Tag Archives: health communications

Unwinding the Art Behind the Science

Can online, social networks really help people stop smoking?

This is what 100 experts came together to discuss in a 2-day workshop in Washington, D.C. The result was a proposed research agenda on online social networks and smoking cessation. The group proposes 34 questions they deem most pressing in four categories: advancing theory, understanding fundamental mechanisms, intervention approaches, and evaluation.

This was 2010.

There is A Need

We are on the edge of 2013. And while the Web is ubiquitous–making qualms between offline and online approaches somewhat void when we should be looking at the overall customer experience…We’re still working to better understand many of the questions proposed:

  • How well do theoretical models of social influence translate between offline and online contexts?
  • How does information spread through an online social network? Are there identifiable patterns of information spread that can be leveraged in intervention research?
  • Can key participants in a network be identified and targeted to foster information diffusion or make it more efficient?
  • What are the drivers of the viral spread of an application, concept, or innovation through online networks?
  • What predicts engagement in an online social network?

All 34 questions themselves are invigorating. I encourage you to take them back to your team to fodder discussion and brainstorming. We need to be asking these questions. We need to test our ideas, explore what’s working and share it with our colleagues. But there’s a greater need.

You Can Help Solve It

As a practitioner, one item stood out among the research agenda. It’s worth filing in your back pocket and pulling out as evidence when you’re in one of those meetings:

“While there are ways in which offline and online behaviors overlap and can reciprocally inform models, mechanisms, implementation, and evaluation, there are also important differences that require critical thinking about online networks. There is a need to challenge and test the assumptions inherent in traditional models when developing, implementing, and evaluating online interventions.”

You are called to challenge traditional models–even tested ones. Rather, find inspirational models. Study them. Find what’s working. Lean on your training, work to better understand people and unwind the assumptions you bring to even the tiniest of tasks. If you’re a graphic designer for example, maybe you look into the psychology of color and how that impacts design and behavior. This is the art behind the science, so go grab your paintbrush.

What do you think about the proposed research agenda? What questions would you add?

What’s In A Campaign? That Which We Call Change

As the science behind social change evolves, how we approach our work must too. And sometimes, it is just semantics. But sometimes, it’s not. It’s a difference in mentality.

Take the idea of a “campaign” for example. The word campaign itself brings with it assumed processes, methods and associations. It also ranks up there with “awareness” as one of the most overused and over-relied upon words in public health. We can do better.

The word-of-mouth company, Brains on Fire, wrote a brilliant manifesto on the inherent differences between a campaign and a movement that can help point us in the right direction:

Campaigns have a beginning and an end.
Movements go on as long as kindred spirits are involved.

Campaigns are part of the war vocabulary. (target, launch, dominate markets…)
Movements are part of the evangelist vocabulary. (evangelize, passion, love…)

Campaigns are dry and emotionally detached.
Movements are organic and rooted in passion.

Campaigns rely on traditional mediums.
Movements rely on word of mouth, where the people are the medium.

Campaigns are part of the creationist theory—we’re going to create something cool
and people will talk about it.
Movements are part of the evolutionist theory—whatever we co-create with the fans
they can own and run with it, which will evolve over time.

Campaigns are you talking about yourself.
Movements are others talking about you.

Campaigns are an ON/OFF switch.
Movements are a volume dial—and there’s no zero.

Campaigns add to awareness.
Movements add to credibility.

Campaigns are “you vs. us.”
Movements are “let’s do this together.”

Next week, the University of Florida’s Center for Digital Health and Wellness will host its first Digital Health Communications Extravaganza. May we approach the week with the idea that we want sustainable movements of change focused on outcomes, impact and building relationships that strengthen communities.

Will you be at #DHCX? What other words rank up there on your list of over-used and over-relied upon?

flickr credit: JanneM

Crossing the Double Divide, Two Million Dollar Questions

Earlier this month, Susannah Fox discussed a health Information divide based on a recent report. This divide was also confirmed in a recent literature review on the effectiveness of social media in public health–cited as a double divide:

“A common concern raised in the published literature (38, 66, 67, 68, 69, 70) relates to the populations with limited online access, poor literacy skills, and disabilities that impair access to social media platforms: “…health scientists exploring the issue of the digital divide have found evidence of a double divide. Specifically, those without internet access (a large portion of whom may be without adequate health care access) are prevented from gaining health information available on the Internet” (38).

