Applying Network Science and Visualization Mapping for Improved Digital Public Health Communication

APPLYING NETWORK SCIENCE AND VISUALIZATION MAPPING FOR IMPROVED DIGITAL PUBLIC HEALTH COMMUNICATION

Moderated by Brittany Seymour, DDS, MPH Public Health Consultant, MIT Faculty Associate, Berkman Klein Center for Internet and Society at Harvard Assistant Professor, Harvard School of Dental Medicine A Story about fluoride Dental Caries Top 10 Public Health Achievements of the 20th Century 1. Vaccines 2. Motor vehicle safety 3. Safer workplaces 4. Control of infectious diseases 5. Decline in deaths for coronary heart disease and stroke 6. Safer and healthier foods 7. Healthier mothers and babies 8. Family planning 9. Fluoridation of drinking water 10. Recognition of tobacco use as a health hazard

Source: Centers for Disease Control and Prevention A Story about Fluoride A Story about Fluoride A Story about Fluoride

Seymour et al, AJPH, 2015 Media Cloud

■ What other tools do: reach and impact metrics ■ What Media Cloud does: influence ■ An open platform, joint project of the Harvard Berkman Klein Center for Internet and Society and the MIT Center for Civic Media Presenters

“Media Influence and Framing the Public Health Narrative Around Unarmed Deaths, Race, and Gun Violence: Mapping the Trayvon Martin Case” Rahul Bhargava, MS Research Scientist, MIT Media Lab MIT Center for Civic Media

“Vaccine hesitancy in digital networks: trust and social proof online” Hal Roberts, MS Fellow, Berkman Klein Center for Internet & Society Harvard University

“Could Fragmented Communication Networks Reshape the Narrative?: Evidence from Tobacco and e-Cigarette Media Coverage” Laura Gibson, PhD Research Director, Tobacco Center on Regulatory Science University of Pennsylvania MEASURING MEDIA ATTENTION TO GUN AND POLICE VIOLENCE

Rahul Bhargava Research Scientist, MIT Media Lab MIT Center for Civic Media @rahulbot [email protected] Minneapolis, MI 12/3/2015 Ferguson, MI 8/17/2014

New York City, NY 11/28/2014 Baltimore, MD 4/29/2015 A PUBLIC HEALTH APPROACH Academic Responses

JAMA, 2013 NEJM, 12/2016 Public Health, 2015 Public Health Approaches

Mozaffarian D, Hemenway D, Ludwig DS. Curbing Gun ViolenceLessons From Public Health Successes. JAMA. 2013;309(6):551-552. doi:10.1001/jama.2013.38 Two examples of how this might work in action.

We can help this effort by mapping the media narratives to identify processes and actors.

1. Looking for changes in media coverage of police violence against unarmed people of color.

2. Understanding the fight over how the media told the story of the Trayvon Martin case. POLICE VIOLENCE AGAINST UNARMED VICTIMS OF COLOR Nathan Matias, Natalie Gyenes, Allan Ko, Ethan Zuckerman, Rahul Bhargava, Hal Roberts Data Sources

Mapping Police Violence The Guardian Washington Post Michael Brown’s death as a key event in recent history of police killings of unarmed people of color.

Sources: Media Cloud articles mentioning victims in the 5 days before, and two weeks after death (n=717,871). Media coverage of these incidents changed after Michael Brown was killed. News articles per unarmed black person killed by US police in in the days surrounding each death, including before & after the death of Michael Brown

Sources: Mapping Police Violence, Washington Post, Guardian 01/01/2013 - 06/29/2016 (n=333). Media Cloud articles in the two week period after death, normalized by total Media Cloud article count. 10 observations within 14 days before Michael Brown’s death are omitted. An unarmed black person killed by US police received 10.5x the incidence rate of News Articles after Michael Brown’s death from those killed before

Sources: Mapping Police Violence, Washington Post, Guardian 01/01/2013 - 06/29/2016 (n=333). MediaCloud articles in the two week period after death, normalized by total MediaCloud article count. NB Model controls for age, gender, and regional population. p=7.84e^-14 Among unarmed black people killed by US police, the number of news articles per person for June 2016 was not significantly different from Jan 2013

Sources: Mapping Police Violence, Washington Post, Guardian 01/01/2013 - 06/29/2016 (n=333). MediaCloud articles in the two week period after death, normalized by total MediaCloud article count. NB Model controls for age, gender, and regional population. Articles about an unarmed black person killed by US police received 49.8x the incidence rate of Total Facebook Shares after Michael Brown’s death

Sources: Mapping Police Violence, Washington Post, Guardian 01/01/2013 - 06/29/2016 (n=333). Facebook Shares to articles in the two week period after death, normalized by total Media Cloud article count. NB Model controls for age, gender, and regional population. p=2.56e^-12 Articles about an unarmed black person killed by US police received 49.8x the incidence rate of Total Facebook Shares after Michael Brown’s death

