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HHS Twitter Guidance

This information applies to the entirety of the U.S. Department of Health & Human Services. Operational Divisions and Offices within the Department may create guidance and establish policies that are more restrictive if the appropriate management so chooses.

Last updated: August 13, 2010  |  Directory of HHS Twitter Accounts


  1. Introduction: What is Twitter?
  2. Twitter Terms of Service Agreement
  3. Demographics: Who uses Twitter?
  4. When should my Office/Agency use Twitter vs. another tool?
  5. When should my Office/Agency NOT use Twitter?
  6. How does our Office/Agency obtain clearance to create a Twitter account?
  7. Twitter Content Manager
  8. Approval of Individual Tweets
  9. What do we need to PLAN and/or prepare for to begin ‘tweeting’?
  10. Are there any privacy/security issues to consider?
  11. How can we meet Section 508 accessibility requirements while using Twitter?
  12. How should we respond to media inquiries on Twitter?
  13. Who else from the government is on Twitter?
  14. Twitter vocabulary
  15. I need more information!

I. Introduction: WHAT is Twitter?

Twitter is a free social network and micro-blogging service that allows participants to send 140-character tweets (messages) to connect with other users – known as followers who subscribe to them. Users can send and receive tweets via the Twitter website, text messaging, or other online external applications.

By its nature, Twitter is a viral mechanism in that it leverages the concept of word-of-mouth-marketing by enabling an immediate reach to followers, who then can reach their followers. Benefits of Twitter include:

  1. Speed – information can be disseminated very quickly
  2. Broad reach potential – a network of networks can be quite vast
  3. Targeted reach potential – there is a growing number of niche interest groups growing on Twitter, including social marketing, health disparities, and health IT
  4. Collaboration – more and more professionals are using Twitter to network, build relationships, and look for mutually beneficial collaboration opportunities
  5. Continued growth as a conversation medium - developers have open access to the Twitter program code and can create new applications to better access, measure, and use Twitter

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II. Twitter Terms of Service Agreement

Several federal agency attorneys (including attorneys at GSA and The White House) have determined that there are no issues with Twitter's standard Terms of Service that would present legal problems for their agencies. The standard Twitter Terms of Service can be at http://twitter.com/tosexit disclaimer.

That being said, offices interested in pursuing Twitter as a communications strategy need to get clearance from their Public Affairs office and should have a comprehensive, integrated strategy for including Twitter in their overall communications plan

III. Demographics: WHO uses Twitter?

  1. As of March 2009 the largest age group on Twitter was18-34; with nearly 15 million unique visitors per month, comprising 44 percent of the site’s audience. The second largest group on Twitter in March 2009 was 35-49 year-olds (33% of the site’s audience).1
  2. Twitter users are also slightly more likely than the average internet user to live in urban areas, with 35% of Twitter users living in urban areas (compared to 29% of all internet users) and just 9% of Twitter users living in rural areas, compared to 17% of internet users.2
  3. As of March 2009, 82% of Twitter users were Caucasian and 8% were African American (Asian Americans and Hispanics each comprised about 5% of visitors).1
  4. Twitter attracts users in a variety of household income brackets: 28% of users earn between $30k and $60k, 27% earn over $100k, 23% earn between $60k – $100k, and 22% earn between $0 and $30k.1

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IV. WHEN should my office/agency use Twitter vs. another tool?

Before moving your office/agency into the twittersphere, you (and/or someone from your team) should experience Twitter first-hand. Go to www.twitter.comexit disclaimer, create a handle for yourself, and begin tweeting and following others. Thenconsider using Twitter as a social media tool for your Agency/Office IF:

  1. The stakeholders you are trying to reach are on Twitter (ALWAYS applies). See Section III above as a starting point and then do your own research about your specific target audiences. Twitter has a search functionexit disclaimer that you can use to search for key terms about the work you do (there are also other Twitter applications created to gauge the popularity of keywords). This will allow you to measure what kinds of conversations are already happening about your work on Twitter and how you can add value to them.
  1. You have time-sensitive updates about your work that you want to announce (e.g., emergency or crisis management). You can harness the power of existing social networks (and tools like Twitter) to broaden your reach during a disaster or emergency situations.
  1. You want to connect with and update your stakeholders about events/conferences your office/agency participates in. More and more organizations are using Twitter to keep participants connected throughout their conferences and events. This allows participants to discuss the conference in real-time with other participants, provides real-time access to details about the conference for those that can’t attend, and provides real-time feedback for technical or other troubleshooting issues so conference organizers can quickly respond to feedback.
  1. You want to share information with your stakeholders in real-time about your work and share information relevant to your work. Remember that Twitter is a social networking tool. Sharing information means you should be prepared to:
  1. Share information not just about the work you’re doing but about work others are doing in your field. This includes ReTweeting other government Tweets (as they relate to your work) and other partner/stakeholder Tweets (as they are appropriate).
  1. Connect with people by asking and answering questions. Responding to feedback is essential AND can help provide helpful insight into what is and isn’t working for your stakeholders.
  2. Make sure to include criteria for ReTweeting and responding to inquiries from others in your Twitter Plan. For more details on how to craft your Twitter Plan, see Section IX.
  1. OTHER. Twitter as a tool is still being defined and diverse ways for its use in government are still being determined. Be creative!

