Using Social Media to Track Geographic Variability in Language About Diabetes: Analysis of Diabetes-Related Tweets Across the United States.

Heather Griffis,Lyle Ungar,Raina M Merchant,David A Asch,H Andrew Schwartz,Alison M Buttenheim,Frances K Barg,Nandita Mitra

doi:10.2196/14431

Abstract

BackgroundSocial media posts about diabetes could reveal patients’ knowledge, attitudes, and beliefs as well as approaches for better targeting of public health messages and care management.ObjectiveThis study aimed to characterize the language of Twitter users’ posts regarding diabetes and describe the correlation of themes with the county-level prevalence of diabetes.MethodsA retrospective study of diabetes-related tweets identified from a random sample of approximately 37 billion tweets from the United States from 2009 to 2015 was conducted. We extracted diabetes-specific tweets and used machine learning to identify statistically significant topics of related terms. Topics were combined into themes and compared with the prevalence of diabetes by US counties and further compared with geography (US Census Divisions). Pearson correlation coefficients are reported for each topic and relationship with prevalence.ResultsA total of 239,989 tweets from 121,494 unique users included the term diabetes. The themes emerging from the topics included unhealthy food and drink, treatment, symptoms/diagnoses, risk factors, research, recipes, news, health care, management, fundraising, diet, communication, and supplements/remedies. The theme of unhealthy foods most positively correlated with geographic areas with high prevalence of diabetes (r=0.088), whereas tweets related to research most negatively correlated (r=−0.162) with disease prevalence. Themes and topics about diabetes differed in overall frequency across the US geographical divisions, with the East South Central and South Atlantic states having a higher frequency of topics referencing unhealthy food (r range=0.073-0.146; P<.001).ConclusionsDiabetes-related tweets originating from counties with high prevalence of diabetes have different themes than tweets originating from counties with low prevalence of diabetes. Interventions could be informed from this variation to promote healthy behaviors.

Highlights

Diabetes affects 30 million people in the United States, and its prevalence varies by geographic region
Diabetes-related tweets originating from counties with high prevalence of diabetes have different themes than tweets originating from counties with low prevalence of diabetes
Examples of topics that correlated with diabetes-related tweets included unhealthy food and drink-themed topics [(cupcakes, whipped, Haribo, and sundae) and] as well as a risk factors theme and a fundraising theme

Summary

Introduction

Background Diabetes affects 30 million people in the United States, and its prevalence varies by geographic region. 1 (page number not for citation purposes) Social media platforms such as Twitter, Facebook, and Instagram have emerged as high-volume, real-time data sources to study and observe communications, including health-related communications, from broad population segments [1,2,3,4,5]. Web-based communities are often far reaching, offering various types of communication including person-to-person communication, information seeking and dissemination, social support, and broadcasting of ideas and opinions. These communities can have similar location-specific characteristics. Social media posts about diabetes could reveal patients’ knowledge, attitudes, and beliefs as well as approaches for better targeting of public health messages and care management

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Discussion

Conclusion