NVAC l February 2020 l Day 2, Pt 2: Online Influence and Immunization Intentions
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NVAC l February 2020 l Day 2, Pt 2: Online Influence and Immunization Intentions


>>THANK YOU FOR YOUR PATIENCE.
NEXT PANEL IS ONLINE INFLUENCE AND IMMUNIZATION INTENTIONS.
I’LL ASK OUR PANELISTS TO PLEASE COME TO THE STAGE.
WITH THE NUMBER OF PEOPLE TURNING TO THE INTERNET TO SEARCH FOR HEALTH INFORMATION CONTINUING
TO INCREASE, AND DIGITAL INFLUENCERS ON BOTH SIDES CONTINUING TO EFFECTIVELY PERSUADE READERS,
THIS PANEL WILL EXPLORE INFLUENCE AND STRATEGIES TO EFFECTIVELY PERSUADE.
REBEKAH GETMAN, IMPACT ON VACCINATION. FOLLOWED BY DR. AMELIA BURKE GARCIA FROM NORC
AT THE UNIVERSITY OF CHICAGO, DISCUSSING HER RESEARCH ON THE BELIEFS AND PRACTICES OF ANTI
VACCINE INFLUENCES IN SOCIAL MEDIA. DR. RUPALI LIMAYE FROM JOHNS HOPKINS WILL
PROVIDE OVERVIEW OF HOW ONLINE INFLUENCERS EFFECT VACCINATION BEHAVIORS, AND DR. AUSTIN
CHIANG FROM ASSOCIATION OF HEALTH CARE SOCIAL MEDIA AND THOMAS JEFFERSON UNIVERSITY HOSPITAL
HIGHLIGHT WORK WITH INFLUENCERS AND HASHTAG #VERIFYHEALTHCARE.
MISS GETMAN, PLEASE.>>THANK YOU SO MUCH FOR HAVING ME HERE AND
FOR THIS REALLY EXCITING PANEL. I’M EXCITED TO HEAR WHAT OTHER PANELISTS HAVE
TO SAY AS WELL. I’M AT NORTHEASTERN UNIVERSITY, JUST ABOUT
IN THE MIDDLE OF MY Ph.D. IN SOCIOLOGY, I STUDY MEDICAL SOCIOLOGY AND GENDER IN SOCIAL
MOVEMENTS. I’M TALKING ABOUT VACCINES FROM THAT PERSPECTIVE
BECAUSE WHAT WE SEE A SOCIAL MOVEMENT, TRYING TO GATHER PEOPLE TO ITS CAUSE, FURTHER POLITICAL
ACTION, THINGS LIKE THAT. THERE ARE TWO MAIN CONCEPTS IN SOCIAL MOVEMENT
THEORY I’M GOING TO BRING IN THE CONVERSATION. FIRST IS RESOURCE MOBILIZATION, WHAT IT SOUNDS
LIKE, HOW DO YOU SPUR PEOPLE TO JOIN YOUR MOVEMENT, GET THEM TO ACT.
SECOND IS DISCOURSE FRAME, TALK ABOUT THE ISSUE IN A WAY THAT RESONATES WITH PEOPLE.
SO JUST A QUICK NOTE, YOU’VE HEARD PROBABLY PRETTY MUCH ALL OF THIS IN OTHER PANELS THIS
MORNING, I’LL BE BRIEF. I’M TALKING ABOUT TWO NETWORK TYPES.
THE FIRST IS THE WEB, WHICH IS THE SORT OF INTERCONNECTION OF LINKS ON WEB PAGES.
WHEN YOU CLICK FROM ONE WEBSITE TO ANOTHER. THE SECOND IS SOCIAL MEDIA, WHICH IS GENERALLY
LINKED BETWEEN PEOPLE, SO FOR THOSE WHO ARE FAMILIAR WITH NETWORK SCIENCE, IN THESE KINDS
OF NETWORKS AND WEB NETWORK NODES ARE WEB PAGES, EDGES ARE THE LINKS BETWEEN THEM.
AND IN SOCIAL MEDIA THE NODES ARE PEOPLE, AND EDGES ARE EITHER FOLLOWERS, BACK AND FORTH,
OR ENTER ACES THROUGH COMMENTS OR SOMETHING LIKE THAT.
I’M GOING TO TALK ABOUT THIS THROUGH THREE INTERCONNECTED STUDIES THAT COVER DIFFERENT
PARTS OF THIS. I’LL GOING THROUGH THE STUDIES REALLY QUICKLY,
JUST FOR SAKE OF TIME BUT I’M HAPPY TO TALK ABOUT METHODS IN Q&A OR OFFLINE IF IT’S HELPFUL.
THE SECOND IN 2014 AN ARTICLE CAME OUT FROM RESEARCHERS AT THE HARVARD SCHOOL OF PUBLIC
HEALTH THAT RECOMMENDING CLASSIFYING FLUORIDE AS A NEUROTOXIN IN CHILDREN.
I DON’T KNOW IF YOU REMEMBER THIS STUDY. ED MADE QUITE A SPLASH IN THE COMMUNITY WATER
FLUORIDATION MOVEMENT. WE WANTED TO SEE HOW THE STUDY TRACKED THROUGH
COMMUNITY WATER FLUORIDATION SOCIAL NETWORK. THE ACTIONS BEHIND IT ARE LARGELY THE SAME,
STILL RELEVANT HERE. WHAT WE DID WAS ESSENTIALLY HAD UNDERGRADUATE
R.A.s WHO JOINED NINE ANTI COMMUNITY WATER FLUORIDATION GROUPS ON FACEBOOK, CONDUCTED
NETWORK ANALYSIS ON THE NETWORKS, ACTUAL GROUPS THEMSELVES.
AND THEN SENTIMENT ANALYSIS ON COMMENTS WITHIN THOSE GROUPS.
THE SECOND STUDY WE REALIZED THE WEB SORT OF WRIT LARGE IS DIFFERENT THAN SOCIAL MEDIA
IN GENERAL. SO WE USED MEDIA CLOUD, WHICH IS A DATABASE
AND SEARCH TOOL HOUSED AT M.I.T. AND HARVARD TO DO A BASIC KEY WORD SEARCH THROUGH THE
WEB. WE SEARCHED ABOUT NINE MONTHS OF TIME FOR
THE STEM OF THE WORD VACCINE, THROUGH 50,000 WEB SOURCES.
ALL ENGLISH LANGUAGE. DURING THAT TIME 4800 SOURCES PUBLISHED 28,000
WEB PAGES THAT MENTIONED VACCINES. THIS TIME PERIOD COVERS THE DISCUSSION AND
PASSAGE OF THE LAW IN CALIFORNIA THAT LIMITED EXEMPTION FOR CHILDHOOD VACCINES IN SCHOOLS,
SO THERE WAS A LOT OF POLITICAL DISCUSSION HERE.
IT WASN’T JUST THE SCIENCE OF VACCINES. BUT IT REALLY SORT OF SHOWS THE SOCIAL MOVEMENT
ASPECT OF THIS. AND THEN THE FINAL STUDY WE TOOK A SAMPLE
OF 100 OF THE MOST INFLUENTIAL STUDIES, INFLUENTIAL STORIES FROM THAT WEB NETWORK, AND TRACKED
HOW THOSE WERE SHARED THROUGH TWITTER. THE STORIES WERE QUOTED BY SENTIMENT.
TWEET ITSELF CODED BY SENTIMENT. WHAT’S THE CONTEXT OF THE TWEET.
SO WHAT DOES THE TWEETER THINK? 20% WERE ANTI VAXER.
THE FIRST RESEARCH QUESTION HERE IS HOW DOES THAT INFORMATION GET INTO GOOD NETWORKS?
WE KNOW THAT MOST CONTENT ON THE WEB IS PRO VACCINE.
IF THIS WAS AN INFORMATION PROBLEM WE WOULD NOT BE SITTING HERE.
WHAT IS HAPPENING? SO, OUR FIRST STUDY IN COMMUNITY WATER FLUORIDATION
HAS GOOD NEWS. WHICH IS THAT HARD SCIENCE, GOOD SCIENCE ABOUT
FLUORIDE IN PARTICULAR BUT THIS I THINK APPLIES TO VACCINES, GETS THE MOST ATTENTION.
THIS IS NOT ACTUALLY GENERALLY PEOPLE YELLING AT EACH OTHER THROUGH FACEBOOK COMMENTS.
THE PLURALITY OF COMMENTS ON THESE FACEBOOK POSTS WERE ABOUT SCIENCE, AND THOSE GOT THE
MAJORITY OF ALL OF THE LIKES AND ALL OF THE INTERACTION.
SO THE COMMENTS BELOW THEM WERE BOTH THEY GOT MORE COMMENTS, MORE POSITIVE ABOUT FLUORIDE.
SO IT REALLY HIGHLIGHTS THE FACT THAT PEOPLE ARE ACTUALLY CRAVING GOOD INFORMATION.
THIS HAS BEEN CONFIRMED IN OTHER CONTEXT, OTHER STUDIES, A STUDY IN PREVENTIVE MEDICINE
LAST YEAR THAT SHOWED SCIENTIFIC INFORMATION FROM REPUTABLE ORGANIZATIONS IS SHARED MORE
ON TWITTER THAN PERSONAL ANECDOTES FROM INDIVIDUALS WHICH I THINK IS PRETTY RELEVANT TO WE’VE
ALL BEEN TALKING ABOUT. THE WEB IS QUITE DIFFERENT.
SO THIS IS THE MAP OF THE WEB NETWORK FROM OUR SECOND STUDY.
SO THIS IS ACTUALLY EACH DOT IS A WEBSITE, AND EACH LINK, EACH EDGE IS A LINK BETWEEN
THE WEBSITES. WE RAN A COMMUNITY DETECTION ALGORITHM ON
THIS NETWORK, WHICH A COUPLE THINGS TO KNOW. ONE, IT’S MATHEMATICAL, NOT QUALITATIVE.
THE COLOR CODING IS THE ACTUAL MAP. COMMUNITY, EACH NODE IN ONE COMMUNITY, ONE
COMMUNITY ONLY. LINKING DOES HAPPEN BETWEEN COMMUNITIES BUT
MEASURES SORT OF HOW OFTEN SITES ARE LIKELY TO LINK TO ONE ANOTHER.