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V. When should my office/agency NOT use Twitter?

Do NOT use Twitter if:

  1. You want to promote a mostly static website. Nobody likes spam or self-promotion.
  2. You don’t have the resources to tweet at least once a work-day. This means at the bare minimum checking for tweets to and about you and responding and/or retweeting. This can take no more than 10-15 minutes, depending on the volume of tweets.

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VI. How does our Office/Agency obtain clearance to create a Twitter account?

An Office/Agency’s presence on Twitter should be part of a broader communications plan. It should enhance your Office/Agency’s efforts to meet your organizational mission and specific objectives. In order to obtain approval to create a Twitter account, your Office/Agency needs to:

  1. Obtain approval and buy-in from your Office/Agency’s Communications Lead
  2. Create a Twitter Plan and incorporate it into an existing communications plan that identifies specific objectives and activities
  3. Designate a Twitter Content Manager. See Section VII for details.
  4. Notify the Center for New Media at digital@hhs.gov of your Twitter initiative, including the purpose and scope of the account, so we can catalog the handle and provide suggestions on collaboration opportunities with other Offices/Agencies in the department who are using social media tools.

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VII. Twitter Content Manager

  1. Each account should have a Twitter Content Manager to be the point of contact for that account.
  2. Each Agency using Twitter should designate a Twitter Content Manager to oversee Agency activities.
  3. The Twitter Content Manager will serve as the point of contact with the HHS Center for New Media for Twitter-related issues.

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VIII. Approval of Individual Tweets

Overall Twitter strategy should be approved through the same process by which Web site content is currently approved for that Agency. The approval process for each individual tweet is up to the discretion of Agency management.

IX. What do we need to PLAN and/or prepare for to begin ‘tweeting’?

Your research/environmental scan will determine whether Twitter is an appropriate tool for your Office/Agency by identifying a target audience to reach and/or a gap in tweets about your Office/Agency’s issue or area of expertise. After you obtain buy-in from you Communications lead, you should then create a Twitter Plan. Below is a set of considerations you should address in your plan:

  1. Username.

    Make your handle easy to remember and short. Remember that each letter in your handle cuts into the 140 character limit for others out there trying to talk about/to you.

  2. Branding.

    The background of your twitter page can be personalized. Be creative with the background of your Twitter page while maintaining your brand identity.

  3. Account Profile.

    Be clear about who the Twitter account represents (e.g., what initiative of what Office/Agency) and what the scope of the account is.

    1. Include a disclaimer regarding tweets of your followers and those you follow to distance yourself from others’ content. Sample language: “Note: Tweets by Followers/Following do not necessarily represent the views of ____.”
  4. Staffing and Frequency of Tweets.

    Be clear from the get-go about how often you expect to tweet: What is the bare minimum you can commit to that will add value to your work and the target audience(s) you are trying to reach? Depending on your specific Twitter strategy, your tweeting expectations may vary. For example, @healthfinder tweets 2-5 times a day (Monday-Friday) on a typical week, but may tweet much more during participation in a conference.

  5. Tweet Content Guidelines.

    Include a clear description of the types of tweets you expect to post, and what your protocol will be for responding to inquiries and ReTweeting others’ content. Here are five types of tweet content categories:

    1. Regular – static content from your site or other products,
    2. Promotional – new content, products, or news about upcoming events,
    3. Researched – topical or relevant content from others on Twitter that you are sharing (includes ReTweets),
    4. Replies – responding to feedback or inquiries; and
    5. Other (depending on your strategy).

    Tweets should aim to be topical, relevant, and not just self-promoting; therefore, they should be a mix of the categories above.

  6. Marketing and Strategy for Building a Following.

    Start by introducing yourself (via a tweet, of course) to all the HHS Twitter handles already out there so that they announce/introduce you to their followers. Then:

    1. Register your Twitter handle in GovTwit directoryexit disclaimer.
    2. Market your new Twitter presence on your Website. Also consider asking your office and/or team to add your twitter handle to their e-mail signatures (e.g., “Follow us on Twitter @MyInitiative!”).
    3. Develop criteria for whom to follow: Start by following the relevant federal and local governemt Twitter accounts first. Then, identify others on Twitter that are “influencers” or “target audiences” for your work.
      1. For example, @healthfinder follows people working on health literacy, disease prevention, or health promotion, among others.
      2. In addition, we recommend you follow those that ReTweet your tweets and are responsive to your updates (your “champions”).
      3. Lastly, know that there is typically a 1:1 ratio of people you follow to those that follow you. However, this doesn’t mean you should follow everyone that follows you.
  7. Reporting and Evaluation.

