Helen: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud. In these podcasts, you get to listen in on my conversations with some truly remarkable people. You will hear what health literacy is, why it matters and ways we all can help improve health understanding.

Today I’m talking with Jessica Rowden who is manager for Health Communication and eHealth at ODPHP (Office of Disease Prevention and Health Promotion) at the US Department of Health and Human Services.

Jessica coordinates and manages health communication activities for a variety of programs, including www.HealthFinder.gov,www.Health.gov and Healthy People 2020. Jessica also oversees ODPHP’s health literacy initiatives, specializing in online health literacy.

Welcome, Jessica.

Jessica: Thank you for having me.

Helen: I’ve interviewed others at ODPHP about some of these health literacy initiatives, and they’re all terrific. I gather that your role there is a little bit different as you’re the one who is telling the world about all of these projects. Do tell. How do you tell everybody about what you’re doing?

Jessica: One of the things we have been focusing on in the last few years is using social media to get our messages out. That includes Twitter, Facebook and LinkedIn.

Helen: You’re using Twitter, Facebook and LinkedIn from the federal government. Is that real?

Jessica: Yes, it is. The government is really trying to be proactive in using these resources, especially since it’s a lot cheaper than printing and sending out all of our materials. It’s a great and inexpensive way to get our message out.

Helen: Is it a way to get your messages out or is the message itself to use social media?

Jessica: It’s a little bit of both. It’s a way to spread our message but also to have a two-way conversation with our audience. It’s not just about telling them the information we want them to know, but it’s really to get their feedback and to get them to interact with the information. We hope to have a dynamic communication with them.

Helen: That’s really interesting. I had a conversation just this morning. I’m presenting about podcasting at a conference. Obviously, I know what I’m talking about when it comes to podcasting. A colleague is presenting on social media.

As we were doing that, we realized that podcasting seems to be information out. She was saying that social media is almost two-way. Tell us more about that.

Jessica: That’s right. One of the great things, especially with Twitter and Facebook, is that you connect with people and get their feedback on things. You can ask questions, and they can answer them or respond to certain things.

Helen: Can you give us an example?

Jessica: One of the things we have for www.HealthFinder.gov is a Twitter account. We have a daily theme for each of our tweets for the day. We try to organize our content and plan ahead with what we’re tweeting. Since Twitter is limited to 140 characters, you have to plan ahead to know what you’re going to be talking about and to be able to set your message in that small amount of space.

We call Wednesdays our Mid-week Share Day and we ask users who follow us on Twitter to respond to us about whatever the theme is. It might be nutrition or physical activity. We might ask them to share what they’re doing related to these topics, like what they do to stay healthy, how they eat healthy and how they stay active.

Helen: Do people really respond? I do use Twitter to announce new podcasts, but that’s really about all I do with it. I find that there’s such a flood of information that I couldn’t even sort out what’s coming. How do you really engage in a meaningful dialog?

Jessica: We have a really dedicated set of followers, and we’ve been working on this for some time now. I think it’s a matter of building your audience and working to reach them and engage them in interesting ways.

With Twitter, we don’t just promote our office or things like that, we really try to give them actionable health information that they can use and take advantage of.

We’ve been growing our Twitter following, and I think we have 165,000 followers.

Helen: Let’s just start at the beginning of this for listeners who don’t know. Can you describe briefly what you mean by Twitter? Just give a quick view of that and then give us a quick example of what a tweet that you would send out might actually look like.

Jessica: Twitter is basically a micro-blogging service. This allows the users to send what we call tweets or status updates. They are limited to 140 characters, so it’s very small. These updates go to anyone who is following you. Users can send and receive tweets. They can follow you and you can also follow them.

At our HealthFinder account, we follow a lot of other organizations that are relevant to the work that we do. It’s really a great way to leverage the word-of-mouth marketing. It provides immediate reach to your followers who then in turn reach their followers. One of the great things about Twitter is that you can re-tweet messages.

If someone likes what you tweeted, they can send it to all of their followers and it just spreads like that.

Helen: Now it’s Wednesday, and let’s say it’s Nutrition Day. In 140 characters, including spaces, what would your message look like?

Jessica: Let’s say we were talking about getting more calcium. We might be promoting some of our resources on www.HealthFinder.gov, so we might say, “Do you know some foods that are high in calcium? Check out this topic that we have on www.HealthFinder.gov. It provides a shopping list.” I don’t know how many characters that was.

