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Background Information and emotions towards public health issues could spread widely through online social networks. Although aggregate metrics on the volume of information diffusion are available, we know little about how information spreads on online social networks. Health information could be transmitted from one to many (i.e. broadcasting) or from a chain of individual to individual (i.e. viral spreading). The aim of this study is to examine the spreading pattern of Ebola information on Twitter and identify influential users regarding Ebola messages. Methods Our data was purchased from GNIP. We obtained all Ebola-related tweets posted globally from March 23, 2014 to May 31, 2015. We reconstructed Ebola-related retweeting paths based on Twitter content and the follower-followee relationships. Social network analysis was performed to investigate retweeting patterns. In addition to describing the diffusion structures, we classify users in the network into four categories (i.e., influential user, hidden influential user, disseminator, common user) based on following and retweeting patterns. Results On average, 91% of the retweets were directly retweeted from the initial message. Moreover, 47.5% of the retweeting paths of the original tweets had a depth of 1 (i.e., from the seed user to its immediate followers). These observations suggested that the broadcasting was more pervasive than viral spreading. We found that influential users and hidden influential users triggered more retweets than disseminators and common users. Disseminators and common users relied more on the viral model for spreading information beyond their immediate followers via influential and hidden influential users. Conclusions Broadcasting was the dominant mechanism of information diffusion of a major health event on Twitter. It suggests that public health communicators can work beneficially with influential and hidden influential users to get the message across, because influential and hidden influential users can reach more people that are not following the public health Twitter accounts. Although both influential users and hidden influential users can trigger many retweets, recognizing and using the hidden influential users as the source of information could potentially be a cost-effective communication strategy for public health promotion. However, challenges remain due to uncertain credibility of these hidden influential users.

We examined Zika-related inquiries to CDC-INFO, the national contact center for the Centers for Disease Control and Prevention, to identify potential communication gaps. The most frequently asked questions related to travel or geographic location of Zika (42% of all inquiries), information about laboratory testing (13%), or acquiring a Zika test (11%).

Objectives The spread of Zika virus throughout Latin America and parts of the United States in 2016 and 2017 presented a challenge to public health communicators. The objective of our study was to describe emergency risk communication practices during the 2016-2017 Zika outbreak to inform future infectious disease communication efforts. Methods We conducted semi-structured telephone interviews with 13 public health policy makers and practitioners, 10 public information officers, and 5 vector-control officials from May through August 2017. Results Within the public health macro-environment, extended outbreak timeframe, government trust, US residence status, and economic insecurity set the backdrop for Zika communication efforts. Limited resources, staffing, and partnerships negatively affected public health structural capacity for communication efforts. Public health communicators and practitioners used a range of processes and practices to engage in education and outreach, including fieldwork, community meetings, and contact with health care providers. Overall, public health agencies’ primary goals were to prevent Zika infection, reduce transmission, and prevent adverse birth outcomes. Conclusions Lessons learned from this disease response included understanding the macro-environment, developing partnerships across agencies and the community, and valuing diverse message platforms. These lessons can be used to improve communication approaches for health officials at the local, state, and federal levels during future infectious disease outbreaks.

Recent history has indicated that crises are becoming more frequent rather than exceptional events. Dozens of organizations, often with very different missions, methods, technologies and cultures, are called upon to coordinate activities in order to mitigate the crisis and assist in recovery efforts. Although several interorganizational coordination perspectives and strategies have been proposed, they have neglected to examine how different organizational communication cultures of crisis response organizations involved in an Emergency Operations Center (EOC) may affect crisis collaboration efforts. Previous studies have also disregarded the important distinction between crisis coordination and crisis collaboration and the challenges and benefits of each to crisis response efforts of EOCs. This study examined in depth two crisis response organizations that are active in most EOCs, a regional chapter of a disaster response organization (DRO) and a metropolitan police department (MPD) in a large U.S. metropolitan city. Data for this instrumental case study was collected using the qualitative approaches of participant observation, interviews, and document analysis. The findings illustrate that the two different organizational communication cultures of the EMU MPD and the DRO resulted in two different worldviews of how organizations think they should work together and communicate with each other when responding to a crisis. The DRO’s humanitarian and service-oriented organizational communication culture defined their crisis response practices as crisis collaboration with all organizations. In contrast, the EMU MPD’s bureaucratic and closed organizational communication culture defined their crisis response as crisis collaboration with similar organizational cultures and bureaucratic crisis coordination with others. This suggests that these different worldviews give rise to processes, structures, and procedures of crisis coordination and crisis collaboration that are cultural artifacts of the organizations. Therefore, once cannot assume a crisis coordination or collaboration structure can easily be imposed on an organization as a way to improve interorganizational collaboration, coordination and communication. This investigation suggests that the different crisis coordination and crisis collaboration worldviews need to first be understood by EOCs and the organizations involved in those groups. Then additional planning and management processes need to be developed in order to ensure effective interorganizational communication and collaboration during a crisis response.