Retweeting in health promotion: Analysis of tweets about Breast Cancer Awareness Month

Abstract Recent years have seen an increase in the use of Twitter for health promotion, yet little research has been done to understand the factors that facilitate the sharing or retweeting of health messages. The goals of this study were twofold: (a) to identify the major themes contained in tweets about the campaign under investigation and (b) to understand the roles of retweeting in a health campaign as well as factors that contribute to the wide dissemination of campaign messages on Twitter. Tweets that included the campaign hashtag of Breast Cancer Awareness Month, #bcam, were collected using the firehose method (N = 1018). Findings revealed that many more tweets were posted about the promotional goals of fundraising or sales events than about the educational goals of teaching and raising awareness about breast cancer. Findings also showed that tweets with photos or images exhibited greater retweetability compared to those without them, whereas the inclusion of hyperlinks or videos did not affect retweetability. The results of the current study shed light on our understanding of the ways Twitter is used in health promotion and offer practical implications regarding strategic use of Twitter for health campaigns.

[1]  H. Toutenburg Fleiss, J. L.: Statistical Methods for Rates and Proportions. John Wiley & Sons, New York‐London‐Sydney‐Toronto 1973. XIII, 233 S. , 1974 .

[2]  A. Bruns,et al.  Structural layers of communication on Twitter , 2014 .

[3]  Danah Boyd,et al.  Tweet, Tweet, Retweet: Conversational Aspects of Retweeting on Twitter , 2010, 2010 43rd Hawaii International Conference on System Sciences.

[4]  Charu C. Aggarwal,et al.  An Introduction to Social Network Data Analytics , 2011, Social Network Data Analytics.

[5]  A. Holton,et al.  Twitter as a source of vaccination information: content drivers and what they are saying. , 2013, American journal of infection control.

[6]  Lu Liu,et al.  Determinants of information retweeting in microblogging , 2012, Internet Res..

[7]  Jue Huang,et al.  The Predictive Power of Content and Temporal Features of Posts in Information Dissemination in Microblogging , 2015 .

[8]  Jeong Yeob Han,et al.  Predicting Retweeting Behavior on Breast Cancer Social Networks: Network and Content Characteristics , 2016, Journal of health communication.

[9]  M. McPherson,et al.  Birds of a Feather: Homophily in Social Networks , 2001 .

[10]  Mark S. Granovetter The Strength of Weak Ties , 1973, American Journal of Sociology.

[11]  Ed H. Chi,et al.  Want to be Retweeted? Large Scale Analytics on Factors Impacting Retweet in Twitter Network , 2010, 2010 IEEE Second International Conference on Social Computing.

[12]  Elihu Katz,et al.  The two-step flow of communication. , 1960 .

[13]  Pamela Briggs,et al.  Understanding Twitter influence in the health domain: a social-psychological contribution , 2014, WWW.

[14]  Jon-Patrick Allem,et al.  Campaigns and counter campaigns: reactions on Twitter to e-cigarette education , 2016, Tobacco Control.

[15]  B. A. Conway,et al.  The effects of laforin, malin, Stbd1, and Ptg deficiencies on heart glycogen levels in Pompe disease mouse models , 2015 .

[16]  E. Larson,et al.  Dissemination of health information through social networks: twitter and antibiotics. , 2010, American journal of infection control.

[17]  Jeong Yeob Han,et al.  Cancer Talk on Twitter: Community Structure and Information Sources in Breast and Prostate Cancer Social Networks , 2014, Journal of health communication.

[18]  Andrew R Binder,et al.  Celebrity Influence and Identification: A Test of the Angelina Effect , 2016, Journal of health communication.

[19]  W. Chou,et al.  Communicating About Cancer Through Facebook: A Qualitative Analysis of a Breast Cancer Awareness Page , 2015, Journal of health communication.

[20]  J. Fleiss Statistical methods for rates and proportions , 1974 .

[21]  Sarah Moreland-Russell,et al.  Diabetes Topics Associated With Engagement on Twitter , 2015, Preventing chronic disease.

[22]  E. Katz The Two-Step Flow of Communication: An Up-To-Date Report on an Hypothesis , 1957 .

[23]  Ting Wang,et al.  Who will retweet me?: finding retweeters in twitter , 2013, SIGIR.

[24]  Wandong Cai,et al.  Analysis of the retweetting behavior of Weibo users based on game theory , 2014, The 2014 5th International Conference on Game Theory for Networks.

[25]  Huan Liu,et al.  Is the Sample Good Enough? Comparing Data from Twitter's Streaming API with Twitter's Firehose , 2013, ICWSM.

[26]  Stefan Stieglitz,et al.  Emotions and Information Diffusion in Social Media—Sentiment of Microblogs and Sharing Behavior , 2013, J. Manag. Inf. Syst..

[27]  Michael Etter,et al.  Broadcasting, reacting, engaging – three strategies for CSR communication in Twitter , 2014 .