You have to tweak it so that it fits within that small amount of space, and there are tools to help you do that. One of the things that we always use is a URL shortener.

Helen: Explain what that is.

Jessica: That’s something that will take the URL of your web page and basically generate a small URL so it doesn’t take up a lot of characters. There is a website called www.Bitly.com that is used a lot, and www.TinyURL.com is used a lot. Those are two that will make a tiny URL that will still direct to your web page, but it’s easy to fit into that 140 characters. It’s usually only 10 characters or so.

Helen: We’ve gotten a shortened URL, and we’ve got the gist of the message where you might be saying, “Do you know about calcium? Here’s something to learn.” How do you get the dialog going? That sounds like one-way to me.

Jessica: That one would be one-way, but we might tweet something that says, “How do you get more calcium in your diet?” We would ask people to provide examples of what they do. We might ask the same sort of thing related to physical activity.

Helen: Would it be like, “What are you doing?”

Jessica: “How do you get 30 minutes of physical activity a day? What are some of your tricks?

Helen: What I can’t seem to manage in this is how it all makes sense when you get it back. Is there a way to keep track? You’ve got over 100,000 followers. How do you keep track of all of this?

Jessica: There a lot of different tools that can help you track what’s going on in terms of your Twitter account. One thing that everyone can use is hashtags. This is a way that helps add context to your tweet and also helps to track different tweets that are on the same topic. It even helps to organize information on Twitter.

For example, one of the hashtags we use would be for health literacy. You basically have the hashtag and the word HealthLit.

Helen: Does the hashtag look like the pound sign?

Jessica: Yes. That’s right.

Helen: Do you always do that pound sign or hashtag HealthLit?

Jessica: Yes.

Helen: What if I was writing about health literacy? Should I use the same one even though I am not working with your group, or is it just yours and no one else can use it?

Jessica: That is for anyone to use. We’ve actually used that hashtag any time we’ve done anything related to health literacy. We’ve actually done some Twitter chats which I can talk a little bit about. Everyone who is involved with health literacy will use this hashtag.

There are many others because you can create your own hashtags. You basically just use the pound sign and then a word or little phrase that you want to use.

Helen: If I was just writing something for the Health Literacy Out Loud podcast, which is different than what you’re doing, is it still okay that I do that?

Jessica: You can absolutely use that. People who are searching for information on health literacy can search for the hashtag on Twitter, and then they can see any of the conversations or tweets that are related to health literacy.

Helen: This is great. You said that when you send these out, you plan them and have a theme. Do you just send them out once a week?

Jessica: Actually, our HealthFinder account is very active for Twitter. We actually tweet five days a week, Monday through Friday, and we typically have about five tweets a day.

Helen: Do you do all of that yourself, or do other people do it?

Jessica: We have contractors to help us, but we do have staff internally who help track the tweets, and we work together with our contractors on this. There are a lot of tools to help manage this as well. One of the things we do is to try to plan quarterly. For our purposes, that works really well.

We figure out what topics we’re going to have each month, and we usually try to feature a health observance of the month. It might be that in October we’re looking at breast cancer.

Helen: It could be Health Literacy Month.

Jessica: That’s right. We’ve actually had health literacy chats in October.

Helen: I was part of one of those.

Jessica: That’s right. We try to plan so we know what’s coming, but we do stay flexible for anything new that might come up. We plan these themes, and each day we try to focus on a specific type of activity.

For example, on Tuesdays we try to share news that might be happening. On Wednesday we have our sharing day. On Mondays we try to mobilize people into action and encourage them to take healthy steps.

If we’re looking at getting vaccinated for the flu, we might be talking about vaccine on Monday and how to get vaccinated and talk to your doctor. These are action steps that they can take to get healthier.

Helen: You’re working for this huge government organization, and you’re doing wonderful work. You keep talking about “we,” so you’ve got some internal people and external people. What about mere mortals like me and many of our listeners who do not have all of those resources? Is Twitter something we could manage ourselves?

Jessica: I absolutely think so. Twitter can be very fitting to whatever your needs are. It can be scalable. You can tweet just once a day or once a week depending on what sort of news you might have. In your case you could tweet about your podcast. If there is other health literacy news that you want to tweet about, you can create a tweet and send it out that day.

