In this section, we will discuss best practices for using social media to optimize and to disseminate health equity research. Why should researchers use social media? Well, social media is a tool that researchers can use to disseminate their own research, access new research from around the world, and furthermore, to evaluate new health equity research. Social media is now being used by the direct education of patients and caregivers to access medical literature and to participate in meetings and conferences remotely, as well as in-person. Social media is also a tool for debate and ongoing dialogue in both the clinical and research professions. As an example, social media is also being used to facilitate online journal clubs for debate and ongoing dialogue of the scientific literature. This also includes collaboration opportunities. Specifically in health equity research, social media can create opportunities for researchers to connect with a broader and more global stakeholder audience. It can also be used to connect with experts worldwide. With social media, you can collaborate through specialized platforms such as ResearchGate, Academia.edu, or Docphin. You can use the concept of crowdsourcing to help with problem-solving or for completing difficult tasks. Another use is through PubPeer, a social network that enables scientists to search for their publications or their peers publications and provide feedback or to start a conversation anonymously. There are both pros and cons of social media use. Let's talk about something I like to call the five V's. Let's start with the pros. First of all, social media is viable, it is viable form of communication that the public and our colleagues are both familiar with and ready to communicate on. Next, social media is visible. By using social media, we can reach more people, provide up-to-date and accurate information, combat the prevalence of fake news or other falsities that are out there online. It's particularly important in public health and medicine to do this. Also, we can see multiple viewpoints on social media. For example, in health equity research, we can gain a greater understanding of the challenges that patients face in treatment and in access to health care. Now for the cons, the cons of social media include violations. These violations are in professional ethics or even HIPAA. Violations with social media have led to the immediate termination of employees in health care, and they could be career ending. Lastly, something both good and bad, social media is like a virus. It can spread information, both good and bad quickly. Virality is one of the key reasons social media is an effective platform for information seeking and for information sharing. Historically, academic impact has been achieved through metrics such as the impact factor of a journal, citation counts, the number of publications, or something called an H-index. The H-index is an author-level metric that attempts to measure both the productivity and citation impact of the publications of a scientist or scholar. The index is based on the set of a scientist's most cited papers and the number of citations that they have received in other publications. However, times are changing. We are now focused on improving the societal impact of our academic and scientific work products. We're starting to care more about things like mentions in news reports and the media. Is our work referenced inside it in policy? Do we have mentioned and engagements on social media platforms? These new alternative metrics are something we're terming altmetrics. In scholarly and scientific publishing, all metrics are now non-traditional metrics that are proposed as an alternative to more traditional citation impact metrics that I just discussed. The term altmetrics was proposed in 2010 as a generalization of article level metrics, and it has its roots in the hashtag altmetrics movement. Altmetrics are data that can explain both the volume and nature of attention that a particular research article receives online. Certain kinds of altmetrics are also indicators for potential downstream impact. Here are some examples of altmetrics. How many times an article has been tweeted, blogged, or appears in a Google Plus Posts, or even picked up on a news outlet? This is an article that was written by Dr. Purnell. It was published in the Journal of the American Society of Nephrology, and it was a pretty substantial paper about the reduced racial disparity and kidney transplant outcomes in the United States. This paper received a lot of attention online, and was mentioned in five news outlets. Eleven people tweeted it at the time that I was able to pull this data, and it was shared on two Facebook pages. The attention score that altmetric gave was 46. That meant that it was in a top five percent of all research outputs that were scored by altmetric. The graph I'm showing here represents an analysis of about 4,600 scientific articles that were submitted to a preprint database. This was a preprint database that was a repository of electronic preprints or e-prints of scientific papers in the field of mathematics, physics, astronomy, computer science, quantitative biology, statistics, and quantitative finance. In this study, they observed a statistically significant correlation between social media mentions and downloaded paper and citation counts. They also noted that Twitter mentions had shorter delays and narrower timespans than downloads. It was also found that highly Tweeted articles were 11 times more likely to be highly cited than less Tweeted articles. We can use social