Though this double divide exists, it does not mean that we should disregard the Internet and social media as a tool in our health communications and social marketing work. There are bright spots of the Internet and social media’s impact in public health and in impacting the health of vulnerable populations. As, the literature review goes on to share that some researchers suggest that social media platforms can actually “augment poor health literacy of basic literacy skills” and “that digital penetration into marginalized groups actually improves access to some specific demographics.”  And this is where the importance of the National Broadband Plan comes into play.

Why? Because of the National Broadband plan not only outlines how to increase access to the Internet across the United States. But, it also includes key recommendations for increasing digital literacy. One of the recommendations that caught my attention most was the call to create a Digital Literacy Corps with the objective of mobilizing thousands of Americans across the United States to improve digital literacy. Compound that with last year’s release of the National Action Plan to Improve Health Literacy and the objectives set out in Healthy People 2020, and we’re on our way to crossing this double divide.

But what do we do until then?

The literature review offers the following recommendations on using social media to improve effectiveness for public health:

  1. Establish clear objectives.
  2. Know your target audiences.
  3. Design campaigns for longevity and/or have exit strategies and clear archiving processes.
  4. Determine resource needs.
  5. Determine agency content-clearance processes and/or prepare pre-approved messaging scripts.
  6. Listen to online health discourse.
  7. Encourage or sponsor research.
  8. Encourage coordination.

These are great recommendations, and number 7 is especially important. But value is gained from having a critical eye. So when data like this from Pew’s Health Topics report is shared, how can we be sure to reach the people who need our attention:

…fewer than half of adults in the following groups in the U.S. look online for health information:

  • African Americans
  • Latinos
  • Adults living with a disability
  • Adults age 65 and older
  • Adults with a high school education or less

As I write and work to use social technologies for social good, I know their potential and understand the benefits they can offer. So I don’t necessarily need “convincing.” Instead, I’m on the lookout for case studies–from the local level and up.

A Case in Point

For example, in St. Louis, the St. Louis County Library and the physicians of Saint Louis University have teamed up on a series of free community health literacy programs, referred to as “60-Minute Health Check-Ups.” The check-ups are” designed to provide information and resources to help attendees learn more about health-related issues. Each program features health information presented by a SLUCare professional, followed by health literacy tips from a St. Louis County Library reference librarian and free health screenings.”

This might not seem wildly innovative–but it’s a strong example of the place “P” in social marketing. And, when you add these stats from the 2010 U.S. IMPACT Public Library study into the mix (borrowed from a comment made by Luke Rosenburger on Susannah’s Health Information Divide post)–you can see the opportunity increased digital literacy could provide for better health:

Research has shown that libraries are a very important nexus for this kind of connection. The “US IMPACT” study, released April 2010 by the University of Washington Information School and underwritten by the federal Institute of Museum and Library Services and the Bill & Melinda Gates Foundation, reveals that nearly one in three Americans age 14 or older — 32% or roughly 77 million people — used a library computer or wireless network to access the Internet in the previous year. Among people living in households whose income was less than 200% of federal poverty guidelines ($44,000 a year for a family of four), 44% used library computers and Internet access.

Thirty-seven percent of library computer users, an estimated 28 million people, focused on health and wellness issues, including learning about medical conditions, finding health care providers, and assessing health insurance options. In one particular group — seniors (65 and older) living in poverty — a full 54% used library computers for health or wellness needs.

The study also suggests that library computer use leads to positive action on health and wellness: roughly half of the people who used a public library computer to find doctors or health care providers reported that they made follow-up appointments. Among those who reported researching diet and nutrition issues online at the library, 83% decided to change their diet; among visitors who searched for exercise and fitness information, 84% decided to change their exercise habits. The benefits also reach beyond just the individuals who come into the library: nearly two-thirds of library computer users (63%) logged on to help others; 56% reported helping friends or family with health matters specifically.

So are libraries the answer? From the information provided and from knowing some smart and savvy librarians, I’d say yes! But, I feel like they are just part of the answer.

The Million Dollar Questions

One:  What are people doing to cross this double divide and what results are they seeing? Show us the case studies and share the lessons learned!

