Quality & Quantity

, Volume 49, Issue 4, pp 1361–1380 | Cite as

Twitter hashtags for health: applying network and content analyses to understand the health knowledge sharing in a Twitter-based community of practice

  • Weiai Wayne Xu
  • I-Hsuan Chiu
  • Yixin Chen
  • Tanuka Mukherjee


We utilize network and content analyses to examine the health-related conversations via Twitter hashtags. The study is an extension of the Leveraging Internet for Knowledge Sharing model to the new Twitter context. The findings show that the conversations involve the themes of knowledge sharing, nurturing relationship (community), and activism/advocacy/promotion (action). The conversation networks are decentralized, with advocates, healthcare providers, and average individuals being the central participants. Conversations flow most frequently between participants of the same healthcare roles, yet there is a considerable amount of conversations from healthcare providers to average consumers, and from average consumers to media. It is also noted that most conversations are not continuous or reciprocal. The findings and their implications are discussed in relation to the characteristics of communities of practice.


Health Network analysis Twitter Social media Hashtag  Community of practice Leveraging internet for knowledge sharing Webometric 



The research team would like to thank Dr.Gregory Saxton for providing guidance in Twitter data-collection.


  1. Abidi, S.: Healthcare knowledge sharing: purpose, practices, and prospects. In: Bali, R., Dwivedi, A. (eds.) Healthcare Knowledge Management, pp. 67–86. Springer, New York (2007)Google Scholar
  2. Achrekar, H., Gandhe, A., Lazarus, R., Yu, S.-H., Liu, B.: Predicting flu trends using twitter data. In: Proceedings of the First International Workshop on Cyber-Physical Networking Systems, pp. 702–707 (2011)Google Scholar
  3. Ahn, Y.Y., Han, S., Kwak, H., Moon, S., Jeong, H.: Analysis of topological characteristics of huge online social networking services. In: Proceedings of the 16th International Conference on World Wide Web, pp. 835–844 (2007)Google Scholar
  4. Anger, I., Kittl, C.: Measuring influence on Twitter. In: Proceedings of the 11th International Conference on Knowledge Management and Knowledge Technologies, p. 31 (2011)Google Scholar
  5. Barnett, G.A., Sung, E.: Culture and the structure of the international hyperlink network. J. Comput.-Mediat. Commun. 11(1), 217–238 (2005)CrossRefGoogle Scholar
  6. Blaaka, G., Cathrine, F.: A social and cultural approach to newcomers’ workplace learning. Int. J. Learn. 12(12), 63–70 (2006)Google Scholar
  7. Borgatti, S.P., Everett, M.G.: Models of core/periphery structures. Soc. Netw. 21(4), 375–395 (2000)CrossRefGoogle Scholar
  8. Boulos, M., Maramba, I., Wheeler, S.: Wikis, blogs and podcasts: a new generation of web-based tools for virtual collaborative clinical practice and education. BMC Med. Educ. 6(1), 41 (2006)CrossRefGoogle Scholar
  9. Boyd, D., Golder, S., Lotan, G.: Tweet, tweet, retweet: conversational aspects of retweeting on Twitter. In: 43rd Hawaii International Conference on System Sciences (HICSS), 2010 (pp. 1–10) (2010)Google Scholar
  10. Briones, R., Nan, X., Madden, K., Waks, L.: When vaccines go viral: an analysis of HPV vaccine coverage on YouTube. Health Commun. 27(5), 478–485 (2012)CrossRefGoogle Scholar
  11. Bruns, A., Burgess, J.: The use of twitter hashtags in the formation of ad hoc publics. Paper presented at the 6th European consortium for political research general conference, Reykjavik, Iceland (2011)Google Scholar