LOOKING AT LABELS, WAIT A SECOND, WHY IS PubMed RIGHT IN THE MIDDLE OF THE VACCINE HESITANT
COMMUNITY? EXCELLENT QUESTION, WE HAD THE SAME ONE.
WHAT IT SHOWS IS THAT THE LABELS ARE QUALITATIVE. WE LOOKED FOR EACH WEBSITE IN EACH OF THESE
COMMUNITIES VACCINE HESITANT COMMUNITY LINKS TO GOOD SCIENCE A LOT OF THE TIME.
VERY OFTEN LINKING TO GOOD SCIENTIFIC SITES TO FIGURE OUT OR TO ARGUE THEIR POINT.
THE LAYOUT IS ALSO IMPORTANT, SO THE CLOSER THE NODES ARE TOGETHER, THE MORE OFTEN THEY
LINK TOGETHER. THE FACT THE CDC SITS RIGHT CLOSE TO THAT
VACCINE HESITANT COMMUNITY EVEN IF IT’S NOT IN IT MEANS THAT THERE’S A LOT OF LINKS GOING
BACK AND FORTH BETWEEN VACCINE HESITANT WEBSITES AND PUBLIC HEALTH.
SO, WE WANTED TO DO A QUALITATIVE REVIEW OF THE RESULTS IN STUDY 2 AND STUDY 3 WHICH ALLOWED
US TO LOOK AT MORE OF THE CONTEXT. THIS IS REALLY THE DISCOURSE FRAMING.
EVERY SOCIAL MOVEMENT DOES THIS. THEY TRY ACTUALLY CONTROL HOW SOMETHING IS
TALKED ABOUT. WE TALKED IN THE LAST PANEL, HEARD A LOT ABOUT
SORT OF THE FACTS OF VACCINATING THAT, YOU KNOW, THE PROMPT ON TWITTER SAYS GET THE FACTS.
WE’RE NOT THE ONLY ONES SAYING GET THE FACTS. FACTS ARE COMING FROM ALL THE PLACES THAT
ARE REPUTABLE SOURCES, FROM THE CDC, W.H.O., PubMed, PUBLISHED PEER REVIEWED SCIENCE.
SO RATHER THAN REJECTING SCIENCE, VACCINE HESITANT SITES AND USERS ON TWITTER ARE USING
IT TO ARGUE THEIR POINT. SOME IS CHERRY PICKING.
SOME IS THE FACT IN SOME PLACES THERE ARE QUESTIONS ABOUT EFFICACY, CERTAIN CONTEXT,
ET CETERA. THE FACT REMAINS THEY ARE FRAMING THE WAY
IT’S USEFUL. THE MEDIA DOESN’T NECESSARILY HELP OUR CAUSE
HERE. HOW MANY OF YOU HAVE QUICK SHOW OF HANDS,
WHO IS ON TWITTER AT ALL? AND WHO WOULD CONSIDER THEMSELVES LIKE ACTIVE
ON TWITTER? OKAY.
ONE OF MY FAVORITE TWITTER ACCOUNTS RETWEETS MAIN STREAM MEDIA SOURCE, STORIES ABOUT SCIENTIFIC
STUDIES, WITH JUST THE CONTEXT, THE CAPTION, IN MICE.
IT’S LIKE CHOCOLATE PREVENTS CANCER, IN MICE, JUST TO SHOW SCIENCE IS SLOW AND HARD.
AND MEDIA DOESN’T OFTEN KNOW HOW TO TALK ABOUT IT IN A WAY THAT IT’S REPRESENTATIVE OF THE
SCIENTIFIC PROCESS OF THE STUDIES THEMSELVES AND OF THE ACTUAL EFFECTIVENESS FOR A LONG
TERM PUBLIC HEALTH ISSUE. SO THERE’S A LOT OF CONFUSION OUT THERE.
AND VACCINE HESITANT WEBSITES AND USERS ARE REALLY USING THAT TO THEIR ADVANTAGE.
THEY ARE SHAPING THE DISCOURSE TO MOBILIZE PEOPLE TO ACTUALLY THINK MORE CRITICALLY ABOUT
VACCINE. SO THE SECOND QUESTION IS REALLY ABOUT HOW
MISINFORMATION TRAVELS WITHIN THIS NETWORK. IT GETS INTO THE NETWORK BY PIGGYBACKING OFF
GOOD SCIENCE BUT HOW DOES IT ACTUALLY TRAVEL? THERE’S TWO THINGS.
FIRST IS SOCIAL PROOF. SECOND IS EFFECTIVE MESSAGING.
I’M GOING TO TALK ABOUT EACH OF THESE IN A LITTLE BIT MORE DEPTH.
FOR SOCIAL PROOF, THE BASIC TENET WE TRUST PEOPLE WE KNOW, EVEN IF THEY ARE NOT AN EXPERT,
MORE THAN WE TRUST AN EXPERT WE DON’T KNOW. IN VACCINES, THAT LOOKS LIKE THIS.
THIS IS THE MAP OF FACEBOOK GROUPS THAT WE THREE OF THE FACEBOOK GROUPS IN OUR GROUP
OF NINE FROM OUR FIRST STUDY. BIGGEST NODES HAVE THE MOST FRIEND LINKS,
INFLUENCE IN THEIR GROUP, THEY ARE CALLED MAYORS, KNOW EVERYBODY, CONVERSE, INFLUENCE
WITHIN THEIR GROUP. THE CHALLENGE IS THAT THEY ARE NOT NECESSARILY
THE MOST INFLUENCE PEOPLE IN A SOCIAL MOVEMENT. SO THE MOST IMPORTANT PEOPLE FOR A SOCIAL
MOVEMENT ARE THE LINKS BETWEEN GROUPS. WHAT WAS HAPPENING HERE AS WE WERE TRACKING
FACEBOOK GROUPS LOOKING AT ALL THE THINGS THEY WERE SHARING, THEY WERE SHARING LIKE
STRATEGIES FOR CAMPAIGNING TO GET FLUORIDE REMOVED FROM COMMUNITY WATER, WAYS TO MITIGATE
PERCEIVED HARM, YOU KNOW, DANGERS OF FLUORIDE, THINGS LIKE THAT.
IT SPREAD TO OTHER GROUPS THROUGH THOSE PARTICULAR NODES THAT HAD LINKS ACROSS, THE INFLUENCERS.
AND THOSE ARE THE PEOPLE WHO WERE ABLE TO BUILD TRUST AND BUILD CONNECTIONS ACROSS NETWORKS
IN WAYS THAT INDIVIDUAL USERS CAN’T. SO THOSE PEOPLE ARE REALLY SORT OF CRUCIAL
FOR THE SPREAD OF INFORMATION. AND THEN THE SECOND QUESTION IS SORT OF WHY
DOES THIS KIND OF MESSAGING WORK. SO, WE KNOW THAT MESSAGING WE KNOW VACCINE
DISCOURSE USES SCIENCE, USES GOOD SCIENCE, USES GOVERNMENT WEBSITES.
BUT THAT’S NOT THE ONLY THING THEY DO. SO WE CONDUCTED A REVIEW OF THE CONTEXT OF
HOW MUCH THE CONTEXT OF THE VACCINE SENTIMENT OUT THERE IN THESE VACCINE HESITANT WEBSITES
AND VACCINE HESITANT TWEETS. SO IF WE GO BACK TO THIS MAP, JUST OVER 20%
OF THESE WEBSITES IN THIS MAP ARE VACCINE HESITANT.
450 WEBSITES IN THIS MAP. ABOUT 20% ARE VACCINE HESITANT.
BASED ON THEIR SENTIMENT THAT WE LOOKED AT. ON TWITTER, IN THE SAMPLE OF TWITTER USERS
THE VACCINE HESITANT USERS THAT CAME OUT OF THE TRACKING OF WEBSITES HAVE LESS INFLUENCE,
FEWER FOLLOWERS, FEWER OF THEM. THEY ARE NOT AS WE THINK OF SORT OF WE THINK
OF DOMINANT LOUD GROUP, AND I THINK ANY OF US WHO EVER TWEETED ABOUT VACCINES PROBABLY
FEEL LIKE THEY ARE A VERY LOUD DOMINANT GROUP, BUT THEY ARE ACTUALLY A SOLID MINORITY HERE.
AND SO THAT’S SORT OF AN INTERESTING TWIST ON THE FEELING VERSUS THE NUMBERS.
AND IN THE WEB COMMUNITY, THE SHARES VACCINE HESITANT LINKS IS 20%, A LOT OF LINKS ARE
NOT VACCINE HESITANT LINKS SO IT’S ACTUALLY A LITTLE BIT LOWER THAN THAT.
GIVEN ALL OF THIS WE’RE NOT SURE WHY WE’RE LOSING THE BATTLE, WHY THIS IS STILL AN ISSUE.
WE REALIZE WHILE 32% OF THE I’M GOING TO GET THIS WRONG.
ON TWITTER, VACCINE HESITANT USERS RELY ON SCIENCE EVEN MORE THAN VACCINE HESITANT WEBSITES
DO. SO THEY ARE TWEETING LINKS TO GOOD SCIENCE,
TO GOVERNMENT INFORMATION WEBSITES, MORE OFTEN THAN THEY ARE LINKED TO ON WEBSITES.
FRAMING ON SOCIAL MEDIA IS DIFFERENT THAN FRAMING ON THE WEB BUT BOTH THINGS HOLD TRUE,
THERE’S WAY MORE SCIENTIFIC INFORMATION IN VACCINE HESITANT DISCOURSE THAN WE HAD EXPECTED.
AND PART OF THAT IS THAT THE SORT OF SENTIMENT, DISCOURSE AROUND THIS IS WELCOMING.
THIS IS POLARIZED, PEOPLE YELL ABOUT THESE THINGS, BUT THEY DON’T ONLY YELL.
AND THEN THE FLIP SIDE OF THIS, SO I’M GOING TO TALK FOR A SECOND ABOUT PRO VACCINE DISCOURSE
FRAMES. I’M GOING TO MAKE TWO POINTS TO START.
