obstetrics, gynecology, and twitter: a primer on strategic social media to improve women's...

Obstetrics, Gynecology & TwitterA Primer on Strategic Social Media to Improve Women’s Health

Neel T. Shah, M.D., M.P.P.September 29, 2010Brigham & Women’s Hospital

Web 2.0Disclosure

I have no financial relationship with a commercial entity producing health care related products or services

Web 2.0What does Facebook have to do with gynecology?

Web 2.0

Source: Congressional Budget Office, W3 Consortium

1960 1980 2000 2020 20400.0%

10.0%

20.0%

30.0%

U.S. Healthcare Spending in % GDP

2000 2002 2004 2006 20080

50

100

150

200

Number of Websites in Mil-lions

What does Facebook have to do with gynecology?the Internet health care

Web 2.0Roadmap

•How do Americans get healthcare information?

•What is web 2.0?

•How do social networks influence health outcomes?

•How is social media being used to influence health choices?

•How can Ob/Gyn’s best engage with social media?

Web 2.0

Disease associations/Support Groups

Pharmaceutical companies

Someone else with the same condition

Nurse/Nurse practitioner

Pharmacist

Television

Newspapers/Magazines

Relatives/Friends/Co-workers

Doctor

Internet

7%

10%

11%

15%

18%

19%

22%

29%

55%

59%

How do Americans get healthcare information?

Source: iCrossing. How America Searches: Health and Wellness. January 2008

Sources used to find or access health information in the past 12 months

Web 2.0How do Americans get healthcare information?

Source: Harris Poll August 2010

62% of American adults who use the Internet have looked up health information in the last month

88% of online American adults have looked up health information at some point


Source: National Cancer Institute Health Information National Trends Survey. 2005.

Provider Internet Other0%

10%

20%

30%

40%

50%

60%

Information source used first among cancer survivors (2-5 years from diagnosis)


Source: Pew Internet and American Life Project

Trends in use of internet for health information

2002 2004 2006 20080%

10%

20%

30%

40%

50%

60%

Specific Disease or ProblemCertain medical treatment or proce-dureExercise or Fitness


Source: Pew Internet and American Life Project, Google Analytics

37% of U.S. adults are getting health information from social media

Women are significantly more engaged then menFB is 57% women – they have 8% more friends and participate in 62% of the sharing compared to men

Web 2.0What is web 2.0?


Web 1.0 – you go to websites to read information

Web 2.0 – information from web brought to you through feeds(social media is the platform used to read these feeds)


Source: Wikipedia 2010

Social media are media for social interaction, using highly accessible and scalable publishing techniques via social networks

Social media are distinct from industrial or traditional media, such as newspapers, television, and film.


Source: Facebook

500 million active users (150 million mobile)If country, would be third largest behind China and IndiaFastest growing demographic > 3530 billion pieces of content shared per month

Gardasil: 106,000 peopleHHS Office of Women’s Health: 1,213 peopleACOG: 0 people (no page)


Source: Twitter, Reuters, Google News

2008 2009 20100

20,000,00040,000,00060,000,00080,000,000

100,000,000120,000,000140,000,000160,000,000

Rapid growth



Changing the world?

•News and opinion•Searching•Marketing, advertising, and campaigning


145 million active users (95 million mobile)Fastest growing demographic 35-4565 million tweets/day (750 per second)Twitter replacing Google search (real time results)

MacArthur ObGyn: 1,200 followersACOG: 800 followers



Source: Wikipedia 2010

Social media are media for social interaction, using highly accessible and scalable publishing techniques via social networks

Web 2.0Social Networks and Health Outcomes

Source: Berkman LF and Syme SL. “Social Networks, Host Resistance, and Mortality: A Nine Year Follow up Study of Alameda Country Residents.” Amer J Epid. 1979.



I II III IV0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

MenWomen

All Cause Mortality Rates by Social Network Index for Men and Women Age 60-69



I IV0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

MenWomen

All Cause Mortality Rates by Social Network Index for Men and Women Age 60-69

RR = 1.8

RR = 3.0

Social Networks and Health Outcomes

Source: Dizon DS, Schutzer ME et al. “Advance care planning decisions of women with cancer: provider recognition and stability of choices”. J Psychosoc Oncol. 2009.

Social networks influence advance care planning decisions of women with ovarian cancer

Social network independently related to postpartum depressionSource: Surkan PJ, Peterson KE et al. “The role of social networks and support in postpartum women's depression: a multiethnic urban sample”. Matern Child Health J. 2006

Social networks normatively influence sexual risk-taking behaviorSource: Dedobbeleer N, Morissette P, Rojas-Viger C. “Social network normative influence and sexual risk-taking among women seeking a new partner”. Women Health. 2005.

Social network independently related to decision to breastfeedSource: Johnston ML, Esposito N. “Barriers and facilitators for breastfeeding among women in the United States”. J Obstet Gynecol. 2007.

Social Networks and Health Outcomes

Web 2.0Network Theory


Source: N.A. Christakis and J.H. Fowler, "The Spread of Obesity in a Large Social Network Over 32 Years," New England Journal of Medicine 2007; 35: 370-379

Largest connected subcomponent of the social network in the Framingham Heart Study in the year 2000



A selected subcomponent of the social network in the Framingham Heart Study in the years

1975 1980




1985 1990




1995 2000



Is the “spread” of obesity in the Framingham Heart Study network induction or homophily?


Source: K. Lewis, J. Kaufman, et al., "Tastes, Ties, and Time: A New (Cultural, Multiplex, and Longitudinal) Social Network Dataset Using Facebook.com," Social Networks 2008

Obesity in a Facebook Network


Source: Centola D, "The Spread of Behavior in an Online Social Network Experiment," Science, Sep 2010

The shape of online social networks can be designed to maximize spread of health behaviors

Web 2.0How is social media being used to influence health choices?

Social networks independently effect health outcomes

Health choices propagate through social networks via induction, independent of geography

Social media enables highly accessible and scalable publication of influential messaging (and it is how many Americans get health information)

Social media is being used to influence health choices


872 hospitals are using social media

Source: Hospital Social Network List ebennett.com August 2010


“… it is our responsibility to help them use social media tools to get the best information, connect with providers and with each other, and inspire healthy choices …”

Web 2.0How can Ob/Gyn’s best engage with social media?


#1 Find out what people are saying about you


#2 Become a credible filter of information


#3 Integrate social media into your practice

Web 2.0Final Thoughts

•How do Americans get healthcare information?

•What is web 2.0?

•How do social networks influence health outcomes?

•How is social media being used to influence health choices?

•How can Ob/Gyn’s best engage with social media?

obstetrics, gynecology, and twitter: a primer on strategic social media to improve women's...

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