So Who Else Caught the Brain Surgery on Twitter Today?

If you were on twitter today, you may have seen the hashtag #MHbrain.  That stood for Memorial Hermann-Texas Medical Center in Houston (@houstonhospital).  Today they live-tweeted a brain surgery which removed a cavernous angioma tumor from a 21-year-old female patient.

According to the hospital's press release, the goal of the "twittercast" was to (1) educate the public about brain tumors and (2) demystify brain surgery by giving a look inside an operating room.  The surgeon, Dr. Dong Kim, added "Someone may have a loved one who is considering a similar procedure and perhaps they can glean some information from this twittercast that may help them make a decision about whether surgery is the right choice for them."

In authentic social media style, the hospital did not just send out information and images. They also had another neurosurgeon, Dr. Scott Shepard, serve as an online moderator who could respond to questions and comments from twitter followers in real time.

While there was much excitement over this event today, it is not the first time we have heard about surgeons tweeting from the operating room.  Back in 2009, CNN picked up a story about surgeons at Henry Ford Hospital in Michigan tweeting the removal of a cancerous tumor from the kidney of a male patient.  Just last February, Memorial Hermann was in the news for the first live tweeted open heart surgery.

A few thoughts on this trend:

How is Memorial Hermann evaluating their twittercast efforts?  

• Was this a huge marketing event or do they actually have health education goals?
• Are they simply looking at the numbers?  For example, the number of twitter followers (up to 13,400 from 5,100 in the past 3 months).  Or the number of visitors to Storify, a site which archives both the heart and brain surgeries.
• Are the demographics of twitter users reflective of their target audience?
• I would hope that they are thinking about how to evaluate the goals they explicitly laid out in their press release.  How will they show that a twittercast can increase knowledge about brain tumors?  How will they show that the public or potential patients have less anxiety about the procedure or choose it more often?  As always, it is important to state goals (for any public health activity) that are measurable.  

How is social media a benefit/challenge for physicians?

• I read an interesting blog post recently called, "Why social media may not be worth it for doctors."  The author was concerned about already burned-out doctors trying to learn and make time for ever-changing technology...with no guarantee that the technology will give them "return on investment".  Do the challenges outweigh the benefits?
• If physicians view themselves as "educators", how much value could twitter bring?

Are there patient safety or confidentiality issues that should be considered?

• Although the patient's name was protected and she gave permission for the twittercast, is it possible that any confidential information could be accidentally shared during the event?
• Although safeguards are in place, errors do happen in the operating room and throughout the hospital.  With the additional staff/equipment (and possible distraction?) in the operating room to conduct the twittercast, could we face an increased risk of error?

What do you think?

Facebook Adds Organ Donation To Timeline: Should We "Like" It?

Typically, I post on Wednesdays.  However, with so much chatter about Facebook's announcement, this felt more timely.
Starting today, you can add your organ donation status to your Facebook timeline using the "share life" tool.  If you are already registered, you can share your story about where and why you decided to become an organ donor.  If you are interested in registering, you can follow links to official donor registries.

ABC has been a primary news source for this announcement, interviewing Facebook CEO Mark Zuckerberg, demonstrating how to use the "share life" tool, and discussing myths and facts about organ donation.

Scanning Facebook and Twitter today (especially among my public health colleagues), the response seems to be overwhelmingly positive.  From my perspective, the Facebook tool has the potential to be effective (i.e., increasing the number of registered donors) because it focuses on action.  The tool is not for education.  The tool actually links to registries so that you can sign up.  The tool aims to increase the visibility of already registered donors, which in turn will influence others to sign up.  The tool aims to decrease the stigma and secrecy of talking about end of life decisions by putting it right up there next to your birth date and relationship status.  This may also influence others to sign up.  In previous posts, I have written about public health campaigns that use social media in order to reduce the stigma around an "undesirable" topic (e.g., STD testing).

Although I am 100% supportive of the mission of increasing organ donors and am familiar with the dire need for donations (e.g., 18 people will die each day waiting for an organ), I have a few reservations about "share life":

In today's New York Times coverage of the Facebook announcement, I read a sentence that concerned me (I added the underlining):

"The company announced a plan on Tuesday morning to encourage everyone on Facebook to start advertising their donor status on their pages, along with their birth dates and schools — a move that it hopes will create peer pressure to nudge more people to add their names to the rolls of registered organ donors".