THE FIRST IS THAT I THINK ACROSS THE BOARD, EVERYONE WHO IS PRO VACCINE IS WORKING TOWARDS
THE SAME GOAL HAVING HEALTHY KIDS AND HEALTHY FAMILIES.
AND I’M IN NO WAY INTENDING TO DEMONIZE OR SHAME ANYONE IN THESE EXAMPLES BUT THERE’S
A LOT OF WAYS PRO VACCINE DISCOURSE LEANS TOWARDS BEING BELITTLING EMPHASIZING SELFISHNESS
OR IDIOCY OF VACCINE HESITANT PARENTS. I COULD SHOW YOU A THOUSAND MEMES ABOUT VACCINE
HESITANT PARENTS THAT ARE NOT VERY KIND TOWARD PARENTS WHO ARE QUESTIONING THIS DECISION.
ON THE OTHER SIDE, IT’S QUITE COMMUNITY DRIVEN. WE THINK OF VACCINE HESITANT DISCOURSE AS
SELFISH, ABOUT THEIR KID AND NOBODY ELSE’S, MAKING DECISIONS FOR THEMSELVES THAT HURTS
THE COMMUNITY. BUT THE LANGUAGE THEY USE ON THEIR WEBSITES
AND DISCOURSE IS ACTUALLY QUITE COMMUNITY DRIVEN.
MORE THAN HALF OF THE WEBSITES THAT I LOOKED AT ACTUALLY USE SORT OF COMMUNITY COLLECTIVE
ACTION LANGUAGE TO TALK ABOUT WHY THEY ARE VACCINE HESITANT OR ANTI VACCINE.
THIS HAS REAL CONSEQUENCES FOR PARENTS WHO ARE UNDECIDED.
THE POINT AT WHICH THEY ENTER THE INFORMATION NETWORK CAN REALLY DETERMINE WHAT THEY THINK
ABOUT EACH OF THESE GROUPS, WHERE THEY FEEL COMFORTABLE ASKING QUESTIONS, AND WHO THEY
ARE GOING TO TRUST WHEN SOMEBODY GIVES AN ANSWER.
I THINK THAT THAT’S REALLY IMPORTANT BECAUSE THIS IS WHAT RESOURCE MOBILIZATION LOOKS LIKE.
THIS IS WHERE PROTESTS AND THE SENATE BILLS IN CALIFORNIA AND THIS IS WHERE THIS STUFF
GETS MOBILIZED, ON THE WEBSITES ON SOCIAL MEDIA, THIS IS HOW THEY FIGURE OUT WHERE THEY
BELONG WITHIN THIS MOVEMENT. RIGHT NOW THIS IS ONE OF THE WAYS WE’RE LOSING.
SO, I THINK THERE ARE A FEW TAKEAWAYS HERE. FIRST IS THAT I THINK NO MATTER WHAT, ALL
PARENTS WANT WHAT’S BEST FOR THEIR CHILDREN. WE SOMETIMES DON’T FRAME THIS MOVEMENT THAT
WAY. HEALTH IS SOCIAL AND RELATIONAL, THE INTERNET
IS A SOCIAL AND RELATIONAL SPACE. WE THINK OF INTERNET AS BEING NOT REAL LIFE
BUT FOR MANY PEOPLE THESE ABSOLUTELY REAL LIFE.
THE RELATIONSHIPS THAT THEY BUILD ON THE INTERNET, THE SORT OF AREAS OF TRUST THAT THEY HAVE
WITH, YOU KNOW, ORGANIZATIONS, WITH PEOPLE, ARE REAL AND THEY FEEL VERY REAL, AND YOU
HAVE TO PAY ATTENTION TO DISCOURSE IN OUR SIDE AND ON THEIR SIDE TO UNDERSTAND SORT
OF HOW PEOPLE ARE SEEING THIS CHOICE. BECAUSE DESPITE THIS MINORITY STATUS, THERE’S
STILL THIS SORT OF LARGE MOVEMENT. IT ABSOLUTELY IS A SOCIAL MOVEMENT.
BOTH PEER REVIEWED SCIENCE AND COLLECTIVE IDENTITY ARE BEING UTILIZED IN A VACCINE HESITANT
MOVEMENT TO BRING PARENTS IN TO MAKE THEM FEEL COMFORTABLE TO ANSWER THEIR QUESTIONS
IN A WAY THAT IS REALLY CHALLENGING TO COMBAT. I THINK THE BEST WAY TO COUNTER THIS IS ALSO
THE HARDEST, UNFORTUNATELY. WHICH IS IN ONE ON ONE CONVERSATIONS, IN DOCTORS’
OFFICES. PEOPLE DON’T TRUST DOCTORS BUT TRUST THEIR
DOCTOR. PEOPLE DON’T TRUST THE GOVERNMENT BUT THEY
TRUST THE CDC MORE THAN THEY TRUST THE GOVERNMENT, AND SO REALLY TAKING ADVANTAGE OF AND LEVERAGING
THOSE RELATIONSHIPS CAN BE REALLY, REALLY USEFUL.
I DON’T KNOW IF ANYONE HAS READ JENNIFER WRIGHT, WROTE A BOOK, “CALLING THE SHOTS.”
I RECOMMEND YOU READ IT. A KEY TAKEAWAY IS IMPORTANCE OF THE RELATIONSHIPS
BETWEEN PHYSICIANS, BETWEEN PEDIATRICIANS AND PARENTS.
BETWEEN PHYSICIANS AND PATIENTS. AND THAT THOSE RELATIONSHIPS ARE REALLY KEY
TOWARDS REALLY KEY FOR MITIGATING MISINFORMATION THAT’S OUT THERE BECAUSE YOU CAN BUILD THAT
RELATIONSHIP AND BUILD THAT TRUST IN A ONE ON ONE SETTING.
THAT IS ALL FOR ME. I’M HAPPY, LIKE I SAID, THE METHODS I DID
BLITZ THROUGH BUT THEY ARE FAIRLY COMPLEX. I’M HAPPY TO TALK ABOUT HOW WE CAME TO CONCLUSIONS
AS IS NEEDED.>>THANK YOU.
WE’LL SAVE QUESTIONS TILL THE END OF THE PANEL. NEXT IS DR. AMELIA BURKE GARCIA.>>GOOD MORNING.
MY NAME IS AMELIA. THANK YOU FOR INVITING ME AND THIS GREAT PANEL
HERE TO TALK ABOUT YOU TODAY. I’M GOING TO TALK A LITTLE BIT ABOUT SOME
RESEARCH THAT I’M CONDUCTING WITH A PARTNER OF MINE, DR. AMY LEADER, HERE TODAY AS WELL.
I’VE BEEN PASSIONATE ABOUT THE ONLINE INFLUENCER SPACE FOR MOST OF MY CAREER AND WORKED IN
VACCINATION FOR MANY YEARS. AND SPECIFICALLY, HAVE BEEN LOOKING AT ONLINE
INFLUENCERS WHO WE’RE CALLING ANTI VAXERS, WHO DO NOT VACCINATE.
I’M GOING TO TALK ABOUT FINDINGS FROM FORMATIVE RESEARCH DR. LEADER AND I CONDUCTED AS PART
OF THIS TALK. WE DON’T MAYBE NEED TO GO THROUGH THIS BUT
CLEARLY SOCIAL MEDIA RADICALLY CHANGED THE COMMUNICATIONS LANDSCAPE AS WE KNOW IT TODAY.
APPROXIMATELY HALF OF AMERICANS GET THEIR NEWS FROM SOCIAL MEDIA AS OPPOSED TO MORE
TRADITIONAL CHANNEL. IN ADDITION THEY ARE READING LESS OF THAT
INFORMATION, RIGHT? THE USER SPENDS 15 SECONDS READING ONLINE
ARTICLE, VIDEO VIEW TIME IS 10 SECONDS. WE THINK ABOUT CONTENT OR COMPLICATED MESSAGING
THIS POSES A CHALLENGE TO HOW PEOPLE ARE CONSUMING INFORMATION ONLINE.
THIS IS CHANGING COMMUNICATION HOW MISINFORMATION IS SPREAD.
THAT’S HOW SOCIAL MEDIA ALGORITHMS WORK. WE SUBSCRIBE TO THINGS WE LOOK AND WANT TO
SEE AND THAT WE BELIEVE IN, AND THAT SORT OF SUPPORT OUR BELIEFS ABOUT CERTAIN TOPICS.
AND BUT IN ADDITION, A LOT OF TIMES THESE SOCIAL MEDIA ALGORITHMS SUPPORT CONTENT THAT
HAVE A LOT OF ENGAGEMENT WITH IT. UNFORTUNATELY, OFTENTIMES THAT IS CONTENT,
THAT IS CONTROVERSIAL IN NATURE, AND INVITES A LOT OF DEBATE.
INFORMATION THAT MIGHT BE A LITTLE BIT MORE STAID OR MUNDANE DOESN’T GET HIGH VISIBILITY
UNLESS YOU PAY FOR IT. AND THERE IS LITERATURE THAT SUPPORTS THIS,
THAT FALSEHOOD ACTUALLY SPREADS FARTHER, FASTER, DEEPER, AND MORE BROADLY ACROSS ALL CATEGORIES
INCLUDING HEALTH IN SOCIAL MEDIA. AS PART OF THE CHANGES THERE HAS GROWN ENCLAVE
OF NEW TYPES OF CONTENT DEVELOPERS. SO IN THE SAME WAY THAT WHEN DESKTOP PUBLISHING
BECAME POPULAR, SO EVERYONE BECAME A GRAPHIC DESIGNER, THERE ARE ALL THESE LAYPEOPLE ONLINE
WHO ARE SHARING COMMENTS, SHARING THEIR VOICES, WRITING LONG FORM BLOG POSTS ABOUT A VARIETY
OF TOPIC THEY FEEL PASSIONATE ABOUT. ONLINE INFLUENCERS ARE NOT NEW.
THESE ARE MODERN DAY EQUIVALENT OF WHAT WE IN HEALTH OFTEN REFER TO AS THE OPINION LEADERS,
AND OPINION LEADERSHIP IS EFFECTIVE DRIVING BEHAVIOR CHANGE.