media to access new literature and to leverage the interest graph. Traditional routes are primarily expensive and are immediately outdated. In scientific publishing, the era of receiving a journal by mail and having that data up-to-date is absolutely moving forward and over. Social media now can be used to link to newly published studies and data by following feeds from different journals and organizations that promote the work. Social media can be used to dynamically connect to new information that is based on following others with similar areas of interests. This is what we mean by utilizing the interest graph. How can you find people and linked information that is known to have content that is of interest to you? In this way, the field can be influenced by the open content trends, you take all the simple stuff, all the basic knowledge, and you make it free. That is the new movement of what's going on with the online access to information and the scientific publication through social media. On this screenshot, you can see a Tweet about a paper published by Dr. Purnell in the journal Health Affairs. By looking at the bottom with the red box, you can see there were 41 users on Twitter that retweeted this article and 34 Twitter users who liked this article. By looking at those individuals, you can start to leverage and utilize this interest graph that I just discussed with you. How do you set up your Twitter account? For those of you who have not yet done so, I will give you a couple of easy-to-use tips now. First of all, you would like to pick a Twitter handle or username, that is easily identifiably yours. Preferably, something with your name. On the screen, you can see that is my name, Macey L. Henderson. You also would like to use a professional picture. A professional picture helps put a face on a more impersonal information. You also would like to create a quick and informative bio, that aligns yourself with your employer, but also your own values. Oftentimes, employers have social media policies that you need to follow, and you need to check that prior to aligning yourself with your employer. For those who work in academic institutions, oftentimes, aligning with your institution is something they encourage and applaud. It's also okay to include a personal twist on your biography. It makes more of a human connection with the audience. What are hashtags on Twitter? A hashtag or the pound sign, is a way to categorize content. Tweets with hashtags get two times more engagement than tweets without. Also, tweets with one or two hashtags have a 21 percent higher engagement rate than those with three or more hashtags. Also, using more than two hashtags can decrease your engagement by an average of 17 percent. The trick with using hashtag, is to find a hashtag that the community is already using, and to attach that to your content, if you would like it to be received by users in your interest area, and in your interest graph. For example, Symplur is a healthcare social media analytics company. They launched the healthcare hashtag project. A free open platform for patients, caregivers, advocates, doctors, and other providers, that connects them to relevant conversations and communities online. We looked it up. There are seven health equity hashtags for health equity research right now. We encourage you to check out the Symplur website frequently, and to register your own health equity related hashtag with them. Should you create one, or use one for your own event. Now, we have five action items for you to try as a health equity researcher. It goes without saying, that you should be tweeting about your latest news, events, and research highlights. It is also equally important to engage with other tweets and other users. Engagement is a key component of what makes Twitter valuable to the research community. Next, we'd like to encourage you to live-tweet at your next conference or live event. Most organizations are encouraging this practice, but some are not. So please be courteous of speakers and conference organizers, and think before you tweet. As a rule of thumb, it's never a good idea to take photos of a speaker's slide and tweet or something they say, if it's unpublished data. Again, just remember, respect all involved. There are plenty of Twitter chats that you might be able to participate in and support. You could even create your own. We absolutely suggest that. Finally, please use Twitter to support and promote your colleagues, institutions, students, mentees, trainees, and any other organization or a cause that you find to be important and engaging. Now, we will talk about some ways that research can be visually appealing to disseminate on a social media platform like Twitter. What is a visual abstract? The Visual abstract was created by one of our friends and colleagues at the University of Michigan, Dr. Andrew Ibrahim. Simply put, a visual abstract is a visual summary of the information contained within an abstract. Similar to the actual text's abstract of a research article, it is meant to convey the key findings of the article in a shorter format. As much as it's important to say what a visual abstract is, it is just as important to say what the visual abstract is not. A visual abstract is not a substitute for reading the article, and does not contain all of the details contained within that article.The goal of a visual abstract is to inform a potential reader of the key findings in an article, to help them decide if they would like to proceed in reading the entire article. It is similar to a trailer of a movie. Just as any single article