I consider declaration as an organ donor to be a medical decision.  In public health and medicine, we strive for patients and the public to make such decisions from a position that is informed and lacks pressure from physicians or family or friends.  Therefore, I have reservations about people signing up without educating themselves first and/or because they feel pressure on Facebook.  Just a few weeks ago, I posted about "hashtag activism" and how easy it has become to get involved in causes via social media.  Are we as thoughtful when we participate in causes on Facebook as when we participate in real life?

My other ongoing concern is regarding the proper security and use of personal information that is gathered by Facebook.  Will your organ donation status result in particular advertisements being sent your way?  I remember updating my Facebook status to "engaged" 4 years ago and being overwhelmed by the wedding planning advertisements on my page.  There is increasing public outcry regarding privacy settings and the personal information you enter being used for Facebook to attract advertisers and other business opportunities. 

Again, I am 100% supportive of the organ donation mission.  I think the reach of Facebook offers tremendous public health opportunities (including the possible elimination of long wait time for organs).  While that is an attractive outcome, we must always remember to focus on the ethics of the process as well.

What do you think?

•  Facebook has become directly involved with several public health issues (e.g., suicide, bullying, organ donation).  Are their strategies effective?  Why or why not? 
• Do you foresee any unintended consequences from the organ donation tool?
• Will you include your organ donation status on your Facebook timeline?  Why or why not?

 

"Hashtag Activism"- Is It Working For Public Health?

Last year on Facebook, my timeline was suddenly filled with status updates of just one word.  Red. Black. White.  "What is this?" I thought to myself.  It turned out that it was a breast cancer awareness campaign.  Facebook users were listing their bra colors to help prevent breast cancer.  And there are tons of these public health campaigns all over social networking sites.  "Like" our Facebook page to prevent cancer!  "Re tweet" this message to prevent heart disease!  For those of you familiar with my blog, you'll remember that I think "raising awareness" is the most counter-productive phrase used in our work.  It is not specific enough to measure for change and (on its own) it will not change health behaviors.  

So I thought of my frustration with these campaigns as I read a great article in the New York Times this week called, "Hashtag Activism, and Its Limits".  David Carr writes eloquently about the ease of supporting a variety of causes:

"If you “like” something, does that mean you care about it?  It’s an important distinction in an age when you can accumulate social currency on Facebook or Twitter just by hitting the “like” or “favorite” button.

The ongoing referendum on the Web often seems more like a kind of collective digital graffiti than a measure of engagement: I saw this thing, it spoke to me for at least one second, and here is my mark to prove it".

I like that David brings up the question of engagement here.  Many of these public health campaigns on social media just strive for "likes" on Facebook or "hits" on a website or "re tweets" on Twitter.  And not that they mean nothing, but those measures are just the tip of the iceberg in measuring audience engagement.  And audience engagement (beyond "raising awareness") is what could actually lead to public health activism, knowledge change, and ultimately behavior change. Leslie Lewis gives a great overview of Return on Engagement (ROE) on her blog "digital.good".  According to Leslie, ROE measures tend to be more qualitative and measure message reach and spread.  In addition to "likes", ROE also measures things like brand/campaign awareness, comments, shares, and returning visitors. 

I certainly do not think that all public health campaigns delivered via social media are ineffective.  On the contrary, I think that social media is an incredibly powerful tool for public health.  David Carr makes similar comments later in his article.  Challenging his initial skepticism of web activism, he lists several recent "campaigns" that have been quite effective (e.g., the reversal of Susan G. Komen de-funding Planned Parenthood).

However, to use social media effectively in public health, we must be strategic and we must evaluate.  

Some sample questions that I ask program planners:

• What is the goal of the campaign?  (e.g., to drive traffic to your website; increase hotline calls; increase specific behaviors like breast self examination?).
• How will the campaign activities (logically) lead to the desired goal/outcome?
• Are your goals/outcomes measurable?
• Have you thought about evaluation before launching the campaign?
• Besides the ideas listed above, how are you measuring "audience engagement"?

 
 What other questions should we be asking?

The Vaccine War: Public Health vs. The Media

A few weeks ago, I had the pleasure of speaking with Laurie Edwards, a writer and blogger who examines chronic illness, healthcare, life balance, public health history, and everything in between.  Among other topics, we talked about the role of social media and mainstream media in the vaccine debate.

So I thought of that conversation as I watched last night's re-run of PBS Frontline's special "The Vaccine War" (originally aired April 27, 2010).  I highly encourage advocates on both sides of the issue to check it out.

