Digital Influence Mapping Project

Social Networks Change Behavior

A Washington Post story covers a new study by Nicholas Christakis of Harvard Medical School and James Fowler at the University of California at San Diego published last week in the New England Journal of Medicine tracking the pattern of smoking - actually quitting smoking - through a social network. They are not refering to an online social network but rather to the more common offline network we all participate in - in this case one whose core focal point is geographic.

You can get the WaPo article here in its entirety.

Here are the interesting parts:

• Over the course of 30 years, the number of smokers in the network dropped from 45% to 21%
• Closer relationships (family, co-workers in small companies, etc..) had more influence and impact
• Yet a single person's quitting seemed to have an effect at least through 3 degrees of separation

There are two assumptions the article reports that I question:

1. The drop in smoking was probably the effect of a shift in 'social norms.'
No doubt. And 'social norms' have become a common lever in social marketing circles (behavior change). We hear it a lot from clients in the government trying to affect change. It has always been around but seems to have risen to the surface of many campaigns via the messaging - e.g. "most people form a driving contract with their teenagers...."

Think about smoking. I quit early in my twenties. When someone quits in your 'circle' you talk about it. It does not remain a secret. People ask what's up, how are you doing with it, how long has it been. The 'quitter' explains their irritability, the different programs they are trying, how long it's been. There is tons of conversation and word of mouth. The researchers previous study focused on obesity. While impolite to mention a ballooning weight, it is also visually obvious. Talking about it, if even in more hushed tones, is inevitable.

I would love to know how many conversations happened between network 'members' about smoking. What was the role of word of mouth?

2. The remaining smokers ended up on the fringes of society. The illustration "proves" this point. I have no doubt that the role of smokers in society has dramatically changed in 30 years. In fact in a recent post, I reported someone's observation that they had become the last true counterculture. They cluster outside office buildings in the scorching heat or bone-chilling cold in small groups to pound back a cigarette.

But are they really the outcasts the article and study suggest? What if you layer in all of the other social networks they may belong to: movie lovers, scifi enthusiasts, wine afficianados, Harley owners? The geographicly rooted social network is one dimension of a "n" dimension of affinity groups we all belong to formally or informally. While the smokers may become isolated in the original network, they may lead vibrant, connected lives across other social networks to which they 'belong.'

Using Social Networks for Social Marketing

The implications of the study on social marketers' use of social media and social networks is great. Can behavior change experts embrace the use of new digital networks to accelerate the spread of social norms and word of mouth? They will need to let go of some control - a lot of control - to do so but we may just find a way to produce behavior change in something under thirty years.

The report confirms the usefulness of engaging influential groups within a network:

"Moreover, medical and public health interventions to encourage people to quit smoking might be more cost-effective than initially supposed, since health improvements in one person might spread to others. Finally, the isolation of smokers within social networks suggests that blanket policy approaches (e.g., advertising and taxation) may be usefully supplemented by interventions targeting small groups."

Roll Up Your Sleeves

If you are interested in how social marketers will begin to use social media (don't get them confused), you shoudl check out Nedra Weinrich, is in town on June 2th to hold her 2.5 day Social Marketing University. This is more than Social Marketing 101. Nedra is a leader in defining how to harness digital innovations and social media for behavior change (social marketing). You can sign up for the regular course Next Generation Social Marketing Seminar on June 4th.

Her blog is Spare Change

WeMedia 08/Miami: Digital Health Empowerment

At WeMedia 08, Scott Mowbray from Health.com is talking with  Kendall Lockhart, Co-Founder, Nenuphar Mobile Media (and yoga practitioner - you had to be there for his intro) about what it means to empower people.

Ways of 'digital health' empowerment
1. Voting
2. Personal empowerment: during a prsonal health episode, it is critical to know what to ask for, what to demand from all of the health providers involved in your care

Social Marketing & Community
Kendall asks 'What if people don't want to change (e.g. lose weight)'
I would throw back - "what about transtheoretical model of social marketing?" that and other models to describe what causes people to change is begging for the suport systems now possible through social networks/communites. In general there is too much emphasis on simple delivery of credible information (vs. building credible community).

Kendall: Is there more 'community' now?
Scott feels that we live in a one-brand (WebMD) world. We are at an early stage of development of alternative sources for credible information.
I would throw back - what about the vast array of LongTail patient affinity groups? Are we really headed towards a model of a handful of WebMD competitors or will it be long tail from here on in with patient affinity groups like those hosted by Inspire.com and PatientsliekMe?

