Introduction. During this presentation we will:



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Introduction The advancement of information technologies and the emergence of social media provide new opportunities for public health professionals. This session will explore the phenomena of social media and related web technologies, their application and the ways in which social media can enhance knowledge transfer and uptake for both the general public and within targeted population groups. During this presentation we will: Guide participants through an analysis of current research findings, including application to upstream determinants; Provide practical examples of how social media can be used in chronic disease programming within public health to maximize the uptake of information, and respond to changing needs in a timely fashion; Review opportunities to use new technologies in program design, engagement, implementation, monitoring and evaluating program effectiveness. 2

Characteristics of Web 2.0 User-generated / driven (broadly democratic) information platforms Collaborative Interactive Rapid and low cost dissemination Repurposing/mashing up

How plugged in are You? Q. What social media do you use: A. YouTube B. Facebook C. Wikis D. Twitter E. Other F. None 5

How plugged in are You? Q. Which social media do you use every day? A. YouTube B. Facebook C. Wikis D. Twitter E. Other F. None 6

How plugged in are You? Q. Do you include social media in your health communication strategies / campaigns? A. Yes B. No C. Plans to in the future 7

Should we take this seriously? Web 2.0 caters to the millennial generation Born between 1981-1993 US largest generation since Boomers 38% non-white Wired and collaborative Expected to have huge influence on society

Obama Web 2.0 Campaign website, which can be individually customized, includes supporter blogs, videos, local events, and a myriad of ways to contribute or participate. Obama has also emerged as a powerful presence on social networking sites. The official Obama Facebook support page has more than 300,000 supporters similar presence on MySpace, where the campaign has nearly 250,000 MySpace friends, and on YouTube, where the Obama channel has been viewed nearly 12 million times (and this video has been viewed over a million times in two days). Michael Geist

Presumed Utility of Social Media Aid consumers to: Seek out health information Experiential components ( practice being a patient ) Consumers can form their own path (information they want in the form they wish to access it) Share information & health experiences with peers (diaries, broadcast, repurpose info) Empower patients (self-manage; more informed; feedback tools; improve safety) Communicate & coordinate with diverse experts (continuity of care) Authority & Trust embedded in sharing and networking tools Virtual Witnessing

Anecdotal Stories of Harm

3 Social Media Case Studies All three examined immunization discourse and utility of platform for public health messaging: 2007 YouTube 2008 MySpace 2009/10 SecondLife

Original Production

Second Life

Virtual Worlds inside Second Life Our avatar experiences a mammogram in the virtual Ann Myers Medical Center (Left); experiences symptoms of Kaposi Sarcoma, an AIDs-related illness, from the University of Plymouth s Sexual Health SIM.

Anti-vaccinationism on the Web Recent studies examining the quality of information about immunization on the world wide web found that search engines returned a high percentage of websites that promoted viewpoints that contradicted conventional medical opinion and advice

Our Findings Social media is being used by vaccine critics to share health experiences, provide a forum for people who share similar medical opinions, and to disseminate alternative medical viewpoints.

Challenges for Researchers Rapid evolution of platforms Clear objectives: Breaking into / steering existing health conversations v. putting stuff out there? Sampling techniques (representative v. networks) Traditional sampling techniques will soon be invalidated by a lack of common mass media Proprietary & closed environments (Facebook) Collaborations with appropriate CS specialists and consultants How to evaluate a successful campaign?

PublicInsite Presentation Overview The Age of Search, the Era of Intent & the River of Demand What the data tells us Everything is measurable Email is for adults Mobile is social, interstitial and local Public health is the platform The Web is the poll Ideas that spread, win. 24

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The competitive marketplace of ideas Paid results Organic results 26

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Insight into intent and need 29

Sources of traffic to GoC web sites n = 120.6 million visits 30

How important is branded search? * * weighted average based on the total number of visits n = 120.6 million visits 31

How important is the home page? n = 120.6 million visits 32

Trends among teens Q. What percentage of teens use email daily? 1. 8% 2. 16% 3. 27% 4. 38%

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But it s not dead yet 37

Mobile is social 38

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Mobile use by time of day 40

H1N1 & Swine Flu Tweet volume 41

Search is social 42

Use of social media in health emergencies Q. What percentage of referred traffic to the Public Health Agency of Canada came from social media sites during the peak of the fall 2009 H1N1 crisis? 1. 5% 2. 9% 3. 12% 4. 20%

Traffic from social media sites 44

Social Media, H1N1 & PHAC 45

Expertise & peer conversations influence source credibility SEO! Traditional Corporate Digital Source: Edelman TrustBarometer, 2009 46

How not to do social media shiny Web 2.0 stuff a wookie or a blob 47

Public Health Online 1.0 Channel blindness Silo ed Reliance on experts Unsustainable systems and costs Tags (social bookmarks) RSS feeds XML data streams Podcasts, Videos Enabling technologies Social media Enterprise 2.0 prism Widgets Blogs Wikis Mash up tools Benefits Public Health Online 2.0 Highly findable & re usable content that is valued across client base Improved responsiveness Meet citizens wherever they are (any social network, any device) Resilient corporate knowledge Sustainable systems Unplanned collaborations Unintended positive outcomes Clear accountability Early warning via crowdsourcing Infrastructure Support systems Search Engine Optimization (SEO) Internal search management Web analytics Content mgt system (publish to mobile, XML, PDF, RSS, HTML, etc.) Structured data, open architectures Openness to APIs & Mash ups Buzz monitoring Robust policies & CA benevolence Management Internal processes Content value / authorship standards / audit trails Support for multiplatform distribution Learning organization / best practices / staff training Cost/outcome based investment strategies Executive level attention Constant incremental enhancement Evidence based management culture Content life cycle / archiving policies 48