JUST FOR THOSE IN THE ROOM, IN CASE COMMUNITY LEADERSHIP IS A NEW CONSTRUCT, IT IS PART
OF THE DIFFUSION OF INNOVATION THEORY. AND OPINION LEADERS TEND TO BE PART OF THE
NETWORKS IN THE COMMUNITIES THEY SERVE AND LIVE, SIMILAR TO PEOPLE IN THEIR COMMUNITIES,
SPEND TIME WITH PEOPLE IN THEIR COMMUNITIES, AND THEREFORE HAVE TRUST WITH THOSE COMMUNITIES.
AS PART OF THEORY OF DIFFUSION OF INNOVATIONS, OPINION LEADERS ARE POSSIBLE, AS OPPOSED TO
NEW INNOVATION OR NEW INFORMATION SPREADING THROUGH A NETWORK, MORE ORGANICALLY, TAKING
A LONGER TIME, OPINION LEADERS CAN LEAPFROG OVER THAT TIME PERIOD AND INTRODUCE NEW INFORMATION
BECAUSE OF THAT TRUST, CAN BE ADOPTED MORE RAPIDLY.
AND WITH THE ADVENT OF SOCIAL MEDIA, THESE OPINION LEADERS ARE MOVING ONLINE.
SO SOCIAL MEDIA CLEARLY IS A PLATFORM FOR INFORMATION DISSEMINATION AND EDUCATION AND
THAT APPLIES IN HEALTH SPACE AS WELL, AND AS MORE AND MORE PEOPLE HAVE ADOPTED THESE
TECHNOLOGIES, ARE PARTICIPATING IN THESE COMMUNITIES, WE SEE THAT THERE IS GROWTH OF INCREASING
NUMBERS OF ONLINE OPINION LEADERS WHO ARE SHARING THEIR OPINIONS, BEING INCREDIBLY INFLUENCE
IN THEIR ONLINE SOCIAL NETWORK. THEY ARE NOW MONETIZED.
INFLUENCER MARKETING IS WHAT IT IS NOW CALLED WHEN YOU ENGAGE WITH INFLUENCERS IN A PAID
CAPACITY. AS OF 2019, THIS WAS EXPECTED TO GROW TO ABOUT
$2.4 BILLION OF REVENUE FOR INFLUENCER MARKETING SPACE.
THAT’S BRANDS, CAMPAIGNS, ORGANIZATIONS, FOUNDATIONS, ENGAGING WITH THESE INFLUENCERS TO SHARE MESSAGES
AND PAYING THEM TO DO SO. NOT ALL INFLUENCERS ARE CREATED EQUAL.
THERE’S DIFFERENT TYPES OUT THERE. SO, THERE’S YOUR CELEBRITY INFLUENCER WHICH
WE TALKED ABOUT IN ONE OF THE EARLIER SESSIONS, JENNY McCARTHY IS CLEARLY A CELEBRITY INFLUENCER.
AS IS KIM KARDASHIAN. THERE ARE PEOPLE LIKE JILL SMOKELER WHO RUN
SCARY MOMMY, WHAT I CALL A BLOGGER TURNED PUBLISHER, SHE HAS ESSENTIALLY OVER TIME STARTING
AS A BLOGGER TURNED HER BLOG INTO A PUBLISHING HOUSE WHERE SHE HAS MULTIPLE WRITERS, EDITORS,
CONTENT DEVELOPERS. AND THEY ARE PUTTING OUT MASSIVE AMOUNTS OF
CONTENT THE SAME WAY A MAGAZINE OR JOURNAL OR NEWSPAPER WOULD DO.
AND THEN THERE ARE THESE EVERYDAY INFLUENCERS, THE LAYPEOPLE, PEOPLE LIKE YOU AND ME WHO
HAVE COMMITTED TO HAVING A VOICE, BUILDING A VOICE ONLINE AROUND A PARTICULAR TOPIC,
WRITE REGULARLY AND THEY HAVE A LARGE FOLLOWING. BUT THEY HAVEN’T REACHED NECESSARILY THE LEVEL
OF NOTORIETY OF OTHER INFLUENCERS. THIS IS A MOM AND HEALTH BLOGGER, LIVES IN
ATLANTA, AND SHE RUNS A BLOG AND HAS SOCIAL MEDIA PROFILES, LOVE, PEACE AND TINY FEEDS.
IT’S THIS LAST AREA I’M INTERESTED IN. IN PART BECAUSE IN HEALTH THE CELEBRITY INFLUENCERS
ARE OFTEN HARD FOR US TO ENGAGE, OFTENTIMES EXPENSIVE, I THINK I ONCE HEARD KIM KARDASHIAN
CHARGES $10,000 FOR A TWEET. IN ADDITION I THINK THAT AS WE THINK ABOUT
OPINION LEADERSHIP, THE RELATIONSHIP BETWEEN THE LAYPERSON INFLUENCERS AND READERS IS CLOSER
AND TIGHTER AND IN MY OWN RESEARCH FOUND THEY MAY KNOW EACH OTHER IN REAL LIFE.
THEY MAY TEXT WITH EACH OTHER, MAY PRIVATE MESSAGE EACH OTHER.
SO THE RELATIONSHIP THAT IS GOING ON THERE IS MUCH DIFFERENT.
SO I DEFINE THIS, DEFINE ONLINE INFLUENCERS FOR MY CONTEXT AS EVERYDAY PEOPLE WHO ARE
INCREDIBLY INFLUENCE WITHIN THEIR ONLINE SOCIAL NETWORK.
WHAT MAKES THEM SO UNIQUE IS THE MEDIUM IN WHICH THEY OPERATE.
YOU COULD ARGUE THERE ARE A LOT OF PEOPLE WHO ARE INFLUENTIAL TO YOU BUT IN PARTICULAR
THESE FOLKS MEET BUILT A RELATIONSHIP WITH THEIR ONLINE FOLLOWING.
THEY HAVE ESTABLISHED THESE ONLINE PROFILES. THEY TALK ABOUT A SET OF TOPICS OR PARTICULAR
AREA OF TOPICS THAT THEY ARE FAMILIAR WITH, THEY HAVE EXPERIENCE IN, AND THEREFORE THEY
HAVE A COHORT OF FOLLOWERS THAT TRUST THEIR THOUGHTS, OPINIONS, PERSPECTIVES.
NOW, INTERPERSONAL RELATIONSHIP RESEARCH IN THE SPACE OF INTERPERSONAL COMMUNICATION,
INTERPERSONAL RELATIONSHIP SUPPORTS THE IDEA THERE ARE DIFFERENT TYPES OF RELATIONSHIP
THAT EXIST. IN PARTICULAR, I LIKE TO THINK ABOUT THE WAY
THAT WE SHARE INFORMATION ONLINE AND JUST IN GENERAL, TIE STRENGTH THEORY.
STRONG TIES ARE ESSENTIALLY WHO YOU SPEND THE MOST TIME WITH.
THEY ARE THE PEOPLE THAT ARE MOST SIMILAR TO YOU.
BECAUSE OF THAT, YOU OFTENTIMES HAVE VERY SIMILAR BELIEFS, SHARE INFORMATION THAT IS
SUPPORTIVE OF THOSE BELIEFS. AND WEAK TIES ARE PEOPLE WHO MAYBE YOU SPEND
LESS TIME WITH, MAYBE YOU HAVE DIFFERING BELIEFS BUT IN THE WEAK TIES THAT NEW INFORMATION
CAN BE INTRODUCED. IF WE ONLY SPEND TIME WITH OUR STRONG TIES
WE SORT OF ONLY KEEP TALKING ABOUT THE SAME THINGS.
AND WHAT’S REALLY IMPORTANT HERE IS THAT FOR IF YOU WANT TO TALK ABOUT SELLING WIDGETS
OR DRIVING WEBSITE CLICKS, THAT’S STRONG AND WEAK TIES MAY NOT NECESSARILY STRONG TIES
MIGHT BE BENEFICIAL. WHEN IT COMES TO HEALTH, TALKING ABOUT LIFE
AND DEATH, DECISION WE’RE MAKING ABOUT INFORMATION SHARED BECOMES VERY IMPORTANT.
AND I SHARE THIS JUST BECAUSE THERE’S THIS VERY RECENT WITH THE NOVEL CORONAVIRUS OUTBREAK,
Q ANON IS A CONSPIRACY GROUP ONLINE, SHARING THEORIES ABOUT THE OUTBREAK OF CORONAVIRUS,
IN PARTICULAR ONE IS IF YOU DRINK BLEACH YOU WILL NOT GET SICK.
WHAT THAT HAS DONE HAS MEANT EMERGENCY ROOMS ARE SEEING HUNDREDS IF NOT THOUSANDS OF PEOPLE,
COMING INTO THEIR EMERGENCY ROOMS, BECAUSE THEY ARE DRINKING BLEACH.
SO MUCH SO THE FDA HAD TO PUT OUT A STATEMENT. THIS IS HAVING AN IMPACT BECAUSE OF PEOPLE
THAT TRUSTING INFORMATION COMING FROM SOME OF THESE SOURCES.
CORONAVIRUS IS TOP OF MIND, VACCINATION MOVEMENT HAS BEEN DEALING WITH THIS FOR A LONG TIME,
FOR DECADES, AND THERE’S EVIDENCE TO SUGGEST AS MANY PEOPLE HAVE TALKED ABOUT TODAY THAT
THE INTERNET HAS BEEN PARAMOUNT IN DRIVING A LOT OF THIS MISINFORMATION.
SO MUCH SO IT’S NOW CONSIDERED A GLOBAL PUBLIC HEALTH THREAT.
SO, AS WE THINK ABOUT STRONG AND WEAK TIES, IT SEEMS LIKE AS SOCIAL MEDIA ALGORITHMS SUPPORT
OUR NEED TO BE CLOSE TO THE INFORMATION AND PEOPLE THAT ARE SIMILAR TO US, WE SUBSCRIBE
TO CONTENT WE WANT TO SEE AND DON’T SUBSCRIBE TO CONTENT WE DON’T WANT TO SEE SO WHAT DOES
THAT LEAVE US? I THINK THINKING ABOUT THIS THROUGH THE FRAME
OF STRONG AND WEAK TIES CAN BE REALLY IS ONE OPTION.