GlaxoSmithKline Gets Social

GSK has launched a blog authored by their very own Steve Burton, VP of weight control for GSK consumer healthcare. (Thanks to Debbie Weil who posted and consulted on this).

Alliconnect just launched. The blog is in support of their alli, weight loss medication. The product site can be found here.  Before jumping to the blog, consider the product site with fairly active message boards. They are allowing lots of good discussion including this excerpt:

"If anyone is expecting a miracle drug in this product, you are NOT going to get it. The information on this product is so misleading. It says you can lose up to 50% more on this pill than dieting or exercising alone..."

But later on in that thread another poster (and others) share different POVs:

"I think that they mean following the alli plan will allow you to lose 50% more weight.  I noticed the problem also, but then realized that I would get the benefit of not absorbing all the fat AND be forced to eat a low fat (usually low calorie also) diet. I have a hard time overeating things that are low in fat because they usually not very interesting"

Allowing this type of open dialogue is a great step for a pharma. I believe it will pay off for them (the drug must be good, too.)

Alliconnect, the blog, is there to officially answer questions. They have a "legal stuff" blurb that goes like this:

"This blog is written by employees of GlaxoSmithKline Consumer Healthcare who are authorized to speak on behalf of the company. 

Our posts and answers to your comments reflect our company's point of view. They are based on the latest in science and what we've learned from talking to consumers.

When we offer personal points of views, or talk about our experience with alli, we'll make sure that's clear."

I particularly like that Steve Burton of GSK who authors the blog says that he used the product to lose 60 pounds and has kept it off for 3 years ( I guess that means he used the drug in clinical trials as it was just released). Here is a drug category that really requires the patient to play an extremely active role. GSK makes that clear and is offering some of the tools like discussion boards that can help.

This step forward into social media will be a huge leap for pharma. It is particularly valuable for this category but others will follow.

Event: Measuring Social Media in DC

On May 31st, top brands in DC will come together to share insights from measuring the perfomance of social media programs. We will be sharing real cases, real metrics, how we are demonstrating that social media can positively impact business. 

How Do You Measure the Success of Social Media?

As the second part of a 2-part series with Julie Perlmuttter's Web Manager's Roundtable, I will be presenting with Pierre Wielezynski, Communications Officer-Online Outreach - The World Bank. We will be hosting a group of Internet professionals from local businesses and organizations in a rapid fire review of how we are all masuring our social media programs.

We have presenters - 7 stories in 7 minutes (used to be 5x5) - who will each share a real case from their experience. In addition, many people have already taken the social media score so that we can compare notes.

• National Geographic
• The Nature Conservancy
• Library of Congress
• Humane Society
• EdWeek
• World Bank
• Ogilvy Public Realtions Worldwide

Here's the write up:

"No matter how new the world of social media is, business leaders must know the measurable benefits of getting involved. How can new strategies around blogs, search, wikis, social networks and new Web 2.0 services pay off for the organization? And what is the distinction between these digital strategies and the larger field of word-of-mouth marketing?

New and old models for measurement exist .There are measurement models from"simple" web metrics to the Net Promoter Score. A collection of promising monitoring services help collect useful data from the deluge. And can we measure "engagement" vs. impressions?

Blog "conversations" can be monitored for share-of-voice, tonality, brand mentions and more. Third party content supportive of your brand or issue can strengthen Google search results. Clever Web 2.0 applications allow you to create new, relevant services for customers and constituents engaging them deeper. And at the end of the day, we need to report success.

In this session, you will leave with practical answers for:

• What are the options for measuring the success of social media initiatives?
• What's in the works?
• What are some simple (low cost) things you can do to see what people are saying?
• What can you do now to benchmark, monitor and report performance of blogs, blog outreach, Web 2.0 applications?
• How can Word-of-mouth be measured?
• How can you assess the impact of your social media efforts when trying to influence policy?
• Where is that one page report the CEO/Director/President needs?"

Julie's Web Manager's Rountable is a great forum of top area executives running the Internet parts of their businesses. It pulls equally from government, non-profit and corporations. This session will be really interactive as we have this lively speed-presenting thing happening. We wanted to hear from a group of brands and put the "roundtable" back into WMRT.

You can track these events via justshowup.com (usually, our event isn't posted as of today, but we'll fix that.

Pandemic Flu Conversation is Exciting!

This week the United States Federal Government launched a group blog. The United States Department of Health and Human Services, the team that oversees CDC, NIH, CMS and other health organizations, has begun a discussion leading up to a summit meeting in DC on Pandemic Flu.

