Friday, April 17, 2015

Health Awareness Days: Sufficient Evidence to Support the Craze? A New Commentary in AJPH

My regular readers know that I have some hesitations about campaigns that focus on "raising awareness". The phrase is vague and its definition often varies depending on who you ask.

So I'm excited to share that I recently published a new commentary on the topic with my colleague Dr. Jonathan Purtle at the Drexel University School of Public Health. "Health Awareness Days: Sufficient Evidence to Support the Craze?" was published by the American Journal of Public Health yesterday. Drexel University posted a great press release that summarizes the article and includes comments from us regarding recommendations and next steps.

I hope you will all read and share the commentary!

Thursday, April 16, 2015

Celebrity Moms Who Side With Science: Today on The Scientific Parent

I have recently joined The Scientific Parent as an Editor at Large. Today I'm talking pop health on the site with "Celebrity Moms Who Side With Science". I'm giving a shout out to celebrity moms who side with science and passionately advocate for vaccination. I also break down their messages to see how closely they align with the barriers we know stand between children and their vaccinations. Please join us there for the conversation!

Friday, April 10, 2015

"Unbreakable Kimmy Schmidt"…Comedy and Public Health?

Image credit: Netflix.com
Over the past year, I've enjoyed binge watching various TV shows after my son’s bedtime. I've been hooked on anything from old school Gilmore Girls to The Good Wife. My husband and I recently started watching Unbreakable Kimmy Schmidt on Netflix. We currently find ourselves 5 episodes into the series.

The show has a funny female lead and a great cast of supporting characters (reminiscent of Parks and Recreation)...so I think it can be easy to forget that we are watching a character who has just survived a serious trauma. In eighth grade, Kimmy Schmidt was kidnapped by the Reverend of a doomsday cult. She and several other women spent years hidden away in an underground bunker. In the pilot episode, the women are rescued from their bunker and Kimmy decides to start her life over in New York City.

In a recent essay for The New Yorker, Emily Nussbaum did an incredible job reviewing this show, discussing Kimmy’s resilience, and highlighting an increasing trend to portray sexual violence survivors on popular TV shows.

While the show is clearly a comedy, it still highlights several public health issues related to experiencing and surviving trauma. And these are important discussion points:

  • The “Right” Language: When I worked in rape crisis services, there was much discussion about the terms “victim” and “survivor”. We were encouraged to use the term “survivor” because it conveyed strength and hope. However, some people seeking services do not connect with that term initially (or ever). Therefore, it is important to ask people what terms they are comfortable with. There is no "one size fits all" in terms of how people label themselves afterwards and how much they do (or don't) want to discuss the experience or have it be a part of their lives going forward. We see this distinction in the very different approaches the bunker survivors take to moving on with their lives.
  • Posttraumatic Growth: The term posttraumatic growth, coined by Drs. Tedeschi and Calhoun, refers to the kinds of positive changes individuals experience in their struggles with trauma. These changes can include improved interpersonal relationships, exploring new possibilities for one's life, etc. This show is all about Kimmy's posttraumatic growth! If you look at the episode guide for the show, each episode explores a new experience for Kimmy (e.g., "Kimmy Gets A Job!" "Kimmy Goes To School!")

What Do You Think?

  • Does the show do an effective job of balancing comedy with real-life challenges for a trauma survivor? (i.e., re-entering the workforce, experiencing PTSD/flashbacks)
  • Is it possible that some trauma survivor organizations (or individuals) will be offended by the show for its comedic approach to such a serious subject? Why or why not?
  • How could the show integrate more effective public health messaging  for the aftermath of trauma? (e.g., "Kimmy Visits A Therapist!)

Friday, January 23, 2015

Should We Trust Similac's "The Mother'Hood"?

If any of you frequent parenting blogs, Facebook groups, or classes, you no doubt saw a link to Similac’s new video “The Mother’Hood”. Trust me- please watch…

I laughed (and cried) watching this video, because it is right on. My favorite line:
“Drug-free pool birth, dolphin assisted”.

In my 51 weeks of parenting so far (yes, my little guy will be 1 year old next week!), I have found the following issues to be HOT and often full of judgment in my circle of parenting groups:

  • Feeding- the early months (breastfeeding vs. formula feeding- or both!)
  • Feeding- the later months (purees vs. baby led weaning; organic food vs. regular food; how and when you introduced solid food)
  • Vaccination 
  • Stay at home vs. parents who work outside the home (and many parents, fall into both camps depending on the day!)
  • Car seats (how long you stay rear-facing; whether you use them on planes)
  • Cloth vs. disposable diapers (and other decisions which impact the environment)
  • Sleep practices (cribs vs. co-sleeping, crib bumpers, sleep training)
  • The type of childcare you select (day care center, in-home daycare, nanny, au pair) 

The list could go on and on….and these are just the hot topics I’ve found in the infant world!

