Mobile & Social Media Breakthroughs:

H1N1 and Seasonal Flu

Jay Bernhardt, PhD, MPH

Centers for Disease Control and Prevention
February 4, 2010
CDC’s Mission

CDC Mission:
…to promote health and quality
of life by preventing and
controlling disease, injury
and disability

eHealth Goals:
….to make CDC content, tools
and services available
when, where and how users
want them
Why Mobile & Social Media
CDC should be (must be) where
people are
• Increases the dissemination and
potential impact of CDC’s science
• Leverages unique characteristics
of emerging channels
• Reaches diverse audiences
• Allows for tailored health
messages
• Facilitates interactive
communication and community
• Empowers people to make
healthier and safer decisions
Personal and Portable

“Mobile users are

inseparable from their
devices… And as these
devices become more
capable, they are
evolving into extensions
of users’ desktops and
home communications
and entertainment
Average number of hours per day
systems.”
mobile phones are within arm’s reach:
19 hours
(From: Pew Internet & American Life Project, The Social Life of Health
Information, Accesed September 10, 2009
From: eMarketer, Mobile Users and Usage: It’s ttp://www.pewinternet.org/Reports/2009/8-The-Social-Life-of-Health-Infor
Personal, Accessed on November 4, 2009 at mation.aspx
http://www.emarketer.com/Reports/All/Emarketer )
_2000589.aspx
Engaging in Real Time Where Users are Located
Mobile provides us with the ability to engage immediately, in real time, (mobile
users in Bangladesh after flooding and cyclones ) where people are and
communicate directly with target audiences.

Photo from: http://www.textually.org/textually/archives/2009/06/023931.htm

Real-Time Access Where Users Are
Mobile Engagement and Access

“Mobile technology is • There are more than

associated with 270.3 million U.S.
deeper engagement mobile subscribers,
in social media and an accounting for 87%
accelerated pace of of the total U.S.
information population.
exchange.” • According to Pew,
while almost three
quarters of white
Americans have cell
phones, 84% of
English-speaking
http://www.pewinternet.org/Reports/2009/8-The-So
Hispanics and 71%
cial-Life-of-Health-Information.aspx
of black Americans
have them.*
* (Pew Internet & American Life Project: May, 2008.
Accessed at http://www.pewinternet.org/Reports/2008/Mobile-Access-to-Data-and Information.aspx on August 23, 2009).
Mobile-Only Households

17.5% of US households were

wireless only in first six months
of 2008
*Metrics Insider - January 2009
Mobile-Only Household Health
Use of the Mobile Web

• Around 50% of mobile

users access the
mobile Web
• 80% believe that the
mobile Web should be
easier to use

October 23, 2008

*Mobile Insider - October 23, 2008

http://m.cdc.gov

Over 100,000 views of

mobile H1N1 flu pages
alone since April 22nd
http://m.cdc.gov

Mobile-ready content that is easy to

read and scan with appropriate
formatting and design.

• Weekly health features

• Hurricane Recovery Information
• Seasonal Flu information for
consumers and physicians
• Travelers’ health alerts
• Emergency response information
Use of the Mobile Web

About two-
thirds of mobile
web traffic is
done with an
iPhone.

October 23, 2008

Use of the Mobile Web

85% of iPhone users

report accessing the
mobile web compared to
13% of the overall mobile
phone market 58% of
total smartphone users

*
http://bits.blogs.nytimes.com/2
008/03/18/iphone-users-are-m
obile-web-junkies
Top Mobile Devices Accessing m.cdc.gov

1. Apple iPhone [44.8%]

2. Apple iPod Touch [10.6%]

3. RIM BlackBerry 8330 (Curve) [9.4%]

4. T-Mobile G1 [4.1%]

5. RIM BlackBerry 9530 (Storm) [3.2%]

Source: Omniture, Jan. – July 2009

vs.

vs.
iPhone version of m.cdc.gov
iPhone version of m.cdc.gov

31% of iPhone users

have watched
mobile TV or a video
clip from their phone,
which is more than
double the
percentage that have
done so on other
smartphones

*
http://bits.blogs.nytimes.com
/2008/03/18/iphone-users-ar
e-mobile-web-junkies
Use of the Mobile Web

92% of Android users

access the Internet
compared to 88% of
those using iPhones,
71% of all smartphone
users and 22% of all
mobile subscribers.

http://blog.nielsen.com/nielsenwire/consumer/the-droi
d-is-this-the-smartphone-consumers-are-looking-for/
Use of the Mobile Web

