Barriers to Public Health Trust-Building Using Social Media: A Qualitative Analysis.

To combat declining trust in public health and effectively communicate during public health emergencies, it is critical for the public health workforce to engage with their communities through social media. Little is known about factors that influence the degree to which public health practitioners use social media for information sharing and bidirectional communication. This study aimed to examine perspectives on barriers to incorporating social media use into efforts to rebuild trust in public health. 31 semistructured interviews were conducted with public health practitioners and subject matter experts. Common themes and barriers to using social media were identified using rapid thematic analysis and analyzed by levels of the socioecological framework. Barriers to public health practitioner social media use included lack of training, time, and fear (individual-level); limited online and offline relationships (interpersonal); lack of resources and supportive policies (organizational); and politicization of public health (societal). This study identifies modifiable factors that could be intervened upon to strengthen the public health workforce's social media communication and highlights existing efforts to address barriers. Sustained investment is required to ensure that public health communicators are maximally supported to effectively use social media for trust-building and communication during public health emergencies.