The Implications of Social Media for Social Marketing and Public Health

1. The Implications of Social Media for Social Marketing and Public Health Seminar in Public Health Communication and Marketing Public Health Communication & Marketing Program George Washington University School of Public Health And Public Health Services September 27, 2006 Three points for today: SOCIAL MEDIA IS ALL ABOUT SELF-EXPRESSION, COMMUNICATION AND SHARING 2. HOW TO SUCCEED IN THIS NEW WORLD OF TECHNOLOGY 3. WAYS TOTHINK ABOUT IT AND USE ITThree points for today: SOCIAL MEDIA IS ALL ABOUT SELF-EXPRESSION, COMMUNICATION AND SHARING 2. HOW TO SUCCEED IN THIS NEW WORLD OF TECHNOLOGY 3. WAYS TOTHINK ABOUT IT AND USE IT

2. The Old World

3. The Networked World

5. The Social Media Ecosystem Blogs Wikis RSS Podcasts Videocasts / Vlogs Moblogs MMS Internet telephony Tools that facilitate: Communication Engagement Transparency Trust Tools that are: Complementary to traditional communication activities Used by organizations who recognize the social characteristics of effective communication Wikis - "type of Web site that allows anyone visiting the site to add, to remove, or otherwise to edit all content, very quickly and easily” RSS - RSS allows someone to link not just to a page, but to subscribe to it, with notification every time that page changes Wikis - "type of Web site that allows anyone visiting the site to add, to remove, or otherwise to edit all content, very quickly and easily” RSS - RSS allows someone to link not just to a page, but to subscribe to it, with notification every time that page changes

6. Social Networks

13. Blogs

18. Wikis Knowledge or content management, Lotus NOTES, expensive software and network solutions Over 800 in the CIAKnowledge or content management, Lotus NOTES, expensive software and network solutions Over 800 in the CIA

21. Who Uses It? 147 million people (73%) on the Internet 84 million (42%) have broadband access at home 57 million read blogs 9 million have downloaded a podcast in the past month 43 million (35% of all adult Internet users) have created or shared content on the web April 2006 report by the Pew Internet and American Life Project, 88% of 18- to-29-year-olds in the U.S. now go online, and 84% of 30- to 49-year-olds do so The most successful podcasts are garnering as many as two million downloads a month, enabling them to attract mainstream advertising. An example -- Dixie Paper Company now sponsors the Mommycast Podcast Series [source: The Economics of Podcasting, a report released today by Nielsen Analytics] In July 2006, the Pew Internet and American Life Project released ‘Bloggers: A portrait of the Internet’s new storytellers. In December, 2005 the Pew Internet and American Life Project reported that 43 million online adults had created or worked on a website or blog for themselves (22%), for a friend or with groups or at work (13%) or had shared online photos, artwork, stories or videos they had created. April 2006 report by the Pew Internet and American Life Project, 88% of 18- to-29-year-olds in the U.S. now go online, and 84% of 30- to 49-year-olds do so The most successful podcasts are garnering as many as two million downloads a month, enabling them to attract mainstream advertising. An example -- Dixie Paper Company now sponsors the Mommycast Podcast Series [source: The Economics of Podcasting, a report released today by Nielsen Analytics] In July 2006, the Pew Internet and American Life Project released ‘Bloggers: A portrait of the Internet’s new storytellers. In December, 2005 the Pew Internet and American Life Project reported that 43 million online adults had created or worked on a website or blog for themselves (22%), for a friend or with groups or at work (13%) or had shared online photos, artwork, stories or videos they had created.

22. Audience Generated Content Nearly 57% of online teens are Content Creators. About one third share their artwork, photos, stories or videos. 22% have their own personal web sites and 19% have their own web log.

