US State Public Health Agencies' Use of Twitter From 2012 to 2022: Observational Study

Area of Science:

• Public Health Communication
• Social Media Analysis
• Health Informatics

Background:

• US health agencies utilize Twitter (X) for public health communication.
• Limited data exists on state health agencies' Twitter (X) usage trends.
• Understanding platform use is crucial amid evolving social media post-COVID-19.

Purpose of the Study:

• To analyze US state health agencies' Twitter (X) engagement from 2012-2022.
• To apply the networked public framework to health communication research.
• To provide insights into platform utilization beyond single-channel analysis.

Main Methods:

• Utilized Twitter (X) API data to assess communication qualities: scalability, persistence, replicability, and searchability.
• Measured tweet volume and engagement for scalability.
• Analyzed retweets and mentions for persistence and replicability.
• Examined hashtag usage for searchability.

Main Results:

• Observed a significant increase in tweet volume during the COVID-19 pandemic (2020), with higher post-pandemic levels than pre-pandemic peaks.
• Noted a shift towards more fragmented searchability, with increased use of state-specific hashtags during the pandemic.
• Found no clear pandemic-era shift in replicability or persistence; account mentions shifted towards state agencies post-2018.

Conclusions:

• State health agencies adopted a more fragmented communication approach on Twitter (X) during the pandemic.
• Communication prioritized message volume and formal replication over enhanced searchability.
• Interactions with other accounts became more prominent, leaving traces of communication networks.