(disclosure: this is a client and something we worked on with them)

Michael O. Leavitt, the Secretary of HHS, kicked off the discussion. Each week a group of bloggers from different community sectors will blog on a topic that will then be framed up at the live summit. This morning features a post from Pierre Omidyar from Omidyar Networks (and founder of eBay).

Why is this exciting?

First, it takes commitment from the Secretary and the others in his organization to be willing to have this discussion out in the open. The ultimate goal is to get the country prepared for Pandemic Flu. It's important. But there is not a lot of history with the government using social media to host such a large discussion.

Second, look at the comments! Only 4 posts so far and one has 31 comments as of now. Clearly, this was a conversation waiting to happen in this way.

Third, this is also co-creation. These bloggers are coming together to co-create the agenda for the in-person meeting. They and many others will continue on to co-create other elements of a communications plan that will ultimately help all of us prepare for the all-to-real threat of pandemic flu.

Here is the blog:http://blog.pandemicflu.gov

Here is government information on pandemic flu: www.pandemicflu.gov

Social Marketing University in DC

Nedra Weinreich who has a great blog on social marketing also does training seminars. Most of the focus is on applying social media techniques to social marketing programs. Our team does a lot of social marketing - behavior change - mostly in the public health and driving spaces. So, I have a deep appreciation for what Nedra is doing to introduce a community driven by science most of the time to try and apply the techniques that truly amplify word of mouth.

You should check out her seminar. This one is happening in DC in March. Here is the skinny:

Social Marketing University

March 28-30, 2007

Cafritz Conference Center, George Washington University

800 21st Street, NW, Third Floor

Washington, DC

2007: Big Year for Social Media & Healthcare

Four things came together in healthcare and social media towards the end of 2006.

• A great phone conversation with Monique Levy from JupiterKagan
• My participation in the first Healthcare Blogging Summit
• My review of Steve Case's new online healthcare service, Revolution (review orthcoming)
• And my father's cancer treatment

Together, the impression is clear. 2007 will be a big year for consumers creating useful content to further their healthcare needs. Monique Levy, a researcher at JupiterKagan will be releasing some interesting research this January. She gave me a little preview and we discussed what some of the opportunities are for healthcare professionals to engage in a universe where peers are talking about issues, doctor and hsopital recommendations and treatments.

According to Monique/JupiterKagan

Of the people looking for health information online (65%), 41% are creating content; 69% are consuming and 32% are doing both. (look for her research soon and that will confirm the context I am remembering for these numbers).

Monique corrected me:

"- As many as 34 percent of online users said they connected to others or the content they created online about health and wellness issues using various types of peer-to-peer and social media in the last year.  Of these health connectors 69 percent are consuming content, 41 percent creating and 32 percent doing both."

The short story is that a ton of folks are creating content: either blogging or message-boarding about issues, treatments, hospitals & doctors.

The Healthcare Blogging Summit was the first in a series from Dmitriy Kruglyak. It felt like the healthcare bloggers were connecting offline for the first time. All povs were lumped together in one room (literally) - policy folks, marketing and business consultants, hospital CEOs, blogging doctors, and patient advocacy groups. Dmitri is rolling out more of these in 2007 (next one in Vegas) and the program will likely focus and get more sophisticated.

Revolution is in beta. They were nice enough to give me an account and I will be reviewing it this week. Fard has already provided a pretty good review.

Like some of my peers, my parents are struggling with new health issues. My dad (80) is undergoing radiation treatment for prostate cancer. Both the disease and the treatments have become common place. He will be getting a computer for the first time in his life in a few weeks ostensibly to share email with family members. But I am square in the bullseye of the generation using the Web to understand what choices he has (and what mine will be when my time comes).

What else will happen this year to advance social media in healthcare?

1. eons will really take off, my dad will become a member, and their most popular content will move from diets to health & wellness
2. a big pharmaceutical will announce a very pro-active social media "listening" program to better understand patients and share that with physicians. they will simultaneously announce a very pro-active adverse events reporting discipline
3. new Congress will revive healthcare reform "noise" (whether they accomplish anything is a whole different story)
4. expect some significant step forward in digital health records
5. consumer-driven healthcare as insurance providers define it will become more popular (i.e. consumers will prefer it and the benefits it brings)

healthcare, revolution, healthcare+blogging+summit, digital+influence, john+ bell

First Healthcare Blog Summit

Monday in DC was the first Healthcare Blogging Summit nestled into the much larger Consumer Health World event. This is Dmitriy Krugliyak's baby. He runs the Medical Blog Network which is both an aggregation of health-related bloggers and an attempt to bond them around common concerns related to the heavily regulated and sensitive world of healthcare.