Sources: Mapping Police Violence, Washington Post, Guardian 01/01/2013 - 06/29/2016 (n=333). Facebook shares of articles in the two week period after death, normalized by total MediaCloud article count. NB Model controls for age, gender, regional population, and article count. A Useful Approach for a Public Health Response

1. Identification: key event

2. Awareness: sustained social media interest

3. Prevention: easier to talk about THE TRAYVON MARTIN CASE

Erhardt Graeff, Matt Stempeck, Ethan Zuckerman A fight over the media narrative about this boy’s death. Data Sources

Media Cloud Bit.ly clicks PageOneX Newspaper front pages n=8,643 n=1,233,899 n=1.91 daily avg

Tweets n=374,690 The Internet Archive Google Trends Change.org Petition n=2,764 n=25k daily avg n=2,038,557 A media story best told in 5 acts

Act 1: Not a Story Act 2: Building Pressure Act 3: National Exposure Act 4: Political Agenda War Act 5: Tabloid Court Case Act 1: Not a Story Feb 26 – Mar 6 Act 2: Building Pressure Mar 7 – 15 Act 3: National Exposure Mar 6 – 22 Act 4: Political Agenda War Mar 23 – Apr 10 Act 4: Plot 1: The Left

The Left goes after the “American Legislative Exchange Council”. Act 4: Plot 2: The Right

The Right goes after Trayvon Martin’s image; labelling him a “drug dealer”. Act 5: Tabloid Court Case Apr 11 – 30 A Useful Approach for a Public Health Response

1. Trajectory: from a clip to national story

2. Piggy-back: activists shifting to their cause

3. Transmedia: analyzing across media CONCLUSION Public Health Responses

• Changing media depictions • Media education campaigns • Publicizing support options • Nonprofit advocacy VACCINE HESITANCY IN DIGITAL NETWORKS: TRUST AND SOCIAL PROOF ONLINE Hal Roberts Fellow, Berkman Klein Center for Internet & Society Harvard University Research team

Brittany Seymour Harvard School of Dental Medicine

Rebekah Getman Harvard School of Dental Medicine

Mohammad Helmi Harvard School of Dental Medicine

Alfa Yansane Harvard School of Dental Medicine

Hal Roberts Berkman Klein Center, Harvard University

David Cutler Department of Economics, Harvard College Vaccine Hesitancy Vaccine Support Media Cloud Topic Mapper Spider

1. Search Media Cloud archive for ‘vaccine*’ in U.S. sources from 2014-06-01 – 2015-03-01. 2. Parse all links from those ~14,000 stories. 3. Download all unrecognized urls and test for the presence of ‘vaccin*’ in the text of each. 4. Add any matching stories to the topic. 5. Repeats steps 2. – 4. fifteen times. 6. Analyze resulting set: 49,144 stories, 53,092 story links, 4,817 media sources, 20,979 links between media sources Link Network Influential Sources

Source Overall Pro vaccine Vaccine hesitant Health and Science Mainstream Media rank 1 cdc.gov scienceblogs.com ncbi.nlm.nih.gov sciencedirect.com nbcnews.com 2 ncbi.nlm.nih.gov sciencebasedmedicine.org nvic.org chemport.cas.org msnbc.com 3 Wikipedia.com Wikipedia.com mercola.com cdc.gov livescience.com 4 ageofautism.com leftbrainrightbrain.co.uk naturalnews.com apps.weofknowledge.co nytimes.com m 5 scienceblogs.com rationalwiki.org whale.to springer.com washingtonpost.com

6 youtube.com braindeer.com youtube.com who.int npr.org 7 nytimes.com pediatrics.aappublications.org greenmedinfo.com jid.oxfordjournals.org latimes.com

8 sciencedirect.com feeds.feedburner.com medalerts.org nature.com huffingtonpost.com

9 naturalnews.com oracknows.blogspot.com healthimpactnews.co jama.jamanetwork.com twitter.com m 10 fiercevaccines.com theness.com sanevax.org tandfonline.com cnn.com Primary Science Authority Community Authority Vaccine Sentiment

PRO

• A story should be categorized as having PRO-vaccine sentiment if any of the following are true:

• the author presents a pro-vaccine argument in her own voice;

• the story describes only pro-vaccine arguments or scientific research;

• the story mentions vaccines in a way that presumes vaccines in general are a public good;

• the story describes efforts by the government or other institutions to vaccinate without critiquing the effectiveness of the vaccines;

• the story presents pro-vaccine arguments as coming from the scientific establishment but presents anti-vaccine arguments as coming only from anti-vaccine advocates who are not scientists or doctors;

• the story presents a critical accounting of only anti-vaccine advocates or their tactics without any counter- balancing anti- vaccine arguments.

