Next Gen Hawai‘i: Collaborative COVID-19 Social Media Initiative to Engage Native Hawaiian, Other Pacific Islander, and Filipino Youth

Abstract

The Next Gen Hawai‘i social media project was initiated in the fall of 2020 to address ongoing public health concerns and the need for accessible and reliable information across Hawai‘i’s diverse communities by strategically amplifying the voices of Hawai‘i’s youth in their Native languages. The collaborative effort arose from conversations within the Hawai‘i’s Native Hawaiian & Pacific Islander COVID-19 Response, Recovery, and Resilience Team, composed of diverse public and private organizations involved in statewide COVID-19 response efforts for Native Hawaiian and Pacific Islander communities. Next Gen Hawai‘i’s focus was on Native Hawaiian, Pacific Islander, Filipino, and other populations disproportionately suffering from COVID-19. Five social media platforms were developed to spread messaging to youth and young adults about COVID-19. Public Health Ambassadors (from high school to young adults) were recruited and engaged to create culturally and linguistically rooted messaging to promote public health and prevention-based social norms. This strength-based approach recognized youth as important community leaders and ambassadors for change and empowered them to create content for dissemination on platforms with national and global reach. Messaging was designed to build individual, community, and digital health literacy while integrating core cultural values and strengths of Native Hawaiian, Pacific Islander, and Filipino communities. Over 250 messages have been delivered across Next Gen Hawai‘i social media channels on topics including vaccine information, mask-wearing, staying together over distances, mental health, and in-languages resources in Chuukese, Chamorro, Marshallese, Samoan, Hawaiian, Ilocano, Tagalog, and other Pacific-basin languages. Reach has included more than 75 000 views from various social media channels, media features, successful webinars, and relevant conference presentations. This Public Health Insights article provides an overview of Next Gen Hawai‘i’s activities and achievements as well as lessons learned for other youth-focused public health social media campaigns and organizations.

Introduction

The Next Gen Hawai‘i social media project¹ (Next Gen Hawai‘i) was initiated in the fall of 2020 to address ongoing public health concerns and the need for reliable and current information across Hawai‘i’s diverse communities during the Coronavirus disease of 2019 (COVID-19) pandemic. The collaborative effort began in Hawai‘i’s Native Hawaiian & Pacific Islander (NHPI) COVID-19 Response, Recovery, and Resilience Team (3R), composed of participants from over 60 diverse public and private organizations involved in statewide COVID-19 response efforts.^2–4 The NHPI and Filipino communities were disproportionately impacted by COVID-19 and experienced collateral health issues and social impacts,⁵ yet NHPI 3R members noted that many in their communities did not have access to informational resources on how to mitigate health risks or access assistance for food and other basic needs.⁶ While there were many strong grassroots efforts,^6,7 additional in-language messaging was needed to fully reach all NHPI and Filipino communities. ^6,8 The NHPI 3R team, who convened weekly to discuss what was going on in the communities they served, determined that offering educational content that youth living in multi-generational homes could use to engage and inform family members, creating avenues of access to health resources in the time of COVID-19.

Next Gen Hawai‘i was founded to address these gaps from a strength-based approach, recognizing youth as important social media ambassadors and creative forces within their communities for public health and societal change.⁹ Five social media platforms were built for Next Gen Hawai‘i to share public health knowledge and resources with those who spoke NHPI and Filipino languages, hoping to leverage social media as a public health tool^10–12 with a goal of reaching, engaging, and empowering youth to stay informed.^13–19 As NHPI and Filipino communities often include collectivist perspectives, inter-generational households, and strong family and communal relationships,²⁰ reaching NHPI and Filipino youth was considered a meaningful pathway for sharing critical public health information into families, social networks, and communities and, thus, building individual, community, and digital health literacy.^21,22

This article provides an overview of Next Gen Hawai‘i’s activities and achievements as well as lessons learned for other youth-focused public health social media campaigns.

Background

Five youth-focused Next Gen Hawai‘i social media platforms were developed in 2020²³ and supported by the Hawai‘i Department of Health (HDOH), Papa Ola Lokahi (POL), NHPI 3R, and the Office of Public Health Studies (OPHS) in the Thompson School of Social Work & Public Health. The focus was on social media given its wide use among youth and young adults. In a recent study of college students, over 95% regularly used some form of social media,²⁴ which is a primary source of health information for many young people.^24–28 Social media was a particularly vital communication channel during the pandemic when in-person contact was limited. Appropriate, targeted, and relevant social media messaging remains critical to combat the COVID-19 “infodemic” of too much information about the pandemic, much of which is misleading.^29–31 Social media provides opportunities to communicate health information to the public on a more personal level and to build engagement and trust.¹² Next Gen Hawai‘i built platforms specifically on Tik Tok, Instagram, Facebook, YouTube, and Twitter.