[28]  Donald K. Wright,et al.  Symmetry, Social Media, and the Enduring Imperative of Two-Way Communication , 2013 .

[29]  Andrew Firman Analysis with a purpose , 1977 .

[30]  Hyojung Park,et al.  Tweeting as Health Communication: Health Organizations’ Use of Twitter for Health Promotion and Public Engagement , 2016, Journal of health communication.

[31]  M. Goodchild,et al.  Spatial, temporal, and socioeconomic patterns in the use of Twitter and Flickr , 2013 .

[32]  Juan-Zi Li,et al.  Social Influence Locality for Modeling Retweeting Behaviors , 2013, IJCAI.

[33]  Youngkyu Kim,et al.  Understanding the Effect of Message Content and User Identity on Information Diffusion in Online Social Networks , 2013, PACIS.

[34]  Grant D. Jacobsen,et al.  Health awareness campaigns and diagnosis rates: evidence from National Breast Cancer Awareness Month. , 2011, Journal of health economics.

[35]  Jenine K Harris,et al.  Communication about childhood obesity on Twitter. , 2014, American journal of public health.

[36]  Shuqiang Yang,et al.  A Dynamic Microblog Network and Information Dissemination in “@” Mode , 2014 .

[37]  Albert,et al.  Emergence of scaling in random networks , 1999, Science.

[38]  Carter T. Butts,et al.  What it Takes to Get Passed On: Message Content, Style, and Structure as Predictors of Retransmission in the Boston Marathon Bombing Response , 2015, PloS one.

[39]  Bernard J. Jansen,et al.  Twitter power: Tweets as electronic word of mouth , 2009 .

[40]  Juan-Zi Li,et al.  Understanding retweeting behaviors in social networks , 2010, CIKM.

[41]  Jiyeon So,et al.  What Do People Like to “Share” About Obesity? A Content Analysis of Frequent Retweets About Obesity on Twitter , 2016, Health communication.

[42]  Jürgen Buder,et al.  Making retweeting social: The influence of content and context information on sharing news in Twitter , 2015, Comput. Hum. Behav..

[43]  Marco Conti,et al.  Why Do I Retweet It? An Information Propagation Model for Microblogs , 2013, SocInfo.

[44]  Mark Wallace,et al.  The Effects of the Social Structure of Digital Networks on Viral Marketing Performance , 2008 .

[45]  Carter T. Butts,et al.  A cross-hazard analysis of terse message retransmission on Twitter , 2015, Proceedings of the National Academy of Sciences.

[46]  Stuart W. Shulman DiscoverText: software training to unlock the power of text , 2011, dg.o '11.

[47]  Jianxin Li,et al.  Predicting the Spread of a New Tweet in Twitter , 2015, ADC.

[48]  Friedrich W. Hesse,et al.  Audience design in Twitter: Retweeting behavior between informational value and followers' interests , 2014, Comput. Hum. Behav..

[49]  Rosemary Thackeray,et al.  Analysis of the Purpose of State Health Departments' Tweets: Information Sharing, Engagement, and Action , 2013, Journal of medical Internet research.

[50]  Pin Luarn,et al.  The network effect on information dissemination on social network sites , 2014, Comput. Hum. Behav..

[51]  Ji Young Lee,et al.  To Tweet or to Retweet? That Is the Question for Health Professionals on Twitter , 2013, Health communication.

[52]  Gregory D. Saxton,et al.  Information, Community, and Action: How Nonprofit Organizations Use Social Media , 2011, J. Comput. Mediat. Commun..

[53]  Eric Sun,et al.  Gesundheit! Modeling Contagion through Facebook News Feed , 2009, ICWSM.

[54]  Dan Zhu,et al.  Understanding Factors Influencing Users' Retweeting Behavior - A Theoretical Perspective , 2014, AMCIS.

[55]  Katherine L. Milkman,et al.  What Makes Online Content Viral? , 2012 .

[56]  Brian G. Southwell,et al.  Social Networks and Popular Understanding of Science and Health: Sharing Disparities , 2013 .

[57]  Peng Bao,et al.  Cumulative Effect in Information Diffusion: Empirical Study on a Microblogging Network , 2013, PloS one.

[58]  Shelly Rodgers,et al.  Analyzing Health Organizations' Use of Twitter for Promoting Health Literacy , 2013, Journal of health communication.

[59]  N. Girard,et al.  National breast cancer awareness month. , 2006, AORN journal.

[60]  Ee-Peng Lim,et al.  Virality and Susceptibility in Information Diffusions , 2012, ICWSM.

[61]  M. Sarvary,et al.  Network Effects and Personal Influences: The Diffusion of an Online Social Network , 2011 .

[62]  Diana M Eccles,et al.  The Angelina Jolie effect: how high celebrity profile can have a major impact on provision of cancer related services , 2014, Breast Cancer Research.

[63]  Amit P. Sheth,et al.  A Qualitative Examination of Topical Tweet and Retweet Practices , 2010, ICWSM.