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Twitter Accounts Followed by Congressional Health Staff
David Grande, MD, MPA; Zachary F. Meisel, MD, MS; Raina M. Merchant, MD, MS; Jane Seymour, MPH; and Sarah E. Gollust, PhD
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Twitter Accounts Followed by Congressional Health Staff

David Grande, MD, MPA; Zachary F. Meisel, MD, MS; Raina M. Merchant, MD, MS; Jane Seymour, MPH; and Sarah E. Gollust, PhD
Disseminating timely and relevant research findings to policy makers is a national priority to inform health policy decisions. Social media is a novel tool to bridge the communication gap.

Objectives: Although health policy research should inform policy making, the communication gap between researchers and policy makers limits successful translation. Social media represents a new opportunity to connect researchers and policy makers. Our objective was to assess who Congressional health policy staff follow on a major social media platform. 

Study Design: Cross-sectional study.

Methods: Our study measured Congressional health policy staff’s use of Twitter and the types of individuals and organizations they follow. To focus on more influential Twitter accounts, we restricted our sample to those followed by at least 3 individual Congressional staff members. 

Results: Of the 30,843 accounts followed by the 115 Congressional health policy staff, 1273 were potentially policy-related and followed by 3 or more staff. Of these, few were academically affiliated (2.4%) or explicitly health-related (5.6%) sites; many were general news media sources (50.9%) and political and governmental sources (36.4%). Health-focused accounts were frequently connected to the news media or government rather than academia. Top accounts followed (ie, highest quintile) were most likely to be national news organizations (odds ratio [OR], 5.88; 95% confidence interval [CI], 1.75-19.7) and elected officials (OR, 8.22; 95% CI, 1.75-38.6) compared with advocacy and interest groups.
Conclusions: Health-related and academic sources are largely absent from the Twitter conversations with US Congressional health policy staff. Even within social media, traditional and political news media are important information intermediaries that researchers and journals should target to disseminate health policy evidence. 
Takeaway Points
  • Many Congressional health staff are Twitter users; however, they are much more likely to follow traditional news media rather than academic or health-specific sources. 
  • Most of the sources they follow on Twitter are traditional news and political media rather than academic or health-specific sources. 
  • Even within social media, traditional and political news media are important targets for research dissemination.
In recent years, researchers, international policy bodies, health funders, and other commentators have called for new efforts to improve the translation of research into health policy.1,2 Yet, there are significant challenges to translating research, particularly to policy-maker audiences.1,3 Researchers often lack the skills, support, and time to effectively translate their work.4,5 Policy makers have very different incentives, values, timeframes, and competing priorities that challenge their efficient use of research evidence to set agendas and make decisions.6-9 Given that these barriers mean that research will not always be used in policy making, one necessary step in translation is effective communication of the research itself.

Social media offers opportunities to rapidly convey public health and health policy–relevant research to target audiences. For instance, researchers, journals, and institutions can use tools like Twitter to communicate findings and provide links to content.10,11 Blogs can “curate” policy-relevant research so that even older research findings can be made available to policy makers when windows of opportunity to use that research become apparent, and social networks can be used to disseminate these research findings.12,13 In 2013, 14% of health policy researchers reported using Twitter to disseminate research, but it is unknown whether they were connected via social media to policy makers—the target users of evidence.14

Congressional staff are responsible for bringing analyses to their legislators and, as drafters of legislation, are direct users of policy evidence.15,16 Research suggests that staffers perceive Twitter as influential17; however, to our knowledge, no research is available about Congressional staffers’ use of Twitter and the types of individuals and organizations they follow as potential sources of information. Rather, prior studies of social media in the US political system have generally focused on its use by elected officials to communicate with constituents, or the manner in which political information spreads within social networks of constituents.18-22 This study was designed to fill this gap in the literature, with a focus on Congressional staff. The primary objective was to describe the Twitter accounts followed by Congressional health staff and to inform potential communication opportunities for researchers.


Social media is emerging as a tool used to communicate research evidence. In this study, we were interested in who a key audience of health policy research—Congressional staff—followed on social media. We focused on a widely used form of social media, specifically Twitter, a micro-blogging tool, and identified 3 key findings.

Study Population

We obtained a proprietary list of Congressional staff members with responsibilities in health from Legistorm,23 a subscription service for government affairs professionals. They collect this individual-level data on Congressional staff from publicly available sources, including government reports and traditional and social media. We purchased a list of 558 staff members with responsibilities in health as determined by Legistorm in April 2014. Legistorm provided us with the Twitter account names (“handles”) of 84 staff members. We then conducted a search for the remaining 474 Congressional staff using Google and Twitter search engines and demographic characteristics provided by Legistorm to determine if they had an active or identifiable account. Because Twitter users can make their account private, all analyses described concerned the subset of staff with public accounts (n = 115).

Accounts Followed on Twitter

Using the Twitter application program interface, we retrieved the list of the Twitter accounts followed by each Congressional staff member in our database. (The retrieval date was July 26, 2014.) We retrieved characteristics of these accounts, including their short biography/description, number of followers, and number of tweets. Because we were interested in potentially influential Twitter accounts, we restricted our sample to accounts followed by 3 or more staff.