The initial, overarching goal for Next Gen Hawai‘i was to share information about resources and key public health messages recommended by the HDOH to minimize the spread of COVID-19 and support overall health and wellbeing in Hawai‘i’s communities. Messaging included urgent updates related to COVID-19 developments (eg, changes to mandates and gathering protocols) and local resources (eg, food access information,³² pop-up testing sites, rental relief, and vaccine clinics³³) as well as general public health messages (eg, the importance of mental health care³⁴ and addressing COVID-19 misinformation³⁵). As the pandemic evolved, Next Gen Hawai‘i continued to stay relevant to address new and ongoing public health concerns and announcements, such as changing vaccine eligibility guidelines,^36–38 boosters updates, and travel guidelines. The project is still ongoing with 4 active channels (Figure 1). To date, over 250 messages have been posted including in-language resources in Chuukese, Chamorro, Marshallese, Samoan, Hawaiian, Ilocano, Tagalog, and other Pacific-basin languages. Reach has included more than 75 000 views from various social media platforms, as well as media attention, and several successful webinars and presentations.

Figure 1.

Social Media Platforms and Account Names for the 4 Active Next Gen Hawai‘i Accounts

Next Gen Hawai‘i Public Health Ambassadors

Youth are accustomed to using social media channels to stay connected and often interact with messaging incorporated into entertainment and parasocial virtual interaction.,^39,40 Because of this, Next Gen Hawai‘i’s Public Health Ambassadors (from high school students to young adults) were engaged to serve as positive and trusted social media influencers to deliver personalized messages. Youth with diverse language skillsets were recruited throughout Hawai‘i, especially in NHPI and Filipino communities. Ambassadors were linguistically competent in a variety of languages, including Chuukese, Chamorro, Marshallese, Samoan, Hawaiian, Ilocano, and Tagalog. Ambassadors introduced themselves on the social media channels, and shared their reasons for joining the Next Gen Hawai‘i project. Ambassadors shared that access to reliable resources was an issue in their communities before COVID-19, but that the pandemic exacerbated those needs and gaps. Content posted on the social media channels included personal stories of adjusting to and living in the pandemic,^41,42 including getting vaccinated,⁴³ how they stay healthy,⁴³ and their favorite pandemic activities or hobbies.

Relevant public health topics and timelines were developed in communication with the NHPI 3R team and HDOH that reflected feedback from partners, ambassadors, and the community. Ambassadors were given general topics and message templates and encouraged to respond to them creatively (Table 1). This allowed ambassadors to have creative liberty and responsibility for the content within the context of the topics.

Table 1.

Topics with Sample Links to Creative Videos

Topic	Example	Language
Videos
Where to get resources in a hard time	https://www.instagram.com/p/CGoKLflD7v8/	Marshallese
Don’t forget about your flu shot!	https://www.instagram.com/p/CHHPNMejdOI/	Chamorro
How to be together when apart	https://www.instagram.com/reel/CHy1-oUDcKx/?utm_source=ig_web_copy_link	Chamorro
You can help kupuna with telemedicine	https://www.instagram.com/p/CH02OqTDUBf/	Hawaiian
Classics Still Apply: Wear your mask; Wash your hands; Observe social distancing; Shaka not shake	https://www.instagram.com/p/CJpYuIRDjwW/	Marshallese
What’s in your bag? Challenge	https://www.instagram.com/p/CNDSMgyLfr9/	English
How to exercise in this time	https://www.instagram.com/p/CK19hVnjawO/	Chamorro
Mental health matters	https://www.instagram.com/p/CNnxNZkrJLB/?utm_source=ig_web_copy_link	Hawaiian
Resources for mental health	https://www.instagram.com/p/CNk65z2LcwL/	English
Getting your COVID shot: Second doses, what to expect, and how to cope	https://www.instagram.com/p/CO32xzADx4r/	Ilocano
Celebrate the little moments	https://www.instagram.com/p/CQHuS9FDVqa/	English
When Hawai‘i reopens , I want to…	https://www.instagram.com/p/CQ1fR4VnEoR/	Tagalog
What’s in my bag? COVID-19 Edition	https://www.instagram.com/p/CND0g-UL1i7/?utm_source=ig_web_copy_link	Hawaiian
Posts
Two truths and a lie about vaccines	https://www.instagram.com/p/CQb_72SD6ti/	Ilocano
I got vaccinated because…	https://www.instagram.com/p/CQj6Yydg1Vy/	English
It’s time to get boosted	https://www.instagram.com/p/CYscXLTr2WA/	Multiple Languages
Make a vaccine acronym	https://www.instagram.com/p/CRkgaszoL3t/	English
How to say face mask in your language	https://www.instagram.com/p/CNDf6luATp-/	Multiple Languages

A primary focus was short Tik Tok-style videos.^10,11 Tik Tok, an app designed for sharing brief videos, was in high use during the pandemic, particularly among youth.^44–46 Videos were shared on the Next Gen Hawai‘i’s Tik Tok channel as well as other social media channels. On Instagram, the short videos are called “reels” and are included in the area for personal stories, which run for 1 day, or can be pinned^47,48 on the Facebook page so they stay highlighted. Some Next Gen Hawai‘i videos have been viewed almost a thousand times, leveraging the power of trusted youth-oriented social media ambassadors in this space to build public health-oriented social norms.

