Presentation at the 19th anniversary conference of the National Institutes of Health (UP Manila). 2 March 2017 Bayanihan Center, Pasig City. It discusses this paper http://actamedicaphilippina.com.ph/content/content-analysis-tweets-pregnant-women-diabetes.

1. SOCIAL MEDIA
& HEALTHCARE
IRIS THIELE ISIP TAN MD, MSC
Professor, UP College of Medicine
Chief, UP Medical Informatics Unit
Director, UP Manila Interactive Learning Center
@endocrine_witch

2. Patients are increasingly using online social networks to
connect with other patients and healthcare professionals
PEER-TO-PEER HEALTHCARE
Pagoda S. et al. Adapting Behavioral Interventions for Social Media Delivery
J Med Internet Res 2016;18(1):e24

3. Isip Tan ITC, Madamba H,
Balandra RJ. Acta Medica
Philippina 2016;50(4):
295-301
Content Analysis
of Tweets of
Pregnant Women
with Diabetes
Concepcion AO, Garcia
AM, Isip Tan ITC,
Fernando G
Reliability of Health
Information
Websites for Breast
Cancer in Twitter
The Main Sources of Anxiety &
Dissatisfaction of Women with
Gestational Diabetes Determined by
Content Analysis of their Blogs
Automated Sentiment Analysis
of Commentaries in a HCP-
moderated Facebook Page in
R programming Language
Evaluation of Facebook’s Capacity
as a Platform for Health
Communication: A Process
Evaluation Strategy
Social Media & Healthcare
Lung Cancer-related
Twitter Activity among
Patients & Healthcare
Professionals
Garcia AM, Concepcion
AO, Isip Tan ITC,
Fernando G
Li, R & Isip Tan ITC
Obrero RJ & Isip Tan ITC
Tiongson N & Isip Tan ITC

4. SYMPLUR HEALTHCARE HASHTAGS PROJECT
Allow exploration by either hashtag
or healthcare subject matter
Thomas M. Lee @tmlfox
http://www.symplur.com/blog/healthcare-hashtags-social-project/
#HEALTHXPH

5. STANFORD MEDICINE X & SYMPLUR
SOCIAL MEDIA ANALYTICS RESEARCH CHALLENGE

6. … precious little is known
about health system or
societal factors that hinder
compliance and what can
be done to improve it.”
“
Nielsen KK, Kapur A, Damm P, de Courten M & Bygbjerg IC.
BMC Pregnancy and Childbirth 2014, 14:41.
PREGNANCY & DIABETES

8. Describe health beliefs of pregnant
women with diabetes using tweets
OBJECTIVES
Describe how information on diabetes in
pregnancy is shared on Twitter
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

9. #diabetes
#pregnancy
#gestationaldiabetes
SYMPLUR
Signals
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

10. RESULTS
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301
SEARCH yielded
6433 tweets
1024 tweets
by patients
524 tweets from manual
scan of 4260 tweets
1548 tweets
coded for content
184 status tweets
79 women
Pregestational diabetes
292 status tweets
206 women
Gestational diabetes
239 tweets with links
93 unique domains
24 women T1D
16 wrote blogs
4 women from Philippines

11. Status tweets
Personal
Temporal
Location
Mechanical
Physical
Work
Automated
Activity
Dann, S. Twitter content classification. First Monday, 15(12). 2010. doi:10.5210/fm.v15i12.2745

12. Rosenstock IM, Becker VJ, Marshall H (1988). Social learning theory and the
health belief model. Health Education & Behaviour 15(2):175-183
Modifying
variables
Perceived
seriousness
Perceived
susceptibility
Perceived benefits vs
perceived barriers
Perceived threat
Self-efficacy
Cues to action
Likelihood of
engaging in health-
promoting behavior
HEALTH BELIEF MODEL

13. Tweets
0
40
80
120
160
Susceptibility Benefits Cues to action Severity Barriers Self efficacy
Pregestational diabetes
Gestational diabetes
Distribution of status tweets mapped to constructs
of the Health Belief Model comparing women with
gestational and pregestational diabetes
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

14. Perceived severity
So, my baby weighs 9 pounds at only 36 weeks gestation.
Hmmmmm..... #pregnancy
#SlightlyApprehensive #birth #gestationaldiabetes
Mom has had way way way too many carbs today. Poor baby
is gonna be on sugar overload. #GestationalDiabetes :(
Heading to an ultrasound to see how big baby girl is...
eeeeeek! #29weeks #gestationaldiabetes
Opinion of how serious a condition and its consequences are
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