The piece was quite balanced with interviews on all sides.  For example, we heard from vaccine advocate Dr. Paul Offit, bioethicist Dr. Arthur Caplan, anti-vaccine advocate parents in Ashland, OR (with one of the lowest vaccine rates in the country),  Jenny McCarthy and her colleagues at Generation Rescue who continue to argue for evidence of the link between vaccines and autism, and from parents of a girl who almost died at 6 weeks from whooping cough.

It explored possible contributors to the fear of vaccines and/or the lowering vaccination rates:

• 1998 Lancet article by Dr. Andrew Wakefield that linked autism to childhood vaccines (*This article has since been retracted and MANY U.S. and International epidemiological studies have found no scientific evidence of a causal link)

• A new generation of parents that are too young to know the devastating effects of vaccine-preventable diseases like polio.  One interviewee used a term that I really like- "Community Recollection".  As Community Recollection of these diseases disappears, we can become complacent.

• A false sense of security because many of these diseases are not seen frequently in the United States.  However, we forget that with the ease of air travel, borders are almost non-existent.  For example, the piece followed an outbreak of measles in San Diego that started when a non-vaccinated 7 year old from the US contracted it while vacationing in Switzerland and brought it home to classmates.

• The Internet.  While it also offers many positive benefits regarding healthcare (e.g., access to information/publications; online support groups and connections with a "community" of individuals with similar diagnoses)- it also has its potential downfalls.
• It can keep controversy alive- even after it has been disproven (e.g., the Wakefield article)
• False or unproven information can go viral and it is hard to retract!  They use the example of the youtube video of Desiree Jennings (a 25 year-old Washington Redskins cheerleader) that claimed that a flu shot caused her debilitating muscle disorder.  

So how can Public Health compete with the Media and the Internet?

• Let's not compete.  Let's collaborate.  Let's learn (either through our own capacity or collaboration) to effectively communicate public health information online.  Our biggest audience (the public) is not usually reading our peer reviewed journals or attending our annual conferences.  This is already starting to happen.  Public health organizations have active Facebook and twitter accounts, blogs, videos.  Let's keep going.  And let's train our public health colleagues/students in health communication.

• Let's remember to share the spotlight with celebrities and other spokespeople that have influence over the public.  Like it or not, the way people get their health information and make decisions is changing.  They do not just agree with doctors or scientists.  I almost always see these debates featuring Public Health (scientist speaking in jargon) vs. Celebrity/Parent with moving emotional story about their child being injured by a vaccine.  That is hard to compete with!  Believe it or not (because we seem to only hear from Jenny McCarthy), there are also pro-vaccine celebrities.  Jennifer Garner and Kristi Yamaguchi have been flu vaccine advocates.  Jennifer Lopez and Keri Russell have been pertussis vaccine advocates.  Let's make sure the public knows that. 

• Let's think about the framing and marketing of vaccination messages.  When the HPV vaccine is framed as a Cancer Vaccine for both boys and girls...versus an STD Vaccine for just girls/young women it is perceived very differently by the public.

Tell me what you think:

• What can we do to change the current "Community Recollection" about vaccinations?
• Other suggestions regarding how public health can collaborate with the media/internet sites to communicate more effectively with the public?

Tumblr Contemplates A New Policy Against Self-Harm Blogs: Let's All Weigh In

Tumblr is a popular microblogging platform.  It lets you share anything from text to pictures to video.  According to their website, the average Tumblr user creates 14 original posts each month, and reblogs 3. The "reblog" button on all Tumblr posts allows a meme to spread rapidly across thousands of blogs with just one click.

As with other social media platforms, tumblr has an enormous reach (18,878,347,183 total posts as of the time of this blog).  Therefore, it has great potential to help and hurt the public's health as it facilitates communication among millions of people.

A few weeks ago, Tumblr presented to its users a challenge (and possible solution) regarding blogs that promote self-harm.  Their users are being asked to weigh in on the policy.  I think that is a smart move.

Here is an excerpt from the Tumblr staff blog: 

Our Content Policy has not, until now, prohibited blogs that actively promote self-harm. These typically take the form of blogs that glorify or promote anorexia, bulimia, and other eating disorders; self-mutilation; or suicide. These are messages and points of view that we strongly oppose, and don’t want to be hosting. The question for us has been whether it’s better to (a) prohibit them, as a statement against the very ideas of self-harm that they are advancing, or (b) permit them to stay up, accompanied by a public service warning that directs readers to helplines run by organizations like the National Eating Disorders Association.