Nielsen projects that

smartphones could cross
the 50-percent mark by the
middle of 2011, which
would mean approximately
150 million Americans
would be using
smartphones.

http://blog.nielsen.com/nielsenwire/consumer/the-droi
d-is-this-the-smartphone-consumers-are-looking-for/
iPhone Application
Our Mobile Users

50% Age Mobile All

41%
40% 36%
32% 32%
30% 27%
20%
20%
10% 5% 3% 3%
2%
0%
19 or under 20-34 35-49 50-64 65 or older

Education Mobile All

60% 52%
50%
36% 39%
40%
29%
30%
20% 18%
11% 8%
10% 7%
0%
Advanced degree College degree Some college High school or less

Source: American Customer Satisfaction Index (N=724): October 4, 2008 - May 11, 2009
Our Mobile Users

Role All Mobile

5%
Researchers/Scientists
5%

8%
Educators
4%

9%
Public Health Professionals
15%

15%
Students
5%

17%
Consumers
18%

32%
Healthcare providers
45%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Source: American Customer Satisfaction Index (N=724): October 4, 2008 - May 11, 2009
Our Mobile Users

• In the past three

months, have you:
• Browsed websites
using your mobile
phone? 73%
• Sent or received text
messages using your
mobile phone? 63%

Source: American Customer Satisfaction Index (N=724): October 4, 2008 - May 11, 2009
Text Messaging

With the use of SMS (text

Avg. monthly messaging) available on 98% of all
txt msg vs.
calls: cell phones, the number of text
357 vs. 204 messaging users continues to grow
steadily. In 2008, there were 92
million text messaging users in the
U.S. alone. That number is
projected to increase to 100 million
by the end of 2010.

( http://www.ctia.org/media/press/body.cfm/prid/1772
http://www.pewinternet.org/Reports
/2008/Mobile-Access-to-Data-and-I
nformation.aspx
Text Messaging

With the use of SMS (text

Avg. monthly messaging) available on 98% of all
txt msg vs.
calls: cell phones, the number of text
357 vs. 204 messaging users continues to grow
steadily. In 2008, there were 92
million text messaging users in the
U.S. alone. That number is
projected to increase to 100 million
by the end of 2010.

( http://www.ctia.org/media/press/body.cfm/prid/1772
http://www.pewinternet.org/Reports
/2008/Mobile-Access-to-Data-and-I
nformation.aspx
Text Messaging

http://www.ctia.org/media/press/body.cfm/prid/1772
Mobile Text Messaging Pilot

• Launched
September 2009
• Subscribers
receive about
three
messages/week
• H1N1 flu
messages and
other health
topics
• Health message
testing and user
evaluation
Example Text Messages

• If sick, stay home (except 2 get

medical care) at least 24 hrs after
fever is gone (w/o using fever-
reducing meds).
• Antiviral drugs 4 treating flu work
best if started w/in first 2 days of
symptoms.
• Traveling 4 the holidays? Wash
hands often & postpone travel if
ill. Wait 24 hrs after fever is gone
(w/o fever-reducing meds) to
travel.
Example Text Messages

Message
Having turkey this Thanksgiving? Test your turkey knowledge with a
turkey quick quiz. Reply TURKEY to start. Call CDC 800-232-4636 or
http://m.cdc.gov.
 
Quiz Question
What is the minimum internal temperature needed when cooking a
turkey? A. 145F B. 160F C. 165F D. 175F
 
Correct Answer
That's right! All poultry, incl. turkey, should be cooked to an internal
temperature of 165F. From all of us @ CDC, have a happy & healthy
Thanksgiving.  

Incorrect Answer
Sorry! All poultry, incl. turkey, should be cooked to an internal temp. of
165F to prevent illness. From all of us @ CDC, have a happy & healthy
Thanksgiving.  
Text Message Subscribers

More than 16,000 subscribers

since September 2009
Satisfaction Question
Jan. 23, 2009

Satisfaction message sent to all subscribers (N = 16,158)

Help us improve our text messages! Please answer one question about UR
satisfaction so we can improve our msgs & better meet UR needs. Reply
FEEDBACK to begin.