15. Logically I know #GestationalDiabetes is not my
fault...pregnancy hormones make it impossible to be logical
#PregnancyProblems #hormonal
Why do I have cravings for sweets a week before my Glucose
Tolerance test?! :P Super worried about #gestationaldiabetes :/
Help me, Oh Lord!
Damn Pregnancy hormones! Kung kelan malapit na! T_T
#gestationaldiabetes #30weeks
Perceived susceptibility
Opinion of chances of getting a condition
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

16. Meat sauce over baked garlic cabbage. #lowcarb
#gestationaldiabetes
Healthy snack. #29weekspregnant #gestationaldiabetes
#healthy #snack #cucumber #carrot #yoghurt
I will do anything for love -- poke my finger 7x a day and get
shots 4x a day #gestationaldiabetes #babylove
Found out I can eat air popped popcorn!! #gestationaldiabetes
woohoo! (Little things make me happy these days)
Perceived benefits
Belief in the efficacy of the advised action to reduce risk
or seriousness of impact
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

17. Perceived barriers
Cheating on a diet and feeling like a murderer while you
frantically hide the evidence! #gestationaldiabetes #sucks
#nosugar #thestruggle
Omg today is national cream filled donut day and I can't
participate because of stupid #gestationalDiabetes, that’s just
crap!
I am sick of this frickin' diet... Just hate it #PregnancyProblems
#gestationaldiabetes #GDM #pregnant
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301
Opinion of the tangible and psychological costs
of the advised action

18. Tweets (gestational diabetes)
Food restriction & hunger 61%
Dealing with emotions 9%
Blood glucose monitoring 7.6%
Clinic consults 6.2%
Lab tests 4%
Tweets (pregestational diabetes)
Emotional 33% Dietary restrictions 23.5%
Perceived Barriers
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

19. Perceived barriers
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301
Opinion of the tangible and psychological costs of the advised action
I miss my mum and sisters.feeling emotional n scared. being
pregnant without them to help is no fun!#diabetes #pregnancy
Well.. I could use a vacation from needles and not-as-low-as-
the-drs-would-like blood sugars today...*sigh* #diabetes
#pregnancy #insulin
Diabetes sucks! #diabetes #diabetics #bloodsugars #pregnancy
#diabeticpregnancy #troubles
WHAT?! After 50 units of #insulin, a 12.1mmol/L
result?!?! UGH!! #pregnancy #diabetes

20. Stupid elevated after lunch sugar number. Hitting the
treadmill. #gestationaldiabetes #32weeks
#30weekspregnant #babybump #gestationaldiabetes
#walking #stayfit #stayhealthy #iloveexercise
Cues to action
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301
Strategies to activate "readiness"

21. Self-efficacy
Hopped on the treadmill for 30 min after work, made dinner, AND walked
the dogs tonight. Woooooot! #kickass #gestationaldiabetes #30weeks
Been monitoring my blood sugar today. Whooped that elevated sugar's
butt! #gestationaldiabetes #aintgotshitonme #pregnancyproblems
Tested my sugar after dinner and it was well within range. #Victorious
#GestationalDiabetes #CelebrateTheSmallThings
Proud that I've learned to inject insulin by myself - have overcome my
deep fear of needles! #gestationaldiabetes
Two miles done and done. Before work. Before 6am. Woooo!
#gestationaldiabetes #kickass #pregnant
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301
Confidence in one's ability to take action

22. Pass along tweets
Retweets
User generated content
Endorsement
Dann, S. Twitter content classification. First Monday, 15(12). 2010. doi:10.5210/fm.v15i12.2745
Health on the Net Foundation
https://www.hon.ch/

23. Health on the Net Foundation
https://www.hon.ch/
9/93 (9.7%) unique domains had HON Code seal
Women with preexisting diabetes shared
blog posts (67%)
Women with gestational diabetes shared links
from organisations or news sites(64%)
Isip Tan ITC, Madamba H, Balandra RJ. Acta Medica Philippina 2016;50(4):295-301

24. Examining tweets of pregnant
women with diabetes identifies
issues important to them
Women with gestational diabetes
and preexisting diabetes had
differing perceptions of barriers
Conclusion

25. IRIS THIELE ISIP TAN MD, MSC
Professor, UP College of Medicine
Chief, UP Medical Informatics Unit
Director, UP Manila Interactive Learning Center
@endocrine_witch