WHERE THE STRONG TIES ARE THESE INFLUENCERS WHO HAVE CONNECTIONS, AND TRUST WITH THESE
NETWORKS. BUT WE BECOME THE WEAK TIES.
WE BECOME THE NEW INFORMATION THAT IS SHARED VIA STRONG TIES TO THE COMMUNITIES THAT THEY
REACH. BUT ONE MORE CONUNDRUM IN THE MIX, HOW DO
YOU ENGAGE PEOPLE THAT DON’T NATURALLY TALK ABOUT THIS, THAT TALK ABOUT DIFFERENT TOPICS
AND THEREFORE HOW DO YOU GET THEM TO TALK ABOUT INFORMATION FROM WEAK TIES?
AND I SHARE THE STORY OF EMILY HENDERSON, A DESIGN BLOGGER.
SHE DECIDED ONE TIME TO POST SOMETHING THAT WAS COMPLETELY OFF BRAND, NOT ABOUT DESIGN.
AND IN ONE NIGHT SHE LOST 4000 FOLLOWERS. AND GOT INTO A TWITTER WAR ABOUT THE FACT
THAT SHE DIDN’T THIS POST WAS NOT ABOUT DESIGN. SHE WAS TOLD TO STAY IN HER LANE.
WE’RE COMING TO A PLACE WHERE WE’RE FACED WITH A LARGE QUESTION, HOW DO WE AS PUBLIC
HEALTH PROFESSIONALS BUILD RELATIONSHIPS WITH AND SUCCESSFULLY LEVERAGE THESE TRUSTED VOICES,
WHO HAVE STRONG TIES WITH FOLLOWERS TO SHARE NEW ACCURATE EVIDENCE BASED INFORMATION AND
ULTIMATELY IMPACT LIVES FOR THE BETTER. IT’S WITHIN THIS LENGTHY CONTEXT, AND I APOLOGIZE
THAT IT TOOK A LITTLE WHILE TO GET HERE BUT I WANTED TO SET UP WHY THIS IS IMPORTANT.
IT’S TO ANSWER THIS QUESTION OR START TO ANSWER THIS QUESTION THAT DR. LEADER AND I UNDERTOOK
A FORMATIVE STUDY TO START TO TRY AND TALK WITH SOME OF THE ONLINE INFLUENCERS WHO ARE
ANTI VAXERS, WHO DO NOT VACCINATE. AND SO WHAT DID WE DO?
WE WORKED WITH A NETWORK TO RECRUIT 15 ONLINE INFLUENCERS.
TO TALK WITH THEM ABOUT THEIR BELIEFS, PERCEPTIONS OF VACCINATION, HOW THEY COMMUNICATE IN SOCIAL
MEDIA AND ON THEIR BLOGS, AND WE WORKED WITH NETWORK, THE MOTHERHOOD.
THEY HELPED US IDENTIFY, VET, RECRUIT THESE 15.
WE ASKS TWO QUESTIONS OF THE NETWORK TO IDENTIFY THE INFLUENCERS IN TERMS OF THEIR VACCINATION
STANCE, IF YOUR DOCTOR RECOMMENDS A VACCINE FOR YOUR CHILD HOW LIKELY ARE YOU TO GET IT
AND DO YOU WRITE ABOUT YOUR POSITION ON VACCINATIONS ON YOUR BLOG OR SOCIAL MEDIA?
WE COLLECTED A NUMBER OF DIFFERENT TIMES OF DATA, AGE OF THE MOTHER, AGE AND GENDER OF
EACH OF HER CHILDREN, MOTHER’S ETHNICITY, MARITAL, EDUCATIONAL ATTAINMENT, URBAN OR
RURAL OR SUBURBAN COMMUNITY, HOW LONG THEY HAD BEEN BLOGGING.
MOST HAD A BLOGA FEW ONLY USED FACEBOOK AND OTHER TYPES OF SOCIAL MEDIA PLATFORMS TO SHARE
THEIR OPINIONS. DIVIDED IN THREE SECTIONS, ABOUT, AGAIN, THEIR
EXPERIENCE BLOGGING, EXPERIENCE WITH VACCINATION, PERCEPTIONS OF RISK AND AUTONOMY.
THEN WE ENDED THE INTERVIEW ASKING TWO BIG QUESTIONS.
ARE THERE ANY CREDIBLE ARGUMENTS IN FAVOR OF VACCINATION?
AND WHAT DO YOU WISH THOSE WHO SAY YOU SHOULD GET VACCINATED WOULD STOP SAYING TO YOU?
THIS IS A QUICK REVIEW, IT DID SKEW MOSTLY WHITE.
WE HAD AN AFRICAN AMERICAN MOM AND HISPANIC MOM IN OUR SAMPLE.
THE AGE RANGE WAS 27 TO 53 YEARS OLD. GENERALLY A WELL EDUCATED GROUP INCLUDING
TWO PhDs, MIX OF GEOGRAPHIC LOCATION. DESPITE FOLKS IN RURAL AREAS EVERYONE SEEMED
TO BE SOCIALLY CONNECTED. THE MAJORITY REPORTED BEING CHRISTIAN.
AND MOST OF THEM REPORTED HAVING VERY STABLE CHILDHOODS, SORT OF GROWING UP IN WHAT YOU
MIGHT CONSIDER A TYPICAL AMERICAN UPBRINGING. SO WE HAD FOUR EMERGING THEMES.
TRADITIONAL MESSENGERS ARE NOT AS EFFECTIVE AS THEY ONCE WERE.
THE OLD COMMUNICATION MESSAGING ARE NOT WORKING FOR THIS GROUP.
TECHNOLOGY SUPPORTS AND AMPLIFIES THESE BELIEFS. AND THE CONVERSATION ABOUT RISK IS MULTI FACETED.
SO IN TERMS OF TRADITIONAL MESSENGERS, THESE NOT BEING AS EFFECTIVE AS THEY ONCE WERE,
IT BECAME CLEAR TO US THROUGH THE INTERVIEWS THAT PARENTS NOW HAVE ACCESS TO OVERWHELMING
AMOUNT OF INFORMATION, WHETHER THAT’S ACCURATE OR NOT.
AND THEY DO NETWORK WITH OTHER PARENTS TO GATHER VACCINE RELATED INFORMATION.
THEY FEEL THAT THEY ARE MORE KNOWLEDGEABLE ABOUT VACCINES AND THEIR CHILDREN’S HEALTH
THAN PEDIATRICIANS AND SHOULD BE MAKING DECISIONS FOR THEIR CHILD AND PEDIATRICIANS SHOULD SUPPORT
THEIR VIEWS. THEY ALSO WILL NETWORK WITH OTHER PARENTS
TO FIND PEDIATRICIANS WHO ALIGN WITH THEIR VACCINATION VIEWS.
IT’S NOT A FALSE STATEMENT ABOUT TRUSTING PEDIATRICIAN BUT NOT ALL PEDIATRICIANS ARE
NECESSARILY GIVING INFORMATION THAT MAYBE WE WANT THEM TO GIVE.
THEY ARE FINDING PEOPLE WHO AGAIN ARE SUPPORTING THEIR BELIEFS AND WILL LET THEM DO WHAT THEY
WANT TO DO. HERE’S A QUOTE, I’M NOT GOING TO BE TOLD BY
AN EXPERT IN THE MEDICAL FIELD THIS IS AN IMPORTANT SHOT.
OLD COMMUNICATION AND MESSAGING DO NOT WORK ANYMORE.
SO SOME OF THE TRADITIONAL MESSAGES THAT HAVE BEEN USED IN THE PAST TO PROMOTE VACCINATION
HAVE RELIED ON THEMES AROUND ALTRUISM, DO IT FOR SOMEBODY YOU LOVE OR SOMEBODY AROUND
YOU THAT MIGHT NOT BE ABLE TO BE VACCINATED, OR MAY BE ELDERLY OR A YOUNG BABY OR HAVE
COMPROMISED IMMUNE SYSTEM. THE MESSAGES HAVE TALKED ABOUT THE BENEFITS
OF HERD IMMUNITY. AND OF COURSE RISK OF DISEASE THAT YOU’RE
VACCINATING AGAINST. THESE MESSAGES DON’T RESONATE WITH THIS GROUP.
THEY VERY MUCH SEE THEMSELVES, AND THIS WAS MENTIONED IN THE PRIOR TALK, WHICH IS TO SAY
THEIR PRIMARY GOAL IS TO BE TAKE CARE OF THE HEALTH OF THEIR CHILD AND THEIR FAMILY.
AND SO THIS IDEA OF VACCINATING FOR OTHERS OR THE BENEFITS OF HERD IMMUNITY REALLY DOES
NOT RESONATE. WE’RE ALSO LIVING RIGHT NOW IN A VERY CUSTOMIZABLE
TIME. WE’VE GOT THINGS LIKE, YOU KNOW, MOVIES ON
DEMAND, TELEVISION ON DEMAND, RADIO ON DEMAND. WE’VE GOT TARGETED ADS COMING AT US.
AND WE HAVE THINGS LIKE PRECISION MEDICINE. SO THIS ONE SIZE FITS ALL MESSAGE OF VACCINATION
IS A PROBLEM FOR PEOPLE, WHETHER OR NOT THAT SCIENTIFICALLY MAKES SENSE OR IT DOESN’T,
PARENTS WANT CUSTOMIZED VACCINES BECAUSE THEY BELIEVE A VACCINE COULD WORK FOR SOMEBODY
ELSE BUT MAY NOT WORK FOR THEM OR FOR THEIR CHILD.
THEY ALSO WANT CLEAN VACCINES. THERE’S A LOT OF TALK ABOUT WHAT’S IN THE
VACCINE, READING THE VACCINE INSERTS AND WANTING SOMETHING THAT WAS A PURE VACCINE.