23. When and Where? MySpace was the most popular site in July 2006 – 60 million members 100 million videos/day downloaded from YouTube (20 million unique visitors/month) Over 40 million blogs Sprint Nextel subscribers share 30 million photos, play 2 million games and access 1 billion web pages – a month 40% of MySpace’s audience are over 35 40% of MySpace’s audience are over 35

25. What Does Social Media Do? Becomes a collaborative platform Harnesses collective intelligence Enables everyone to be a content creator Provides greater access to knowledge and information resources Encourages media multiplexity Expands and manages social networks Collaborative platforms: most well known are wikis, but others include various collaborative sites such as Vyew and Campfire The Wisdom of Crowds With the help of the internet, people are able to maintain active contact with sizable social networks, even though many of the people in those networks do not live nearby. Helping another person with a major illness or medical condition*: About 17 million said the internet had played a crucial or important role in this. Dealing oneself with a major illness or health condition*: About 7 million said the internet had played a crucial or important role in this. Moreover, there is media multiplexity: The more that people see each other in person and talk on the phone, the more they use the internet. People use the internet to put their social networks into motion when they need help with important issues in their lives. The internet’s role is important in explaining the greater likelihood of online users getting help as compared to non-users. Americans’ use of a range of information technologies smoothes their paths to getting help. Source: Jeffrey Boase, John B. Horrigan, Barry Wellman, Barry, and Lee Rainie. The Strength of Internet Ties. Washington, DC: Pew Internet & American Life Project, January 2006.Collaborative platforms: most well known are wikis, but others include various collaborative sites such as Vyew and Campfire The Wisdom of Crowds With the help of the internet, people are able to maintain active contact with sizable social networks, even though many of the people in those networks do not live nearby. Helping another person with a major illness or medical condition*: About 17 million said the internet had played a crucial or important role in this. Dealing oneself with a major illness or health condition*: About 7 million said the internet had played a crucial or important role in this. Moreover, there is media multiplexity: The more that people see each other in person and talk on the phone, the more they use the internet. People use the internet to put their social networks into motion when they need help with important issues in their lives. The internet’s role is important in explaining the greater likelihood of online users getting help as compared to non-users. Americans’ use of a range of information technologies smoothes their paths to getting help. Source: Jeffrey Boase, John B. Horrigan, Barry Wellman, Barry, and Lee Rainie. The Strength of Internet Ties. Washington, DC: Pew Internet & American Life Project, January 2006.

26. Using New MediaKaiser Family Foundation. New media and the future of public service advertising. April, 2006. VERB (8372) Centers for Disease Control and Prevention Fight Mannequinism The Federal Voting Assistance Program and Ad Council Above the Influence Office of National Drug Control Policy, Partnership for A Drug-Free America National Day to Prevent Teen Pregnancy National Campaign to Prevent Teen Pregnancy, Teen People Small Step U.S Department of Health and Human Services, Ad Council Girls Go Tech Girl Scouts of USA, Ad Council

27. New Media Cookie Cutter Set up a web site with information and/or 'cool stuff' to interact with or download Convert the PSAs and print material into digital formats Promote like crazy through traditional media and the web (blogs, MySpace, viral, WOM) - now it's new! Use cell phones and SMS as a response channel Push messages and alerts out to participants who opt-in at the web site or through SMS to receive them Measure results by eyeballs and click throughs

28. Other Ways to Think About It

31. What’s Social About Health Behavior? Asymptomatic Screenings Lifestyle Modifications Cessation of Addictive Behaviors Medical Regimen Compliance Precaution Adoption

32. Social Network Interventions Enhance existing linkages? Develop new linkages? Enable indigenous helpers? Create new networks? Empower existing ones? Weave together networks? Engage communities in new ways?

