UCLA looks to Twitter for health trends

Tweets may reveal public health issues
Tweets may reveal public health issues

Twitter's 140-character limit may be just long enough to help researchers track the health concerns of hard-to-reach patient groups like the transgender community, according to a UCLA study.

UCLA researchers studied the tweets of transgender individuals during a 24-hour snapshot in July of last year. They said Twitter is an accessible forum that can create a community around common interests and provide a level of anonymity that makes it easier for users to have conversations they consider difficult. Transgender individuals are likely to drop out of school, have high levels of mental distress and often experience violence. Tweets can help researchers see this.

“It is imperative to better understand the nature of these experiences in order for public health and social work practitioners to implement effective intervention strategies,” they wrote in the study published in JMIR Mental Health earlier this month.

The researchers winnowed down a pool of 5,860 tweets to 1,135 excluding factors like duplicate tweets, irrelevant content, sexually explicit messages or languages other than English.

They found that three hashtags dominated the tweet pool—#girlslikeus, #transgender and #trans. The content fell into four categories, with positive tweets making up the majority of tweets associated with the transgender community. Positive social tweets, which showed support for policies or individuals, represented 54.7% of the tweet pool, while negative social tweets, which discussed actions that had a negative impact on tweeters—such as “w/out accurate ID #transgender people face tremendous difficulty fully participating in society”—made up 26.3% of the surveyed tweets.

Greg Matthews, managing director at healthcare agency W2O group, told MM&M that Twitter is an effective way to track a broad range of health conversations. His firm, which is not affiliated with the UCLA researchers, does this type of research on a regular basis and the researchers continue to evaluate how best to use the platform for health information.

Researchers at Johns Hopkins University noted in 2011 that Twitter's health insights can go beyond tracking the flu's regional infection patterns; researchers Michael Paul and Mark Dredze wrote at the time that tweets can also show that antibiotics were being given to treat the flu even though they would not have an impact on the virus. In a separate study, researchers also said Twitter can help professionals spot language cues that are associated with certain conditions, like post-traumatic stress disorder and depression.

But one limitation of using Twitter to track patients or hard-to-reach groups is that Twitter anonymity makes it hard to verify the interests of the people tweeting. W2O's focus has long been physicians, in part because they can verify the doctor based on the bio, which leads to a series of checks including their medical license number. However, patients can't be verified in that manner. W2O is working on tackling that issue so data provided by everyday non-licensed individuals can be considered reliable.

Despite drawbacks like the small data pool and anonymous data, Matthews said the UCLA study is a good example of research that is being done about online interactions.

Although Twitter users are generally thought to be in their late teens or in their early 30s, Matthews said healthcare tweeters are older, usually in their 40s. He said this applies to both health professionals and patients. Higher physician use of Twitter is partly due to more flexible schedules, unlike younger residents who are more crunched for time, as well as a sign that they are comfortable using the platform to communicate.

He said health-tweeting patients are generally older because it's the age at which they become responsible for caring for children or parents and they are using Twitter to share information or concerns.