660310

research-article2016
HEBXXX10.1177/1090198116660310Health Education & BehaviorStrekalova

Article
Health Education & Behavior

Health Risk Information Engagement 1­–8

© 2016 Society for Public
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News About an Emerging Pandemic DOI: 10.1177/1090198116660310

heb.sagepub.com

on Facebook

Yulia A. Strekalova, MS, MBA1

Abstract
Emerging pandemics call for unique health communication and education strategies in which public health agencies need to
satisfy the public’s information needs about possible risks while preventing risk exaggeration and dramatization. As a route
to providing a framework for understanding public information behaviors in response to an emerging pandemic, this study
examined the characteristics of communicative behaviors of social media audiences in response to Ebola outbreak news.
Grounded in the social amplification of risks framework, this study adds to an understanding of information behaviors of
online audiences by showing empirical differences in audience engagement with online health information. The data were
collected from the Centers for Disease Control and Prevention (CDC) Facebook channel. The final data set included 809
CDC posts and 35,916 audience comments. The analysis identified the differences in audience information behaviors in
response to an emerging pandemic, Ebola, and health promotion posts. While the CDC had fewer posts on Ebola than
health promotion topics, the former received more attention from active page users. Furthermore, audience members
who actively engaged with Ebola news had a small overlap with those who engaged with non-Ebola information during the
same period. Overall, this study demonstrated that information behavior and audience engagement is topic dependent.
Furthermore, audiences who commented on news about an emerging pandemic were homogenous and varied in their
degree of information amplification.

Keywords
information behavior, information engagement, social amplification of communication, social media listening, risk
communication

Communication during emerging pandemics presents a
unique public health education challenge. On the one hand,
health consumers need to be informed about an impeding
health threat. On the other, public reaction to the news about
a spreading infectious disease is likely to lead to increased
anxiety and amplification of risk perceptions (Chew &
Eysenbach, 2010; Kim & Liu, 2012; Ratzan & Moritsugu,
2014). Therefore, information about the risks of emerging
pandemics should neither be downplayed nor exaggerated
but, rather, carefully guided.
Health risk communication occurs in diverse situations.
They can be of high objective and low perceived risks (e.g.,
obesity), low objective and high perceived risks (e.g., vacci-
nation), or high objective and perceived risks (e.g., natural
disaster; Sandman, 1993). This typology encompasses a
wide range of risk communication and health education situ-
ations. However, emerging pandemics, like severe acute
respiratory syndrome, H1N1 influenza, or Ebola, when an
infectious disease that has broken out in a particular area
threatens to spread across a larger region, introduce uncer-
tainty about objective risks and next best actions. The com-
munication of facts is likely to be perceived as insufficient
(Kass-Hout & Alhinnawi, 2013; Locatelli, LaVela, Hogan,
Kerr, & Weaver, 2012), and health consumers are likely to
seek social cues to formulate their risk perceptions
(Alaszewski, 2005) turning to established, trusted sources
for information, like public health departments and govern-
mental health agencies (Holmes, 2008; Love, Arnesen, &
Phillips, 2014). Prior research has evaluated the role of health
1
University of Florida, Gainesville, FL, USA
Corresponding Author:
Yulia A. Strekalova, Division of Graduate Studies, College of Journalism
and Communications, University of Florida, POB 118400, Gainesville, FL
32610, USA.
Email yulias@ufl.edu

