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While social media offer an unprecedented opportunity for orchestrating large-scale communication campaigns, it is often difficult to track audience responses on various digital platforms over time and to ascertain if their engagement is aligned with the original intention. In this article, we share a promising solution—the purposive embedding and tracking of unique content elements as “markers” using text analytics techniques. Four markers were introduced in an Indian melodramatic television serial, Main Kuch Bhi Kar Sakti Hoon ( I, A Woman, Can Achieve Anything ), which was part of a larger transmedia edutainment initiative in India to promote sanitation, family planning, and gender equality. These markers served as anchors for audience engagement with the originally intended messaging embedded in the narratives as well as for program monitoring and evaluation. We applied various web-based tools to systematically track marker-related engagement on Facebook, Twitter, and YouTube across eight months. We also conducted semantic network analysis to better understand how marker-related social media comments evolved over time. Our investigation of using markers for digital engagement and narrative exchange in MKBKSH makes an important and timely methodological contribution to the scholarship and praxis of social and behavior change communication.

In today’s media landscape, audiences increasingly turn to online communities for media consumption and to exchange information about specific niche interests such as health-related topics. This calls for a segmented approach in which interventions are targeted at online communities, tailored to their specific cultures and health-related perceptions, and leverage the dynamics of conversation and social influence in online networks. Strategies drawn from the field of influencer marketing provide interesting opportunities to reach and engage with audiences in a personally relevant manner, including with those who may disagree with an intervention’s message. This article reflects on what health communicators might learn from influencer strategies and proposes digital methods to target and tailor health communication in the digital era. More concretely, we present methods to: (a) identify online communities engaging on a specific health issue; (b) map community specific cultures and health-related perceptions; and (c) identify influencers as potential collaboration partners. As such, we adopt a slightly different take on tailoring by putting the creative and cultural competences of social influencers central, and by aligning our methods with a media mapping protocol to create influencer strategies that are tailored to the cultures and health-related perceptions of multiple online audience segments. We illustrate the potential of these methods with a study of how vaccination is discussed among Dutch Twitter users.

In recent years, vaccination rates in the Netherlands have declined slightly, but steadily. The Dutch National Institute for Public Health and the Environment (RIVM) commissioned a Committee for Vaccine Willingness (VWC) to study the societal context of the decline. One of the societal contexts is the Internet, where audiences discuss vaccination and refer to sources of health-related information of varying quality.Working for the VWC, we have explored the Dutch vaccination debate on Twitter in order to: (1) identify online communities in the vaccination debate, (2) identify vaccine-related narratives; and (3) understand how the online communities interact with each other. We identified seven different communities, including (public) health professionals, writers and journalists, anti-establishment, and international vaccination advocates.The debate is spearheaded by the writers & journalists community, while the health- and anti-establishment communities try to influence it. The health community circulates facts, figures and scientific studies, while negative messages about vaccination – either from a homeopathy or conspiracy perspective – are most prevalent in the anti-establishment. The facts and figures shared by the health community hardly reach other communities, whereas the myths introduced by the anti-establishment do spill over to other communities. Our study provides further evidence that negative perceptions about vaccination might be rooted in a wider sentiment of distrust of traditional institutions.We argue that Dutch health organizations should try to address questions, doubts, and worries among the general audience more actively, and present scientific information in a simpler and more attractive way. Keywords: Vaccine hesitancy, Health communication, Social media, Network analysis