Public health as the platform; chronic disease as the app Ideas that spread, win. Perceptions that persist, matter. 49

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Parting thoughts We cannot pave cowpaths Need a rethink of role in the information marketplace The platform is open & release content into the cloud Share expertise, crowdsource experience & capture knowledge The gulf between theory and practice will grow One thing to set up a YouTube channel or Facebook page, but quite another thing to launch and maintain vibrant, engaged, community and meet it s expectations Epidemiology in a mobile, location aware, searched based world Measure. Evaluate. Understand. Evolve. Systems to understand and coldly evaluate impact vs. effort

Introduction Explore the phenomena of social media and related web technologies Ways in which social media can enhance knowledge transfer 56

IsaiX Presentation Overview Integrating new technology and social media into knowledge exchange strategies for Chronic Disease Prevention Millennials: future opportunities to innovate our population health learning approaches 57

Health Information Much more needs to be known and shared about how best to use social media to achieve public health outcomes. Action research focused on learning by doing and sharing lessons among peers across the globe is vital. Source: What social media offers to health professionals and citizens, Bulletin of the World Health Organization, Volume 87, Number 8, August 2009

Social Media Users Q. What percentage of social network site users have one or more chronic disease(s)? 1. 5% 2. 13% 3. 18% 4. 25%

Internet Users with Chronic Disease According to Pew: one in four social media users have a chronic condition. (25%) Reference: Pew Internet Project tracking survey, December 2008 and September 2009

Public Health Agency of Canada Outreach and Engagement Mobile RSS feeds Twitter Microblogs Social networking sites (Facebook) Online videos (YouTube)

Public Health Outreach and Engagement Youth Health and Technology engagement forum March 2010, hosted by the Centre for Health Promotion of the Public Health Agency of Canada. 62

CDC Outreach and Engagement Mobile SMS text messaging for emergency updates Mobile-friendly web sites Users subscribe to 30+ RSS & Email updates on 100s of topics ecards allow others to propagate key messages easily Add a widget to your Web site or blog to share updates and data on important health topics Buttons for links from other sites to Social networking targeted info presence: Facebook MySpace Watch Director of the National Center Daily Strength for Health Marketing talk about CDC Caring Bridge social media Flickr 63

Chronic Disease: Sharing Advances 64

Who Needs to Collaborate More Urgently on Chronic Disease? Q. Collaboration on Chronic Disease Needs: A.Health Care Practitioners B.Researchers C.General Public D.People Affected E.Social Media Specialists 65

Integrated Approach to Chronic Disease 66

Sharing and Collaborating on Chronic Disease Prevention Evidence 67

Social Media Regarding Chronic Disease... The Future is here! 68

Next Big Advances in Social Media Q. In terms of priority, where should we first use social media with respect to chronic disease prevention and control: A. YouTube B. Facebook C. Wikis D. Twitter E. Other 69

Current Practical Examples Twitter: PHAC s CCDPC Heart Health initiative used twitter for sharing information and links on specific projects. Information aggregators: RSS (Real Simple Syndication) used for sharing information on the Canadian Best Practices Initiative

Tools We Can Easily Use Now Facebook, LinkedIn: Building professional networks. One or more of these could provide the platform for Learning Exchange Networks in the field of chronic disease prevention and control. Wiki: Following the success of GCPedia, use Wikis to privately and/or publicly share information on chronic disease, for example: Wiki for public health practitioners experimental projects Wiki for the public about fast facts on chronic disease 71

Mayo Clinic YouTube 72

Mayo Clinic YouTube 73

Mayo study direct link 74

Live Tweets During Operation In February, Henry Ford Hospital became one of the first hospitals to tweet a live procedure from an operating room. 75

Sunnybrook: Social Media Sunnybrook is extensively using social media and has a library of webcasts 76

Montreal Children s and Twitter 1,812 followers and more than 575 tweets

Helping Kids Share through Social Media

A New Generation: Challenges and Opportunities 79

The Impact of Millennials The reality is that, increasingly, the world around us is focused less on the achievements of individual experts, and more on collaboration between individuals and groups to solve complex problems Our culture code needs to be collaborative, transparent, outcomes-focused, mutually accountable, team-based, service-oriented and patient-centered. Darrell Kirch, M.D. President and CEO AAMC President s Address (American Association of Medical Colleges)

Some Important Characteristics Digital natives Read less Consume media Collaborative Social 81

In Conclusion New technology and social media is making its way into knowledge exchange strategies for chronic disease prevention, encouraging greater outreach and engagement. Canadians - younger and older - are engaging faster and easier through social media. Millennials are arriving and are coming on to the scene as practitioners and patients.

Discussion and Questions 83