“What Do I Say? How Do I Say it?” Twitter as a Knowledge Dissemination Tool for Mental Health Research

Figures & data

Figure 1. Organization selection process.

Figure 2. Tweet selection process.

Table 1. Content codebook for research tweets

	THEMATIC CATEGORY	PREDICTOR VARIABLES (n = 27)
“What do I say?”	MESSAGING	Tweet promotes research results or evidence-based information
		Tweet promotes research program or tool
		Tweet contains announcement
		Tweet features participant recruitment for study
		Tweet includes call to action
		Tweet includes statistic
	RESEARCH AREA	Research area is prevention or early intervention
		Research area is epidemiology
		Research area is treatment
		Research area is translation or implementation
		Research area unclear or NOS
	MENTAL HEALTH AREA	Mental health area equals general or NOS
		Mental health area equals anxiety
		Mental health area equals depression
		Mental health area equals bipolar, schizophrenia or psychosis
		Mental health area equals suicide
		Mental health area equals OCD
		Mental health area equals ADHD or autism
		Mental health area equals substance use
		Mental health area equals trauma
		Mental health area equals general wellbeing
		Tweet focuses on mental health of specific population group
		Tweet features lived experience of mental health
“How do I say it?”	EXTERNAL NETWORKS	Tweets mentions other accounts
		Tweet uses hashtags
	MEDIA FEATURES	Tweet includes media (e.g., image, video)
		Tweet includes hyperlink

NOS = Not otherwise specified

Table 2. Predictor variable frequencies and reliability coding results

		Frequency		Reliability coding
THEMATIC CATEGORY	PREDICTOR VARIABLES	(Tweets = 300)		Set 1 (Tweets = 150)			Set 2 (Tweets = 150)			Combined av. (Tweets = 300)
		n	%	Kappa	Std Err	p	Kappa	Std Err	p	Av. Kappa	Av. Std Err
MESSAGING	Tweet promotes research results or evidence-based information	150	50.0%	0.54	0.06	<.001	0.57	0.67	<.001	0.56	0.37
	Tweet promotes research program or tool	82	27.3%	0.61	0.11	<.001	0.31	0.65	<.001	0.46	0.38
	Tweet contains announcement*	129	43.0%	0.65	0.06	<.001	0.57	0.68	<.001	0.61	0.37
	Tweet features participant recruitment for study	26	8.7%	-	-	-	-	-	-	-	-
	Tweet includes call to action*	104	34.7%	0.45	0.08	<.001	0.77	0.54	<.001	0.61	0.31
	Tweet includes statistic	6	2.0%	-	-	-	-	-	-	-	-
RESEARCH AREA	Research area is prevention or early intervention	52	17.3%	0.70	0.07	<.001	0.40	0.96	<.001	0.55	0.52
	Research area is epidemiology	8	2.7%	-	-	-	-	-	-	-	-
	Research area is treatment	66	22.0%	0.56	0.08	<.001	0.34	0.99	<.001	0.45	0.54
	Research area is translation or implementation	56	18.7%	0.19	0.10	.014	0.74	0.68	0.128	0.46	0.39
	Research area unclear or NOS	145	48.3%	0.48	0.07	<.001	0.24	0.76	<.001	0.36	0.41
MENTAL HEALTH AREA	Mental health area equals general or NOS*	186	62.0%	0.70	0.06	<.001	0.67	0.61	<.001	0.68	0.33
	Mental health area equals anxiety	8	2.7%	-	-	-	-	-	-	-	-
	Mental health area equals depression*	31	10.3%	0.93	0.05	<.001	0.96	0.04	<.001	0.95	0.04
	Mental health area equals bipolar, schizophrenia or psychosis	15	5.0%	-	-	-	-	-	-	-	-
	Mental health area equals suicide*	49	16.3%	0.95	0.04	<.001	0.93	0.04	<.001	0.94	0.04
	Mental health area equals OCD	0	0.0%	-	-	-	-	-	-	-	-
	Mental health area equals ADHD or autism	5	1.7%	-	-	-	-	-	-	-	-
	Mental health area equals substance use	10	3.3%	-	-	-	-	-	-	-	-
	Mental health area equals trauma	6	2.0%	-	-	-	-	-	-	-	-
	Mental health area equals general wellbeing	26	8.7%	-	-	-	-	-	-	-	-
	Tweet focuses on mental health of specific population group*	137	45.7%	0.53	0.07	<.001	0.73	0.56	<.001	0.63	0.31
	Tweet features lived experience of mental health	2	0.7%	-	-	-	-	-	-	-	-
EXTERNAL NETWORKS	Tweets mentions other accounts**	169	56.3%
	Tweet uses hashtags**	270	90.0%
MEDIA FEATURES	Tweet includes media**	250	83.3%
	Tweet includes hyperlink**	235	78.3%

