Leapfrogging: What Social Media Is Doing for Communicative Competence
Plain Talk in Complex TimesChristina Zarcadoolas, PhD
CUNY SPH at Hunter CollegeSept. 23 2011
Falling Through the Net…the Coming Digital Divide - 1990’s
• On July 28, 1998, NTIA – report on telephone and computer penetration rates.
• Finds, there is still a significant "digital divide" based on race, income, and other demographic characteristics in computers in homes.
• http://www.ntia.doc.gov/ntiahome/net2 National Telecommunications and Information Administration
Who had computers at home?
Who was online?
Divide – dis-equity
What a difference a new century makes.
Narrowing Digital Divide
National Center for Educational Statistics http://nces.ed.gov/
Household Broadband Use by Race/Ethnicity
Asian, NH White, NH Black, NH AI or AN, NH Hispanic0
10
20
30
40
50
60
70
80
9077.3%
68%
49.4% 48.3% 47.9%
Dept of Commerce 2010 Report(Slide courtesy of Vish Viswanath)
Technology is ever more powerful
• It’s growing EXPONENTIALLY – iPhone 1,2,3….• Technology is crowd- sourced• It gets cheaper - Hard drive was $3400 - now
$100 ( 10 megabyte)• It gets more personally “relevant” – we can
“quantify ourselves” : Fit Bit ; deCode Me • It’s in the common discourse and media –
People Talk About it - IBMs WATSON beats humans on Jeopardy
Technology growth
• Exponential - iPhone 1, 2, 3,4• 20,000 different apps for the iPhone today• You can pee on an S chip or check blood
glucose via mobile device• Yes – there’s an app for that. (See - TED talk - David Kraft, June 2011)
Web 2.0 Crowd Sourcing
Texting• 75% of teens have cell phones(up
45%/2004)• They send 50 - 100 text messages
a day • Nearly three quarters (73%) of
online teens and an equal number (72%) of young adults use social network sites.
Youth Media Diet – 12 hours
Source: 2009 Alloy College Explorer
Broad Band Use (2010)
• 69% of African Americans and 58 % of Hispanics now regularly use the Internet, compared with 79% of whites.
• Rate of broadband adoption in African American homes has risen to 59% from the 46 percent.
(Joint Commission for Political and Economic Studies, 2/25/10 National Minority Broadband Adoption: Comparative Trends in Adoption, Acceptance and Use, Joint Center's website at (www.jointcenter.org)
African-Americans and Hispanics leading the charge in growth of mobile.
• 46 % of non-Hispanic blacks and 51% of English-speaking Hispanics use their phones for internet access, compared with 33% of non-Hispanic white Americans. (poll not in Spanish language)
• “This is my laptop”
http://www.pewinternet.org/Reports/2010/Mobile-Access-2010.aspx
http://techcrunch.com/2008/07/11/nielsen-iphone-in-fourth-place-among-smartphones-first-in-customer-satisfaction-not-for-long/
Minorities have equal or greater usage on most major social media platforms
Social networking sites
Online video Twitter0
102030405060708090
Social media usage by race/ethnicity(% of Internet users)
WhiteBlackLatino
PEW Internet and American Life Project 2010 data
The communication technology revolution: rethinking health literacy
Web 2.0Informatics
eHealth
eHealth
• An emerging concept known as "eHealth" seeks to capitalize on the promise of new media technologies to facilitate equal access to timely and credible health information.
Web 2.0 communication: key measures
• Internet penetration (~69-75% adults1, 2) • Broadband adoption (~66%2) • Mobile technologies (~82% 2) • Social networking participation (23% of Internet
users1)• Health information seeking online (80% of Internet
users2)• Health-related Internet use3
1 Chou, WS et al. 2009. Social Media Use in the US: Implications for health communication, JMIR, 1(4): e48.2 Pew Internet and American Life Project3 Chou, WS et al. 2011. Health-related Internet Use among Cancer Survivors: Data from Health Information National Trends Survey, 2003-2008. J Cancer Survivorship.