The Mother’Hood Message: Why Does It Help?

The reality is that new parents can often feel very isolated and judged. This has many public health implications, especially for women at risk for postpartum depression. So for that reason, I like the primary message of the campaign which is that we should focus on the things that unite us, not divide us. At the end of the video, we read:

“No matter what our beliefs, we are parents first”.

And although the “cliques” (e.g., the bottle feeding group, the breast feeding group) are meant to show our separations…I also think it can mean that you will find others to spend time with who have a similar approach to parenthood that is compatible with yours. And that is reassuring.

This video is part of a larger campaign from Similac called “The Sisterhood of Motherhood”. The tag line for the campaign is, “Where moms get encouragement, not judgment”.

Can We Trust This Message From a Formula Company?

When I watched the video, I thought to myself- “makes sense this comes from Similac, their customers know a thing or two about being judged”. As I have previously written, it concerns me that public health has not found an effective way to promote breastfeeding without stigmatizing formula feeding.

So I was a little surprised to see (in social media and news article comments) that many viewers liked the video until they realized it came from Similac. Some expressed feelings that the message was less genuine since Similac stands to benefit financially when there is less public stigma about formula-feeding. One commenter wrote, “I was all for this, until I found out that it was created by Similac”.

Tell Me What You Think:

  • Does the fact that the video comes from a formula company make the message less meaningful or genuine? 
  • Why or why not?

And Can We Trust A Message That Forgot About Dads?

I was really excited to see Dads in the video! They were baby wearing and caring for their kids- it was great. They were even included in the tag line “No matter what our beliefs, we are parents first”…but in the next screenshot, we find out they were excluded from the campaign overall: “The Sisterhood of Motherhood”.

Many online commenters focused on this exclusion. Several asked, “Why not call it “The Parent’Hood”.

In my opinion, this is an unfortunate miss in an otherwise funny, relevant, and moving video. Why include Dads in the video just to exclude them at the end? What about families that have two fathers or a father who serves as the primary caregiver?

Tell Me What You Think:

  • Was the video and overall message ruined for you because fathers were excluded? 
  • Why do you think that the video and campaign developers made that decision? 
  • Do you think they regret it now?

Friday, January 9, 2015

Vaccination is a Work of Art


Vaccination is one of the most important issues we work on and champion in public health. This week we’re talking about nine confirmed cases of measles at Disneyland in California. We just had a measles scare locally in Philadelphia at the beloved Please Touch Museum. News that this year’s flu vaccine is less effective due to a mutated strain has started a public debate about the “worth” of the shot (spoiler alert: you should still get your flu shot!) And internationally, many health workers put their lives at risk every day to deliver vaccines that are so desperately needed.

Over the years, there have been many attempts to creatively and effectively communicate the value and safety of vaccines to key audiences (parents, health care workers, etc.) For example, efforts have included (1) incorporating themes from popular movies/TV shows (check out this Star Wars PSA from the 1970’s!), (2) engaging celebrities as champions, and (3) creating engaging documentaries. The newest effort comes from the Bill & Melinda Gates Foundation. Their campaign, “The Art of Saving a Life” tells the story of the past success and future promise of immunization using the talents of more than 30 world-renowned photographers, painters, sculptors, writers, filmmakers, and musicians. The goal of the campaign is to increase world-wide knowledge about the value of vaccines so that the Foundation (and partners) can build momentum and raise funds in their efforts to reach millions more with these life-saving inoculations.

A few of my favorite images in the campaign:


Campaign developers are hoping that the images will be widely shared and viewed, and inspire dialogue and donations. Since the campaign is targeted towards an international audience, I think primarily using images (vs. writing) will bridge countries, cultures, and literacy levels effectively. You can follow #vaccineswork on social media to participate in the discussion.

In terms of evaluating this campaign, I am assuming (and hoping) they will track:

  • Activity on social media that uses the campaign hashtag #vaccineswork. *One thing to note is that this hashtag is not unique to this campaign. So their staff may need to sort through what is directly sharing/discussing the campaign vs. general vaccine promoting communication to get a more accurate view of the hashtag’s usage.
  • How many people go on from their campaign website to visit the sites of partnering organizations listed on the bottom of each page (CDC, PATH, UNICEF, etc.) And how many of those people go on to take action on a partner site (i.e., make a donation, sign a petition, register to volunteer, etc.) 
  • Some type of qualitative feedback on the art pieces themselves. Overall, are these images more effective for communicating with an international audience? Were certain pieces more effective than others? If so, why were they more effective and with what audiences?