We are planning to post a new, revised Content Policy in the very near future, and we’d like to ask for input from the Tumblr community on this issue.

The blog goes on to say that they currently think the right answer is to implement a policy against pro self-harm blogs.  They aim to focus only on blogs that actively glorify or promote these behaviors. They also intend to start showing public service announcements (PSAs) on specific search terms like "anorexic" or "thinsperation".  It is unclear from their post how this policy will actually be implemented.  It would take enormous staff resources to comprehensively review their site and remove concerning materials. 

Other online and social media platforms have struggled with similar issues regarding how to respond to users that may be searching for or posting worrisome content.  Here are a few examples of other challenges and solutions:

• When someone uses Google or Yahoo to search for the term "suicide", the link to the National Suicide Prevention Lifeline is provided as the first result.
• In December 2011, Facebook began a new service that allows "Friends" to report concerning posts.  Facebook then sends an email to the person who posted the suicidal comment encouraging them to call the hotline or click on a link to begin a confidential chat. Note that Facebook does not troll the site itself, but instead waits for reports to come in.  
• Pop Health has previously posted about the debate regarding Twitter's duty to restrict hate speech vs. its duty to promote free speech among its users.

From these examples, you can see that there have been a variety of approaches to address potentially unhealthy or unsafe posts on social media platforms.  Sites can decide to be inclusive of all posts, they can let users police each other and report concerns, they can post resources in response to keywords, they can actively prohibit certain content...or they can use some combination of these strategies.

• What strategy or combination of strategies is best for the public's health?  
• If users are prohibited from posting, does that make them more isolated and less likely to connect to services?
• Should the overall health of the user group outweigh the health of that individual?

Tumblr is encouraging users to weigh in on their plan...so I ask you to both comment here and contact them at policy@tumblr.com. 

Rainn Wilson Apologizes for "Poorly Conceived Date-Rape Joke": What Would RAINN Think?

When I saw a twitter headline today that read, "Rainn Wilson Apologizes for "Poorly Conceived Date-Rape Joke", I first thought, "Is there ever a well conceived date-rape joke?"  Next I thought, "Well- that's certainly a coincidence."

The coincidence being that the other RAINN (Rape, Abuse, and Incest National Network) plays an important roll in calling out celebrities (and educating them) regarding the consequences of throwing around the term "rape".  The misuse of the term seems to be hitting epidemic proportions lately:

•   In June 2010, "Twilight" actress Kristen Stewart compared the constant scrutiny that she receives from the paparazzi to a woman being raped.  "What you don't see are the cameras shoved in my face and the bizarre intrusive questions being asked, or the people falling over themselves, screaming and taunting to get a reaction," she said of the constant paparazzi crush. "The photos are so ... I feel like I'm looking at someone being raped. A lot of the time I can't handle it. It's f---ed. I never expected that this would be my life." Stewart later apologized.  

•  In October 2011, actor Johnny Depp compared having his picture taken to being raped.  “You just feel like you’re being raped somehow. Raped. The whole thing,” he told Vanity Fair. “It feels like a kind of weird—just weird, man… Whenever you have a photo shoot or something like that, it’s like – you just feel dumb. It’s just so stupid.”  Depp later apologized.

• In November 2011, "Jersey Shore" cast mate Vinny released a song about raping strippers.  I will not repeat the lyrics here.  Vinny later apologized.

• In January 2012, actress Kim Novak took out an ad in Variety magazine to declare that she felt raped by the makers of the Oscar nominated film "The Artist" because the film used a score from one of her old movies.  The difference here:  Novak's team is not apologizing. 

Whether we like it or not, celebrities influence social norms.  When celebrities use the term "rape" as a joke or to describe their dislike of having their picture taken or their work borrowed, it cheapens what it really means.  It is meant to describe a violent act against women, men, and children...and it is a serious public health issue.  As with any public health issue, it is influenced at multiple levels (individual, interpersonal, community, society). The language we use everyday (whether to friends, family, co-workers, twitter followers, facebook friends) impacts our society on every level.  So think about the words that you choose and do your part to change the conversation.  