    You should track your ongoing progress on Twitter on a regular basis. There is a plethora of tools for monitoring Twitter. What follows is a list of the top three issues to consider when drafting your evaluation plan:

    1. Track click-throughs to your links. You’ll want to know how many people click on the any of the links you post. And since Twitter only allows 140 characters in your posts, you’ll want to shorten your links to be able to use more characters on content.
    2. Analyze your ‘influence’ on Twitter. Twitter is all about the social influence you have on your followers through your tweets. This can begin to be quantified by several factors including the number of followers you have your willingness to share information whether its through ReTweets or links or the use of hashtags, and the likelihood that your posts are shared by your followers.
    3. Analyze your followers. As with any communications plan, we always want to keep our finger on the pulse of what our stakeholders (or in this case followers) are behaving and who they are. For Twitter, it is important to know how many of your followers are active vs. inactive (an indicator of level of reach), which of them are most likely to ReTweet your posts, and potentially where they are geographically speaking.

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X. Are there any privacy/security issues I should know about?

Twitter was created and is used as a public forum. That is to say that anyone can see what anyone else is saying. Therefore,

  1. Do not discuss any private or personal information (or respond to inquiries that would divulge such information) on Twitter – move it to e-mail or phone as needed. This includes Direct Messages (DMs) which function as private messages but can still be hacked into.
  2. Avoid using third-party Twitter services that ask you for your Twitter handle password, since they may not be built with sufficient security measures.

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XI. How can we meet Section 508accessibility requirements while using Twitter?

An independent developer has taken the Twitter program code and created an application to meet accessibility needs: www.accessibletwitter.comexit disclaimer. The site, which is still in development, features a simple, consistent layout and navigation which meets WAI and Section 508 Accessibility Standards. The site also assures that all links are keyboard accessible and that users can access their Twitter account with or without JavaScript. Accessible Twitter uses large default text size and high color contrast and works well in both high and low resolution browser settings.

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XII. How should we respond to MEDIA inquiries?

Do not respond via Twitter to any media inquiries. Direct any media-related inquiries via Twitter to your usual media contact within your Office/Agency.

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XIII. Who else from the government is on Twitter?

Visit the CNM Twitter page to see the HHS Twitter accounts.

A growing listing of Government agencies currently on Twitter can be found at http://govtwit.comexit disclaimer.

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XIV. Twitter Vocabulary

  1. Direct Message

    (DM): Private message sent between two people. Keep in mind that Twitter as a site can still be hacked so don’t discuss private information on the site, even through DMs.
  2. Fail Whale

    The site will show this when too many people are Tweeting! Twitter is still a relatively new site and has not accounted for the large number of users it has garnered. Watch out for the fail whale (you can’t control or prevent it).
  3. Favorites

    A public area to save your favorite tweets of the users you follow.
  4. Followers

    People who choose to receive your updates. You can (and should) also follow others’ updates, starting with other HHS and government initiatives on Twitter.
  5. Handle

    Your username (e.g., @MyInitiative)
  6. Hashtag

    e.g., #myhashtag: A tag that allows for conversation tracking. Go to http://hashtag.orgexit disclaimer for more information on current hashtags (you wouldn’t want to use one already in use!).

  7. ReTweet

    e.g., RT @YourInitiative: Sharing someone else’s tweets with your followers (and vice versa). You can repost someone else’s tweet with “RT (space) @theirusername” followed by the tweet.
  8. Tweet

    A message sent over twitter. All tweets are public.
  9. Twittersphere

    The virtual space where all the tweets are.
  10. Tweet-up

    A face-to-face gathering of those who tweet (self-organized). Keep in mind that Twitter is ultimately about building relationships with people – it is not a one-way communication tool.
  11. Updates

    (aka Tweets): Posting a 140-character or less message on Twitter.

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XV. Great information! BUT I still need a one-on-one consultation

If you still have questions about whether Twitter is the right tool for your office/agency, what content is or isn’t appropriate to Tweet about, or want to brainstorm a new way to implement Twitter with your stakeholders, you can contact us at digital@hhs.gov.


1http://www.quantcast.com/twitter.com#summaryexit disclaimer (Data from March 2009 from Quantcast. Accessed on 4/25/2009.)
2http://www.pewinternet.org/Reports/2009/Twitter-and-status-updating/Part-1/Section-3.aspx?r=1exit disclaimer (Data from May 2008 Pew Internet & American Life Project survey. Accessed on 4/25/2009.)

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