He told me that they will hold 3 more of these next year bundled into larger events like this one. that's actually a great model and may do more for spreading the word than holding a little specialty event on blogging. 

I spoke on a panel that featured public health professionals, a CEO of a hospital system (who was very on-message about his "brand" - nice work), a communicator from March of Dimes who like me was a pre-bubble Internet professional.

Dr. Jay Berhardt from the CDC's Office of Health Marketing spoke about the small steps taken by his group with his blog. I actually blogged about this when he launched it and despite the few posts applaud his initiative. Small wins like this can be influential in an organization as large as the CDC.  Clearance is an issue. Every post is reviewed and scrutinized before posting - mostly for accuracy. He does write all his own material(never doubted that). Time is the biggest challenge. He did share about launching the CDC podcasts which are now available. (A neat resource within his team's site is a list of the public health/social marketing campaigns currently running at CDC.)

He also shared about an initiative to reach out to mombloggers regarding flu communications and actually allowing them to communicate directly with scientists. We do a lot of work with moms and mombloggers and this is a great idea. There is no reason the CDC couldn't form a group of moms online to help guide them on health communications that impact the family and then actually become ambassadors of that message. The question is will they ask them for that level of involvement or only look at them as messengers. 

Patricia Goldman from MOD shared about shareyourstory.org where they connect NICU (preemies) families into an active community. If you dive inside to the Parent to Parent boards there is a lot of posting activity. This is a great example of hosting a dialogue that really helps people (and was probably happening in some other, less powerful way).

Great stuff. More later.....

The CDC has a Blog! Sort of...

We often wrestle with just how to apply some of the new, new media "best practices" we employ on behalf of our commercial clients for our government clients. Blogs and other formats that invite people into a conversation mean letting go of some control. Generally, that "letting go" is a good thing - a demonstration of willingness on the part of an organization to really engage in a conversation and not rely on throwing messages over the transom to communicate.

In many cases, government teams within agencies struggle with layers of communication requirements: scientific fidelity, risk-aversion and sometimes the burden of a large bureaucracy.

Well, here's a case where there's a face out there: Dr. Jay Berhardt, the Director at the National Center for Health Marketing at the CDC has a blog. First of all, it's interesting that there is a National Center for Health Marketing at all. Here's how their mission reads:

"The mission of the National Center of Health Marketing is to protect and promote health and advance CDC’s goals through innovative health marketing programs, products, and services that are customer-centered, high-impact, and science-based.  NCHM helps define the future of health marketing within CDC, the federal sector and beyond."

Their definition for "health marketing" sounds very close to "social marketing" perhaps without the leading "behavior change" implicit in the latter. Still, I think we are talking about the same thing. I suspect that the Center is trying to aggregate best practices from within the Centers and NIH (they feature the NCI "Pink Book" in their Resource area).

It's great that they are putting a face on this initiative (see Dr. Jay's video). As for the blog, there is a single entry from July 15 so far. And a handful of comments from academic peers. The "comments" are actually a "mail-to" feature which is probably smart at the end of the day. Still, I am not sure wrapping this Web page in some of the trappings of a blog without the functions and openness is all that great. We will see how the blog unfolds overtime. And it is a start.

The Power of Angry Moms

We are deeply respectful of the power of moms in the new personal media space. We have been paying a lot of attention to how moms are using blogs and other personal media.

[tidbit: when we asked our panel of mombloggers about whether they used any of the message board-centric services such as ParentCenter/BabyCenter, they all seemed to have used message boards and in particular at least one of the two brand sites mentioned but all had stopped their message board activity in favor of blogging]

Take a look at the online efforts of Two Angry Moms. They are pretty much what their label suggests: two moms who are sick and tired of the unhealthy food choices in the public school system. They are actually creating an online documentary in installments. Here's how they describe the situation:

"Are you sick and tired of making your kids a brown bag lunch everyday because lunch at their school is unfit for human consumption? Do you feel guilty when your children “buy” instead of “bring”? Are you annoyed that the healthy school lunch you pack your kid is undermined by a barrage of birthday cupcakes, candy rewards, holiday treats and vending machine cuisine?"

The two women behind this are seasoned pros. Amy Kalafa is a TV poducer. Dr. Susan Rubin is, well, a doctor who has wrestled with food and nutrition issues in schools for years. While they must struggle with causing change from within the local school board/government system, they will develop a large grassroots following on the Web that will add power to their effort. The unfolding of the documentary in segments, as it is produced is a great way to keep people connected to the issue.