National Sexual Assault Hotline:  1-800-656-HOPE (4673)

Chris Brown's Return to the Grammys: The Other Public Health Story

Sunday's Grammys were a mixture of high and low notes (pun intended), as the joy was often overshadowed by the death of Whitney Houston.  As someone who grew up in the 80's singing her songs, I too was quite shocked and saddened.  Despite broad speculation of an overdose, I'll wait to post on Whitney until we have a confirmed cause of death.

However, there was a second public health story on Sunday night.  It was the three year anniversary of Chris Brown assaulting Rihanna...and he made his return to the stage.  While Grammy executive producer Ken Ehrlich has defended the decision to bring Brown back and believes that he deserves a second chance, the warm sentiment was certainly not felt by all.  I personally turned the TV off when he began his performance.  My facebook and twitter feed blew up with comments from friends and colleagues like, "I'm no math wiz, but I'm pretty sure domestic abuser + 2 years= still a domestic abuser".  Many celebrities (both Grammy attendees and beyond) voiced the same sentiments on twitter.  For example, Wil Wheaton said simply, "everyone who apparently forgot what Chris Brown did to Rihanna should read the police report on exactly what he did."

Do you think that Chris Brown was worthy of a second chance at the Grammys? 

In addition to a discussion of giving second chances, remembering, or forgetting what he did...we must also discuss those who actually encourage what he did.  While there were outraged tweets during his performance, there were also those providing support.  The tweets that I found most disturbing were those from young women poking fun at the assault and saying that they would be happy to have it happen to them anytime.  For example, one woman said, "chris brown could beat me all he wants, he is flawless."

One of the biggest problems in our society is that we have a culture of violence where intimate partner violence is acceptable and abusers are not held responsible for their actions.     

What do you think we can do to stop the culture of violence?

In my opinion, Chris Brown is still the same angry and aggressive person that he was 3 years ago.  For example, instead of rising above and ignoring any negativity, he continues to lash out.  He took to his twitter after the ceremony to address his "haters".  He said, "HATE ALL YOU WANT BECUZ I GOT A GRAMMY Now! That's the ultimate F*** OFF!"  The tweet has since been deleted and he tried again with a slightly less offensive message.  But I don't buy it.  

For those of you interested in a more in-depth analysis of the original media coverage of the assault, I'll offer a publication.  This article was written by some fantastic colleagues at Boston University School of Public Health:

Rothman, EF, Nageswaran, A, Johnson RM, Adams, KM, Scrivens, J, Baughman, A. (in press).  U.S. tabloid magazine coverage of a celebrity dating abuse incident: Rihanna and Chris Brown.  Journal of Health Communication. Available online ahead of print.

If you or someone you know needs help, please call the National Domestic Violence Hotline at:  1-800-799-SAFE (7233)

Anti-vaccine ads on Delta planes; Magic and Ellen as celebrity champions for HIV/AIDS prevention...and more- What Am I Reading This Week?

New pop culture and public health stories to check out this week:

1. Darrell Hammond of Saturday Night Live fame reveals that child abuse led to alcohol/drug use and cutting. He details the horrific abuse in a new memoir, "God, If You're Not Up There, I'm F*cked".

2. Fellow Boston University School of Public Health alum Elizabeth Cohen reports on the 20th anniversary of Magic Johnson's announcement that he is HIV positive. His announcement had an incredible impact on the public's health- both in terms of reducing stigma of those diagnosed and proving that the diagnosis is not always a death sentence.

3. Delta airlines is seeing backlash from public health organizations and other flu vaccine advocates after airing a 3-minute PSA from the National Vaccine Information Center that describes alternate ways to avoid the flu (besides getting the flu shot).

4. Ellen DeGeneres is named global envoy for AIDS awareness. The hope is that Ellen's enormous platform (from both her TV show and social media channels) will allow her to reach millions of people with the prevention message. Ellen is a partner in other important public health issues, for example- bullying prevention.

5. This week, Evelyn Lauder passed away from Ovarian Cancer. Evelyn was one of the powers behind the creation of the pink ribbon campaign for breast cancer awareness.

How about you? What are you reading this week?

Miami Dolphin Brandon Marshall's New PSA for Borderline Personality Disorder

In July 2011, Brandon Marshall revealed that he was diagnosed with Borderline Personality Disorder (BPD). According to the National Education Alliance for Borderline Personality Disorder, this serious mental illness centers on the inability to manage emotions effectively. The condition which has strong heritability (68%) and a high suicide rate (10% of adults with BPD die by suicide), produces symptoms such as impulsivity, anger, and chaotic relationships.