34. e-Health Tools and Functions Health Information Behavior change Self-management On-line communities Decision support Disease management Healthcare tools e-Health resources enable consumers, patients, and informal caregivers to gather information, make healthcare decisions, communicate with healthcare providers, manage chronic disease, and engage in other health-related activities. Most tools support several of these functions, generally structured around a primary purpose such as disease management. • Health information—either a spectrum of searchable information or more narrowly defined content • Behavior change/prevention—support for a specific behavior change such as smoking cessation • Health self-management—tools for achieving and maintaining healthy behavior in lifestyle areas such as diet and exercise • Online communities—Internet-based communities for interaction among consumers, patients, or informal caregivers about shared health concerns • Decision support—structured support for making treatment decisions, choosing and evaluating insurance programs or healthcare providers, or managing healthcare benefits • Disease management—monitoring, recordkeeping, and communication devices for managing a chronic disease, usually in conjunction with healthcare providers • Healthcare tools—means of maintaining or accessing health records and interacting with healthcare providers. This category includes personal health records. e-Health resources enable consumers, patients, and informal caregivers to gather information, make healthcare decisions, communicate with healthcare providers, manage chronic disease, and engage in other health-related activities. Most tools support several of these functions, generally structured around a primary purpose such as disease management. • Health information—either a spectrum of searchable information or more narrowly defined content • Behavior change/prevention—support for a specific behavior change such as smoking cessation • Health self-management—tools for achieving and maintaining healthy behavior in lifestyle areas such as diet and exercise • Online communities—Internet-based communities for interaction among consumers, patients, or informal caregivers about shared health concerns • Decision support—structured support for making treatment decisions, choosing and evaluating insurance programs or healthcare providers, or managing healthcare benefits • Disease management—monitoring, recordkeeping, and communication devices for managing a chronic disease, usually in conjunction with healthcare providers • Healthcare tools—means of maintaining or accessing health records and interacting with healthcare providers. This category includes personal health records.

35. Evaluating Effectiveness of e-Health tools Access Availability Appropriateness Acceptability Applicability of content Access. Large numbers of e-health tools have been developed, but it is not known how many people know about these tools, how many are using these tools outside of research studies and closed healthcare systems, and how many may be willing to try them. Availability. Many of the studies utilized convenience samples or required computer ownership. This approach has led to a disproportionate amount of information on Caucasian women with higher education levels. The lack of diversity in the research samples and limited evidence indicating differential effects based on demographics suggest major gaps in knowledge. Appropriateness. Some tools have been developed that target special populations, and some of these were developed with input from the target audience. These studies show that with careful attention to cultural, literacy, and technological needs, successful tools can be developed for and used by diverse groups. Acceptability. People like e-health tools and generally find them easy to use. Although usage seemed to decline over time, the declines were not as steep as those found in the control conditions. Applicability. Many studies found positive changes in knowledge and intention after just one interaction using e-health tools. Findings on actual behavior change and health outcomes have been less clear. However, many of these studies may not have provided interventions with enough frequency or intensity to bring about desired changes in these areas, or they may not have used appropriate control groups. Many studies relied on self-reported data to document change. Access. Large numbers of e-health tools have been developed, but it is not known how many people know about these tools, how many are using these tools outside of research studies and closed healthcare systems, and how many may be willing to try them. Availability. Many of the studies utilized convenience samples or required computer ownership. This approach has led to a disproportionate amount of information on Caucasian women with higher education levels. The lack of diversity in the research samples and limited evidence indicating differential effects based on demographics suggest major gaps in knowledge. Appropriateness. Some tools have been developed that target special populations, and some of these were developed with input from the target audience. These studies show that with careful attention to cultural, literacy, and technological needs, successful tools can be developed for and used by diverse groups. Acceptability. People like e-health tools and generally find them easy to use. Although usage seemed to decline over time, the declines were not as steep as those found in the control conditions. Applicability. Many studies found positive changes in knowledge and intention after just one interaction using e-health tools. Findings on actual behavior change and health outcomes have been less clear. However, many of these studies may not have provided interventions with enough frequency or intensity to bring about desired changes in these areas, or they may not have used appropriate control groups. Many studies relied on self-reported data to document change.

36. e-Health Tools: Behavior Changes Improve dietary habits Increase physical activity levels Reduce heavy drinking Decrease disordered eating behaviors Improve adherence to treatment protocols Impact on health care utilization and costs?