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2 Health Education & Behavior 
risk communication strategies employed by message senders
(Berry, Wharf-Higgins, & Naylor, 2007; Cairns, de Andrade,
& MacDonald, 2013; Lee & Basnyat, 2012; Prati, Pietrantoni,
& Zani, 2011). Extending this line of research, the present
study focuses on the role of audiences in the process of dis-
semination of health risk information and examines informa-
tion behavior characteristics that contribute to information
amplification. Specifically, this study, guided by the social
amplification of risks framework (SARF; Kasperson et al.,
1988), analyzed consumer information behaviors in the situ-
ation of an emerging pandemic, Ebola, on a social media
channel, a Facebook page maintained by the U.S. Centers for
Disease Control and Prevention (CDC).
Literature Review
Social Amplification of Health Risk Information
The SARF identifies four information mechanisms that con-
tribute to the amplification of risk perceptions: volume of
information about a particular risk, ambiguity of information
and apparent disagreement among experts, dramatization of
facts and possible consequences, and symbolic connotations
communicated in the process of information sharing
(Kasperson et al., 1988). Specific to the communication
about an emerging pandemic, a recent study has shown that
covering H1N1 influenza, mass media attention translated to
an increased coverage of H1N1, and the dramatization of
news occurred through increased sharing of threat over pre-
cautionary news (Klemm, Das, & Hartmann, 2016). Another
study has looked at the news about Ebola and shown that the
ambiguity of communicated signals, which resulted in posi-
tive appraisal of information and trust in governmental
actions as well as negative appraisal and concerns about the
spread of Ebola, present challenges for the dissemination of
information about emerging pandemics (Johnson, 2016).
SARF also identifies audiences as communication sta-
tions that contribute to information amplification (Pidgeon,
Kasperson, & Slovic, 2003). Amplification refers to the pro-
cess during which audience members disseminate health risk
information through their social networks, thus increasing
information reach and engaging others (Pidgeon et al., 2003).
Consequently, the tenets of the SARF allow explaining infor-
mation behavior on social media. Seeking and passively con-
suming information can be viewed as the first step to the
engagement with an issue (Napoli, 2011). However, in the
context of health information dissemination, laypersons may
not be able or willing to analyze fully the risk information
that they encounter (McComas, 2006) and rely on shortcuts
to assess the level of risk (Fischhoff & Kadvany, 2011).
Information consumers who express interest in a particular
news, for example, by liking a post on Facebook, create
social cues that signal the value of information to others
(Gittelman et al., 2015; Sun, Rau, & Ma, 2014). By actively
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commenting, information consumers increase the relevance
of the topic for other members of their social networks, thus
acting as dissemination agents for the original message and
amplifying message effects.
Health Information and Audience Engagement
Collectively, social media are a powerful communication
channel that can be used to disseminate information to large
audiences (Ho, 2014). In general, social media can be defined
as an environment that facilitates the creation and exchange
of user-generated content (Rains, Brunner, & Oman, 2014).
A growing body of research shows that communication
through social media is a welcome trend among health con-
sumers (Clayman, Manganello, Viswanath, Hesse, & Arora,
2010; Fisher & Clayton, 2012; Thackeray, Crookston, &
West, 2013) and a practice widely adopted by public health
organizations (Kim & Liu, 2012).
Social media both carry distinct benefits and present
unique challenges for health communication and education.
Specifically, they provide a platform for quick information
dissemination about public health risks but may cause unin-
tended consequences when audiences actively share their
interpretations of information and contribute to the amplifi-
cation of risk perceptions (Merchant, Elmer, & Lurie, 2011).
These challenges may be especially dire for government
organizations (Larson & Heymann, 2010). Yet the potential
of social media as a dissemination channel has been recog-
nized by public health agencies (Thackeray, Neiger, Smith,
& Wagenen, 2012), and while most U.S. state–level public
health agencies have small Facebook audiences (Thackeray
et al., 2012), the CDC page had 573,530 followers as of
March 31, 2016 (Facebook, 2016).
Social media listening can aid in the understanding of the
mechanisms of information amplification, and Facebook
feeds represent the evidence of information behavior for
those who choose to communicate actively and play a role in
information amplification. To examine the differences in
social media information behaviors in response to posts
about an emerging pandemic and general health promotion
topics, this study asked the following research questions:
Research Question 1: What are the differences in infor-
mation engagement and amplification in response to an
emerging pandemic, Ebola, and health promotion posts?
