“Elite users” on Twitter: Examining key features for crafting future HPV vaccination communication campaigns

Background: Growing evidence using social media for public health research and practice, coupled with the composition of Twitter users, supports the extension of this research into the area of human papillomavirus (HPV) vaccination.

Methodology: Using data mining software, we collected 185,644 unique tweets between August 1, 2014 and October 31, 2014 that contained at least one of 13 keywords related to HPV vaccination. We randomly selected 10,000 tweets to examine key features utilized by “elite users”, defined as the top 10% of users in terms of followers. In our sample, this was defined by having 4,508 or more followers. After dichotomizing users as elite vs. not, chi-square analysis was used to examine variations in use of specific Twitter functions used to strengthen social communication, including the hashtag (#), at sign (@), and retweet (RT). 

Results: TIME Magazine was the top elite user to tweet about HPV with 6,304,119 followers, followed by G1 Brazilian News (3,339,280) and Ultimas Noticias Venezuelan News (2,254,743). Compared to non-elite users, elite users were less likely to use RT and @ (p<0.001), but more likely to use # in their tweets (p<0.001).

Conclusion: Elite users are not likely to participate in interpersonal communication using RT and @ features, but widely use the # feature, likely to create trends or contribute to popular dialogue. As HPV vaccination campaigns continue to utilize social media platforms, using the # feature may be more effective to connect with elite users and consequently may lead to a wider reach of message.