NOS = Not Otherwise Specified

*Subjective predictor variables found to be valid and reliable, underwent further regression analysis

**Objective predictor variables not requiring validity or reliability testing, underwent further regression analysis

Table 3. Regression results for predictor variables found to be valid and reliable

		Retweets			Comments			Favourites
THEMATIC CATEGORY	PREDICTOR VARIABLES	IRR	95% CI	p	OR	95% CI	p	IRR	95% CI	p
MESSAGING	Tweet contains announcement?	0.99	0.79, 1.23	0.891	1.69	0.89, 3.25	0.110	1.19	0.95, 1.49	0.117
	Tweet includes call to action	0.89	0.69, 1.13	0.333	1.65	0.79, 3.48	0.180	0.90	0.70, 1.16	0.413
MENTAL HEALTH AREA	Mental health area equals general or NOS	0.97	0.72, 1.30	0.836	1.87	0.79, 4.83	0.170	1.27	0.95, 1.69	0.086
	Mental health area equals depression	0.92	0.62, 1.39	0.683	1.30	0.37, 4.38	0.670	1.24	0.83, 1.86	0.282
	Mental health area equals suicide*	1.39	0.98, 1.96	0.053	2.75	1.00, 7.87	0.052	1.59	1.13, 2.24	0.007
	Tweet focuses on mental health of specific population group?*	1.12	0.89, 1.41	0.331	2.20	1.10, 4.52	0.028	0.98	0.78, 1.24	0.883
EXTERNAL NETWORKS	Tweets mentions other accounts?	0.94	0.76, 1.15	0.539	1.33	0.70, 2.56	0.390	1.13	0.91, 1.39	0.269
	Tweet uses hashtags?*	0.86	0.60, 1.22	0.400	0.41	0.14, 1.22	0.100	0.63	0.43, 0.89	0.011
MEDIA FEATURES	Tweet includes media?*	1.32	1.00, 1.74	0.045	0.87	0.39, 2.06	0.750	1.19	0.90, 1.55	0.22
	Tweet includes hyperlink?*	2.05	1.53, 2.75	<0.001	0.76	0.34, 1.73	0.500	0.90	0.68, 1.19	0.456

NOS = Not Otherwise Specified, IRR = Incidence Rate Ratio, OR = Odds Ratio, CI = Confidence Interval

* <0.05

Table 4. Preliminary guidelines for mental health researchers using twitter

What do I say?	How do I say it?
1. Tell the audience what the information is, and where it came from (i.e., your key finding and the evidence-basis is clear) 2. Tell your audience who you’re speaking to (i.e., if your finding relates to a specific population group, make it clear)	Use media that adds to the Tweet, expanding on what the information is and where it came from (e.g., images, videos) Use hyperlinks to verify research information in Tweet Minimize over-use of hashtags (i.e., seek out hashtags that relate to specific events, communities or conversations)

Table 5. An example of the guidelines in practice using mock tweets

Not using guidelines	Using guidelines
Evidence basis of information is unclear (what is the information, and where did it come from?)	Evidence basis of information is clear (prevalence of trauma in young people, comes from analysis of a clinical trial)
Image used adds nothing to Tweet	Image used adds to Tweet, shows information is also based on expert opinion
Hyperlink to verify research information in Tweet	Hyperlink to verify research information in Tweet
Specific population group that findings relate to is clear (young people)	Specific population group that findings relate to is clear (young people)
Hashtags are not over-used (relate to specific conversations)	Hashtags are not over-used (relate to a specific conversation)

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.