AND THIS SORT OF HAS COME UP A COUPLE TIMES. WHAT THIS IS LEADING TO IS THE OVERARCHING
FEELING OF ALIENATION AMONGST THIS GROUP. SO THESE NON VACCINATING ONLINE INFLUENCERS
AND PEOPLE THAT THEY ENGAGE WITH ONLINE REALLY DON’T FEEL LIKE THEIR VOICE IS RESPECTED OR
HEARD BY THE PRO VACCINE COMMUNITY. THEY FEEL LIKE THEY CAN’T SHARE THEIR VIEWS
WITHOUT BEING, YOU KNOW, HAVING NEGATIVE ATTENTION DRAWN TO THEM OR HAVING PEOPLE ATTACK THEM,
AND SO THERE REALLY IS A DIVIDE BETWEEN THOSE WHO ARE SAYING YOU SHOULD VACCINATE AND PEOPLE
WHO ARE EITHER HESITANT OR COMPLETELY DO NOT VACCINATE AT ALL.
SO HERE’S ANOTHER QUOTE. PARENTS HAVE THE RIGHT TO DO WHAT THEY FEEL
IS BEST FOR THEIR CHILD. IN THEIR HOME, NOT KEEPING IN MIND THE COMMUNITY
ASPECT. TECHNOLOGY SUPPORTS AND AMPLIFIES THESE BELIEFS.
THESE WERE SOME OF OUR MOST INTERESTING FINDINGS I THINK.
THEY ARE ALL INTERESTING BUT THIS IS SO FASCINATING TO ME.
SOCIAL MEDIA IS PROPELLING THE ARGUMENT. NO, THEY ARE USING EMERGING TECHNOLOGIES,
FOR INSTANCE LIKE GENETIC TESTING TECHNOLOGIES, THEY ARE WORKING WITH 23ANDME AND OTHER TYPES
OF GENETIC TESTING TOOLS TO SWAB THEIR KIDS, REQUEST RAW DATA WHICH I DIDN’T KNOW WAS POSSIBLE
AND USING PEDIATRICS OR THIRD PARTY APPS TO ANALYZE DATA, TELLING THEM THEIR KIDS HAVE
A PREDISPOSITION FOR VACCINE ADVERSE REACTION. THEY ARE USING THAT DATA TO MAKE A CASE THAT
THEY SHOULDN’T THEIR KIDS SHOULD NOT GET VACCINATED. IF WE’RE STILL BATTLING THIS ISSUE HOW DO
WE EVEN TALK WITH PEOPLE WHO DON’T WANT TO VACCINATE AND COMBAT, THEY ARE MOVING TO FIND
OTHER WAYS TO SUPPORT THEIR VIEWS THAT’S GOING TO GET HARD FOR US TO WRAP OUR ARMS AROUND
THIS. THEY ALSO ARE USING TECH TO SUPPORT ALTERNATIVE
INFORMATION. WE TALKED IN THE LAST SESSION ABOUT CENSORSHIP
OR IF IT’S GOOD OR BAD. THEY DON’T WANT TO BE CENSORED.
WHAT THEY ARE DOING IS GOING ELSEWHERE AND FINDING INFORMATION THAT THEY WANT IN OTHER
VENUES, THEY ARE USING A SEARCH ENGINE, DUCK DUCK GO, YOU MAY HAVE HEARD OF IT.
IT IS IT’S AN INTERESTING SEARCH ENGINE. CAN YOU CLEAR YOUR COOKIES REGULARLY BUT DOESN’T
DO ANY KIND OF PRIORITIZATION THE WAY GOOGLE DOES IN TERMS OF ALGORITHM.
IF I CAN’T GET WHAT I NEED THROUGH GOOGLE I’LL FIND IT ELSEWHERE.
SO HERE’S A QUOTE. I GO TO FACEBOOK BECAUSE I KNOW.
I CAN’T GO TO GOOGLE AND SEARCH SOMETHING BECAUSE IT’S CENSORED.
I’M NOT GOING TO FIND TRUE INFORMATION. AND FINALLY THE CONVERSATION ABOUT RISK IS
COMPLEX AND MULTI FACETED. I TOUCHED ON THIS IN THE SECOND TEAM, WHICH
IS THE AUDIENCE IS ALWAYS THIS AUDIENCE IS ALWAYS WEIGHING THE BALANCE BETWEEN THE RISK
OF THE DISEASE AND RISK OF THE VACCINE. IN MANY CASES, PEOPLE WILL RECOGNIZE THAT
CERTAIN DISEASES ARE RISKY BUT ALMOST ALWAYS RISK OF VACCINE OUTWEIGHS RISK OF DISEASE.
THEY ALSO ARGUE THAT THEY ARE MAKING THESE DECISIONS AS PARENTS THAT LOVE THEIR CHILDREN,
PRIMARY GOAL IS TO PROTECT THEIR CHILD. SO THEY DON’T SEE THEMSELVES AS MAKING BAD
DECISIONS. THEY DON’T SEE THEMSELVES AS ALSO NOT BEING
RIGHT OR NOT USING FACTS. THE INFORMATION THEY FIND OR STORIES THEY
HEAR ARE, FOR THEM, FACTS. THERE’S A FUNDAMENTAL IDEOLOGICAL SHIFT BETWEEN
THE IMPORTANCE OF COMMUNITY AND IMPORTANCE OF THE INDIVIDUAL.
AND AMONGST THIS IS AUDIENCE THE INDIVIDUAL OFTEN WILL TRUMP THE COMMUNITY.
FINAL QUOTE, THE KNOWN RISK OF HPV AGAINST WHAT I SEE IS UNKNOWN RISK OF VACCINATION.
JUST A COUPLE KEY TAKEAWAYS, SOCIAL MEDIA IS A POWERFUL FORCE FOR HEALTH COMMUNICATION
AND MESSAGING. THE WAY IT WORKS THOUGH DOES SUPPORT THE BROAD
CIRCULATION OF MISINFORMATION. FOR HEALTH THIS HAS LIFE AND DEATH IMPLICATIONS.
VACCINATION IS A VITAL PUBLIC HEALTH ISSUE WHERE WE’VE SEEN THIS PLAY OUT FOR DECADES.
WORKING WITH INFLUENCERS CAN HELP THIS BUT THE PUBLIC HEALTH COMMUNITY NEEDS TO ADAPT
TO INCORPORATE INFLUENCERS INTO THEIR PLANNING AND PROGRAMS, ESPECIALLY TO HELP OVERCOME
BARRIER BETWEEN WHAT WE’RE CALLING RIGHT NOW THE PRO VACCINATION AND ANTI VACCINATION MOVEMENT.
WE NEED TO UNDERSTAND PAIN POINTS IN ORDER TO FIGURE OUT HOW TO ADDRESS THEM.
AND ULTIMATELY NEED NEW MESSAGES AND NEW MESSENGERS TO HELP US BRIDGE THOSE GAPS.
PUBLIC HEALTH COMMUNITY MUST RECOGNIZE IMPORTANCE OF THESE TRUSTED ONLINE SOURCES, WORK TO CHANGE
BEHAVIOR FOR THE BETTER. SO OUR WORK IS NOT DONE.
WE PLANT TO CONTINUE THIS WORK. WE WANT TO DO ADDITIONAL RESEARCH WITH ONLINE
INFLUENCERS OF VARYING VACCINATION BELIEFS. I’VE DONE A LITTLE BIT IN THE PRO VACCINATION
SPACE IN ADVANCE OF THIS STUDY BUT WE WANT TO ACTUALLY DO SOMETHING A LITTLE BIT BIGGER.
WE WANT TO DO NEW MESSAGE TESTING AND INTERVENTION BASED RESEARCH AS WELL.
HERE ARE MY SOURCES. AND THANK YOU SO MUCH.
>>THANK YOU VERY MUCH. NEXT IS DR. RUPALI LIMAYE.
>>HI, I’M RUPALI LIMAYE FROM THE JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH, BEHAVIORAL
SCIENTIST BY TRAINING WITH FOCUS IN SOCIAL EPIDEMIOLOGY AND I’VE SPENT THE LAST FOUR
YEARS MOSTLY WORKING IN VACCINE HESITANCY. I MUST SAY THESE VIEWS ARE MINE AND NOT REPRESENTATIVE
OF THE INSTITUTION AND I HAVE NO CONFLICTS TO DISCLOSE.
I WANT TO FOCUS ON FOUR POINTS TODAY. ONE IS WHERE ARE PEOPLE GETTING VACCINE INFORMATION,
TO FOLLOW UP WITH THAT I WANT TO SPEND A LITTLE BIT OF TIME TO TALK ABOUT WHY ARE PEOPLE CHOOSING
SOURCES THEY ARE NOW CHOOSING, AND FROM THERE WHAT ARE THE IMPLICATIONS OF THIS DECISION
WITH REGARDS TO THE PLACES WHERE INDIVIDUALS ARE GOING, AND HOW SHOULD PROVIDERS ENGAGE
ONLINE, WHAT ARE SOME PRACTICAL NEXT STEPS THAT WE SHOULD THINK ABOUT MOVING FORWARD
FROM A COMMUNICATION PERSPECTIVE. LET’S START WITH WHERE ARE PEOPLE GETTING
THEIR INFORMATION. I THINK IT’S VERY CLEAR WE LIVE IN THIS POST
TRUTH AND POST FACT WORLD, THOSE OF US THAT ARE SCIENTISTS ARE FEELING THIS MORE THAN
ANYTHING, THIS ANTI SCIENCE BACKLASH THAT’S BEEN MATRICULATING THROUGH DISCOURSE THAT’S
HAPPENING. AND WE’VE FOUND ACTUALLY OBJECTIVE FACTS ARE
LESS INFLUENCE IN SHAPING PUBLIC OPINION THAN THOSE THAT ACTUALLY USE APPEAL, SO TALKING
ABOUT FRAMING, IF YOU CAN USE EMOTIONAL AND PERSONAL FRAMING YOU’RE MORE LIKELY TO BE
INFLUENTIAL. BECAUSE OF THIS IDEA OF PEOPLE GOING ONLINE
EVERYONE IS NOW AN EXPERT IN HEALTH CARE. YOU KNOW, I DON’T KNOW HOW MANY PEOPLE COME
TO ME AND SAY I WENT TO WEB MD AND I HAVE CANCER.