Next Gen Hawai‘i also created infographics that were translated into different languages to reach communities that did not speak English (Figure 2). These were a primary focus on the Instagram account, which has also served as an archive due to its visual capabilities and relevance to youth.

Figure 2.

Screenshots from a Next Gen Hawai‘i Multilingual Public Health Message (selected) Mahalo to the Community Alliance on Prisons for sharing the linguistic resources to build the infographics.

Following wise practices of social media engagement, graphics and video messages were shared with regular postings of new content, usually at least 3 times per week, but often more frequently. These typically included #hashtags (terms which can be searched in social media archives), emojis (tiny pictures), and enthusiastic captions to support engagement. For example, a video done by Elarie, an Ilokano speaking ambassador, was shared with the caption: “Listen in to hear what Elarie hopes to do once Hawai‘i is open again! #HIGotVaccinated #VaccinateHawaii #COVID19Vaccine.”⁴⁹ In the video, Elarie shared how she hoped to go on her foreign exchange trip to Korea (made possible by the vaccine) and hang out with family and friends when Hawai‘i opened up again. This was as COVID-19 restrictions were starting to loosen after the vaccine was made available to the general public, keeping content relevant to current events. Additionally, messages were planned so content could be delivered on a specific schedule with the ability to pivot when there was a shift (eg, vaccine availability, booster eligibility, new COVID strains, or newly identified symptoms). Hootsuite,⁵⁰ a leading social media managing dashboard, was used to help organize and maintain posting schedules. Content was planned week-by-week and posted to all social media simultaneously via Hootsuite.

Posts were created to adhere to public health needs. As the ambassadors’ social media feeds established themselves over time, a curated archive that shared relevant information and was aesthetically pleasing was created. Figure 3 shows an example of this sequencing from Instagram.

Figure 3.

Screenshots from the Next Gen Hawai‘i Instagram Showing Graphic Design Building from a Sequence

Messages were posted across all platforms, where they could then be amplified and shared by other individuals or organizations. The social media channels also amplified other programs focusing on public health outreach and messaging to NHPI and Filipino communities and their activities and events.48 Youth engagement did not generally focus on the Facebook page as younger populations often use TikTok and Instagram more frequently. Instead, the Facebook page was used to amplify the shareable content to reach a broader audience that was then re-posted by trusted partners, including OPHS, POL, and the NHPI 3R, who have their own social media with many followers. Twitter was similarly used as an amplification platform, engaging a network including other NHPI, youth, and public health-focused organizations locally, nationally, and internationally. YouTube was used primarily for video archiving since there was limited engagement with this channel in fall 2020 and was subsequently not kept current over time.

Activities were created to encourage wise practices and engagement with followers such as the Shaka for Shot contest,⁵¹ which promoted vaccine uptake in youth. The ambassadors also engaged with other groups that aligned with the mission and goals of Next Gen Hawai‘i. Students in a UHM undergraduate health communication class in fall 2020 and fall 2021 built health communication messages from their lessons in videos shared across the social media platforms as part of a class assignment.^52,53

Achievements

The social media channels have had a broad reach and have enabled the project to virtually and physically collaborate with other organizations to share out information and events. The National COVID-19 Resiliency Network and the Asian and Pacific Islander American Health Forum⁵⁴ in a conversation with the National Hispanic Medical Association have shared the project’s media information, which led to additional sharing by other organizations and social media users. Ambassadors and their social media connections have also organically amplified Next Gen Hawai‘i messages on additional pages, including personal social media accounts. Additional outreach included presentations at local, national, and international conferences. Some examples include University of Hawai‘i recognition,²³ a Star Advertiser article,²⁵ a mention in Civil Beat,⁵⁵ and inclusion of some videos in the Pasefika Su.i Fefiloi concert (71 000+ views).⁵⁶ Next Gen Hawai‘i presented at the Hawai‘i Public Health Institute’s Public Health Action Webinar, the International Health Literacy Association, the National Tribal Public Health Summit, the American Public Health Association, and other local, national, and international events. These show ongoing engagement, relevance, and reach, which helps to build trust and continuity within communities. Next Gen Hawai‘i was described as an example of this social media outreach to multi-linguistic youth communities specifically in a recent academic public health article.⁵⁷