Two:  In what ways can we reach people on the side of the divide without health information and without digital literacy skills–and bridge the gap in terms of health disparities and health information, services and products? (And before you answer “MySpace” or “mobile” –show me the evidence. As, I feel more and more strongly, to cross the divide, we need a markets-based approach to health that addresses changes regarding the social determinants of health. No?)

BONUS: CDC’s January 2011 Health Disparities and Inequalities Report (CHDIR) — The information in this report is astounding and eye-opening.

flickr credit: kcryder

Social Marketing Works

For all those working to raise awareness, guess what? Awareness just got punked. See this excellent video appropriately titled “Awareness Schmawareness:” from the wonderful Nedra Weinreich to see what I mean:

httpv://www.youtube.com/watch?v=hRhXKTAG0kc

If you feel the awareness building fever catching in your organization or team, have no fear. Review these questions to get back on the right track. The TurningPoint Collaborative also has the following resources (for free!) available:

Last but not least, you can always ask questions here at SocialButterfly. Take a step today towards effectiveness–know that the social marketing approach works. Why else would it now be an official part of how our nation plans on improving our country’s health (see objective 13)?

Quote of the Week: Failure Happens (and One Way to Avoid It)

This is not a boggy-too sad to read post. This post is about failure, yes, but it’s also about what can be learned from it. This week’s quote comes from Sarah Ragsdale over at the Walking the Path blog:

“Failure happens.”

However, Sarah doesn’t mope and pity in the eye of failure–instead she offers insights into why failure happens based on the text Marketing in Public Health. Sarah reviews four types of common failures when it comes to communications interventions:

  1. Strategy failures occur when external barriers exist in the community that cannot be overcome by communication messages. For example, a condom usage campaign may be very effective in raising awareness, but if condoms are not available in the community, the campaign is moot.
  2. Execution failures are the result of poorly constructed messaging or targeting the wrong audience. We must always remember to do our homework and study our audiences.
  3. Measurement failures happen when we planned the communication strategy appropriately and delivered it well, but we had a poor evaluation strategy.
  4. Expectation failure results from overestimating the campaign’s impact in the community. Change occurred but not to the level stakeholder’s expected.

I would like to call your attention to reason number 3–measurement and evaluation. Why? Because this can be one of the easiest to avoid and is also one of the most important elements in any social marketing campaign. Think about a project that you are currently working on–do you have an evaluation strategy for your communications? If not, some resources you may find helpful are provided below:

If you do have an evaluation strategy, I want to also challenge you and ask you two questions: What are you evaluating and why are evaluating it? Often, by asking these questions, you can avoid some of the other failure pit stops that Sarah mentioned. I know our team internally are asking ourselves these very questions on some great projects we are brewing up–and I look forward to continued thoughts from the team and from you. Because when it comes to “success” in social marketing, my head automatically thinks of desired behaviors, behavioral objectives and behavioral outcomes–what does your mind think of?

flickr credit: fireflythegreat

Crossing the line or a Creative Cross? MySpace Research with “Dr. Meg”

Have you heard of Dr. Meg? Maybe not, but if you’re a teen on MySpace you may have. Interesting research that was first published in the January issue of Archives of Pediatrics & Adolescent Medicine showed that adult supervision of MySape can raise adolescents’ awareness of how accessible their profiles are online.

To come to this conclusion, Dr. Megan Moreno, a pediatrician and adolescent medicine specialist at the University of Wisconsin-Madison, and fellow researchers, embarked on two separate studies to explore this issue further. Both research studies are to 1) encourage increased parental and adult supervision by family and friends, and 2) to potentially encourage similiar outreach approaches.

Dilemma: To Cross or not to Cross the Ethical Line

The research is very interesting, however, I feel an ethical discussion must be had. I am not saying Moreno’s approach was wrong or right, but I think we should slow down and discuss it further to learn and develop best practices, as well as ethical guidelines, especially since others may adopt this practice towards younger youth.

Headlines have buzzed about “Busybody Dr. Meg,” concluding that this outreach and behavior-change may offer hope to future, similiar methods being implemented by others. To me, I feel there can be high-levels of concerns with a universal application of this approach unless the strategy and concept is stretched. Including, but not limited to – the age those being contacted, how people are being contacted, the language and type of approach involved, the privacy and the stalking-like component, among other items. Additionally, does it matter who, as in which type of organizations embark on this strategy? For example, I can foresee potential problems if adopted by government health agencies and citizens’ concerns over freedom of expression. Curious on others’ thoughts on this! 😉

Background About the Studies

Study 1. For the first, researchers located 190 MySpace public profiles in a single urban ZIP code, randomly selected from 10 U.S. Census areas with the lowest average income because researchers wanted to target adolescents who might have less access to doctors.

