New media spread the word on H1N1

Twitter, YouTube messages aimed at public

By Stephen Smith
Globe Staff / December 11, 2009

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“No lines, free H1N1 vaccine still available at West Roxbury flu clinic. Hurry. The clinic closes today at 4.’’ - Twitter message from the Boston Public Health Commission, Sunday afternoon

Never before has a virus gone viral like this. There are swine flu blogs and swine flu tweets, swine flu videos on YouTube and swine flu groups on Facebook.

The arrival of the H1N1 virus, and young people’s vulnerability to it, have forced public health agencies to muster new media with unprecedented fervor. It’s a matter, disease specialists said, of going where the young audience is.

“They don’t watch the news at 6 o’clock,’’ said Barbara Ferrer, executive director of the Boston Public Health Commission. “They’re not going to pick up our pamphlets.’’

So Ferrer’s agency commissioned a rap rendition that exhorts viewers to cover their coughs and posted it on YouTube, the popular video-sharing service. The Massachusetts Department of Public Health composed blogs in three languages and invited public comments, yielding an on-the-ground perspective that helped hone disease-fighting strategies. And the nation’s swine flu war room in Atlanta created eCards that friends and relatives can send to offer a gentle nudge to wash hands or get a flu shot.

Despite flinty budgets and a culture of caution, public health’s embrace of social media is resonating with consumers, preliminary evidence suggests.

Swine flu videos posted by the US Centers for Disease Control and Prevention on YouTube have attracted 3 million views since late April, a more than respectable level of traffic but still not in the league with blockbusters like the British TV debut of novice chanteuse Susan Boyle (80 million views).

Still, at least one specialist in health communications argues that public health agencies need to be more aggressive in tracking and responding to outside bloggers who have sewn doubt about the safety of vaccines and the dangers of swine flu.

“The traditional model of one-way communication, with knowledge developed on high, has been overthrown by new media,’’ said Jay Winsten, a Harvard School of Public Health professor. “We have to be part of the conversation, or it’s going to go on without us.’’

That conversation continues even though the second wave of swine flu infections has peaked. State health authorities reported yesterday that the volume of new cases has reached the lowest point in nearly two months.

Last week influenza accounted for 2.53 percent of visits to a representative sampling of Massachusetts physicians, the report from the state Department of Public Health found. A week before that it stood at 3.55 percent, and at some points in November nearly 10 percent of visits were attributed to the flu.

About three years ago, the CDC created the Division of E-health Marketing to preside over social media campaigns.

“Our philosophy had been, dip your toe in the water, start small, make it better over time, and build it,’’ said Janice Nall, director of the division.

The emergence of the H1N1 virus last spring forced the CDC to expedite its approach.

Officials shot videos, wrote Twitter missives (140 characters maximum), and transmitted text messages to cellphone screens - 15,000 people now subscribe to the service.

But the urge to respond through social media, with its casual patter and truncated messages, had to be balanced against the need to remain faithful to scientific knowledge.

“In government, it’s not a real risk-loving culture,’’ Nall said. “When you’re dealing with scientists who want full data, it’s a little troublesome to get all that data in 140 characters.’’

In one telephone text message, for example, specialists managed to squeeze advice about protecting infants into about one screen-full:

Babies under 6 mos. can’t get flu vaccine & are at high risk 4 complications. If U care 4 or live w/infants, get vaccinated to protect them. CDC 800-232-4636.’’

Whether the tweets and text messages are translating into better health remains unclear, but a CDC survey found that people who connected to new media through the agency’s website were more satisfied with the information they received than people who didn’t.

At the very least, the agency has become the predominant online choice for swine flu information. About 28 percent of search engine users who hunted for H1N1 guidance during the past month wound up going to the CDC website; next closest was Wikipedia, at 9 percent, said Bill Tancer, general manager for global research at Experian Hitwise, which measures Internet traffic.

Swine flu blogs run by the Massachusetts Department of Public Health are averaging 2,500 hits a day and have reached as high as 8,000.

The public health agency started the first blog anywhere in the state’s executive branch in January when it unveiled a nutrition and exercise initiative. The Mass in Motion blog provided a template three months later, on a frantic April weekend, as swine flu colonized the United States.

“So we were able to quickly set up an H1N1-specific blog,’’ said Suzanne Crowther, the department’s communications director. “We posted things as quickly as we were finding it out, and we were able to have a two-way conversation.’’

The blogs - in English, Spanish, and Portuguese - proved an immediate success, generating so much traffic that the department abandoned its original goal of answering every question. Instead, moderators used the comments to identify the most pressing concerns and respond in blog posts.

The agency also launched swine flu podcasts in six languages, addressing issues specific to ethnic communities. In a Spanish-language podcast, a specialist explains that although the word gripa can refer to a cold or influenza, the viral ailments are distinct, said Jordan Coriza, the department’s director of ethnic media engagement.

In September and October, the latest two months for which information is available, the podcasts were downloaded 2,000 times.

The Boston Public Health Commission enlisted interns to create a witty video branded “Talkin’ ‘bout the Flu,’’ riffing on a Kanye West and The Dream recording.

“When you think of the Boston Public Health Commission, you probably think of a suit, very strict, very straight to the point,’’ said Ethan McCoy, a 22-year-old who stars in the YouTube video, which has drawn nearly 5,000 views. “When you loosen it up, and people realize the people relaying the message are from their community, they’re going to sing it to themselves over and over - ‘I’ll cough in my sleeve’ - and they’ll start coughing in their sleeve.’’

Stephen Smith can be reached at