June 5th marks the 25th anniversary of the day the Centers for Disease Control and Prevention introduced the world to the disease that we now know as AIDS. Snapshots of some of the public education campaigns are included in the review including their different approaches, historical context and impact. This document should find its way into many classes and texts on developing sustained and responsive health communication and social marketing campaigns to public health threats. Fun Fact of the Day: The first position in the US government with 'social marketing' in its title was at the CDC in their America Responds to AIDS Program. Blog that publishes text and some graphics on topics related to social marketing and social change issues. So, nutrition education has yet to get people to 'know their caloric number,' confusion still reigns and a majority are still trying to change their behaviors anyway. If there's truly a war on obesity, maybe it's time for new strategies and not just adjustments in tactics. It takes about 1800 calories a day for me to maintain, even though everything I've read says I should be able to eat more.
I've cut out all refined grains, eat only low-sugar fruits (such as strawberries, avocados and tomatoes), and when I do eat grains, it is always 100% whole wheat. The growing popularity and use of Web 2.0 and social media is not going unnoticed by employers. On other fronts, Shel Holtz noted last April that corporate firewalls were blocking access to RSS feeds and podcasts and that companies were initiating other measures to block employee access to the internet (a move he likened to not allowing employees to bring newspapers to work because they might look at sports scores rather than only 'business-related' items).
In some quarters, restrictions on employees going to social network sites are getting lumped together with prohibitions against pornography and gambling sites. If you work in a public health agency, the next time you are trying to make a case for using social media, or even more radical, developing open source wikis for your agency or social marketing program, be sure you have a copy of this article from the LA Times in hand. The article describes ProMED, a free, open source and access website that is the Wikipedia of disease surveillance.
In 2003, ProMED was first to report the disease that turned out to be severe acute respiratory syndrome, or SARS.
Quite a track record and high praise for an open source approach to knowledge development and management, and maybe something that will resonate with those managers and colleagues who still think the laboratory, RCTs and tortured clearance procedures are the path to truth and wisdom. There are other internet systems for disease outbreaks available, such as Global Public Health Intelligence Network, which does real-time monitoring of media in  seven languages. Two-thirds of all teens who have created a personal profile on a social network site limit access to it (Bet you don't see that lead in the popular press).A data memo released this weekend from the Pew Internet and American Life Project reports the results of a survey of teens and their use of social network sites [pdf file].
55% of online teens have created a personal profile online, and 55% have used social networking sites like MySpace or Facebook. 91% of all social networking teens say they use the sites to stay in touch with friends they see frequently, while 82% use the sites to stay in touch with friends they rarely see in person. 72% of all social networking teens use the sites to make plans with friends; 49% use the sites to make new friends. Older girls ages 15-17 are more likely to have used social networking sites and created online profiles.
One takeaway from the data may be that teens are more responsible about the use of social network sites than many critics fear, or that they have heard and responded to the coverage about the potential dangers of social network sites.
This year's campaign to have children and adults get their flu shots is getting an extra boost from some of the CDC's first encounters with social media. As they announced at the Healthcare Blogging Summit, the National Center for Health Marketing also held a webinar for bloggers about the flu this past Monday.
I understand there's a lot of excitement in some corners of CDC about stepping into this space. Personally, I like the widget - especially for this time of year (it may be the only White Christmas I see in these parts).
And for seizing the reins of the global media, for founding and framing the new digital democracy, for working for nothing and beating the pros at their own game, TIME's Person of the Year for 2006 is you.
In some quarters the TIME POTY is a conversation starter for the holiday parties, and the subject of saturation news and blog coverage starting today. The coverage includes 15 short profiles of Us, including the most prolific contributors to Amazon reviews and Wikipedia, and a longer piece on the founders of YouTube. As you try to get people's attention about the world of social media and the changing power dynamic between the old world model of  'senders' and 'receivers' of communication, this coverage might break provide some breakthrough for precontemplators (just be sure to get them a hard copy).
