Public health informatics is ”the systematic application of information and computer science and technology to public health researches, practice and learning” including health promotion, health prevention and improving health services and reporting. Nowadays, Social media has showed impact in every field such as business, health sector and social lives. It has potential to improved public health communication between individuals and organisations(Thackeray,2012). One ICT tool of social media, twitter is followed by 261 million international users which account for 79% of twitter accounts are based outside the United States.

FINDING FROM THREE PUBLIC-HEALTH RELATED TWITTER ACCOUNTS
During writing this paper, posts from 3 public-health related twitter accounts were followed for a period of 4 weeks. They include @PHAA, @PHInformatics, @aiwh. A summary of the findings is presented below:
@PHAA @PHInformatics @aiwh
Official handle Public Health Association Australia The Public Health Informatics Institute, a program of @TFGH and affiliate of @EmoryUniversity Australian Institute of Health and Welfare
Focus PHAA supports for the health and well-being of all Australian It works to improve health outcomes worldwide through information It is the Australian national agency for health and welfare statistics and information
Number of followers 11,100 2139 16,600
Total number of tweets 8127 6181 1375
Language medium of tweets English English English
Frequency of tweets (last 4 weeks) Approximately 9 times a week Approximately twice a week Approximately 3 times a week
Nature of posts/tweets About new rules on using drugs, aware people about the health General information about public health, reminders for putting question Links, reports and information about mental health and public health issues
Ease of understanding tweets General information that can be understood by both medical and non-medical professionals General information that can be understood by both medical and non-medical professionals General information that can be understood by both medical and non-medical professionals
Examples of tweets Protecting children from obesity, healthier population, tobacco control, climate change, cervical cancer etc. Stopping HIV transmission before 2030, smallpox, foodborne illness etc. Childhood immunisation, overweight/obese, smoking, breast feeding and cancer, birth and suicide rate
Etc.

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Table 1. summary of finding from 3 public-health related twitter accounts.

APPLICATION OF TWITTER IN THE AREA OF PUBLIC HEALTH
After observed these three twitter accounts it has cleared that how twitter can be used around the area of public health and how beneficial for the growth of public health. The area of public health discusses based on three main domains of public health that are health promotion, health prevention, improving health services and reporting.

Health promotion
Health promotion is the process of aware people to increase control over their health(WHO,2018). To achieve this goal, there is need to educate the people about the diseases and health. This can be done with the help of ICT tool public-health twitter accounts which has large amount of audience e.g. @aiwh tweets on October 1 about the breast cancer awareness project and introduced that cancer in the female age group 50-74 have declined since BreastSCreen Australia began.

Health prevention
Health prevention is the early detection, minimize the burden of disease and its risk factors(WHO,2018). @PHInformatics, in one tweet they informed about the project about prevention of HIV transmission before 2030.

Improving health services and reporting
This means adequate quality of care to produce health benefits, efficient use of resources.it is proved by some studies that twitter messages and tweets help to tracking and analysed influenza rate and aware the community of the UK and US in public health area (Paul & Dredze, 2012). In account @PHAA, there is tweet on October 11 by Tedros Adhanom Ghebreyesus about obesity in children and how we can control the obesity.

STRENGTHS OF USING TWITTER IN PUBLIC HEALTH
The following aspects make twitter an effective ICT tool for public health delivery:
Twitter is the platform to provide knowledge about public health and for positive impact of health campaigns on large audience (Yousef,2015)
It is easy to use and cost effective.

In this Era more people are connected by social media worldwide, so, during any public health crisis, through twitter has proved beneficial to aware the people about disease and protections (Russell,2017)
CRITIQUE OF USING TWITTER IN PUBLIC HEALTH
There are some factors which make twitter ineffective for delivery of public health:
Absence of posts of the source of information about health: the twitter accounts 1 and 2 which I followed had lot of tweets from non-scientific
sources. For instance, they tweet more about the conferences, winning awards.

Lack of source citation and blind authorship- In account 3 which I followed had some tweets without proper citation and had no authors. These factors declined the popularity of the tool of sharing information.