Some examples of PRO-vaccine stories:

• Large New Study Confirms That Childhood Vaccines Are Perfectly Safe http://thinkprogress.org/health/2014/07/01/3455131/childhood-vaccine-study-safe/ [ pro-vaccine argument ]

• Has human progress stalled? And if so, what can we do about it? http://www.aei.org/publication/progress-stalled-can/ [ presumes vaccine as public good ]

• US approves first bird flu vaccine for people http://www.newscientist.com/article/dn11626-us-approves-first-bird-flu- vaccine-for-people.html [ describes government vaccination ]

• "The way God intended" - California parents are having "measles parties" instead of vaccinating their kids http://www.salon.com/2015/02/10/the_way_god_intended_california_parents_are_having_measles_parties_instead_of_ vaccinating_their_kids/ [ critical of anti-vaccine advocates ] Overall Sentiment

ANTI 15%

PRO NA 46% 16%

NONE 10% PRIMARY 13%

70,21% of all ANTI stories located in Anti Vax link community 66.67% of stories in MSM link community are PRO Conclusions

• The Vaccine controversy is strongly segregated into vaccine hesitant, pro vaccine, public health, and mainstream media content. • ANTI vaccine content is a small part of the overall debate. • Almost all ANTI vaccine content is located within the vaccine hesitant link community. • Mainstream media publishes mostly PRO and little ANTI vaccine content. • The vaccine hesitant community relies mostly on subverting the traditional mode of scientific authority by citing primary research, whereas the pro vaccine community relies mostly on Wikipedia’s community mode of authority. Thanks!

• This study was funded by the Pershing Square Fund for Research on the Foundations of Human Behavior • Media Cloud project led Ethan Zuckerman at the Center for Civic Media at the MIT Media Lab and Yochai Benkler at the Berkman Klein Center for Internet & Society at Harvard University • Funding by the Ford Foundation, the Open Society Foundations, the John D. and Catherine T. MacArthur Foundation, Bill and Melinda Gates Foundation and the Robert Wood Johnson Foundation. COULD FRAGMENTED COMMUNICATION NETWORKS RESHAPE THE NARRATIVE?: EVIDENCE FROM TOBACCO AND E- CIGARETTE MEDIA COVERAGE Laura Gibson Research Director, TCORS University of Pennsylvania Research team

Robert Hornik Laura Gibson Matt O’Donnell Sharon Alajajian Sherry Emery

Health Media Collaboratory NORC at UChicago

Faculty Consultants Joseph Cappella, Paul Allison, Catherine Maclean, Janet Audrain-McGovern Post-doctoral fellows Kirsten Lochbuehler, Alisa Padon, LeeAnn Sangalang, Candy Yang Doctoral students Michelle Jeong, Kwanho Kim, Elissa Kranzler, Stella Lee, Jiaying Liu, Danielle Naugle, Leeann Siegel, Allyson Volinsky More tobacco news coverage, less teen smoking 2001-2003 Proliferation of sources The idea of the Public Communication Environment

Broadcast Specific media use by individuals News Major

newspapers Scanning Measures Entertain- ment TV Tobacco/ PCE Exposure e-cig ads

Websites

Facebook fan pages YouTube comments Personal Cognitions/ Twitter conversation Behaviors Changing tobacco environment This study

■ Do all of the sources move together? – [Test: Does coverage in websites popular among youth and young adults vary together with coverage in traditional media sources over time?]

■ Do they move together regardless of topic? – [Test: Is it the same for tobacco and e-cigarettes?] Sources included

AP National State/Local 8 Broadcast TV/Radio News Channels

Top 50 Newspapers

Top 50 Popular Websites each Quarter 1. Finding texts

smoking, smoker(s), smokes tobacco, nicotine hookah(s) cig(s), cigar(s), cigarette(s), cigarillo(s), ecig(s), ecigar(s), ecigarillo(s), ecigarette(s), vaping, vape*

2. Finding tobacco & e-cig texts Sample 2 Sample

Sample 1 Content in sources May 2014-Jun 2016 Tob E-cig Source All Texts Tob E-cig NPM NPM 8,454 6,053 803 AP (72%) (9%) 53,630 42,693 2,731 News (80%) (5%) 5,417 3,611 223 BTN (67%) (4%) 78,061 51,427 3,709 Web (66%) (5%) Total 145,562 103,784 7,466 Passing mentions