Tell me what you think:

  • What images/stories in the campaign do you find most interesting or inspiring?
  • What other outcomes besides those above should be evaluated?
  • What other campaigns have effectively used art work to communicate about a public health topic?


Friday, January 2, 2015

Searching for Mental Illness on Twitter: Data Jackpot or Ethical Minefield?

Just after Christmas, the New York Times published an article about the “Risks in using social media to spot signs of mental distress”. The piece detailed the failed launch of the application Samaritans Radar developed by the Samaritans, a well-known suicide prevention organization in Britain. The free app alerted users when someone they follow on Twitter wrote a worrisome post. For example, the app would detect phrases such as “tired of being alone” or “hate myself”. Soon after the launch, concerns were raised about the app identifying and targeting people who were already vulnerable. Several experts in the NY Times article also expressed concern about the app contributing to stigma, discrimination, and inaccurate diagnosis/labeling of people who may or may not actually have a mental illness. The app is currently disabled and the developers are working with partners to evaluate user concerns and test potential adaptations to the app.

While I agree with pulling the app to address privacy concerns, I was very surprised by the following quote which accompanied the NY Times article:

“If someone tweets ‘I’m going to kill myself,’ you can’t just jump in,” said Christophe Giraud-Carrier, a computer scientist at Brigham Young University who studies the role of social media in health surveillance. “There are all these psychological factors that come into play that may push someone over the edge.”

While I acknowledge that there are complex factors in suicide intervention, I worry that this statement discourages intervening online (or developing applications that could facilitate this intervention). A lot of suicide prevention work has focused on training community members (I would argue this includes your online community) to be active bystanders who intervene when they see someone at risk. For example, gatekeeper trainings are popular strategies which help participants to develop the knowledge, attitudes, and skills necessary to identify those at-risk for suicide, determine levels of risk, and make referrals when necessary. The National Suicide Prevention Lifeline provides guidance for helping online when someone might be suicidal. They also link to safety teams at each social media site, including Twitter.

From my review of the research and relevant articles, there seems to be an emerging line between using Twitter to gather anonymous, aggregate mental illness data and identifying and intervening with individual users. For example, researchers at Johns Hopkins University have had a very positive response to their research using Twitter to collect new data on post-traumatic stress disorder, depression, bipolar disorder, and seasonal affective disorder. The scholars emphasize that their findings do not disclose the names of people who publicly tweeted about their disorders. Their goal is to share timely prevalence data with treatment providers and public health officials.

Tell Me What You Think:

  • Do these two stories represent the boundaries of using Twitter to search for warning signs or symptoms of mental illness? In other words, is using Twitter to gather anonymous data sets the only way to use it ethically and safely? 
  • Or is there a way to overcome the privacy concerns to empower/enable/encourage users to intervene with their fellow users if necessary?

Monday, November 3, 2014

Research Notes: Spotlight on Social Media and Angelina Jolie (Again)


Here are the top public health and popular culture stories I'm reading this week:


Authors: Robin H. Juthe MPH, Amber Zaharchuk MBA & Catharine Wang PhD, MSc

Genetics in Medicine (2014) doi:10.1038/gim.2014.141
Published online October 23, 2014

The study found huge spikes in Internet traffic on selected National Cancer Institute (NCI) sites in the immediate aftermath of Angelina’s May 14, 2013 disclosure in the New York Times that she has a BRCA1 mutation and underwent a mastectomy. 

I first wrote about Angelina Jolie in May 2013 when she penned the op-ed. At the time I posed the following question to my readers, "What (other) public health implications could result from Angelina Jolie's disclosure in today's New York Times?" As you can imagine I'm thrilled to see that formal research was conducted to examine various outcomes that followed her writing. In a December 2013 Research Notes post, I highlighted another research study that surveyed the public to document their understanding, reactions, perceptions, and subsequent health-related actions following the media coverage of Angelina's story.


Authors: Jenine K Harris, PhD;  Sarah Moreland-Russell, PhD;  Bechara Choucair, MD;  Raed Mansour, MS;  Mackenzie Staub; Kendall Simmons

Journal of Medical Internet Research (JMIR) (2014)
DOI: 10.2196/jmir.3622
Published in Vol 16, No 10, online on October 16, 2014

Researchers analyzed a "Twitter Bomb"- more than 600 tweets in one week against the Chicago proposal regarding local regulation of electronic cigarettes. Most against the regulation were from outside the Chicago area, while Twitter users from Chicago were significantly more likely to tweet in support of the policy. About 14 percent of the tweets used an account or included elements consistent with “astroturfing,” a strategy used to promote a false sense of consensus. 

I highly recommend reading this innovative study, as its methods and findings can help public health organizations to anticipate, recognize, and respond to coordinated social media campaigns.

What are you reading this week?