Research Question 2: What are the characteristics of
information behavior exhibited by the CDC Facebook
page audiences in response to Ebola posts?
Method
An institutional review board approval was obtained to
ensure that data collection and analysis were compliant with
ethical standards for behavioral research.
Strekalova
Table 1. Data Set Characteristics Including Number and Percentage of Posts, Comments, Comment Likes, and Unique Users.
Topic Posts, n (%) Comments, n (%)
Health promotion 652 (80.59) 12,771 (35.75)
Ebola 157 (19.41) 22,948 (64.25)
Both topics
Total 809 35,719
Situational Context
In December 2013, a 2-year-old boy in Guinea died of an
unknown disease. Soon after, his mother, sister, and grand-
mother died. Only in March 2014, almost 4 months later, the
spread of a deadly fever was recognized, and it took almost
10 months to identify the boy as Patient Zero in what has
become the largest Ebola virus outbreak ever recorded (Baize
et al., 2014; Gostin, Lucey, & Phelan, 2014). Although the
cases of Ebola were primarily contained to West Africa, the
outbreak attracted significant attention from the U.S. public
(Love et al., 2014). Attention to Ebola increased with the
withdrawal of several U.S. missionary medical workers in
August 2014 and skyrocketed after the first domestic case of
Ebola diagnosis in September 2014 (Upadhyay, Sittig, &
Singh, 2014). As the information coverage of Ebola
increased, the public’s anxiety and fear related to it rose as
well (Chan, 2014). Addressing the public’s need for informa-
tion, the CDC provided regular updates and news releases
regarding Ebola while continuing to cover health promotion
topics.
Data Source
The data were collected from the CDC Facebook channel
through a Microsoft Excel add-on, Power Query, which
allows downloading posts, comments, share counts, and lim-
ited user metadata. Data collection occurred in late November
2014, and all posts from March 25, 2014 (the date of the first
World Health Organization report concerning Ebola in West
Africa), to October 31, 2014 (end of data collection), were
included in the analysis. A delay between the last post date
and the data collection date allowed capturing comments to
the later CDC posts.
In total, 836 posts and 35,973 comments to the original
posts were downloaded from the CDC Facebook page. Using
text search formulae, the posts were categorized into two
groups, emerging pandemic (Ebola) and health promotion.
Presence of the word “Ebola” was used to identify the posts
for the former category. A word frequency analysis also
showed that words “outbreak” (N = 67), “epidemic” (N =
15), and “pandemic” (N = 1) were mentioned in 83 posts, of
which 27 related to a Salmonella outbreak. These 27 posts
and associated comments were excluded from the analysis to
minimize data contamination. Additionally, following meth-
odological guidelines for content analysis (Krippendorff,
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3
Comment, likes, n (%) Users, n (%)
30,933 (33.97) 3,211 (25.58)
60,116 (66.03) 8,406 (64.35)
1,445 (11.06)
91,049 13,062
2012), a random sample of 50 health promotion posts was
reviewed to establish the reliability of automated coding. All
reviewed posts were not related to Ebola or other emerging
pandemics and no manual changes were necessary.
The final data set included 652 (80.59%) posts on health
promotion and 157 posts about Ebola. Table 1 shows addi-
tional information about associated comments and active
users.
A Facebook-assigned unique user ID was selected as the
unit of analysis. Average number of likes per comment was
operationalized as the measure of information amplifica-
tion, and total comments per user was operationalized as the
measure of information engagement. Table 2 provides infor-
mation about other information behavior variables used in
this study.
Analytic Procedures
A t test was run to answer Research Question 1 and compare
mean differences in audience behavior for emerging pan-
demic and health promotion posts. Next, a cluster analysis
was performed to answer Research Question 2 and identify
audience segments of active CDC Facebook users who fol-
lowed Ebola coverage. Earlier studies provided methodolog-
ical suggestions for the identification of the number of
clusters (Matthes & Kohring, 2008; Miller, Andsager, &
Riechert, 1998; Strekalova, 2014). The hierarchical agglom-
erative analysis with squared Euclidean distance method was
used to assess dissimilarity and distance among cluster items
and identify the optimal number of clusters for the character-
istics of user information behaviors.1 Using the elbow rule to
examine at which point the addition of a cluster resulted in a
lesser addition to variance explained, three groups were
identified as the optimal number of clusters. Next, a two-step
cluster analysis was performed to assign the users to groups
and confirmed that three clusters was the optimal number for
a good model fit (average silhouette = 0.7). Once users were
assigned to cluster groups, an analysis of variance was con-
ducted to determine differences across base variables.
Results
Research Question 1 aimed to identify the differences in
information engagement and communication amplification
of the CDC Facebook posts with an emerging pandemic,
Ebola, and health promotion information. An independent
4 Health Education & Behavior 