should not change one's practice, a visual abstract alone, should not influence clinical decision-making or opinion about that paper. What are the key components of an effective visual abstract? The key components include; a summary of the key question being addressed. This usually comes from the title of the article or a heading of a key figure. You want to keep this short and clear. You also want to include a summary of outcomes. You will need to spend time thinking about outcomes you want to present. Most articles have many more than three, so you will have to prioritize. It's always important to include the author of the article and a citation. Always include at least the first author's name and year of publication. You also need to state the outcome comparison. A short phrase that clearly states the outcome with respect to groups being compared. For example, decreased need for blood transfusions. It's easier to follow than simply blood transfusions. As much as possible, you should use the same prowess used in the article for consistency. There is also the need to have a visual display of your outcome, hence the visual abstract. You will want a visual that reflects the outcome you are describing. You will also want to present the data that you have about your outcome. In addition to stating the outcome, you will want to get the numeric representation. Be sure to include the units. Most importantly, you want to know who created this visual abstract. A lot of scientific journals are adopting visual abstracts. However, it also may be the individual author. It is important not to use the logo of the journal without their permission. Dr. Ibrahim and his colleagues studied the impact of the visual abstract, and here's what they found. Key findings from the trial demonstrated that compared to only a tweet containing the title of the article, tweets containing a visual abstract had a seven-fold higher impressions, which means how many times that tweet was actually seen on Twitter. It had an eight-fold higher retweets, which means how many times people re-tweeted that tweet on Twitter, and nearly a three-fold higher article visits than just if that article had been accessed through the publisher website. There is more information on visual abstracts, courtesy of Dr. Ibrahim at surgeryredesign.com. So finally, I'd like to end with my top 10 do's and don'ts list of social media for a professional researcher. The first thing on your list, do ask yourself, "Am I okay to post this to my personal account if the information were to end up on the front page of The New York Times?" I know this sounds extreme, but it could actually happen, and it has. Number 2. Do use the platform regularly if you want to gain traction for your message and your audience. Number 3. Do look for ways to meet the needs of your audience on platforms they already use. Meet people where they are. If most of the research community is on Twitter, utilize Twitter to disseminate your research. Do share from trusted sources regularly. Retweeting from trusted sources and organizations, helps to grow your audience, as well as theirs. It also enables you to build networking collaboration with those groups when you need help from them to disseminate your research down the line. Number 5. Never mismatch the medium and the message. Facebook is always better for discussion, and Twitter is great for rapid dissemination. However, recent changes to Twitter have enabled longer character counts. It was previously 140. Now, it is 280. There's more opportunity for a longer discussion on Twitter than previously. Number 6. Do review patient communities periodically to make sure that you are in touch with their concerns, questions, and needs. Oftentimes, these patient communities are on social media. They are on Facebook, they are on Twitter. Find them, pay attention. Number 7. Don't ignore the potential for things like mobile apps to change the delivery of healthcare. Mobile apps are in line with social media, providing accessible information at your fingertips. Number 7. Don't ignore the potential for apps to change the delivery of healthcare. It's happening. Mobile apps like social media are at the tip of your fingers, enabling you to access information, and share information rapidly. Number 8. Do use social media to mentor the next generation of health equity researchers. Those who have already established themselves as a researcher, can help the next generation by sharing their work through social media and promoting them. Number 9. Do register your name on an existing or an emerging social media platform, even if you don't plan to engage. This will allow you to protect your own identity, and to allow you to leverage any platform later, if you so desire. Number 10. Do try to engage an existing social media platform in a new way. If you're already on Twitter, and you like to talk research, why don't you join a live tweet about a health equity topic? That was one of our challenges to you earlier. Some final thoughts. If more than 90 percent of Americans are online, we should be too. It's a meaningful thing if social media platforms can help us to increase access to information and education about health care, as well as to promote the visibility of our research. I think it is very important to remember that violation of social media can be detrimental to a career. Particularly HIPAA violations for health care providers. My final advice is to engage on social media thoughtfully. Look for ways to connect patients and other stake holders. Offer and share good information, support, and education online.
