JMIR Publications

ABSTRACT

Background:

The protection of public health depends on the effective communication of health-related information to the public, especially during times of crisis or emergency. While public health communication campaigns have traditionally relied on mass media outlets, they increasingly incorporate social media platforms. This article presents a content analysis of original communications posted to X (formerly Twitter) by the Chicago Department of Public Health from May 1, 2022–April 30, 2023, a time characterized by the concurrent COVID-19 pandemic and mpox epidemic emergencies.

Objective:

To investigate (1) what information was being discussed by officials, (2) how information was being presented to the public, and (3) why officials were engaging in risk communication. A secondary objective included using a bioethical risk communication framework to investigate the intent of mpox-related communications.

Methods:

Original communications posted by the CDPH from May 1, 2022–April 30, 2023, were collected. Select communication attributes were extracted as data at the time of collection. Two researchers independently reviewed the communications using a coding schema that was developed to codify the health topics and the intent of communications relating to mpox. Once coding was complete, the percent agreement and Cohen’s kappa were used to assess intercoder reliability. Negative binomial regressions were used to investigate the impact of communication attributes on public engagement. Spearman’s rank correlation coefficients were used to measure the strength and direction of the correlation between the weekly number of reported mpox cases and the number of weekly mpox-related communications.

Results:

Overall, 1,105 original communications were posted, with a majority posted in English, during the standard workday, and with additional media. None of the communications directly responded to content posted by other accounts. Regression analysis suggested that communications posted in English, those with additional media, and those discussing select health topics received significantly higher levels of engagement; notably, communications discussing communicable diseases were not among these. Additionally, mpox-related communications were positively correlated with reported mpox cases at a significant level, and most mpox-related communications were posted with the intent of informing the public, as opposed to explicitly influencing public behavior.

Conclusions:

Social media platforms can represent valuable tools for risk communication during public health emergencies but should supplement other dissemination vehicles that may be more appropriate for communicating nuanced information, achieving behavior change, or reaching certain demographic groups. Clinical Trial: Not applicable.