When Brandon announced his condition this summer, he vowed to become the face of borderline personality disorder. He seems to be following through on his promise, as he has just released a public service announcement (PSA) in collaboration with the National Education Alliance for Borderline Personality Disorder. The 33-second video is primarily focused on 3 key messages:

1. Prevalence of this condition is high (15 million Americans)
2. There is hope (treatment exists for those who suffer and education exists for families coping with the disorder)
3. There are resources: visit the NEABPD website or follow Brandon on Twitter (@BMarshall19) for more information

I like the PSA for several reasons. It is simple with clear messages (above). The messages are delivered both verbally by Brandon and visually with key words appearing on the screen. The "call to action" is clear. Viewers are directed to the NEABPD website and Brandon's Twitter feed for more information.

I also like that this particular health issue has found a champion or spokesperson. Unlike other mental health conditions like depression with several celebrity spokespeople (e.g., Brooke Shields), less is known about BPD and those who suffer from it. Experts in mental illness stigma like Patrick Corrigan state that there are several strategies for reducing stigma...and one of those strategies is called "Contact". Contact challenges public attitudes about mental illness through direct interactions with persons who have these disorders. The contact does not have to be face to face, but instead can occur through a channel like a PSA.

The strategies that I see for improving this PSA are focused less on its composition, but instead on its distribution/promotion. Although the video has been on YouTube for 6 days, it only has 309 views. Announcements about the PSA are located primarily on football blogs (e.g., Shut Down Corner) or BPD specific websites. It does not seem that the PSA has been picked up by mainstream media or health blogs. This is in sharp contrast to PSAs I've spoken about previously on Pop Health, like in July 2011 when I discussed Kim Kardashian's ovarian cancer research spot which currently has 33,431 views.

Readers- please weigh in: which mental health advocacy organizations would have the best "reach" in promoting this PSA? What other strategies could they use for distribution/promotion?

Pink Fatigue? JCPenney's Sexist Merchandise. Smoking and its Box Office Impact. What Am I Reading This Week?

Here are the top 5 stories I'm following this week:

1. Amid breast cancer month- Is there pink fatigue? A very important public health story. "Awareness" does not equal behavior change (e.g., increased screenings or access to medical care). A related story appeared last week in Upstream: A forum on interdisciplinary health communication.

2. JCPenney CEO responds to petition to stop selling sexist clothing marketed to young girls like "I'm too pretty to do homework". The company is using this incident as a "teachable moment".

3. The use of social media in street protests can be effective for both protesters and police. A story in ScienceDaily.

4. Smoking is a drag at the box office. An analysis of top-grossing movies from the past decade shows that films with smoking make less money.

5. Video game can reduce fatigue in African American women with lupus. A pilot study to explore using Wii Fit to reduce fatigue.

What are you reading this week?

#NoHomos on Twitter, "50/50" looks at Cancer, Johnny Depp's Rape Comments, Chris Christie's Weight, and Steve Jobs: What Am I Reading This Week?

Whew- it has been a busy week for Pop Health! Here are the top 5 stories I've been reading:

1. Twitter is no place for #NoHomo: Should Twitter take a more proactive stance regarding hate speech that can result in trending topics?

2. "50/50"- A Hollywood movie takes on cancer: Cancer has been a theme in many movies (e.g., "Funny People") and TV shows (e.g., "The big C" on showtime)- how does this movie compare?

3. Johnny Depp offers apology for rape remarks: Depp offers an apology for comparing being chased by paparazzi to being raped. Forgivable?

4. Chris Christie's Weight- Big problem or none of our business?: Although Gov Christie has recently announced that he will not run for President in 2012, the conversation continues about his weight and its influence on his ability to be a successful Governor or President. What do you think?

5. Steve Jobs and Pancreatic Cancer: There have been many stories about the death of Steve Jobs and the contribution of pancreatic cancer to his passing. I thought Celebrity Diagnosis did a nice job of guiding readers through his diagnosis.

Please use the comment box to tell me what you think about these stories and about others that you are reading this week!

(Dis)Connected: MTV Explores the Impact of Digital Drama on the Health and Safety of Young People

On Sunday October 10, 2011, MTV will premiere "(Dis)Connected". The movie will explore the experiences of four young people. They have never met in-person, but their lives collide online and are forever changed by their digital interactions.

