[Use of Social Media to Monitor and Predict Outbreaks and Public Opinion on Health Topics]

by

ACKNOWLEDGEMENT

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

DECLARATION

I, [type your full first names and surname here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

Signed __________________ Date _________________

ABSTRACT

This thesis reports on the use of Twitter during the 2009 H1N1 pandemic to explore its use as an "infoveillance" approach complementary to traditional surveys and content analysis. This study aimed to: 1) report on the use of "H1N1" versus "swine flu", 2) conduct a qualitative analysis of tweet content, and 3) assess the feasibility of Twitter as a real-time content, sentiment, and public attention trend tracking tool. A manual content analysis of tweets revealed that H1N1 resources were the most commonly shared. Few tweets provided inaccurate information. News websites were the most popular resources while official agencies were rarely referenced directly. Our automated analysis correlated well with manual results and showed that Twitter activity was influenced by external events. This study describes the character and quality of Twitter communications during the H1N1 pandemic, and illustrates the potential of using social media to conduct real-time "infodemiology" studies for public health.

TABLE OF CONTENTS

ACKNOWLEDGEMENT2

DECLARATION3

ABSTRACT4

CHAPTER 1: INTRODUCTION7

Research Objectives:10

CHAPTER 2: LITERATURE REVIEW12

Social Media13

Social Media Applications15

Facebook15

Flickr21

YouTube21

Internet & Social Media Usage27

Twitter Usage29

Social Media Analytics32

Public Health Emergencies34

The Social Amplification of Risk & Social Media37

Specific CDC Social Media Campaigns38

Federal Emergency Management Agency (FEMA)39

Public Health Agency of Canada (PHAC)40

The Public's Use of Social Media & Web 2.0 in Emergencies40

2003 SARS Epidemic41

August 29, 2005 Hurricane Katrina43

May 12, 2008 China Sichuan Earthquake49

2008 Hurricane Gustav & Ike51

2009 Red River Flooding52

January 13, 2010 Haiti Earthquake54

CHAPTER 3: METHODOLOGY56

Data Collection & Database58

Knowledge Translation: H1N1 versus Swine Flu Terminology59

Audit of Retweets60

CHAPTER 4: DISCUSSION AND ANALYSIS61

Effectiveness of Youtube and other social networks69

Infodemiology & Infoveillance71

Infodemiology Applications in Research72

Infodemiology Applications in Public Health75

Implications to public relations theory76

Implications for practice78

Advantages & Disadvantages of Infodemiology Approaches85

Public Perceptions & Attitudes towards H1N187

Emotional Responses to H1N188

H1N1 Vaccination Attitudes & Intentions88

Perceptions of Authorities90

Information Needs & Sources90

CHAPTER 5: CONCLUSION95

Overview of Principle Findings95

Knowledge Translation: H1N1 versus Swine Flu Terminology95

Tweet Content & Public Attention96

Retweets98

Information Demands & Sources99

Automated Analysis101

Methodological Limitations & Advantages102

Practical Implications for Public Health106

Research Objectives Revisited107

Future Directions109

REFERENCES112

CHAPTER 1: INTRODUCTION

Most influenza viruses occur in birds, particularly the aquatic waterfowl that are their natural reservoir. Only a few types of influenza virus have circulated widely in humans. "Bird flu" refers colloquially to both influenza in birds and to instances when these avian viruses jump the species barrier to cause human disease. The influenza A genome encodes 2 major surface glycoproteins, the hemagglutinin (H) and neuraminidase (N) proteins. The subtypes of these proteins are antigenetically distinct, having 16 H subtypes and 9 N subtypes. All of these subtypes may be found in birds, but only H1, H2, and H3 ...