Nowadays, there were many social network research use NodeXL to explore the relationship between users [7,8,9,10,11,12,13]. Nevertheless, this is the first study exploring how government officials use the Facebook fan page to promote policies and analyze the interaction between agencies and people by using a social network analysis. We found that agencies of the “Social and Family Affairs Administration” and “Health Promotion Administration” contributed the most policy posts. The policy of “Physical and mental health promotion” entailed the most agencies to be involved. The “Department of Nursing and Health Care” received the largest public response, for which “Long-term care” received the most public interest.
With the continuous advancement of technology and the peak penetration rate of internet usage, the public can easily obtain complete information from social networks, and posts on social media are often accompanied by images, making them easy for the public to understand and increasing the view rate. In other words, the age of information is upon us and “internet media platforms” have become the bridge of communication between governments and the public. Social media has brought the changes in the communication landscape, and rapid increased globally, including in health care contexts [2,3,4,5,6, 14,15,16]. Most of the general public, and health-related professionals are using social media to communicate about health issues. In the United States, 61% of adults search online and 39% use social media such as Facebook for health information [17]. An empirical research found that Twitter and Facebook can engage citizens in two-way communications [18]. When focusing on social media for health communication, it is important to understand of these technologies, such as Facebook, Twitter, and YouTube, their impact on health communication. Governments provide correct health information through websites that not only increase the visibility of governance, but also give the public an effective method for obtaining information and to achieve interactive exchanges that improve public participation and increase knowledge and literacy in various areas [14, 19].
“Long-term care” isn’t only the government’s most promoted health policy, it also receives the most public response. This result shows concerns about Taiwan’s aging population and the growing number of elderly people in society because both government officials and the public care deeply about this issue. Before the MoHW was founded, long-term care policies were jointly set by the Ministry of the Interior, the Council for Economic Planning and Development, and the Health Administration with the Ministry of the Interior’s Social Affairs Administration in an attempt to provide broad solutions [16]. After the MoHW was founded, long-term care-related operations were transferred to the “Department of Nursing and Health Care,” as supported by the data results of this study. Also, the requirements for long-term care have become a major health and welfare issue as the population continues to age and the number of feeble elderly increases. Since 1996, the government has continued to plan projects to address this problem, primarily basing solutions in 2007’s “10 Year Long-term Care Plan,” 2015’s “Long-term Care Service Act,” and 2016’s “10 Year Long-term Care Plan 2.0.” These solutions originally serviced elderly individuals above the age of 65, indigenous people between the ages of 55 and 64, those with mental disabilities between the ages of 50 and 64, and elderly individuals living alone who are IADLs feeble. However, it was expanded to include individuals above 50 with slight mental disabilities, those under 50 with disabilities, the feeble elderly above age 65, and indigenous people with disabilities between the ages of 55 and 64 to address the growing population of mentally or physically disabled people and the demand for long-term care [15]. However, everyone experiences “birth, aging, disease, and death,” so anyone has the opportunity to use long-term care services. Long-term care services not only cater to the service target, but also provide a necessary break for relatives and care givers. In other words, this massive and complicated issue and its related services cannot be explained to the public with a few simple sentences. This phenomenon also relates to the results of this study. While the Department of Nursing and Health Care doesn’t have the largest number of posts, it received the largest amount of public response, and the MoHW’s 2017 Annual Project Plan showed policies and posts focused on long-term care that also received the highest public response. This shows that both government and the public care more about long-term care issues compared to other policies.
The results of this study show that aside from long-term care, the public also cares deeply about issues such as medical care and food- and drug-related incidents. Medical incidents in 2017 included problems with emergency medical protocols due to flu, condemning improper coverage disparaging the image of nursing, using World Hospice and Palliative Care Day to highlight DNRs, using seminars with celebrities to teach the public about organ donation, and promoting medical services for indigenous people/remote areas. Food- and drug-related incidents at the time included an incident involving fake CRESTOR medication on the market, identifying Chinese medicine ingredients or inappropriate transaction behavior, control of expired drugs, children’s abuse of drugs, improper food labeling, the allowing of beef imports, regulations on creamer ingredients and labeling, among others. It can be seen that the MoHW is highly effective in policy announcements and that it uses internet resources to provide the public with correct information in regard to health and welfare. Articles provided by Taiwan’s government not only address issues of public scrutiny, but also provide information that can often be neglected or unknown to greatly increase public awareness and their understanding and recognition of health and welfare issues.
Of the agencies, SFAA and HPA primarily use Facebook to advocate policy, mainly promoting content related to long-term care, welfare services for minority groups, and physical and mental health promotion. These two major agencies are more adept at using internet media to market policies and increase public absorption of related knowledge that help achieve goals in governance. Also, the results of this study show that the greatest number of agencies are involved in policy related to “physical and mental health promotion.” This phenomenon now encompasses a broader scope compared to other policies in the 2017 annual project plan and has received support such as the Department of Mental and Oral Health and their networks in anti-drug use for children, suicide prevention, and mental health; HPA provides help to quit smoking, internet addiction, or osteoporosis. SFAA has child services (birth registration, health insurance for newborns, etc.). CDC advocate clearing disease sources. The Department of Chinese Medicine and Pharmacy discusses issues of supplementary foods. The Department of Planning’s release of quarterly flyers show the results of participation through multiple agencies. Looking at other policies with a more uniform nature or targeted towards specific groups, the number of agencies that can participate is severely limited. For example, prevention of infectious disease and epidemics and response policies is mainly the responsibility of CDC while FDA primarily manages food and drug policy.
This study primarily uses NodeXL to analyze the MoHW network relationships to explore their promotions and degree of interaction with the public. This analysis benefited MoHW agencies and helped them reflect on policies with insufficient advocacy. For example: in Fig. 1, the budget allocation policy does not appear in the network relationship figure, so in other words, the fan page made no mention of related information or articles at the time. Furthermore, while the cause and effect relationship of the public and postings cannot be confirmed, meaning that public attention on issues can occur before or after a post, but the issues that the public care about can be identified. For example, Fig. 4 shows that long-term care, medical care, and food and drug policies receive the highest response rate, which is beneficial for future consideration of agencies in promoting policies. This study found that some agencies lack advocacy on the MoHW fan page, but this might be due to them having their own fan pages, where they focus their marketing efforts such as CDC’s “1992 Epidemic Prevention Master.”
In addition, although commenting on posts may not be because a policy is more controversial. Also it is important not to see any necessary relationship between the number of comments on a post and the number of reads and indeed interest. Facebook user activities including like, comment, share are related to posting time as well as general interests of public at that time/period, most studies have investigated Facebook page to understand the user thought and how effectiveness and efficiency for the post [20,21,22,23,24]. Thus, we consider that each comment on the post either positive or negative response regarded as which post were attracted the attention of the public compared the public who did not response, so this quantitative study shows the relatively potential interactions between agencies, policies, and the interest of the public.