The film supports the network's "A Thin Line" campaign which empowers youth to stand up against digital abuse of all kinds (e.g., bullying, discrimination, etc).

The movie is inspired (in part) by the tragic death of Abraham Biggs in 2008. Biggs, a 19-year old college student, live streamed his suicide on the internet, with some users egging him on and some trying to talk him out of it.

(Dis)Connected supports an ongoing discussion in public health regarding the question: "Does technology help us or hurt us when it comes to issues such as bullying or suicide?" The answer is not clear. There are examples on each side. One year ago today, I wrote the post "Bullying: Is Technology Helping Us or Hurting Us?" The post was inspired by the dialogue of how technology may have contributed to the suicide of Tyler Clementi but also how it was being used in a positive way to prevent bullying in the aftermath (e.g., the "It Gets Better" project).

On her blog "Promoting Hope, Preventing Suicide", Elana Premack Sandler writes about research and advice for preventing teen and adult suicide. Just in the past year, she has extensively explored the issue of technology/social media and its impact on suicide prevention. Some example posts include: Facebook Support Networks (September 21); YouTube Prevents Suicide? (May 4); and Promoting Hope Through Social Media (April 13).

Let's all check out (Dis)Connected on October 10 and let the dialogue continue.

If you or someone you know is in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK or visit their website here.

Kim Kardashian is a Spokesperson (Again) for a Public Health Issue...Will the Public Buy In This Time?

This afternoon I saw a tweet from Kim Kardashian that read "Recognizing Ovarian Cancer is the 1st step in fighting Ovarian Cancer- please watch and share this video". So my first thought was- "I wonder if this campaign will be more successful than her last?" As you may remember, in December 2010 I blogged about Kim and other celebrities that staged their digital deaths in order to raise money for World AIDS Day. In addition to my concerns about the campaign's design (which included a less than clear cue to action for the audience), its "success" was also questionable because it ended up taking much longer than intended to reach their 1 million dollar goal. So I was quite intrigued to view Kim's newest PSA on YouTube.

The event called "Super Saturday Live" is a collaboration between QVC and the Ovarian Cancer Research Fund (OCRF). On Saturday, July 30, 2011- designer clothes sold on QVC will be 50% off and the net proceeds will be given to OCRF. The PSA informs the audience that this money is necessary because there is currently no good early detection test for ovarian cancer.

I was pleasantly surprised by the PSA. It didn't feel too long (94 seconds). It kept my interest with minimal and appropriate statistics. For example, instead of scaring the audience, the music was upbeat and focused on the positive- a 92% 5-year survival rate when the cancer is detected early. The PSA also had information presented through both audio and visual channels. Finally (and most importantly)- as an audience member, I knew exactly what I was supposed to do. The cue to action was clear. I was to share the video- "like" it, post it, forward it. And finally, I should tweet about #supersaturday. This way the "trend" can get ahead of ovarian cancer.

In addition to the look and feel of the PSA, I think it is important to discuss the strength and popularity of the chosen spokesperson. Just as I mentioned in December, Kim Kardashian is an obvious choice if you are looking for a huge reach. As of tonight, she had 8,380,553 followers on twitter. The PSA already had 5,965 views on YouTube. However, I have my concerns about her genuine interest in this public health issue. Does she have a personal connection or does she just jump on the bandwagon (like in December) for any way to promote her "brand"? I ask because I have concerns due to how she behaves on her E! show- Keeping Up with the Kardashians. For example, just a few weeks ago on the show, Kim had her butt x-rayed to "prove to the media" that it was real (without butt implants). I watched this episode while on the elliptical machine at the gym and felt enraged. First of all, what type of terrible physician allows his time and resources to be taken up with such nonsense? Also, what type of terrible physician agrees to expose Kim, his patient, to needless radiation to help her prove this point? And how much extra time does she (and her sisters) have on their hands to participate in this silly trip to the doctor? If I were the Executive Director of OCRF, even with her extensive popularity, I doubt that I would choose her for a spokesperson.

So let's all check out Twitter on Saturday, July 30th...let's see if #supersaturday is trending and if Kim's "quantity" of followers can help balance out her sometimes lack of "quality" as a spokesperson.

"Friends Don't Let Friends Drive Drunk": How Soon is too Soon to Find the Teachable Moment in the Death of Ryan Dunn?

"Friends Don't Let Friends Drive Drunk". A memorable tag line from the 1990s, found in many drunk driving prevention public service announcements (PSAs).

