How U.S. children's hospitals use social media: A mixed methods study
Introduction
Social media, including social networking sites (Facebook.com, Google+), microblogs (Twitter.com), and photograph and video sharing (Pinterest.com, YouTube.com), are changing the speed and depth of interaction between healthcare organizations and the public. Early hospital adoption of social media has focused considerably on marketing.1, 2 In addition to supporting a hospital's marketing goals, social media can be used for health education, a cornerstone of pediatric primary care, and to promote the population health of communities.3, 4
Children's hospitals have a unique social media target audience that includes both families and children, who interact with social media at increasingly younger ages.5, 6, 7 Dissemination through social media of timely healthcare messages and promotion of events for the community can result in community benefit, a goal of increasing importance as non-profit hospitals face stricter definitions of community benefit under the Affordable Care Act (ACA).8, 9 Under this ACA provision, tax-exempt non-profit hospitals are required to conduct an assessment of community needs and develop an implementation strategy to address the identified needs every 3 years.8
Little is known about the state of social media engagement and use by children's hospitals. In this cross-sectional mixed methods study, we examined the association between children's hospital characteristics and social media presence, and conducted a content analysis of Facebook themes and engagement. Using these mixed method, we provide a comprehensive description of the social media presence and distribution of Facebook content curation and engagement across free-standing US children's hospitals. The mixed methods approach offers a richer description of the social media landscape than either a quantitative or qualitative approach alone.10 Identifying current patterns of social media use and public engagement among children's hospitals can inform ways to maximize hospitals' social media efforts and its potential to address the ACA's community benefit requirement. We hypothesize that social media adoption by children's hospitals will be high and that public engagement with their social media platforms will be variable.
Section snippets
Materials and methods
We examined the social media presence of all 47 freestanding US children's hospitals, which were identified through the Children's Hospital Association.11 Freestanding children's hospitals rather than combined adult–pediatric hospitals were selected to allow for focus on the social media efforts directed towards children and their families. We excluded two freestanding children's hospitals with shared social media accounts for a larger affiliated children's hospital or its affiliated adult
Social media platform adoption and engagement
All US children's hospitals in the sample (n=45) maintained Facebook and Twitter accounts. The median number of Facebook page likes was 26,218 (1st quartile 15,475, 3rd quartile 52,768). Two hospital outliers had 725,688 and 1,257,737 likes. On Twitter, the median number of account followers was 7951 (1st quartile 3408, 3rd quartile 9699). A single hospital outlier had 264,867 followers.
The geographic distribution of social media engagement on Facebook and Twitter is presented in Fig. 1. No
Discussion
Social media adoption by US children's hospitals was widespread with varying levels of public engagement. Through a Facebook content analysis, we identified that beyond its traditional marketing role, social media can serve as a conduit for engagement with communities, health education, and likely community benefit. While Facebook posts that featured narratives and community partnerships achieved higher engagement, those with health educational messaging did not.
We found universal adoption of
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