Informing humanitarians worldwide 24/7 — a service provided by UN OCHA

World + 3 more

Health Information Needs and Health Seeking Behavior During the 2014-2016 Ebola Outbreak: A Twitter Content Analysis

Attachments

AUTHORS

Dr. Michelle Odlum

Sunmoo Yoon

ABSTRACT

Introduction: For effective public communication during major disease outbreaks like the 2014-2016 Ebola epidemic, health information needs of the population must be adequately assessed. Through content analysis of social media data, like tweets, public health information needs can be effectively assessed and in turn provide appropriate health information to address such needs. The aim of the current study was to assess health information needs about Ebola, at distinct epidemic time points, through longitudinal tracking.

Methods: Natural language processing was applied to explore public response to Ebola over time from July 2014 to March 2015. A total 155,647 tweets (unique 68,736, retweet 86,911) mentioning Ebola were analyzed and visualized with infographics.

Results: Public fear, frustration, and health information seeking regarding Ebola-related global priorities were observed across time. Our longitudinal content analysis revealed that due to ongoing health information deficiencies, resulting in fear and frustration, social media was at times an impediment and not a vehicle to support health information needs.

Discussion: Content analysis of tweets effectively assessed Ebola information needs. Our study also demonstrates the use of Twitter as a method for capturing real-time data to assess ongoing information needs, fear, and frustration over time.

FUNDING STATEMENT

The author(s) received no specific funding for this work.

INTRODUCTION

The 2014-2016 West African Ebola outbreak was the most pervasive in history, reaching epidemic proportions 1. The outbreak was marked with 11,325 fatalities, 28,652 reported cases and uncontrolled spread 2. It was further characterized as an epidemic of fear and anxiety, when case identification reached the US and Europe 3. In spite of reports describing modes of transmission, signs and symptoms and the low likelihood of a widespread epidemic, people in developed nations remained overly anxious. In fact, Americans listed Ebola as the third top health concern in October of 2014, clearly indicating fear and highlighting the need for effective health education 3,4. As described by the Conceptual Framework of Public Health Surveillance and Action (PHSA), public health surveillance and action to control disease are connected through data information messages. 5. To support public health action, health information messages must be widely disseminated to the public. As fear drives epidemics, evidenced by the Ebola spread in West Africa, it is essential to understand public opinion to identify health information needs 23. When these needs are recognized, tailored literacy appropriate health information can be disseminated to diminish widespread fear 6. Social media can support dissemination efforts. It allows tremendous opportunities to provide literacy appropriate health information through mass dissemination 8. Evidence by health information tweets disseminated regularly through organizations including the CDC, World Health Organization and local health departments 17, 21. Social Networking Sites like Twitter encourages users to provide and share information. The analysis of social media data allows for an assessment of the public’s knowledge, personal experiences, and health information needs 7.

Mining of social media data provides a snap shot of health knowledge in addition to the longitudinal tracking of changes in such knowledge and emerging health information needs over time. Micro-blogging is a very powerful and popular communication tool. Millions of messages are sent daily on micro-blogging sites such as Twitter 8. Research has demonstrated that Twitter is a reliable source for tracking knowledge and opinions for a variety of events and issues 7. Such tools allow the public to play a role in knowledge translation including information generation, filtering and dissemination 7,9 . It then becomes critical during epidemics and other emergencies to monitor online public perceptions and responses. Online monitoring allows for the examination of knowledge translation and for the modification and tailoring of health information for effective health educational campaigns 5,7.

The current study sought to assess health information needs about Ebola through longitudinal tracking. We provide a snapshot of beliefs, opinions and responses at three time points beginning in August 2014, when the outbreak raged out of control and through March 2015, when the outbreak showed evidence of containment. Through natural language processing (NLP) and content analysis, we explore how Twitter users communicate about Ebola-related events over time and identify health information needs that emerge at each time point.