Bias- In the handlers of these three twitter accounts, there is tendency to post about their personal aspects.

CHALLENGES, BARRIERS AND LIMITATIONS OF USING TWITTER IN PUBLIC HEALTH
There are some factors which inclined the popularity of twitter in the health service delivery, such as:
The main concern of twitter is a lot of irrelevant health information and quality of the provided information. Sometimes, the amount of information received through tweets is inaccurate by dint of having unrelated posts (Moorhead, 2018)
Concern of privacy, ethical issues of using data: There are no terms and conditions that data posted through tweets is used publicly by third parties and researchers. When data posted, people assumed that it is public data and they can use that (Wallace & Townsend, 2018). The ethical concepts were concerned with privacy like there are no regulations and ethical framework that how and who can use the data from tweets (Conway M,2018)
Time barrier: there is limited time in twitter for tweets that mean tweets can lost with time. If someone follows more following, he must hire someone for tweet again for his followers (Soffar,2015)
Issues of internet access: in the developing countries and in rural and remote areas, where people do not have access of internet such as Nigeria, Germany and India and they do not used twitter (Neal,2013). Therefore, using twitter for service delivery of public health is unsuccessful in these regional areas.

THE FUTURE OF PUBLIC HEALTH IN TWITTER

With the help of twitter, it can be easy to get success and to achieve goals in public health because this is the ICT, used by number of people and twitter gain popularity worldwide and this is the easiest way to convey the information about health to the people.
To avoid this project for becoming ‘Pilotitus’ following steps can be considered
a. All data that could be used to identify tweet authors, should be secured. No information collected from twitter should be used to precure more data about tweet authors from another source.

b. The context in which a tweet is sent should be respected by researches.

c. Study design using twitter-derived data should be transparent and readily available to the public etc.

CONCLUSION
The use of twitter is growing, and it offer both opportunities and challenges to public health area. It showed impact in the sector of public health by providing a space to share preventative information, detection of potential outbreaks, monitoring emergency situations and frame policy debate. However, the limitation of using twitter should not be neglected such as privacy concerns, cyber-attacks etc. To avoid misuse of twitter, proper care and guidelines should be followed. These steps should be helpful to make twitter a greater ICT tool in public health.

REFERENCES
1 -Thackeray, R., Neiger, B., Smith, A., & Van Wagenen, S. (2012). Adoption and use of social media among public health departments. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-242?report=reader2- Public Health Association Australia (@_PHAA_) on Twitter. (2010). Retrieved from https://twitter.com/_PHAA_3-AIHW (@aihw) on Twitter. (2009). Retrieved from https://twitter.com/aihw4-PHII (@PHInformatics) on Twitter. (2011). Retrieved from https://twitter.com/PHInformatics5-Paul, M., & Dredze, M. (2012). Retrieved from https://www.aaai.org/ocs/index.php/ICWSM/ICWSM11/paper/viewFile/2880/32646-Yousef Albalawi Jane Sixmith. (2015) Identifying Twitter influencer profiles for health promotion in Saudi Arabia. Retrieved from https://doi.org/10.1093/heapro/dav1037-Russell, J. (2017). Social Media in Health Care: Benefits, Challenges, and Opportunities. Retrieved from https://blog.hootsuite.com/social-media-health-care/8-Moorhead, S., Hazlett, D., Harrison, L., Carroll, J., Irwin, A., & Hoving, C. (2018). A New Dimension of Health Care: Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636326/9-Conway, M. (2018). Ethical Issues in Using Twitter for Public Health Surveillance and Research: Developing a Taxonomy of Ethical Concepts from the Research Literature. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285736/10-Wallace, C., & Townsend, D. (2018). Social media research: A guide to ethics. Retrieved from http://www.dotrural.ac.uk/socialmediaresearchethics.pdf11-Soffar, H. (2018). The advantages and disadvantages of Twitter | Science online. Retrieved from https://www.online-sciences.com/technology/the-advantages-and-disadvantages-of-twitter/12-Neal, R. (2013). Retrieved from https://www.ibtimes.com/twitter-usage-statistics-which-country-has-most-active-twitter-population-147485