15% of subscribers replied (N = 2,435)

How would you rate UR overall satisfaction with the text messages:  A) Very
Satisfied, B) Satisfied, C) Dissatisfied, D) Very Dissatisfied - Reply A, B, C, or D

Of those who replied, 90% completed the quiz (N = 2,198)

 34% Very Satisfied
 53% Satisfied
 10% Dissatisfied 87% Satisfied
 3% Very Dissatisfied
Satisfaction Question
Jan. 27, 2009

Follow-up message sent to SATISFIED subscribers (N = 1,936)

We're glad U R satisfied w/ our text messaging pilot. We'd like to improve.
Reply to this message w/ the keyword INPUT & let us know how we can do
better!

27% of SATISFIED subscribers replied (N = 523)

How can we improve? 1)Make msgs more relevant 2)Pick better topics 3)Make
msgs more actionable 4)Reduce frequency of msgs 5)Other. Reply w/ 1
answer: 1,2,3...

Of those who replied, 69% completed the quiz (N = 363)

 27% Make messages more relevant
 19% Pick better topics
 30% Make messages more actionable Relevancy &


4%
20%
Reduce frequency
Other
Actionable
Satisfaction Question
Jan. 27, 2009

Follow-up message sent to subscribers who were NOT SATISFIED (N = 262)

Not satisfied with CDC's text messages? Please tell us why, so we can improve.
Reply to this message w/ the keyword IMPROVE & let us know how we can do
better.

33% of subscribers who were NOT SATISFIED replied (N = 87)

How can we improve? 1)Make msgs more relevant 2)Pick better topics 3)Make
msgs more actionable 4)Reduce frequency of msgs 5)Other. Reply w/ 1 answer:
1,2,3...

Of those who replied, 48% completed the quiz (N = 42)

 45% Make messages more relevant
 12% Pick better topics
 14% Make messages more actionable Relevancy
 5% Reduce frequency
 24% Other
Social Media at CDC
H1N1 Social Media Response
H1N1 Flu Social Media Response

http://www.cdc.gov/SocialMedia/Campaigns/H1N1/
H1N1 Flu Metrics

CDC’s eHealth Metrics

Dashboard:
http://cdc.gov/metrics
Online Video: YouTube

• 19 videos posted on YouTube

• 3.02Million Views since April 22nd
Most Popular H1N1 Video (2009)

Symptoms of Swine Flu

YouTube views:
2,024,581

CDC-TV:
76,592 views

YouTube: http://www.youtube.com/watch?v=0wK1127fHQ4
CDC-TV: http://www.cdc.gov/CDCTV/SwineFlu/index.html
Facebook

52,700 fans since CDC

Facebook page
launched May 1st
CDC Podcasts

2.67M views of CDC

H1N1-related podcasts
since April 22nd
Twitter

• 1.18M followers on 3 CDC Twitter

profiles
• 447,754 click throughs to CDC.gov
content from links posted on Twitter
since April 22nd
Email Updates

• 260,525 subscribers to
H1N1 flu email updates
• 7.44M H1N1 flu related
emails sent
Widgets

5.5M views of
H1N1-related www.cdc.gov/widgets
widgets since
April 22nd
Content Syndication and RSS

Content syndication provides a streamlined process for

disseminating current and credible content in real-time
on other Web sites.

•37.05 Million views of H1N1 Content via CDC RSS Feeds

•407,334 views of CDC H1N1 content via Content Syndication
The Future of mHealth

• Location, Location, Location

– Geocoding data and GPS

• Apps, Apps, and More Apps

– There is (or will be) an app for everything

• Convergence
– Media, Data, Devices
CDC Mobile Resources

– Mobile Activities at CDC:

http://www.cdc.gov/mobile/
– Mobile Health Coalition:
http://www.cdc.gov/mobile
health/
– eHealth Data Briefs:
http://www.cdc.gov/Health
Marketing/ehm/databriefs/
– Mobile Metrics
http://www.cdc.gov/metrics
/socialmedia/mobile.html
CDC Social Media Resources
– Novel H1N1 Flu:
http://www.cdc.gov/Social
Media/Campaigns/H1N1/i
ndex.html
– Novel H1N1 Flu (Spanish):
http://www.cdc.gov/spanis
h/mediossociales/h1n1/
– Seasonal Flu:
http://www.cdc.gov/Social
Media/Campaigns/Season
alFlu/index.html

– eHealth Metrics
Dashboard and eHealth
Data Briefs:
http://www.cdc.gov/Social
Media/Data/index.html
 Questions?
jbernhardt@cdc.gov
@jaybernhardt

This presentation is the opinion of the author and does not necessarily represent the official position of CDC or HHS.