We categorized accounts along the following domains: individual versus organization, health versus nonhealth, and type (academic, political/government, news media, or interest group/advocacy, which included think tanks). The coding categories were not mutually exclusive. We created subcategories for the political/government category (elected official, partisan political organization, and government agency) and news media category (national, local, and political). Coders used the Twitter bio to classify accounts; for example, any entity that cited a “.edu” address in the bio or offered a university affiliation was classified as academic and any entity that used health-related terms anywhere in their bio was classified as health-related. Accounts on Twitter that could not be categorized into this scheme were determined to be unlikely to be related to professional duties (eg, local restaurants, non–news-focused television programs) and excluded from our analysis. For the purposes of this study, we defined the remaining Twitter accounts as policy-related. We pilot tested the coding instrument with 2 trained coders. Each coder then classified all Twitter accounts. If a coding category had an inter-rater reliability below 0.61, a third coder and co-investigator (JS) adjudicated after discussing with the study team.


Statistical Analysis

We calculated frequencies for each Twitter account followed to determine the number of Congressional staff following each, and limited our analyses to those accounts followed by 3 or more staff (n = 2203). We modeled the characteristics of the most-followed accounts (ie, those falling in the top quintile of sources) using multivariable logistic regression.

The study was reviewed and approved by the institutional review board at the University of Pennsylvania. Data collection and analyses were done in compliance with Twitter’s terms of service.


From a database of 558 Congressional staff, we identified 33% (184) with Twitter accounts. Of the 184 with Twitter accounts, 69 had private accounts and 115 had public accounts. The 115 Congressional staff with public accounts collectively followed 30,843 different individual or organization Twitter accounts. Three or more Congressional staff followed 2203 of these Twitter accounts.

Types of Accounts Followed on Twitter

Of the 2203 individuals and organizations followed by 3 or more Congressional staff, 1273 (57.8%) were policy related (Table 1). Of these 1273, just 71 (5.6%) were health related. Very few (30; 2.4%) of the Twitter accounts followed were affiliated with academic institutions. Congressional staff most commonly followed news media accounts; 648 (50.9%) were affiliated with news media organizations, primarily national news organizations and political news organizations (eg, Politico); local news organizations were less commonly followed. Political and governmental accounts were the second most common category, representing 464 (36.4%) of accounts followed.

Top Twitter Accounts Followed

The top accounts were followed by 40 to 67 Congressional staff (Table 2). These accounts also had a large number of followers, ranging from 62,876 to 44,129,382. The top 6 included political news organizations (Politico, The Hill), national news organizations (The New York Times), elected officials (The White House, Barack Obama), and a political satirist (Stephen Colbert). The other most frequently followed accounts were predominantly related to news media organizations.

In a multivariable logistic regression model, we modeled the association of the characteristics of Twitter accounts with their likelihood of being highly followed (top quintile). We restricted this analysis to the 1273 accounts followed that were coded as policy related. Although there were more Twitter accounts in our sample representing individuals, individual accounts were less likely to be frequently followed by Congressional staff than those representing organizations (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.10-0.92; P = .035). Accounts representing national news organizations (OR, 5.88; 95% CI, 1.75-19.7; P = .004) and elected officials (OR, 8.22; 95% CI, 1.75-38.6; P = .008) were the most frequently followed by Congressional staff.

Top Health-Related Twitter Accounts Followed

Among the 71 health-related accounts followed by Congressional staffers (top accounts shown in Table 2), the most popular account was that of Sarah Kliff, a journalist and blogger with a national media organization (, formerly of the Washington Post). Health-related news media accounts (eg, NY Times Health) and governmental and political accounts (eg, HHS) were frequently represented among the top accounts. Health Affairs was the only health-related academic journal followed by 3 or more Congressional staff.


Using Twitter, we identified 3 key findings. First, many Congressional staff used Twitter and followed accounts that may be related to their professional roles. In our sample of health-related Congressional staff, we were able to successfully identify one-third of targeted individuals with Twitter accounts. This is likely an underestimate given that we were unable to search for individuals who preferred to obscure their identity on Twitter (eg, use of pseudonyms). Second, even among Congressional staff with a health focus, very few of the accounts followed were health or health-policy related (just 71 of 1273; 5.6%). The accounts that were explicitly health-focused were often associated with major news media outlets. Third, beyond health-focused accounts, Congressional staff were most likely to follow national and political news media organizations and second most likely to follow political and governmental individuals and agencies.

Academic sources were almost completely absent from Twitter accounts frequently followed by Congressional staff.24 The few academic accounts represented in the sample were typically individuals with faculty appointments who had once served in a political or governmental role. It has been well documented that traditional news media can shape policy-makers’ agendas25,26 and that information sources from government and interest groups are important to decision makers.27 However, social media does not appear to circumvent traditional pathways of information dissemination (ie, the news media), but rather serve as an alternative channel to connect entities with influence that predated social media.

Study Implications

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