Table 2. Operationalization of Variables.

Variable label Variable coding description

User ID Facebook-assigned unique user ID. This field was used as a unit of analysis.
Post ID Facebook-assigned post ID was recoded and used to calculate the number of unique posts and
comments per post ID.
Post day Facebook-assigned original post date was recoded. March 25, 2014, was assigned a code of Day 1 with
all subsequent days labeled sequentially in numerical order.
Ebola coverage All collected posts were coded as 0 if no word “Ebola” was found by a text search formula, or 1 if the
word “Ebola” appeared in the post. A random sample of 50 posts coded as non-Ebola was reviewed
to ensure the quality of automated coding. All reviewed posts were not related to Ebola and no
manual changes were necessary.
Total comments The total number of Ebola and non-Ebola comments to the CDC Facebook page was calculated for
each unique user based on the Ebola coverage variable.
Comment lag Facebook-provided time-stamps for posts and comments, rounded to the fill hour, were used to
calculate the lag time between a post and a comment. The average lag time in hours was calculated for
each unique user and used on the data analysis.
Earliest comment day The earliest day of a comment, using March 25 as Day 1
Latest comment day The latest (most recent) day of a comment, using March 25 as Day 1 and October 31, 2014, as Day 221
Comment length LEN() formula in Excel was used to calculate total comment length, which included spaces and all
user-provided special characters and emoticons. The average comment length was calculated for each
unique user and used on the data analysis.
Comment likes Average number of likes per user comment was calculated to assess communication amplification
contributed by CDC audience members.

Note. CDC = Centers for Disease Control and Prevention.

Table 3. Values of Information Behavior Variables for Ebola and Non-Ebola Comments on the Centers for Disease Control and
Prevention Facebook Page.

Variables M SD Min value Max value t (df)

Total comments Non-Ebola 2.73 12.80 1 471 3.41 (13,032)
Ebola 2.33 14.17 1 1,159
Comment lag Non-Ebola 27.90 141.38 0 3,074 23.24 (13,032)*
Ebola 43.30 200.52 0 2,177
Comment length Non-Ebola 154.32 252.11 1 5,425 0.43 (13,032)
Ebola 157.39 227.26 1 5,479
Comment likes Non-Ebola 2.13 3.39 0 38 98.76 (13,032)*
Ebola 2.75 3.57 0 42
First comment day Non-Ebola 123.54 74.65 1 221 5,2060.32 (13,032)*
Ebola 187.10 32.56 134 221
Last comment day Non-Ebola 134.71 72.59 1 221 4,333.41 (13,032)*
Ebola 192.07 31.52 134 221
Ebola 2.75 3.57 0 42

*p < .01.

sample t test showed that comments to Ebola posts were
more concentrated around the time the U.S. citizen was diag-
nosed as infected with the virus (min day M = 187.10, SD =
74.72; max day M = 192.07, SD = 31.52). Response time for
Ebola posts was longer (M = 43.30, SD = 200.52). Although
the difference in total number of comments was not signifi-
cant with slightly fewer Ebola (M = 2.33, SD = 14.17) than
health promotion (M = 2.78, SD = 12.79) posts per user, t(1)
= 3.38, p = .07, there were more average likes for comments
on Ebola (M = 2.75, SD = 3.57) than health promotion
(M = 2.11, SD = 3.37) posts, t(1) = 103.94, p < .01. Table 3
shows the data for the analyzed variables.
Research Question 2 aimed to identify the characteris-
tics of active CDC Facebook audiences who responded to
Ebola news. The analysis identified three distinct groups
among those who commented to Ebola posts based on four
continuous variables: average response lag time, average
response text length, total comment count, and average
likes per comment. The groups were labeled as Contributors
(N = 7,867, 79.9%), Promoters (N = 1,736, 17.6%), and