Addressing the barriers and answering the protests about using social media and collaborative tools cannot be any more difficult than in the spy business. The need to focus on the challenges posed by your organizational culture even more than the technologies to make them work for you. Designing the innovations of using wikis and blogs to be quickly and broadly adopted by a critical mass of workers (early adopters and early majority) and not just a few fashion-setters or geeks. Acknowledging and working with the 'traditionalists' or 'laggards' in your organization who, for better of worse, are often in critical positions to influence whether innovations are introduced in the first place. As you think about introducing social media into your organization, or are just beginning to do so, the examples from the intelligence community may help persuade some of your colleagues of their untapped potential. And for some other resources about wikis, here's a post on some of the interpersonal and management issues you need to plan for and the wikimatrix site that can help you choose from among the many wiki platforms that are currently available.
For those who look for 'divides' the data point to differences in podcast use among men and women (15% vs 8%), those 64 years and younger vs 65+, and those with 6+ years of online experience vs those with 3 or less years.
A Business Week 'news analysis' on 'What Podcasting Revolution?' asks are they doing it regularly? The reporter is also looking for the mass market appeal of podcasts, seemingly oblivious to the idea that the power of podcasting is narrowcasting or slivercasting by and for people of like minds for their own communities, not creating the next RCA.
Podcasts should make audio recordings (and purchases) of conference presentations extinct in 2007.
I just came across the North Carolina RE3 project website and social media components and have to pass on my congratulations to the crew putting it all together and commend all of you to take a look at it. Then there's the MySpace site where you have to play Grandaddy Nature Anthem (my convenience sample confirms that the tune is infectious). Yes, places like MySpace and YouTube are great for the big dogs to create and manage and for people who want to get lost in the masses, but what about something we can do with a local angle and flavor? The idea of aggregating health conditions rather than creating sites for each specific one has some advantages from both a business POV as well as allowing for interactions among people with different health and medical conditions - but similar challenges and coping strategies.

The site notes a small group of health experts who are 'Community Advisors,' but I did not find much to suggest what the developers are doing to assure any standards of quality or credibility for the health information on their site.
To allow users to evaluate the quality and appropriateness of Internet health resources, health-related Web sites should publicly disclose the following essential information about their site: (1) the identity of the developers and sponsors of the site (and how to contact them) and information about any potential conflicts of interest or biases, (2) the explicit purpose of the site, including any commercial purposes and advertising, (3) the original sources of the content on the site, (4) how the privacy and confidentiality of any personal information collected from users is protected, (5) how the site is evaluated, (6) and how the content is updated. Nedra Weinreich has been covering the Second Life beat from a social marketing POV and reports that the CDC has landed. Jay Bernhardt, at Health Marketing Musings, gives a nod to the value of social media - bloggers and several wikis in particular, and notes their important role in helping the CDC communicate in times of natural disasters and public health emergencies.
In addition to enhancing and enabling this group wisdom through various collaboration tools like wikis, I also believe that thinking about public health problems and their solutions by building on the assets of existing social networks, linking them and creating new ones when needed, are another set of opportunities these new technologies create for social marketers and all social change agents. I'm pleased to see some senior people in the CDC embracing social media and starting to think about it from the POV of its possibilities, rather than harping on their possible dangers, pitfalls and problems. The Council for Excellence in Government is launching a social network site for federal workers today. The plan for the site includes allowing users to set up their own blogs, friends' lists, search and calendar functions. Yesterday I was part on an expert panel to discuss trends and innovations in communications and their implications for Federal health communication programs held at IQ Solutions. The invited audience consisted of HHS health communicators including people from five Institutes at the National Institutes of Health. An  immediate response was that moving into places like MySpace and YouTube (two examples I used in my talk) meant that even more time and investments would be necessary to develop effective messages for these new channels.
The question was raised about what the role of the Federal government should be as a source of health information in this new world? A concern was expressed by researchers that submitting investigator-initiated grants to the NIH to conduct research with new media and technologies has been met many times by rejection by peer review committees whose members are not conversant with these technologies.
Some participants also shared how they have been tapping into thought leaders from the commercial world to introduce ideas and new technologies to the executive level staff at some Institutes.
The session was not intended to come to conclusions, but to raise and explore issues about the changing world of communications and how they may affect efforts to improve people's health. The connection between social support networks and a variety of health and medical conditions is well documented (see also Social Support and Physical Health). As we look at the role social media can play in public health and health care, it is important to remember that it is not just a set of tactics we are exploring, but a way of thinking about health behaviors that focuses on understanding, enabling and expanding social networks.
