JMIR Publications

ABSTRACT

Background:

Social media has emerged as a prominent approach for health education and promotion. However, it is challenging to understand how to best promote health-related information on social media platforms such as Twitter. Despite commercial tools and prior studies attempting to analyze influence, there is a gap to fill in developing a publicly accessible and consolidated framework to measure influence and analyze dissemination strategies.

Objective:

This study aims to develop a theoretical framework to measure topic-specific user influence on Twitter for public use and support public health agencies in improving their dissemination strategies.

Methods:

We designed a consolidated framework for measuring influence that can capture topic-specific tweeting behaviors. The core of the framework is a summary indicator of influence decomposable into four-dimensional measures: activity, priority, originality, and popularity. These measures can be easily visualized and computed efficiently for any Twitter account without the need for private access. We demonstrated the proposed methods using a case study on dietary sodium with sampled stakeholders, then compared the framework with a traditional measure of influence.

Results:

More than half a million sodium tweets from 2006 to 2022 were retrieved from Twitter for sixteen U.S. domestic and international stakeholders in four categories, including public agencies, academic institutions, professional associations, and experts. We discovered that the World Health Organization (WHO), the American Heart Association (AHA), the Food and Agriculture Organization of the United Nations (UN-FAO), and World Action on Salt (WASH) were the top four sodium influencers in the sample. Each had different strengths and weaknesses in their dissemination strategies, and two stakeholders with similar overall influence, such as UN-FAO and WASH, could have significantly different tweeting patterns. In addition, we identified exemplars in each dimension of influence. Regarding tweeting activity, a dedicated expert published more sodium tweets in the past 16 years than any organizations in the sample. In terms of priority, WASH had more than half of its tweets dedicated to sodium. UN-FAO had both the highest proportion of original sodium tweets and posted the most popular sodium tweets among all sampled stakeholders. Regardless of excellence in one dimension, the four most influential stakeholders excelled at least two out of four dimensions of influence.

Conclusions:

Results from the case study demonstrated that our method not only aligned with a traditional measure of influence but also advanced influence analysis by composing topic-specific influence into four dimensions. We also provided quantifiable measures for users to optimize their time and financial investments on Twitter and for public health entities to refine their social media campaign strategies. Our framework can be applied to improve the dissemination of other health topics, as well as assist policymakers and public campaign experts to maximize population impact.