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Using Social Media to Augment Traditional Tuberculosis Contact Investigation Methods

Using Social Media to Augment Traditional Tuberculosis Contact Investigation Methods. Leslie Henry, BSN, RN, PHN Nurse Consultant Tuberculosis Control Branch California Department of Public Health. Objectives.

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Using Social Media to Augment Traditional Tuberculosis Contact Investigation Methods

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  1. Using Social Media to Augment Traditional Tuberculosis Contact Investigation Methods Leslie Henry, BSN, RN, PHN Nurse Consultant Tuberculosis Control Branch California Department of Public Health

  2. Objectives • Describe how social media sites can be used to identify and locate potential contacts and possible exposure sites • Identify ethical considerations to keep in mind when employing social media in a contact investigation

  3. Disclosures • The faculty have no conflicts of interest to disclose

  4. What is Social Media? • Social media: Computer-mediated tools that allow people to create, share or exchange information, ideas, and pictures/videos in virtual communities and networks • Used to share ideas, exchange information, display viewpoints • Arranged as forums, communities, or networks • Instantly connect and transmit messages to large numbers of people • Vast amount of personal, formerly ‘private’, data available Trieu, 2014

  5. Social Media Platforms • Facebook(2004) • Online profile: ability to share pictures, posts, and opinions • As of 2018 there are 2.3 billion mobile active users • 5 new profiles are created every SECOND • Instagram(2010) • A primarily mobile application profile of photo sequences • 1 billion users worldwide • 95 million photos shared per day • Twitter(2006) • Exchange of messages of 280 characters or less • 321 million monthly users who send 500 million Tweets a day • LinkedIn(2003) • Online resume used for professional networking • Has more than 500 million users • YouTube(2005) • A web sharing device for videos • 1.3 billion users • 300 hours of video are uploaded every minute • Yelp(2004) • Publishes reviews on local businesses with personal input from users • 33 million unique Yelp visitors a month Trieu, 2014

  6. Who Uses Social Media • Law Enforcement • Lawyers • Government Agencies • Schools and Universities • Hospitals • Insurance Companies • Prospective Employers

  7. How many of you use social media as part of your job? (Facebook, Instagram, LinkedIn, Yelp)

  8. Uses of Social Media in TB control • Contact investigations • Identifying additional contacts • Verifying work/school/congregate exposure sites • Outbreak and genotype cluster investigations • Identifying/confirming epidemiologic links • Finding lost patients • Identifying new locating information • Monitoring adherence to isolation • Photos of the patient in public during isolation Trieu, 2014

  9. What information can you get from using Social Media? • Identify how TB patients might be connected • Are they friends with other cases? • Identify additional contacts • Find additional case information: • Where do they spend time? • Where do they work? • Field safety issues

  10. Snow White Mickey Mouse Tigger Donald Duck Jiminy Cricket Belle

  11. How to use the information found • Social media is more of an information gathering tool that can help guide certain questions • Use info gathered from social media sites to confirm what the case/contact saidduring an earlier interview • It is recommended that you not reveal that social media is the source of your information

  12. How to use the information found: Interviews • Locations • Vacations • Parties • Social gatherings • Family gatherings • Hobbies • Photos • Are there photos of the case with children? • Are there any photos that show the case out in public when they were supposed to be isolated? • Comments from friends • Anything said about how much weight a case has lost could be helpful in establishing or confirming an infectious period

  13. What to do when you can’t find them on Social Media? • Try searching for other family members or known friends • If the name is unique, try a basic Google search • If you have a phone number or email, use this information to search for them on Facebook • Sometimes you will be unsuccessful

  14. Case Study 1 – Establishing Epi Links • Outbreak in a large extended family • Foreign-born adult index case • 7 children mostly US-born, all related to index case • Age ranges of children 1 – 12 years old • A new case identified • US-born adult • Not a family member • Does not match outbreak demographics • On Humira for RA • Genotype matches the outbreak

  15. Case Study 1 – Results • A Facebook search of both cases • Both the index and new case had an adolescent child • Both children played soccer in the same league • This information was used in the reinterview of the new case • The reinterview revealed that the new case drove the index case’s child to soccer practice • Epi-link established • Time and resources were saved by not having to look further for a link

  16. Case Study 2 – Identifying contacts • Index case • US-born teenager • Smear/culture positive, cavitary TB • Household CI – all positive • School CI had a high positivity rate • Repeatedly stated they had no friends other than the family

  17. Case Study 2 – Results • The index case’s Facebook was viewed • Facebook revealed several additional contacts, including children • Pictures showed they belonged to a gymnastics team • 2 additional cases were found and treated

  18. Ethical Considerations • Protect patient confidentiality • The potential is there to link the patient to TB • Don’t mix business with personal • Consider having a generic profile • Restrict use of social media for public health purposes only • Develop local policy for the use of social media • If no local policy is available, seek supervisory support before using social media for work

  19. Tips for Avoiding Ethical Lapses • Do not post, tweet, blog, or otherwise disclose protected, sensitive, or confidential information • Access only publicly available information; do not attempt to gain access to non-public social media content • Do not friend patients or their contacts • Do not accept friend invitations from patients • Do not ask to follow a private Twitter or Instagram account • Do not subscribe to patients’ YouTube accounts • Do not connect on LinkedIn

  20. Conclusions • Social media is widely used and can be a helpful tool for routine TB control • Locating patients who need follow-up • Enhancing contact, outbreak, and genotype cluster investigations • It is not a substitute for a good contact investigation • Privacy and confidentiality issues must be addressed when developing protocols on how to use social media • Consult with your organization’s administrators Trieu, 2014

  21. Acknowledgements • TBCB • Anne Cass • Corrine Stuart • Maureen O’Rourke-Futey • NYC • Trieu, Lisa. 'Beyond Liking, Friending And Poking‘. 2014 NTCA Presentation References

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