All the users involved revealed that they were 18 to 20 years old and their pages included three or more references to sex, drinking, drug use or smoking. Of the 190 profiles selected, half were sent “Dr. Meg” e-mails. After three months, 42% of those getting a “Dr. Meg” e-mail had either set their profiles to “private,” or they had removed both sexual or substance usage references. 29% of those not contacted made changes over the three-month period.

Study 2. In another study, Moreno and other researchers looked at 500 randomly selected MySpace profiles of 18-year-olds nationwide and found that more than half contained references to risky behavior such as sex, drinking and violence.

Your Turn: Crossing the line or a creative cross?

What do you think? I agree that there is a growing issue and concern for online safety and online identity of teens, youth, young adults and people in general, and this is an interesting new development to the field. How can you see this approach being adopted by your organization, or what would be your reaction if you were approached? Am I over-reacting?

photo credit: LoonSky

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Health Promotion Policy is 20/20

As they say, ‘Hindsight is 20/20.’ However, social marketing thought leader extraordinaire and fellow social marketing blogger at On Social Marketing and Social Change, Craig Lefebvre, is hoping that the future of health policy will be ahead, rather than behind the curve. Lefebvre launched a new blog series titled ‘Healthy People 2020,’ and invites you to participate. Lefebvre writes:

If you haven’t heard, the process of developing the nation’s health objectives for the next decade has started – and you and your readers could become part of the conversation. Healthy People 2020 is the next update of the objectives that have guided our country’s health promotion and disease prevention efforts for the past 25+ years.

As part of my work with ODPHP, I am hosting a series of guest blogs on how people envision the interactions of health communication, social marketing, and health information technology – including social media – in improving the Nation’s health in the next decade.. The first topic is Information Rx for Healthy People in 2020 by Joshua Seidman from the Center for Information Therapy.

Due to the limited resources to take HP 2020 to a greater level of participation, Lefebvre hopes to garner participation through the use of social media to help spread the word and generate the conversation. For more information and to see the latest post in the series contributed by Cynthia Solomon titled Personal Health Records for All, and add in your thoughts.

Lefebrve said he welcomes inquiries, post contributions, and cross-post opportunities. Lefebrve’s blog is where talking about health and inspiring people to get involved in national health promotion and disease prevention policy meet.

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Distinguishing Experiences

Going off of the topic of the day from the Social Marketing Listserv, I would like to add to the conversation some of my experiences when people get social marketing confused with social media marketing. (For more information regarding the differences, click here.)

When I tell many friends, family or professors that I’m studying social marketing as my focus in graduate school, oftentimes it is embraced by excitement. This is then followed by a huge conversation about all the cool, new technology that’s coming out. Which to note, I also do enjoy because I like talking about new technology. But, I thirst for full conversations with those practicing the real social marketing.

Another time, I was interviewing to help volunteer for a new business in town. Knowing the confusion surrounding the term ‘social marketing,’ I started out early in the interview describing it in brief-length…the application of the marketing mix to change behavior, do good…mostly found in health communications but is branching out into other realms…main distinction is that its end objective is not related to commercial profit” and so on…After my 2-3 minute speal and promotion of social marketing, the interviewer exclaimed, ‘Great! You might have a few great ideas for our blog and can work with our IT person.” Now, if this was framed in a social marketing context, then I would have been overjoyed. But, he was getting it confused I believe with social media marketing.

A third experience. I was at the annual dinner for Kansas City’s Sister Cities Association and began talking with a gentleman. He asked what I was studying and I said, “Well, you could describe it as kind of like non-profit advertising.” Which, understandably, he asked what exactly that was. So I replied, well, the technical term of what I’m studying is social marketing, but sometimes that’s confusing –” and he jumped right in and knew all about it! It was a first for me, a very exciting first. I wanted to talk to this older gentleman all night! He said that he thought social marketing will be the next great realm as more organizations see its benefits, etc. and that it was a really exciting area to be in. It made my night.

Curious, what are some fun experiences you have had when distinguishing between social marketing and social media marketing?