Early Monday morning, June 20, 2011, Ryan Dunn and a passenger were killed in a car accident in Pennsylvania. Ryan appeared in all three seasons of "Jackass" on MTV, as well as their movies.

Shortly after the news of Ryan's death broke (along with preliminary reports of speeding and photos of him drinking at the bar hours before the accident), Roger Ebert tweeted "Friends Don't Let Jackasses Drink and Drive". Although Roger did not "intend to be cruel"- he "intended to be true", there was a lot of backlash to his play on the old PSA tagline. Ryan's friends and colleagues from "Jackass" tweeted their anger in response and popular celebrity blogger Perez Hilton posted that Roger responded insensitively to Ryan's death. All felt that it was too soon to hold Ryan up as an example of the dangers of drinking and driving.

So the question I pose is: How soon is too soon to capitalize on a "teachable moment"?

Teachable moments are important in public health. They let us identify a time when our audiences will be more open to prevention education/intervention because they will see its relevance to their lives. Often the identification and sustainability of teachable moments are supported by media reports on the health/lives of celebrities.

As this week has moved along, more information has been released about the accident that killed Ryan Dunn and his passenger. His alcohol level was approximately twice the legal limit in Pennsylvania (0.196%) and he was traveling at a very high rate of speed (estimated at 132-140 mph) at the time of collision. Therefore, there is clearly a lesson to be learned here- about speeding and about drinking and driving. But much of these lessons our audience already knows. If you drink and drive- you could die (and/or kill someone else). If you speed- you could die (and/or kill someone else).

So maybe the lessons have to be broader. Apparently Ryan had a history of speeding and driving under the influence. These factors put him at risk. What could he, his friends, his family, the courts, the bar done to prevent this tragedy? What about the bystanders? His friends at the bar...employees at the bar...his friend who ultimately got into the car...could someone have stopped him from driving? What are the lessons you find in this story and how/when should they be communicated?

The Role of Social Media in Emergency Preparedness and Recovery

Last month I attended a presentation about a research study which evaluated the content of State-level emergency preparedness websites. The reviewers were looking for the presence of essential components such as clear contact information and links to federal emergency preparedness resources. I raised my hand and asked, "Are you evaluating these websites/organizations for a social media presence?" I used the example of the most recent Philadelphia "emergency" I encountered, 15 inches of snow. I did not go onto the city's emergency management website for information. I follow NBCPhiladelphia and SEPTA (the city's mass transit system) on Twitter. So I looked at my phone to find out what offices were closed and which buses/trains were running or cancelled. As always the key question remains, how does your target population get their information? What systems will still be working in an emergency (e.g., what if you lose electricity or internet?)

Since last Friday, we have all been watching the sad and heartwrenching images from the earthquake and tsunami in Japan. And you may wonder, with so much of the country affected, how will people make contact with their loved ones and how will the government get critical information out quickly? This morning, Mashable ran an article called, "Social Media Plays Vital Role in Reconnecting Japan Quake Victims with Loved Ones". While the earthquake knocked out electricity, the internet remained largely intact. The US Embassy in Tokyo is trying to take advantage of this fact and is encouraging Americans in Japan to contact their loved ones via text message and social media (i.e., Facebook and Twitter). Facebook and Twitter analytics from the day of earthquake show incredibly high usage.

A recent post on the Federal Emergency Management Agency (FEMA) blog discusses how social media is being considered as a key element in emergency preparedness. FEMA administrator Craig Fugate discusses a January 2011 planning meeting in which he met with the founder of Craigslist and editors from Wired, Twitter, Apple, and Facebook. He reports that they discussed:

• "The need to provide information to the public as data feeds, because they are a key member of our emergency management team"
• "The importance of referring to people impacted by a disaster as survivors and utilizing them as a resource"
• "The importance of providing good customer service"
• "How [emergency managers], need to stop trying to have the public fit into our way of doing things and receiving information, but that we should fit the way the public gets, receives and seeks out information"

It is great to hear that emergency managers are identifying social media as a powerful tool and planning how best to take advantage of it during an emergency.

Other online resources for making connections after a tragedy include:

Google Person Finder : This google service is used in the aftermath of such tragedies and allows users to click, "I am looking for someone" or "I have information about someone".

Red Cross Family Links: The purpose of this website is to help people get connected after being separated by disaster or conflict. Currently, there are links for Japan, Bosnia, Kosovo, Nepal, Iraq, and Somalia.