In my talks about social media I make the point about the misconception people have of who is joining social network sites [I'm taking danah boyd's point about the difference from social networking sites]. Another round of data are in documenting that the most popular social network sites such as MySpace and Facebook are trending towards more older adults being engaged with them.
And here is a list of some of the other more notable social network sites you might explore. For those of you worried about YouTube, don't, the Office of National Drug Control Policy is there. Danah Boyd is issuing a call to gather together people who are conducting research on social networking sites and have published in the area. If you, or people you know, are conducting research or have published on this subject, please let her know (and cc me if you will). Who knows, maybe a few policy-makers will see it and recognize the value of long term planning and sustained commitment to public education and health marketing initiatives: youth obesity anyone? It's one thing when the kids are setting up private email and IM accounts and using social network sites; it's another when it's their employees.
He also presents the business case for why employee access to RSS feeds IS important (for those of you who need some talking points).
Many administrators in these agencies are physicians, and often epidemiologists, by training. Though China initially tried to squelch news of the mysterious outbreak, Madoff says, ProMED tracked the spread of the disease. You might also be able to to open them up to the idea that social media and open source projects lead to a heightened ability to sense and respond to changes in the real world rather than having less control it.
However, it only monitors news media outlets and lacks a complete open source component (where anyone can contribute to it at any time). As part of the kick-off activities during National Influenza Vaccination Week, immunizations for the Y-Flu began in Whyville on November 22nd with 1,644 vaccinations on the first day and over 10,000 by the end of the first week - just as the flu was being ‘released’ on the 30th [click on image to enlarge]. Two flu experts discussed the recommendations for who should get a flu shot and some of the communication lessons learned from audience research and experience in previous 'flu vaccination' campaigns. As one of the attendees said during the webinar: Bloggers can provide more in-depth information [about the flu and vaccinations] than PSAs. This year, the TIME editors believe that the people who create and share content - blogs, photos, podcasts and video, whether they be informational, newsworthy, entertaining or simply as Grant McCracken has put it 'the raw feed of contemporary culture' - are the true heroes (my parents will be SO proud!). It's about the cosmic compendium of knowledge Wikipedia and the million-channel people's network YouTube and the online metropolis MySpace.
In the Sunday NYT Magazine (free registration required), Clive Thompson reports on how the US intelligence community has been incorporating blogs and wikis into the way they do business. For the intelligence agencies to benefit from “social software,” he said, they need to persuade thousands of employees to begin blogging and creating wikis all at once. The resistance comes from the “iron majors” — career officers who occupy the enormous middle bureaucracy of the spy agencies.
But also remember that it is a diffusion of innovations process in an organizational setting. Note: NO significant differences among age groups until 65, NO significant differences among educational levels, and NO significant differences among household incomes.
Focus on developing and delivering content that allows people to participate when and where they can at their convenience.
Every major presentation made at your organization or institution, especially by outside experts, should be a podcast that any employee (and us interested 'outsiders') can listen to and appreciate later (if you invite us in).
Finally, the YouTube site features several videos on recycling - I like the Tag Recycle Commercial. People are presented with choices, such as who to share the site with and what kind of look it will have.Ning has built templates for hosting discussions and sharing music, photos and videos. They indicate what conditions those treatments were for, whether they were effective and provide a narrative about the experience.

The section on treatments where people comment and rate the effectiveness of their therapy is also sure to raise some interest. Yes, people have their own experiences with health conditions they should be able to share with interested others.
An additional mark of quality which should be present in a Web site relates to the site’s accessibility by all users. In this post she has pictures of their presence in SL and interviews CDC's John Anderton and his avatar, Hygeia Philo. Hopefully this can serve as a call to other government agencies - Federal, state and local - to wake up to the music and learn to hum along. I'm also curious about what the ad policy will be - Geico is the corporate supporter for the effort and is featured on the home page.
This could be a good idea IF the opportunities for targeted advertising and 'education' are understood and protected.
From past reactions I have received on social media from people involved in both federal and state health programs, I was especially interested in the participants' reactions and comments during these 3 hours of presentations and discussion.