Lessons Learned

Lessons from this project can inform other social media campaigns and community-facing organizations wishing to promote public health messages to communities. Creating content and scheduling them across platforms takes time and expertise. Each social media platform has strengths and weaknesses for engagement as well as specific criteria and algorithms for posting and amplifying information. Adapting posts created for one channel for another channel may necessitate different formatting, sizing, captions, or uploading strategies. Visuals are important but time-consuming. These are the basic principles of social media marketing, but those without such training may not build in sufficient time, staff, or resources for these logistics. Participants also learned that while they have made meaningful content, it is hard to make a message go viral.

A strength of social media platforms is that they allow for global engagement; however, a broad reach with open comments enables users who may have not only differing opinions about the public health and health protocols but also various goals to interact publicly. These can include negative comments, problematic links, or inappropriate content. This was the case when Next Gen Hawai‘i paid a small fee to “boost” some social media content on Facebook and Instagram to reach more accounts. This strategy reached a wider audience, broadening the reach and providing valuable information in a cost-effective way, but resulted in more anti-vaccine and health misinformation added in the comments of the boosted posts. Negative or misleading comments were typically deleted to minimize their impact on viewership and the spread of misinformation. These instances revealed, in a very intimate way, the incredible impact of misinformation, including deliberately misguided campaigns, and the need to continue to draw upon new knowledge, theory, and wise practices to combat this.

Ambassadors learned personal lessons from participating in the project, including the strengths of having both a collective perspective and personal stories that add value regarding COVID-19 awareness and mitigation. Public health issues affect the whole community and, thus, when one invidividual is at risk, the community is also at risk This is particularly true in the pandemic. Everyone in the community needs access to resources, including trusted health information, and to be able to understand how to use those resources. Next Gen Hawai‘i was designed specially to create in-language content targeted toward youth who live in multi-generational households so they can share information within their close circle and increase community health and well being through education. Creating social media content on behalf of these NHPI and Filipino communities who are often overlooked in public health messaging was a deeply meaningful experience and there is still so much work to be done. Ambassadors were able to use the experience from this project to build research questions and project ideas for their personal efforts and academic studies.

Another key lesson was learning about timing and perspective. Many community members are on their own timelines of understanding and acting upon public health information and resources because of a history of mistrust and resentment towards the government and other decision-making entities. Public health communication efforts can provide people with the tools and support to make wise decisions, but action may not be immediate. Patience with community members is important as is framing and providing information in ways where it will be best received. Additionally, it is critical to draw upon the rich archive of history and experiences to contextualize the work and decisions made within those communities.

Finally, ambassadors were also able to connect with each other across shared goals at a time when in-person connections were limited due to COVID-19 restrictions. This new method of collaboration presented challenges, but ambassadors fruitfully engaged with each other in the virtual world even with all their busy schedules. Among several collaborations was a “COVID-19 Explained!”⁴³ shared video activity.

Conclusions

The pandemic changed lives dramatically and made in-person events of all kinds impossible to hold, leading to the increased use of online platforms and social channels to stay connected. Social media was a way to not only see loved ones from a distance but a place for many organizations to pivot in order to reach their core audiences virtually. Many health organizations struggled to take advantage of social media.¹² Such efforts demand considerable time and expertise, including staying up-to-date with rapid social media changes, relevant trends, and different platform optimization specifications. Disseminating information across multiple languages is also critical to reaching many vulnerable communities, which necessitates strong translation skills and cultural knowledge by the content creators. Reaching youth and young adults with health messages that feel relevant to them is also critically important yet challenging. Collaborative efforts such as Next Gen Hawai‘i that leverage the knowledge, skills, and creativity of youth for successful multi-linguistic public health messaging from a strengths-based perspective are vital to building trust, strong social norms, and health equity across Hawai‘i communities.

For more information about Next Gen Hawai‘i, contact hawaiinextgen@gmail.com. Social media: Next Gen Hawaii Instagram @hawaiinextgen, Next Gens Hawai‘i Facebook @nextgenhawaii, Next Gen Hawai‘i You Tube, Tik Tok: @nextgenhawaii, Twitter: @GenHawaii.

Abbreviations

3R

Response, Recovery, and Resilience Team

COVID-19

Coronavirus disease of 2019

HDOH

Hawai‘i Department of Health

NHPI

Native Hawaiian & Pacific Islander

Next Gen Hawai‘i

Next Gen Hawai‘i social media project

OPHS

Office of Public Health Studies

POL

Papa Ola Lokahi

UHM

University of Hawai‘i Manoa

WHO

World Health Organization