NOT REALLY EXACTLY WHAT’S GOING ON BUT YOU CAN IMAGINE HOW THIS CHANGED THE CONVERSATION
AND INTERPERSONAL COMMUNICATION THAT’S HAPPENING BETWEEN PROVIDER AND PATIENT NOW WHICH HAS
CAUSED A NUMBER OF CHALLENGES. THE THING THAT’S INTERESTING TO WHY PEOPLE
GO TO THE INTERNET WE CAN THINK ABOUT THIS ON A CONTINUUM WITH REGARD TO CERTAINTY.
IF YOU’RE CERTAIN ABOUT A SPECIFIC TOPIC, YOU ARE MORE LIKELY TO TALK TO PERSONAL INFLUENCERS,
ONE ON ONE, SOMEONE YOU KNOW WITHIN A SOCIAL NETWORK.
HOWEVER, THE INTERNET IS THE PREFERRED PLACE TO GO WHEN YOU HAVE UNCERTAINTY ABOUT A SPECIFIC
TOPIC SUCH AS VACCINE INFORMATION, FOR EXAMPLE. THE OTHER PIECE IT HAS LED TO A NUMBER OF
CHALLENGES IN THIS SPACE IS THIS IDEA OF MOMMY BLOGS.
SO PARENTS ARE INCREASINGLY SPEAKING INFORMATION ON LINE, AND USER GENERATED PLATFORMS, SO
THOSE THAT ACTUALLY HAVE VACCINE SAFETY CONCERNS, THOSE PARENTS THAT HAVE THOSE TYPES OF CONCERNS,
OR ARE MORE LIKELY TO DELAY OR REFUSE VACCINES ARE MORE LIKELY TO SEEK HELP ONLINE RATHER
THAN TALKING TO A PEDIATRICIAN OR OB/GYN IF YOU’RE PREGNANT, FOR EXAMPLE.
THE QUESTION COMES WHY IS THIS HAPPENING? WHY ARE PEOPLE TURNING AND CHOOSING SOURCES
THEY DECIDE TO GO TO? SO, I THINK SOMEONE TOUCHED UPON THIS BEFORE
IN SOME QUESTIONS FROM THE LAST SESSION, FOCUSED ON THIS.
BUT THERE WAS A REVIEW THAT LOOKED AT ESSENTIALLY HOW PROVIDERS WERE PERCEIVING THEIR RELATIONSHIPS
WITH THEIR PATIENTS, AND IN ESSENCE PROVIDERS ARE REPORTING INCREASING CHALLENGES TO BUILDING
A TRUSTFUL RELATIONSHIP, AND THIS IS PARTICULARLY TRUE WITHIN THE VACCINE CONTEXT.
TRUST IN PROVIDERS HAS BEEN DECLINING, THERE’S BEEN A SYSTEMATIC REVIEW FOUR YEARS AGO THAT
FOUND THIS, INCLUDING THE VACCINE SPACE. WHEN YOU LOOK AT COMMUNE STRATEGIES, THAT
PROVIDERS ARE USING WITH THEIR PATIENTS, IT’S REALLY IMPORTANT TO THINK ABOUT THESE DECISIONS,
RIGHT? I WOULD SAY SORT OF THE OLD VIEW AND WAY THAT
COMMUNICATION IS FRAMED IS MAYBE PERHAPS THROUGH A MORE DIDACTIC APPROACH, MAYBE MORE PATRIARCHAL
BUT BECAUSE OF THE IDEA OF SHARED DECISION MAKING, HOW CONVERSATIONS CHANGED, PATIENTS
WANT A DIFFERENT TYPE OF INTERACTION. AND WE NEED TO ADAPT TO THAT FROM A PROVIDER
PERSPECTIVE. THE OTHER PIECE I THINK IS THAT BECAUSE THIS
USER CONTENT, THIS CONTENT ONLINE IS USER GENERATED, INFORMATION SHARING IS SEEN AS
MORE DEMOCRATIC ON SOCIAL MEDIA, SOMEONE WAS MENTIONING EARLIER IT’S CREATING ECHO CHAMBERS.
YOU’RE GOING TO SEEK INFORMATION, CONFIRMATION BIAS, THAT AGREE WAS YOUR OWN OPINION.
YOU’RE NOT GOING TO ENGAGE. I THINK THE FIRST PRESENTER TALKED ABOUT THIS
IDEA OF WEAK TIES BECAUSE THOSE ARE TIES THAT ACTUALLY LINK TWO NETWORKS TOGETHER, THAT’S
WHERE YOU’RE GETTING NEW INFORMATION FROM. IF YOU THINK ABOUT YOUR OWN SOCIAL NETWORKS,
THINK FOR A SECOND, THINK ABOUT DO YOU ENGAGE WITH PEOPLE THAT ARE PERHAPS POLITICALLY DIFFERENT
THAN YOU ARE? THINK ABOUT HOW THAT DISCOURSE HAS CHANGED,
HOW THAT INFORMATION IS NOW BECOMING QUITE CENTRALIZED AND A BIT OF ECHO CHAMBER.
WHAT ARE IMPLICATIONS AS TO WHY PEOPLE ARE SEEKING INFORMATION ONLINE?
I THOUGHT THIS WAS REALLY INTERESTING. DICTIONARY 2018, WORD OF THE YEAR WAS “MISINFORMATION.”
THIS WAS ABOUT TWO YEARS AGO. I WANT TO MAKE A DISTINCTION HERE.
WHEN PEOPLE SHARE MISINFORMATION, PARTICULARLY ONLINE, THEY BELIEVE THAT INFORMATION THEY
ARE SHARING, DOESN’T MATTER IF IT’S RIGHT OR WRONG, ACCURATE OR NOT.
DISINFORMATION IS DIFFERENT, CRAFTING A MESSAGE AND DISSEMINATING WITH INTENT TO MISLEAD OTHERS,
INTENT TO HARM. AN EXAMPLE HERE IS IF A POLITICIAN STRATEGICALLY
SPREADS INFORMATION THEY KNOW IS FALSE, THAT’S DISINFORMATION.
AN INDIVIDUAL LIKE ME SEE IS. I DON’T KNOW IF IT’S TRUE OR FALSE AND SHARE
IT, THAT’S MISINFORMATION. MISINFORMATION PARTICULARLY AROUND VACCINES
IS CONTINUING TO SPREAD AT A RAPID PACE. WHY ARE WE SEEING MORE OF THIS?
SOCIAL MEDIA IS GREAT IN A LOT OF DIFFERENT WAYS.
IT’S ALLOWED FOR A MUCH MORE DEMOCRATIC DEBATE ON ISSUES BUT INCREASES THE POSSIBILITY OF
RAPID DISSEMINATION. THE OTHER PIECE, I TALK ABOUT THIS A LOT,
PARENTS, WHEN YOU THINK ABOUT WHAT YOU’RE POSTING ON FACEBOOK OR TWITTER OR ANY SORT
OF SOCIAL MEDIA, WE JOKE ABOUT THIS WITH OTHER PARENTS THAT I ENGAGE WITH AND THAT WORK IN
THIS SPACE. I SAID HOW MANY OF YOU POSTED A PICTURE OF
YOUR CHILD GETTING A FLU SHOT AND SAID, THAT WAS AN AWESOME EXPERIENCE?
RIGHT? IT’S NOT VERY COMMON.
THE TYPE OF INFORMATION THAT YOU’RE GOING TO SHARE ON THESE TYPE OF PLATFORMS TEND TO
BE NEGATIVE EXPERIENCES, AND THOSE ARE THE ONES THAT TEND TO GO VIRAL, THAT PEOPLE ARE
INTERESTED IN. SO IT’S ALSO PART OF THE DISCOURSE OF THE
TYPE OF INFORMATION THAT’S MORE LIKELY TO BE POPULAR I WOULD SAY.
THE OTHER PIECE THAT’S INTERESTING ABOUT SOCIAL MEDIA IS THAT THERE IS NO FACT CHECKING AND
NO VETTING. YOU COMPARE THIS TO TRADITIONAL MEDIA SOURCES,
TYPICALLY HAVE TO GO THROUGH RIGOROUS FACT CHECKING PROCESS, AND THERE’S NOT A VET ON
SOCIAL MEDIA. AND THEN THERE’S ALSO THIS ISSUE OF INFLUENCE
BOTS WHICH WE’RE TRYING TO STUDY AND LOOK AT FOR ARTIFICIAL INTELLIGENCE TYPE OF LENS,
ANONYMOUS, AUTOMATED AGENTS UNATTACHED TO A REAL INDIVIDUAL AND SHARE DISINFORMATION
ON PURPOSE. AGAIN, WITH THE INTENT TO HARM.
SO WHAT SHOULD WE DO, RIGHT? WHAT IS THE WAY FORWARD?
THERE’S A NUMBER OF CHALLENGES I THINK THAT HAVE BEEN PRESENTED TODAY.
WE THINK ABOUT THIS FROM A PROVIDER PERSPECTIVE. WE’VE DONE A LOT OF RESEARCH LOOKING AT THIS.
SO THE NUMBER ONE THING I WOULD SAY FROM A PROVIDER PERSPECTIVE OR ANY SORT OF PERSPECTIVE
IF YOU’RE TALKING TO SOMEONE ONE ON ONE THAT PERHAPS DOES NOT SHARE A PRO VACCINE STANCE
LIKE YOU DO, DON’T CORRECT MISPERCEPTION, THIS IS HARD FOR PEOPLE TO STOMACH BECAUSE
OUR INSTINCTIVE IS TO CORRECT IT. WHEN YOU THINK ABOUT TOPICS WHERE THERE’S
UNCERTAINTY OR CONTROVERSY WHICH UNFORTUNATELY VACCINES ARE NOW CONTROVERSIAL, IF YOU PRESENT
A MESSAGE THAT’S CHALLENGING AN INDIVIDUAL’S PREEXISTING BELIEF OR ATTITUDE THAT WILL LEAD
THEM TO HAVE A STRONGER STANCE TOWARDS THAT INCORRECT BELIEF OR MESSAGE.
