1. Riding the Mobile Wave: What Local Health Departments Need in order to Adopt Social Media and Mobile Health Technologies for Emergency Preparedness Disaster Information Specialists Program Thursday, June 12, 2014 Sara Rubin, MPH, MA NACCHO

2. Trends in Social Media and Mobile Device Use: Daily Communications & Emergencies

3. What Research Tells Us: Increasing Use Communities are increasingly communicating via mobile technologies and social media to share and find information: 89% of American adults own cell phones 80% use their phones to send or receive text messages 56% use them to access the internet 31% use them to look up health or medical information online 67% of adults who use the internet also use social networking sites Data from Pew Research Center

4. Considerations Regarding Factors Affecting Access to Mobile Apps and Social Media 1.Age 55+ has at least 45% lower uptake than youngest age bracket 2.Geographic Location Almost 20% difference in urban vs. rural use 3.Household Income Slight correlation between higher income and use – 19% difference between lowest and highest brackets 4.Education Level Slight correlation between higher education and use – 18% difference between lowest and highest brackets

5. What Research Tells Us: Application During Disasters Mobile health (mHealth) and social media are influential tools during responses to disasters and public health emergencies (PHEs): Communities are increasingly communicating via these platforms to share and find information during emergencies; Some technologies are more widely used than others in different stages of an emergency; Public officials benefit from using these technologies for emergency communications.

6. What Research Tells Us: Increasing Use and Expectations American Red Cross Survey (2012) The public has a growing expectation that public officials will use these technologies in disasters. There is an increasing number of “emergency social users.”

7. Research Gaps: What Remains Unclear 1.How can local health departments (LHDs) capitalize on these technologies for emergency communications? 2.How can these technologies specifically be applied to preparedness and planning communications?

8. Overview of Our Study

9. Overview of our study (2) Purpose: Identify factors that enable or hinder the adoption and use of mHealth and social media among select LHDs, particularly for preparedness. Outcome: Fill a research gap by identifying factors that are necessary to build and improve organizational capacity at LHDs to enhance their use of these technologies in all disaster phases. Methodology: Select LHDs exhibiting efforts to use mHealth or social media for public health purposes. Phone-based interviews with staff at selected LHDs. Completed Interviews: 65 interviews completed, from 47 LHDs.

10. Interviewee Characteristics Total Interviews: 65 States: 23 Health Departments: 47

11. Positions Interviewed

12. Findings & Examples from Local Health Departments

13. In-house Capacity Ability of both staff and the LHD as a whole to effectively integrate social media and mHealth programs into their department’s overall communication and emergency preparedness strategy Key FactorsSuggestions & Requests Staff KnowledgeTraining FundingInformation Resources & IT supportIndustry Collaboration

14. Leadership Support & Policies Implied or expressed support of leaders, in the LHD and at other government levels, to encourage the use of social media and mHealth, and the existence of specific rules or policies, formal or informal, regulating or encouraging the use of such technologies Key FactorsSuggestions & Requests Support for mHealthShare best practices LHD policies to support useBuild an evidence base Local, state and federal policies to support use Identify resources for policy development State and federal encouragement

15. Case Study: Chicago Department of Public Health “It is a priority across the city to become more technologically ‘with it,’ and to make government more accessible and transparent.”

16. Case Study: Chicago Department of Public Health (2) Chicago Health Atlas: visualizes aggregate health-related information so that people can see the prevalence of specific health conditions in their area Flu Shots: helps Chicago residents locate and find public transportation to CDPH’s free flu shot clinic events Foodborne Chicago: uses computers & code to search Twitter for tweets related to food poisoning in Chicago.

17. Reporting Food Poisoning: Open 311 System

18. Legal & Security Issues Concerns around security of information and the application of legal guidance for mHealth and social media programs Key FactorsSuggestions & Requests Applicability of federal lawsFederal guidance Liability concernsPublic/private support for managing liabilities Security impediments to expansion

19. Audiences Intended and targeted audiences at which LHDs aim to direct programs, including those in different geographic locations and those considered vulnerable or at-risk Key FactorsSuggestions & Requests Purpose-specific platformsImproved collaboration with CBOs and other external organizations Limited capacity for 2-way communication Integrate mHealth and social media into communications plans Specific needs of vulnerable populations

20. Ready San Diego Alert San Diego 100,000 residents opted-in Reverse 911 calls San Diego (SD) Emergency app Started after 2011 blackout Android and iPhone ~10,000 downloads Features: Disaster preparedness information Interactive checklists to help create an emergency plan & build an emergency kit Emergency updates with interactive maps

21. Recommendations for Practitioners and Policymakers

22. Recommendations for Practitioners and Policymakers (2) LHDsPolicymakers In-house capacity- Assess capacity and augment with external support - Expand communications plans - Create information exchange database - Integrate local information sharing into national system Leadership Support & Policies Learn from other practitioners Legal & Security Concerns Identify resources for policy development - Provide guidance on applicability of federal laws - Clarify regulation of new technologies Audiences- Identify key audiences and how they communicate - Coordinate with CBOs - Support program and jurisdiction interoperability Support resources to reach vulnerable and at-risk populations

23. For More Information Sara Rubin, MA, MPH srubin@naccho.org Get the full report at: www.nacchopreparedness.org www.upmchealthsecurity.org Presentation adapted from Nidhi Bouri’s slides.