Lower Use with Less Education
2338
14611461
391
0%
10%
20%
30%
40%
50%
60%
70%
80% Requested password
Logged on
College Grad/Post Grad
Some College High School/
GED
No High School Degree
0%
10%
20%
30%
40%
50%
60%
70%
80%
College Grad/Post Grad
Some College High School/GED No High School Degree
N=14,102
N=5671
Internet for health purposes
0
10
20
30
40
50
60HINTS 2008, N=998 Internet Users
16.423.3
8.1
52.0
Emailing Providers
Online Rx purchase
Support group participation
Internet as 1st source of health information
Chou, WS et al. 2011. Health-related Internet Use among Cancer Survivors: Data from Health Information National Trends Survey, 2003-2008. J Cancer Survivorship.
National Research Corp. survey: 1 in 5 Americans use social media websites as a source of health care information; 94% respondents reported having using social media to gather health information.
Facebook as 1st choice (94%) and YouTube second (32%).
Use of social media for health information
http://hcmg.nationalresearch.com/public/News.aspx?ID=9
% of Internet users
Reported having: Sample
22.97% Participated in a social networking site
N=1159
4.59% Participated in an online support group
N=232
7.06% Written in a blog N=356
Social media use among Internet users in 2008 (69% of US adult population)
• 250 million > users on facebook worldwide
There’s an app for that!
Users are driving the need for us to develop more usable (
readable/navigable/efficient/entertaining) health communication tools
What app?
Exercise, Nutrition, Smoking Cessation
Online blogging
Find my iPhone
Empowering Communities with Direct Access to Health Data: Patient use of Electronic
Medical Records
Christina Zarcadoolas, PhD, Wendy Vaughon, MPHWith Sara J. Czaja, PhD,
Maxine L. Rockoff, PhD, Joslyn Levy MPANIH R21 1 R21 CA133487-01A2
Common Themes Across Groups (a) • Consumers unanimously very interested in patient
accessible EMRs although most didn’t have access to one.
• Physical access to technology not a primary barrier. • Many participants accessed the internet wirelessly using
mobile technology.
“This is my laptop.” • High interest in lab/test results, but reviewing results,
posed unusually high reading and numeracy demands– “If I could read it and understand it [I would use it] … I
can’t understand it.”
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Common Themes Across Groups (b)
• Want health education specific to their condition in their records
• Want ‘just-in-time’ links to sources that use understandable language.– “Web MD … that thing is so hard … it
doesn’t really break it down where the average person can understand … some of the translation is in doctor terms … the average person that’s looking at it gets lost.”
34
Access empowers
“Information is power.”
“It all boils down to the same thing … a lot of people don’t take charge of their health because they don’t … remember to take care of themselves and a lot of times they don’t even know at what age they should be checking for what things.”
Common Themes Across Groups (c)
Categories of Barriers
User Characteristics:• Linguistic/reading• Confidence• Navigation• Active reasoning -
cognitive demands
Patient Portal:• Readability• Strategic repetition • Design • Navigability
36
Portal Example - Symbols
Patient Portal - Numeracy
Categories of Opportunities
• Target audience likes and uses social media tools – – Usable layouts– Easy navigation tools – Short, sound byte language – Mouseovers – the define and explain content– Wikis– Google searches – Voice overs– Streaming video – Etc.
Using social media – what is it teaching people?
• Immediacy • Crowdsourcing• Community • Empowerment• Leapfrogging over cumbersome vocabulary
and syntax
Approach to Communication
1. Use health literacy principles to develop content.
2. Use human factors engineering and user-centered design.
3. Use communication modalities and tools people are using in their daily lives.
4. Strive for shared decision making & empowerment
A Paradigm Shift
Past 20 years we’ve focused on identifying what people CAN’T DO
It’s time to focus on identifying what people CAN and ARE doing;
To Achieve -• Virtuous • Honest
• Inclusive Health Literacy