One participant who works in the substance abuse area talked about the difficulties they were having with pro-marijuana and drug use people hijacking their sites and messages, including on-going debates with editors of Wikipedia over the slant being given to some drug entries.
It was felt that this lack of expertise and experience on these review committees (whose members determine to a large extent whether grants are funded or not) may imperil opportunities to understand and best utilize these new media in health communications and behavior change efforts. I believe a shared feeling was that this type of cross-fertilization and exploration of new ideas had to become more commonplace at NIH. I don't believe we came to any conclusive next steps, but it appeared that everyone left with new ideas and an openness to exploring how they might harness the power of the concepts and technologies inherent in social media.
The nature of health care provider-patient communications and its relation to health outcomes has also received much attention in the health care literature. I have had two different conversations this week (and it's only Tuesday!) about this reaction and how to work with it. As I work with clients to develop their social media capabilities and expand their repertoire of social marketing capacity, I am very aware that in some corners of these organizations there are people who believe they are witnessing the rise of anarchy, or at least the wild, wild west.
Having an equal balance of the marketing and communication needs of the organization with those of the IT and legal beagles would be a nice touch too.
While they might appreciate the value of a good sound bite, they often have a difficult time relating to social marketing, and the notion of 'losing control' over communications with social media is frightening (they won't say that, but it is!). You can also intrigue your epidemiologist colleagues with the blue sky discussion of INSTEDD, the International System for Total Early Disease Detection, at Lunch Over IP and the 'what ifs?' of adding human inputs to these more automated systems.
It's about the many wresting power from the few and helping one another for nothing and how that will not only change the world, but also change the way the world changes. And that requires a cultural sea change: persuading analysts, who for years have survived by holding their cards tightly to their chests, to begin openly showing their hands online. They might find the idea of an empowered grass roots to be foolhardy; they might also worry that it threatens their turf.
Follow what we know about diffusion theory and you are likely to be much more successful and avoid a number of headaches along the way. One great value of these new media is that you do not have to expend a large amount of resources to reach everyone at one space and time any more; you can learn to aggregate listeners and viewers over time at very low incremental costs to your program. Any important internal meeting whether it be programmatic or administrative is a podcast for dissemination to others. But for those of you who want to get some ideas about how a blog might work to support a social marketing program, they have one up and going this month as well. That information is then aggregated by condition and treatment - so it’s easy to see what a large number of people have done in response to a condition or what it’s really like to undergo a certain treatment. Will the government and voluntary health agencies engaged in places like SecondLife be as attracted to participating in this community? Contents of the site should be presented in a way that it can be used by people with disabilities and with low-end technology. Teens spend even more time online, increasing 27 percent from an average of 21 hours and 4 minutes in September 2003 to 26 hours and 48 minutes in September of this year. We can expect the time kids spend online to increase along with expanded offerings on the Web and the growing network of their friends and family who use the Web frequently.”If your work touches kids or teens and you need another reason to visit social network sites.
The notions of transparency and audience-generated content as being realities of these new media were recognized and accepted by many people in the room, but moving from linear, one-way communication models to more networked models of communication is going to be as difficult for them as it is for many companies and agencies. Or is it going to be one on many (hundreds?) of voices competing for people's attention and trust? As one participant put it, the NIH is renowned for its curiosity and research into new ideas and approaches to health and disease; this attitude needs to be equally applied to issues in health communications, behavior and new media. How these social networks and interpersonal relationships actually influence health and medical outcomes is less well understood. Being a believer in the power of social learning and diffusion theories I think the answer lies in showcasing the innovators and coping models. For some of their perspectives see Mary Wehmeier's post at Hello Mary Lu and Enoch Choi at Tech Medicine. Interestingly, users with broadband access were not significantly more likely to download podcasts than internet users with dial-up connections (14% vs 10%). Building the transparency and trust for a successful social network site to operate in while protecting its users from unwanted health fraud, hoaxes and DTC advertising and promotions from many different types of marketers will be a ongoing and delicate balance to strike.
What does the trend of democratization of information portend for communications planning and health communications and social marketing programs? Then building the efficacy of the early adopters, weaving or reinforcing the links between different networks of practitioners and letting their WOM take over from there.
Monitoring this new environment (blogs, social network sites, Wikipedia) was also pointed to as a new task for these offices that would require attention.

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