Using Artificial Intelligence Methods to Evaluate the Effect of the National Cytomegalovirus Awareness Month on the Content and Sentiment of Social Media Posts: Infodemiology Study

Abstract

Background: The month of June has been recognized as the National Cytomegalovirus (CMV) Awareness Month since 2011 in the United States. Established by government resolution, the goal is to increase awareness and reduce the incidence of congenital CMV infection, a leading cause of preventable birth defects and developmental disabilities. Social media is a powerful tool to support public health by making health information easily accessible. With an estimated 246 million users in the United States and more than half of adults seeking health information through such platforms, social media offers an unparalleled opportunity to promote CMV awareness and prevention.

Objective: This study aimed to evaluate social media messaging before, during, and after the National CMV Awareness Month to assess how the campaign influenced messaging patterns and sentiment related to specific CMV health topics.

Methods: Publicly available posts on Twitter/X from May to August 2023 that contained at least one of the five most used CMV-related hashtags were collected using a media monitoring platform. The dataset was preprocessed using a customized Bidirectional Encoder Representations from Transformers tokenizer and a language detection package to remove irrelevant and non-English posts. Validated and artificial intelligence (AI) methods (Cohen κ=0.69) were used to determine the thematic content of posts (N=14,900), such as awareness and prevention messaging, and to characterize the sentiment. Changes in post characteristics were measured in relation to the National CMV Awareness Month.

Results: CMV-relevant post volume increased by 55% during the campaign month and returned to precampaign levels in July. Overall, academic/university researchers were the most frequent authors, pediatrics was the most frequent population discussed, and vaccines were the most frequently mentioned prevention. Significant associations were observed between the month of post publication and the target audience (χ²₂=144.3, P<.001), awareness or prevention messaging (χ²₂=107.8, P<.001), and post sentiment (χ²₄=163.6, P<.001). The intended audience of posts shifted toward the general population from scientists/health care professionals during the campaign month (adjusted Pearson residuals, P=.009). Awareness messaging increased in June 2023, particularly in relation to CMV transmission and disease burden, while prevention messaging decreased (adjusted Pearson residuals, P=.008). Finally, although posts were generally neutral in sentiment, a significant shift occurred toward a positive sentiment during the campaign month (adjusted Pearson residuals, P=.006), a sentiment that was more likely to engage the user (Kruskal-Wallis; χ²₂=194.31, P<.001).

Conclusions: The National CMV Awareness Month in 2023 shifted the digital CMV conversation toward public-facing messaging and raised awareness efforts. Although posts related to CMV prevention generally conveyed a positive sentiment, prevention messaging declined during the campaign. These findings highlight opportunities for future CMV social media initiatives to balance awareness with prevention through evaluation and strategic design using AI models to strengthen CMV public health communication and engagement.

Keywords: artificial intelligence; cytomegalovirus; public health, health communication; sentiment analysis; social media.