■ Scott Disick Parties in Mexico With Three Models, Is No Longer Interested in Recovery | E! Online – “…While Kourtney Kardashian's former partner was busy on the phone and drinking water in this particular photo, his vacation has not been entirely sober. Earlier in the week, Disick was photographed drinking what appeared to be a beer and a mixed drink while also smoking a cigarette…” ■ More food, less hibernation mean bigger NC bears – “…Farmers shifting from inedible crops like tobacco and cotton to edible items like corn and soybeans give the bears plenty to eat so they no longer have to expend so much energy and lose weight hibernating, state Wildlife Resources Commission black bear biologist Colleen Olfenbuttel said…” ■ Not passing mentions – At least 3 tobacco-related words in a paragraph & in more than one sentence – Or 1 tobacco-related word in the title Content in sources May 2014-Jun 2016 Tob E-cig Source All Texts Tob E-cig NPM NPM 8,454 6,053 1,319 803 624 AP (22%) (78%) 53,630 42,693 4,831 2,731 1,772 News (11%) (65%) 5,417 3,611 416 223 118 BTN (12%) (53%) 78,061 51,427 7,619 3,709 2,516 Web (15%) (68%) Total 145,562 103,784 14,185 7,466 5,030 Note: NPM = Not passing mentions only Results over time – Tobacco

25 10

20 8

6 15

4 10

2 5

Average dailyAverage- Tobacco only count

0 0 Average proportionWeb: daily Tobacco only - 01jul2014 01jan2015 01jul2015 01jan2016 01jul2016

AP BTN News Web Results over time – E-cig

25 10

20 8

6 15

4 10

Average dailyAverage- E-cig count 2 5

Web: Average proportionWeb: dailyE-cig -

0 0 01jul2014 01jan2015 01jul2015 01jan2016 01jul2016

AP BTN News Web Removing linear and weekly cyclical trends

■ Weekly trends – AP & Websites have less coverage on the weekend – Newspapers have more coverage on Sundays

■ Linear time trends – For example, some decrease in newspaper coverage when San Diego Union Tribune bought by LA Times Example: De-trended & aggregating 3-days

# News Predicted Residuals 3-day Stories average Sun, 6/22/14 16 10.1 5.9 Mon, 6/23/14 4 5.6 -1.6 2.4 Tue, 6/24/14 10 7.1 2.9 Wed, 6/25/14 7 8.6 -1.6 Thu, 6/26/14 14 9.3 4.7 2.1 Fri, 6/27/14 11 7.8 3.2 Do sources move together?

Tobacco E-cigarette Topic r 95% CI r 95% CI difference Web-AP .36 [.25, .46] .35 [.24, .45] Same Web-News .31 [.19, .41] .60 [.52, .67] Ecig > Tob Web-BTN .14 [.02, .25] .59 [.50, .66] Ecig > Tob News-AP .30 [.19, .41] .48 [.38, .57] Ecig > Tob News-BTN .17 [.05, .29] .57 [.48, .65] Ecig > Tob AP-BTN .06 [-.07, .18] .30 [.18, .41] Ecig > Tob

Note: Correlations among residuals of topic mentions (> passing mention) in media sources with 3-days as the unit of analysis (N=258) E-cig Web–News (r = .60)

E-cigarette E-cigarette residuals3-dayaggregated to

-5 01jul2014 01jan2015 01jul2015 01jan2016 01jul2016

Web Newspapers Usefulness of websites

Top 50 Popular Websites each Quarter

■ Chosen because popular among our target population

■ Include non-news sites

■ Even among news websites, contributing unique information relative to traditional sources – Average inter-correlation with corresponding specific News or BTN source, Tobacco = .24, E-cigarette = .47 Summary

■ Coordination across sources (not different for Web) ■ Coordination stronger for e-cigarettes across all sources – More tobacco coverage (mostly in passing) – More variation across time in e-cigarette coverage

■ Still value in adding online sources popular among youth and young adults Next steps

■ Valence of coverage – Don’t know if sources are coordinated in framing of e-cigs

■ Themes (addiction, health, policy, youth) – Perhaps sources emphasize different themes

■ Connect to survey outcomes – Test if content coverage is associated with youth reported exposure & outcomes over time Thank you!

Laura Gibson [email protected]

Research reported in this presentation was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and FDA Center for Tobacco Products (CTP) under Award Number P50CA179546. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration (FDA). Exploratory Theories

■ Decentralization of information systems/ dismantling of traditional information authorities

■ Key events lead to peaks of attention and opportunities for framing/reframing an issue

■ Language usage and linking behaviors create online “communities” Take Home Message:

General public is not merely a target audience, but also a strong contributing player in shaping online narratives Public Health Communication?

Broadcast Social Diffusion (Scientific proof) (Social Proof)

Image source: Goel, et al. The structural virality of online diffusion. 2013 “Community water fluoridation: open discussions strengthen public health.” -Alfredo Morabia, MD, PhD, Editor-in-Chief of AJPH, Washington, DC.

■ Questions? ■ Thank you!