37. A Closer Look Sampling biases favor easy Internet access, technology availability and requiring little tech support. Understand how different groups seek and find health information and tools. Design and test elements that make tools more culturally relevant, consistent, comprehensive, and understandable for diverse users. How to engage, motivate and sustain use of tools. Areas with the largest numbers of tools are nutrition education, weight management, tobacco cessation, and cancer and diabetes prevention and management. Although most of the tools in these studies are designed for adults, some target children and adolescents. Each tool contains health information specific to its intended purpose. This information can be general, targeted to a specific user group, or tailored to an individual user. In addition to information, other features might include interactive games and simulations, video clips, chat rooms, message boards, e-mail to and from healthcare providers, self-assessments, decisionmaking tools, disease management tools, and links to other sites. there appears to be a bias in the literature toward studying those persons who have easy Internet access, can use readily available technologies without adaptation, and do not need much if any technical support. The Pew Internet & American Life Project’s 2005 report on search engine use found that 84 percent of Internet users have used search engines, 92 percent of those who use search engines are confident about their searching ability, and 87 percent report successful search experiences most of the time (Fallows, 2005, TR#59). Some user groups, however, have special challenges related to information-seeking. Zarcadoolas, Blanco, Boyer, et al. examined the navigation skills of adults with low literacy and identified several factors that affect availability for this group (2002, TR#81). These include spelling problems that interfere with searching, difficulty entering Web addresses, and difficulty using navigational tools such as graphic links, back arrows, and scrolling. Areas with the largest numbers of tools are nutrition education, weight management, tobacco cessation, and cancer and diabetes prevention and management. Although most of the tools in these studies are designed for adults, some target children and adolescents. Each tool contains health information specific to its intended purpose. This information can be general, targeted to a specific user group, or tailored to an individual user. In addition to information, other features might include interactive games and simulations, video clips, chat rooms, message boards, e-mail to and from healthcare providers, self-assessments, decisionmaking tools, disease management tools, and links to other sites. there appears to be a bias in the literature toward studying those persons who have easy Internet access, can use readily available technologies without adaptation, and do not need much if any technical support. The Pew Internet & American Life Project’s 2005 report on search engine use found that 84 percent of Internet users have used search engines, 92 percent of those who use search engines are confident about their searching ability, and 87 percent report successful search experiences most of the time (Fallows, 2005, TR#59). Some user groups, however, have special challenges related to information-seeking. Zarcadoolas, Blanco, Boyer, et al. examined the navigation skills of adults with low literacy and identified several factors that affect availability for this group (2002, TR#81). These include spelling problems that interfere with searching, difficulty entering Web addresses, and difficulty using navigational tools such as graphic links, back arrows, and scrolling.

39. Who Uses It? Over 200 million cell phone subscribers 40% use SMS (32.5 billion txt msgs sent in last half of 2005) 44% of people use their mobile as their main camera 34.6 million use mobile Internet services By 2009, every US mobile subscriber will have a SMS-enabled phone; 98% will be web-enabled

40. Health MarketingSexInfo: San Francisco Department of Public Health Address rising prevalence of STDs among urban youth Make it private, personal and timely First quarter: 1,538 inquiries Condom failure, STD info and pregnant (?) top three calls

41. m-Change and Obesity The appropriate model for obesity and weight management is tailored information according to design principles suggested by Social Cognitive Theory and the Social Marketing Model. The health behaviors to target are self-monitoring of diet and physical activity. The devices are Web-enabled “smart” cellular telephones and wireless PDAs.

42. mChange: Mobile Technologies for Change

43. Implications for Social Marketers ‘Be Everywhere’ [Media Multiplexity] Interactivity and AGC (audience generated content) Collaboration and Sharing Social Networks and Social Capital Aggregate or COGs (Centers of Gravity) Education, Engagement, Entertainment, Empowerment and Evangelism

44. Quotable Quotes The Social Web empowers people's ability to engage in self-expression and communicate and share information with whomever they choose – Tech Crunch Social technologies succeed when they fit into the social lives and practices of those who engage with the technology – danah boyd It’s not about using new media; it’s about using media in new ways – Craig Lefebvre