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Strekalova
Table 4. Means and (Standard Deviations) for the Cluster Groups Based on the Information Behavior Variables.
Variables Contributors, M (SD)
Total comment count 1.96 (2.96)
Comment lag 16.94 (31.62)
Comment length 102.61 (86.89)
Comment likes 1.60 (1.60)
Number of submitted comments (%) 15,424 (67.21%)
Number of Facebook users 7,867 (79.9%)
commenting on Ebola posts (%)
Champions (N = 248, 2.5%). Table 4 provides full descrip-
tive statistics for the base cluster variables for each group. In
essence, a relatively quick response time (M = 16.94 hours),
shortest comment length (M = 102.61 characters), and low-
est number of likes (M = 1.60 likes) characterized the infor-
mation behavior exhibited by Contributors. Although
Contributors were the predominant group representing
almost 80% of those who commented about the CDC
Facebook posts, the low number of comments that users in
this group submitted (M = 1.96) made the relative propor-
tion of the comments from this group (67.21%) smaller
compared with its size. The second group, Promoters, was
characterized by the quickest response time (M = 14.15
hours), midpoint comment length (M = 353.78 characters),
and highest average number of likes (M = 7.89). The last,
smallest group is Champions. This group was defined by the
longest comment lag time (M = 1,084 hours, or 45 days),
largest comment length (M = 520.76 characters), and rela-
tively low comment likes count (M = 2.95).
A follow-up analysis of variances was performed to assess
if the four cluster variables and minimum and maximum post
date variables were significantly different among the groups.
Levine’s test of homogeneity of variances indicated unequal
variances for six variables. Variable transformation was not
successful, and a Kruskal–Wallis test was conducted to eval-
uate differences among the clusters. The test showed signifi-
cant differences for the total number of comments, χ2(2, N =
9,851) = 231.49, p < .05, first comment day, χ2(2, N = 9,851)
= 270.14, p < .01, last comment day, χ2(2, N = 9,851) =
214.63, p < .01, average response time lag, χ2(2, N = 9,851)
= 550.86, p < .01, average text length, χ2(2, N = 9,851) =
2071.64, p < .01, and average comment likes, χ2(2, N =
9,851) = 3103.57, p < .01. All pairwise comparisons showed
significant variances except no differences were found
between Contributors and Promoters for the number of com-
ments and the average response time.
Discussion
This study looked at the information behavior of social media
audiences in a situation of amplified attention to an emergent
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5
Cluster groups
Promoters, M (SD) Champions, M (SD)
1.87 (2.41) 17.23 (86.39)
14.15 (28.08) 1,084 (671.74)
353.78 (254.98) 520.76 (929.15)
7.89 (5.06) 2.95 (4.45)
3,251 (14.16%) 4,273 (18.62%)
1,736 (17.6%) 248 (2.5%)
pandemic health information topic, the Ebola outbreak.
Grounded in SARF, this study adds to an understanding of
information behavior of online audiences by showing differ-
ences between an emerging pandemic and health promotion
posts and identifying characteristics of active audiences.
While the CDC had fewer Facebook posts about Ebola,
these posts received more attention and comments from
active page users. Also, audience information behavior was
different in response to this amplified topic, posts about
Ebola received more likes, and comment lag was greater.
The latter finding suggests that social media users were com-
menting on more immediate health promotion posts but were
actively searching for previously published Ebola posts.
Furthermore, audiences engaged with Ebola information, for
the most part, did not overlap with those who commented on
health promotion posts. If selective and focused attention to
the information provided by a communication channel is
viewed as a component of an active engagement (Napoli,
2011), this finding signals that online audiences make con-
scious decisions to engage with particular health informa-
tion. Further studies could collect feedback from social
media users to empirically assess this interpretation.
Next, this study looked for the characteristics of informa-
tion behavior of active users who commented on Ebola posts.
The users were clustered into three groups based on the com-
monalities in their information behavior. The largest group,
Contributors, posted shortest comments and received fewer
likes, which also means this group’s members contributed
the least to information amplification. The second group,
Promoters, posted midlength comments, received the most
likes per comment, and their comment lag was the shortest.
This finding implies that those who actively monitor and
provide more substantive comments are most likely to con-
tribute to information amplification. Finally, the last, small-
est group was labeled Champions. Although this group
included about 2.5% of active users, it was responsible for
almost one fifth of comments. These topic champions wrote
the longest comments. Also, the lag time between original
posts and comments was the longest for this group suggest-
ing the highest level of engagement with the information.
The sizeable number of likes that this group gained positions
6 Health Education & Behavior 
its members as important stakeholders for topics that have
longer term implications. Further research could investigate
if this group could become a partner for community-based
and peer-to-peer education, policy debates, and information
dissemination efforts.
This study makes a number of theoretical and practical
contributions, but it also has limitations. First, the data
included one source of information. Additional sources can
provide a more comprehensive data set and a base for com-
parison and additional generalizations. Also, the inclusion of
unstructured text in the analysis was limited. To keep the
study focused, only the coding for Ebola as a post topic was
included, but an additional analysis of text data, sentiment,
and message framing can evaluate audience reactions and
provide insights into the effectiveness of communication
strategies used by public health organizations. Finally, limited
availability of user metadata collected through Power Query
(demographics, organizational affiliations, and sharing activi-
ties per user) precluded the examination of additional factors
that could explain information amplification behaviors.
Theoretical Implications
Although the framework was developed almost two decades