There doesn’t need to be the same level that we do at HealthFinder since we do have a lot of resources and people working on it, but there are definitely things that you can do. You want to make sure that you really promote what you do and what’s important to you.

It’s not just about promoting your organization, but what does your organization do? What are some activities, topics of interest, news stories or things that people would be interested in?

Helen: I’ve heard that you’re not supposed to be overly promotional, but it’s more about information sharing. You can’t just say, “I’m great and wonderful, so go here and buy this.”

Jessica: That’s right. It’s really about engaging the audience with what they want to hear. I think that’s always the key with these types of social media. It’s not just about sending out that message but giving information that can be useful to people.

Helen: I have one last question about this. I know that I use a tool called TweetDeck. Not only can I send out tweets that way, but somehow I click these magical little boxes and it shows up in Facebook, LinkedIn and wherever else I want. It’s the same little 140-character message. Are tools like that something you could explain to people?

Jessica: Yes. TweetDeck is one that we actually use as well. It’s a platform to help people publish their tweets in more places than just Twitter. Like you said, it will go to Twitter, but it will also go to Facebook. It can go other places.

TweetDeck can also help you monitor keywords and track what’s happening. It can also help you organize tweets of those you follow, and it can help you shorten the URLs like I mentioned. There are a lot of built-in features that can be helpful.

Helen: I can even set up different columns. I can do that hashtag HealthLit, and I’ll get everything that’s written with that hashtag in it. I find that that helps me manage it because if not, I’m overwhelmed with all of it.

Jessica: That is a great way to do it, especially if you have an account and you start following a lot of other organizations or people. It’s definitely hard to manage what’s coming in because there’s a constant flow of tweets. Something like TweetDeck is great because it can help you organize that and help you monitor certain things that are important to you.

Helen: Thank you. I think that you gave us more of a sense of Twitter and how you use it. I get the sense that you genuinely like it and use it as a real tool of this two-way communication. What other social media tools do you use and recommend?

Jessica: Facebook is another social media tool that we’ve been using. We started this more recently. I think it’s another great option in addition to Twitter. Twitter is more for sharing among a lot of people. It has weaker ties than Facebook.

People on Facebook tend to develop really strong ties with people because they follow a close network of their friends, family and colleagues. There is a very strong influence in that environment, so it’s a different way to reach people.

Helen: I can give you my sense of it. I don’t use it personally, and I don’t choose to use it. I see that other people do, so I get their information. For speaker colleagues of mine or other people who are speaking professionally, I see that some of them put something up every day or two.

I’m actually beginning to learn about their business in a different way. Is that what you mean by the stronger ties and the repetition day after day?

Jessica: It’s just that it’s a trusted network. When you follow people or organizations on Twitter, you follow them for the information, information sharing and that interaction. On Facebook, you tend to be closer to the people that you are friends with or whose pages you “like.” I think it’s a more trusted source of information.

People tend to go to their friends, family and other trusted people for information, and I think that’s how Facebook differs from Twitter a little bit.

Helen: You’re the federal government. We’re not talking about friends and family here. How do you use the same platform in such a professional way?

Jessica: With Facebook, we’re not promoting our office. We’re promoting HealthFinder, healthy habits, healthy behaviors and things like that. It’s really about promoting what we do and not the office itself. What I’m trying to say is that it’s not promoting the government.

Helen: It looks the same.

Jessica: It basically looks like our www.HealthFinder.gov website. It’s really meant to engage people in prevention and wellness and educate them about how to change their behavior. Our content comes from government sources like the dietary guidelines and physical activity guidelines, but it’s really meant to be understandable for all consumers who want to be healthier.

Helen: Would your Facebook page be under the name of HealthFinder and not your name?

Jessica: It’s under HealthFinder. If you searched HealthFinder, you could probably find us and “like” our page. That’s one thing different about organizations versus people on Facebook. People have profiles, but organizations have what you call pages. You can “like” a page on Facebook.

Helen: What about LinkedIn? That’s actually one that I think I like more than the others. Tell me about that.

Jessica: LinkedIn is great. It’s really meant for professionals. It’s a professional social network. What’s great about it is that it integrates a lot of different features, including web mail, online messaging, sharing, discussion boards and even job seeking and things like that.

Helen: There are also groups.

Jessica: Exactly. We have a LinkedIn group for our Healthy People 2020. It’s a great way for exchanging ideas, networking and participating in these discussions.