  12. Burton, S.H., Tanner, K.W., Giraud-Carrier, C.G., West, J.H., Barnes, M.D.: “Right time, right place” health communication on twitter: value and accuracy of location information. J. Med. Internet Res. 14(6), e156 (2012)Google Scholar
  13. Chin, A., Keelan, J., Tomlinson, G., Pavri-Garcia, V., Wilson, K., Chignell, M.: Automated delineation of subgroups in web video: a medical activism case study. J. Comput.-Mediat. Commun. 15(3), 447–464 (2010)CrossRefGoogle Scholar
  14. Choi, S., Park, J.Y., Park, H.W.: Using social media data to explore communication processes within South Korean online innovation communities. Scientometrics 90(1), 43–56 (2012)CrossRefGoogle Scholar
  15. Chung, C.J., Barnett, G.A., 48(2) Park, H.W.: Inferring international dotcom web communities by link and content analysis. Qual. Quant. 1–17 (2014)Google Scholar
  16. Ebner, M., Reinhardt, W.: Social networking in scientific conferences-twitter as tool for strengthen a scientific community. In: Proceedings of the 1st International Workshop on Science, vol. 2, pp. 1–8 (2009)Google Scholar
  17. Eysenbach, G., Powell, J., Englesakis, M., Rizo, C., Stern, A.: Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ. British Med. J. 328(7449), 1166 (2004)CrossRefGoogle Scholar
  18. Fadul, J.A.: Big data and knowledge generation in tertiary education in the Philippines. J. Contemp. East. Asia, 13(1), 5–18Google Scholar
  19. Freeman, L.C.: Centrality in social networks conceptual clarification. Soc. Netw. 1(3), 215–239 (1979)CrossRefGoogle Scholar
  20. Gruzd, A., Wellman, B., Takhteyev, Y.: Imagining Twitter as an imagined community. Am. Behav. Sci. 55(10), 1294–1318 (2011)CrossRefGoogle Scholar
  21. Hu, Y., Sundar, S.S.: Effects of online health sources on credibility and behavioral intentions. Commun. Res. 37(1), 105–132 (2010)CrossRefGoogle Scholar
  22. Jung, K., No, W., Kim, J.W.: Who leads nonprofit advocacy through social media? Some evidence from the Australian marine conservation society’s Twitter networks. J. Contemp. East. Asia, 13(1), 69–81Google Scholar
  23. Jung, K., Park, H.W.: Interaction among networks in the age of “big data”: social, knowledge, innovation, and triple-helix networks. J. Contemp. East. Asia 13(1), 1–14 (2014)CrossRefGoogle Scholar
  24. Keelan, J., Pavri-Garcia, V., Tomlinson, G., Wilson, K.: YouTube as a source of information on immunization: a content analysis. J. Am. Med. Assoc. 298(21), 2482–2484 (2007)CrossRefGoogle Scholar
  25. Kimmerle, J., Thiel, A., Gerbing, K.K., Bientzle, M., Halatchliyski, I., Cress, U.: Knowledge construction in an outsider community: extending the communities of practice concept. Comput. Hum. Behav. 29(3), 1078–1090 (2013)CrossRefGoogle Scholar
  26. Kwak, H., Lee, C., Park, H., Moon, S.: What is Twitter, a social network or a news media?. In: Proceedings of the 19th International Conference on World Wide Web, pp. 591–600. ACM (2010)Google Scholar
  27. Lave, J., Wenger, E.: Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, Cambridge (1991)CrossRefGoogle Scholar
  28. Lewis, B., Rush, D.: Experience of developing twitter-based communities of practice in higher education. Res. Learn. Technol. 21, 1–35 (2013) doi: 10.3402/rlt.v21i0.18598
  29. Liang, B.A., Mackey, T.K.: Prevalence and global health implications of social media in direct-to-consumer drug advertising. J. Med. Internet Res. 13(3), e64 (2011)Google Scholar
  30. Lombard, M., Snyder-Duch, J., Bracken, C.C.: Content analysis in mass communication: assessment and reporting of intercoder reliability. Hum. Commun. Res. 28(4), 587–604 (2002)CrossRefGoogle Scholar
  31. Lorentzen, D.G.: Webometrics benefitting from web mining? An investigation of methods and applications of two research fields. Scientometrics 99(2), 409–445 (2014)CrossRefGoogle Scholar