before the introduction of social media as an information-
sharing channel, this study contributed to the growing body
of literature that showed that SARF provides a robust
grounding for the analysis of audience engagement and com-
munication amplification behaviors online (Chew &
Eysenbach, 2010; Klemm et al., 2016; You & Ju, 2015).
Social media have been identified as versatile communica-
tion channels that combine the features of a rich information
source that affords interactive communication and feedback.
Earlier studies of social media and discussions about the
measurement of the information flow identified several
important areas where measurement is necessary and effec-
tive: volume of communication, engagement and feedback
from the audience, and the role of the audience as secondary
sources of information. SARF identifies audiences as possi-
ble amplification stations, and changes in information behav-
ior on social media can serve as indicators of information
amplification. The results of this exploratory study allow
formulating some operationalization and propositions related
to the audience information behavior.
First, a comment lag can be used as an indicator of audi-
ence attention to and involvement with an issue. Specifically,
this behavior suggests that online information consumers
search for the past posts and exercise information value judg-
ment when commenting. Subsequently, active audience
members, serving as social amplification stations, are likely
to search for relevant information rather than screen readily
available and most recent information.
Second, the larger number of likes relevant to health pro-
motion posts suggests that commenters indeed serve as ampli-
fication stations for select information topics. This finding,
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therefore, provides empirical evidence to SARF’s assumption
about social amplification stations applied to social media
environment. Health promotion communication is a broad
area of research and practice, and future studies could use
social amplification as a framework for the analysis of dis-
semination activities related various health domains. This
study also found that the shortest comment lag was associated
with more comment likes from other users. In other words,
social amplification of recent information is likely to have a
larger ripple effect compared with past information.
Third, earlier research on the link between information
needs and information evaluation showed that the increase in
people’s perceptions of risk, fear, and anxiety may lead to a
higher need for information (Huurne & Gutteling, 2008).
SARF also posits that information users may selectively
attend to the information distributed by their social circles.
This study showed that more users exhibited active informa-
tion engagement in response to Ebola posts. Therefore, situ-
ations of high-affect information perceptions will increase
the number of social media users actively engaging with
information through active commenting and passive liking
and further amplifying communication on the topic.
Practical Implications
Communication during emerging pandemics presents out-
reach and education opportunities for public health agencies.
The twofold nature of online communication presents a chal-
lenge for public health organizations. On the one hand, these
organizations need to raise awareness about particular topics
of public interest and importance. In the case of Ebola, they
may need to caution travelers or encourage donations for dis-
ease prevention efforts. At the same time, by posting more
information about an emerging pandemic, these organiza-
tions may create a false sense of anxiety, which will amplify
harm perceptions. The communication efforts could have
two competing goals, to reassure people and to alert them at
the same time. However, to be effective, health communica-
tion messages should also account for possible differences in
the audiences and target the information. Previous research
looked at the role of demographic factors that could serve as
the base for communication targeting. However, information
behavior factors can provide additional, psychographic
information to explain how audiences engage with and use
information.
Findings of this study have several practical implications.
First, information posted on social media channels has a
long-term, retrospective effect, but the majority of audience
responds to most immediate posts. For topics of high impor-
tance, public health and health education organizations could
plan reposting core messages to increase audience informa-
tion exposure. Second, audience behaviors vary depending
on an information topic. Therefore, targeted message and
communication strategies could increase the effectiveness of
social media communication efforts. For example, messages
Strekalova
can include calls for action (e.g., post sharing) or invite com-
ments. Third, the audiences that actively engage through
social media are not homogenous and can form separate,
nonoverlapping groups depending on the topic. As this study
showed, only a tenth of the CDC Facebook followers were
interested in both Ebola and non-Ebola information, which
means that regular health promotion efforts should continue
taking place during a health crisis.
Overall, this study demonstrated that information behav-
ior and audience engagement is topic dependent. In addition,
this study showed that online health information audiences
are not homogenous and could have varying effects as com-
munication amplification stations. Strategic message and
communication decisions could help organizations engaged
in online information dissemination achieve higher effec-
tiveness in outreach and stakeholder engagement efforts.
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The author received no financial support for the research, author-
ship, and/or publication of this article.
Note
1. The hierarchical agglomerative analysis with squared
Euclidean distance method was used first to identify the optimal
number of clusters, and then k-means analysis was employed
to assign individual cases to clusters. The elbow rule was used
to determine the number of clusters. The agglomeration sched-
ule showed Step9845 = 91,985,204, Step9846 = 123,106,167,
Step9847 = 171,805,009, and Step9848 = 287,849,908, Step9849
= 525,866,627, and Step9850 = 906,877,486, with 9,851 total
cases and the largest change at Step 9,848.
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