Helen: Our listeners come from all kinds of backgrounds, and I don’t know how savvy they are about social media. I’m assuming from the tone of our conversation that they know something about it. This isn’t quite starting at the beginning, but it’s not far down the line either.

What recommendations and lessons learned would you like to share?

Jessica: One of the things that is always important is that once you have a social media account, whether it’s Facebook, LinkedIn or Twitter, it’s really important to promote it so that you get the followers and get people involved.

One of the things we did was to send out messages to our different email lists to let them know to “like” us on Facebook or follow us on Twitter. We’re always trying to promote our social media accounts so we can get more visibility, get more information out there and have those continued conversations.

Another thing is don’t promote your organization or office but promote what’s important and what you’re doing. If you focus on diabetes, then focus on those messages to help people manage their diabetes or whatever it may be. Get those messages out there and interact with them on that topic.

Another thing with all of these is to not bombard people with constant tweets or messages. It is important to manage it and make sure that you’re not over-promoting things.

Helen: How would you weight that? When I see what other people are putting out I’m thinking, “It’s way too much.” What’s that three-letter acronym? It’s TMI for too much information. They might think they’re being perfect, and I think they’re way overdoing it. How do you know?

Jessica: I think it’s a matter of balancing it and watching your engagement and what happens. For instance, with Twitter, we tweet five times a day. That works for us. We’re still increasing the number of followers, people are engaging with us and things like that.

With Facebook, we actually changed how many times a day we posted and what we were posting on because we weren’t getting as much feedback and interaction as we would like. We were trying to get people to post pictures of their healthy plates that followed the dietary guidelines of My Plate, the new icon. People weren’t doing that, so we had to shift what our focus was.

The important thing is to monitor that. Clutter is definitely bad, so if you’re tweeting or posting on Facebook so much that people can’t keep up with you, they’re not going to be interested. They might unfollow you or “unlike” your page. It’s a matter of trying to do it so that they find it interesting and useful.

You could probably tweet 10 times a day if you had all new information, but most organizations probably don’t have that. You want to make sure that what you’re featuring are things that people will find interesting.

It’s a social network, so consider how you would share content with your neighbor or friend. How would you converse or interact with them? You don’t want to tell them everything that’s happening, but there are certain important, timely or relevant things that you would share with them.

Helen: Thank you. I feel that you’re giving us all of this information, but I think we need to let people catch their breath on this one. Why don’t you tell us how they can go about finding you, “liking” you, clicking you, tweeting you or all of those different ways to get in touch with you? We will also put this on the Health Literacy Out Loud web page with this broadcast.

Just give people some high spots of how to contact you, find you, follow you or like you or whatever they do.

Jessica: On Twitter we’re available at @HealthFinder.

Helen: Do you use the @ sign?

Jessica: Yes. That’s called your user handle. Everyone’s handle has an @ sign, so we are available at @HealthFinder. We also have the Healthy People one which is @HP2020.

On LinkedIn, it’s also a Healthy People 2020 group. You can search for that and find us.

On Facebook, it’s HealthFinder.gov. You can do a search for it and find us as well.

Helen: That’s wonderful. Jessica, I’m wowed by all you’re doing. If I just did a little bit like I’ve been doing and not do it as much as you, is it still okay?

Jessica: Absolutely. I think it’s great to be able to use these as a way to get your message out and engage your audience. It’s really little cost to do this, and I think you can get a big reward for using social media.

Helen: Thanks so much for sharing it with listeners of Health Literacy Out Loud.

Jessica: You’re welcome. Thank you for having me.

Helen: I learned so much from talking with Jessica Rowden, and I hope that you learned a lot from our conversation too. Health literacy isn’t always easy. For help clearly communicating your health message, please visit my Health Literacy Consulting website at www.HealthLiteracy.com. While you are there, sign up for the free e-newsletter, “What’s New in Health Literacy Consulting.”

New Health Literacy Out Loud podcasts come out every few weeks. Subscribe for free to hear them all. You can find us on iTunes, the mobile app Stitcher Radio and the Health Literacy Out Loud website, www.HealthLiteracyOutLoud.com.

Did you like this podcast? Did you learn something new? If so, tell your colleagues and friends. Actually, tweet your colleagues and tweet your friends. Together, let’s let the whole world know why health literacy matters. Until next time, I’m Helen Osborne.