  32. Love, B., Himelboim, I., Holton, A., Stewart, K.: Twitter as a source of vaccination information: content drivers and what they are saying. Am. J. Infect. Control 41(6), 568–570 (2013)CrossRefGoogle Scholar
  33. Lovejoy, K., Saxton, G.D.: Information, community, and action: how nonprofit organizations use social media. J. Comput.-Mediat. Commun. 17(3), 337–353 (2012)CrossRefGoogle Scholar
  34. Neiger, B.L., Thackeray, R., Burton, S.H., Thackeray, C.R., Reese, J.H.: Use of twitter among local health departments: an analysis of information sharing, engagement, and action. J. Med. Internet Res. 15(8) e177 (2013)Google Scholar
  35. Park, H.W., Thelwall, M.: Hyperlink analyses of the World Wide Web: a review. J. Comput.-Mediat. Commun. 8(4)
  36. Park, H., Rodgers, S., Stemmle, J.: Analyzing health organizations’ use of twitter for promoting health literacy. J. Health Commun. 18(4), 410–425 (2013)CrossRefGoogle Scholar
  37. Rogers, E.M.: Diffusion of Innovations, 5th edn. Free Press, New York (2003)Google Scholar
  38. Schmidt, K., Ernst, E.: Assessing websites on complementary and alternative medicine for cancer. Ann. Oncol. 15(5), 733–742 (2004)CrossRefGoogle Scholar
  39. Seidman, S.B.: Network structure and minimum degree. Soc. Netw. 5(3), 269–287 (1983)CrossRefGoogle Scholar
  40. Stewart, S.A.: Combining social network and semantic content analysis to improve knowledge translation in online communities of practice (Doctoral dissertation, Dalhousie University) (2013)Google Scholar
  41. Stewart, S.A., Abidi, S.S.R.: Applying social network analysis to understand the knowledge sharing behaviour of practitioners in a clinical online discussion forum. J. Med. Internet Res. 14(6), e170 (2012)CrossRefGoogle Scholar
  42. Sugawara, Y., Narimatsu, H., Hozawa, A., Shao, L., Otani, K., Fukao, A.: Cancer patients on Twitter: a novel patient community on social media. BMC Res. Notes 5(1), 699 (2012)CrossRefGoogle Scholar
  43. Syed-Abdul, S., Fernandez-Luque, L., Jian, W.S., Li, Y.C., Crain, S., Hsu, M.H., Liou, D.M.: Misleading health-related information promoted through video-based social media: anorexia on YouTube. J. Med. Internet Res. 15(2), e30 (2013)CrossRefGoogle Scholar
  44. Thackeray, R., Neiger, B.L., Smith, A.K., Van Wagenen, S.B.: Adoption and use of social media among public health departments. BMC Public Health 12(1), 242 (2012)CrossRefGoogle Scholar
  45. Warmbrodt, J., Sheng, H., Hall, R.: Social network analysis of video bloggers’ community. In: Proceedings of the 41st Annual Hawaii International Conference on System Sciences (pp. 291–291). IEEE (2008)Google Scholar
  46. Wenger, E.C., White, N., Smith, J.D.: Digital habitats: stewarding technology for communities. CPsquare, Portland, OR (2009)Google Scholar
  47. Wenger, E., McDermott, R., Snyder, W.: Cultivating Communities of Practice. Harvard Business School Press, Boston (2002)Google Scholar
  48. Wright, K.: Perceptions of on-line support providers: an examination of perceived homophily, source credibility, communication and social support within on-line support groups. Commun. Q. 48(1), 44–59 (2000)CrossRefGoogle Scholar
  49. Xu, W.W., Sang, Y., Blasiola, S., Park, H.W.: Predicting opinion leaders in twitter activism networks the case of the wisconsin recall election. Am. Behav. Sci. (2014). doi: 10.1177/0002764214527091

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Weiai Wayne Xu
    • 1
  • I-Hsuan Chiu
    • 1
  • Yixin Chen
    • 1
  • Tanuka Mukherjee
    • 1
  1. 1.Department of CommunicationState University of New YorkBuffaloUSA

Personalised recommendations