THE FIRST THING, DON’T CORRECT THE MISPERCEPTION. SECOND THING WOULD BE TAP INTO AN AVAILABILITY
HUERISTIC, THINGS THAT WE USE ON A DAY TO DAY BASIS, SHORT CUTS TO MAKE DECISIONS SO
WE DON’T HAVE TO THINK THROUGH EVERY SINGLE DECISION WE’RE GOING TO MAKE IN A PARTICULAR
DAY. IN TERMS OF THE AVAILABILITY HUERISTIC, IT
DESCRIBES OUR PROPENSITY TO ESTIMATE PROBABILITY OF EVENT HAPPENING BASED ON HOW EASILY INSTANCE
COMES TO MIND. A PERSON MAY ARGUE WITH YOU THAT SMOKING IS
NOT UNHEALTHY BECAUSE LET’S SAY THEIR GRANDFATHER SMOKED TWO PACKS A DAY AND LIVED TO BE 100,
RIGHT? IT’S THIS IDEA THAT PEOPLE TEND TO OVERESTIMATE
THE IMPORTANCE OF INFORMATION THAT’S AVAILABLE TO THEM.
TAP INTO INFORMATION THAT THEY ARE FAMILIAR WITH AND THAT THEY KNOW AND USE THAT TO THEIR
ADVANTAGE WHEN YOU’RE TALKING REGARDING VACCINE CONVERSATIONS.
THE OTHER PIECE I THINK IS REALLY IMPORTANT, A BIT OF A CHALLENGE SOMETIMES IS FOCUSING
ON THE DISEASE. A LOT OF PARENTS THAT WE SPEAK TO, PARTICULARLY
RELATED TO THINGS LIKE POLIO, FOR EXAMPLE, THEY HAVE NEVER SEEN THESE DISEASES.
THEY HAVE NO CONTEXT OR IDEA. THEIR RISK PERCEPTION, I.E. ABILITY TO THINK
WHETHER OR NOT THEIR CHILD IS SUSCEPTIBLE TO THE DISEASE AND HOW SEVERE THE DISEASE
MIGHT BE IF THEY END UP CONTRACTING IT IS RELATIVELY LOW.
WE HAVE TO FLIP THAT CONVERSATION AND THINK HOW DO WE ENHANCE RISK PERCEPTION.
PIVOT TO THE DISEASE ITSELF AS WELL AS SUSCEPTIBILITY AND SEVERITY OF THE DISEASE.
THE OTHER PIECE THAT’S INTERESTING AND WE’RE STARTING TO DO MORE WORK IS THIS IDEA OF USING
NUDGES AND DEFAULTS, SO YOU’RE USING PRESUMPTIVE COMMUNICATION.
SO INSTEAD AS A PATIENT COMES IN AND YOU SAY, HI, JOHNNY, WOULD YOU LIKE TO JOHNNY TO GET
HIS MMR VACCINE, RIGHT? THE CONVERSATION INSTEAD SHOULD BE, IT’S TIME
FOR JOHNNY TO GET HIS MMR VACCINE SO YOU’RE AUTOMATICALLY MAKING ASSUMPTION THE PARENT
IS GOING TO ACCEPT, SHOWN ACROSS A NUMBER OF TOPICS.
I LIVED OVERSEAS AND WORKED IN HIV, OPT OUT APPROACH IS SUCCESSFUL SO YOU HAVE TO OPT
OUT IF YOU’RE A MOTHER THAT’S GIVING BIRTH IN PARTICULAR COUNTRIES AND EVEN HERE IN THE
UNITED STATES NOW, YOU AUTOMATICALLY GET TESTED FOR HIV, WE COULD DO THIS IN VACCINE CONTEXT
AS WELL SO YOU DON’T ALLOW FOR PARENTS TO HAVE A DECISION, YOU ASSUME THEY ARE GOING
TO ACCEPT THE VACCINE AND YOU MOVE ON. SO WE’VE ACTUALLY WRITTEN A BOOK THAT HAS
FOCUSED A BIT ON SOME OF THESE THINGS WE’VE LEARNED, SOME STUDIES I’VE TALKED ABOUT, SORRY,
POINTS I’VE MADE TODAY ARE ACROSS A NUMBER OF RCT STUDIES WE HAVE CONDUCTED AND WE HAVE
A LOOK THAT LOOKED AT WAYS WHICH PROVIDERS CAN IMPROVE COMMUNICATION.
WHAT WE DID, ONE OF OUR STUDIES, WE DECIDED ONE OF THE MAJOR CHALLENGES WHEN WE’RE THINKING
ABOUT DECISION MAKING OF VACCINES, MOTHERS WHEN THEY ARE PREGNANT NEED TO HAVE INFORMATION
THAT’S TAILORED TO THEM. SO, YOU KNOW, I STARTED WORKING ON THIS WORK
WHEN I ESSENTIALLY WAS PREGNANT WITH MY SECOND CHILD.
I HAD A LOT OF QUESTIONS ABOUT VACCINES. AGAIN, THE PIECE HERE IS TO THINK ABOUT I
THINK A LOT OF MOTHERS DO HAVE QUESTIONS ABOUT VACCINES.
THERE’S NOTHING WRONG WITH THAT. SO WHAT WE NEED TO DO IS MAKE SURE WE’RE TAILORING
INFORMATION IN A WAY THAT IS UNDERSTANDABLE, THAT’S CREDIBLE.
SO WHAT WE DO IS DEVELOPED AN ALGORITHM, USING AN APP, WHERE I WOULD ANSWER A NUMBER OF QUESTIONS,
LET’S SAY, LET’S SAY MY CONCERN ABOUT VACCINES IS RELATED TO INGREDIENTS.
I WOULD THEN GET TAILORED EDUCATIONAL CONTENT ABOUT INGREDIENTS SPECIFICALLY.
WE FOLLOWED A BIT OF THIS STORY PATHWAY. THE NUMBER ONE THING WE’RE FINDING ACROSS
OUR STUDIES, WE JUST ACTUALLY DEVELOPED A SCALE TO MEASURE TRUST, IS THAT THIS IS THE
BIGGEST ISSUE THAT WE’RE FINDING. THERE’S FOUR MAIN CONCERNS THAT WE FOUND ACROSS
OUR WORK AS TO WHY PEOPLE HAVE CONCERNS ABOUT VACCINE INGREDIENTS, SCHEDULE, SIDE EFFECTS,
HOW DO WE ESTABLISH TRUST BETWEEN A PROVIDER AS WELL AS PATIENT SO WE CAN ENSURE THAT PATIENT
KNOWS THAT DOCTOR CARES ABOUT THEM. SO IN TERMS OF THIS APP, AND THIS TAILORED
INFORMATION THAT WE’VE DEVELOPED, WE START WITH ESTABLISHING TRUST.
WE THEN FOCUS ON EMPATHY. THIS WAS A HUGE POINT OF CONTENTION WHEN WE
DEVELOPED THIS WORK BECAUSE I SAID, LISTEN, MOTHERS WANT TO DO WHAT’S RIGHT FOR THEIR
CHILD. WE NEED TO BE EMPATHETIC, THEY MIGHT HAVE
CONCERNS, WE DON’T WANT TO REINFORCE CONCERNS BUT WANT TO UNDERSTAND AND BE ABLE TO RELATE
TO THEM THAT WE EMPHASIZE THEY WANT TO DO RIGHT.
WE PIVOT TO DISEASE RISK, FOCUS ON THE IDEA OF SELF EFFICACY, CALL TO ACTION, AND WE HAD
PROVIDERS, THESE WERE OB/GYNs AS WELL AS PEDIATRICIANS, FOCUSED FOR MATERNAL VACCINATION AND PEDIATRIC
VACCINATION, TALK ABOUT THEIR OWN STORY. THIS IS WHAT I WOULD SAY TO MY CHILDREN, THIS
IS WHAT I I DID WITH MY CHILDREN. AND THIS IS WHY.
WITH THAT I THINK I’M DONE AND I’LL HAND IT OVER.
>>THANK YOU VERY MUCH. NEXT IS DR. AUSTIN CHIANG.
>>HELLO. THANK YOU VERY MUCH FOR HAVING ME.
I KNOW I’M THE ONLY THING BETWEEN US AND LUNCH I BELIEVE.
HOPEFULLY I’LL BE PROVIDING DIFFERENT PERSPECTIVE. A LITTLE BIT OF BACKGROUND, I’M A GASTROENTEROLOGIST,
ADVANCED ENDOSCOPIST, A PHYSICIAN ACTIVE ON SOCIAL MEDIA, SOME WOULD SAY THAT I’M AN INFLUENCER
BECAUSE I’M SO ACTIVE ON SOCIAL MEDIA, THAT’S PART OF THE REASON I’M HERE TODAY TO SPEAK
ABOUT SOCIAL MEDIA AND THE HEALTH PROFESSIONAL. I’M GOING TO TALK HOW WE THINK ABOUT SOCIAL
MEDIA OR TRY TO CONVINCE MY PHYSICIAN COLLEAGUES AND CLINICIAN COLLEAGUES TO THINK ABOUT SOCIAL
MEDIA. MY MOTIVATION IN GETTING INTO THIS SPACE AND
SOME CHALLENGES THAT WE FACE. IT GOES WITHOUT SAYING THAT SOCIAL MEDIA HAS
AN IMPACT ON OUR SOCIAL POLITICAL LANDSCAPE, AND AS SOME PREVIOUS SPEAKERS HAVE MENTIONED,
WE OFTEN ATTRIBUTE SOCIAL MEDIA TO INFLUENCER CULTURE, SELFIES, TAKING PICTURES OF YOUR
FOOD BUT NOT NECESSARILY HAVING AN IMPACT ON HEALTH.
AND AT THE SAME TIME, WE KNOW THAT THERE ARE A LOT OF PEOPLE OUT THERE WHO ARE USING SOCIAL
MEDIA TO THEIR ADVANTAGE, TO DISSEMINATE BOTH POSITIVE AND NEGATIVE HEALTH MESSAGES.
SO IF WE THINK ABOUT THE IMPACT OF SOCIAL MEDIA, WE CAN THINK IN TERMS OF SELFIES, SOME
LEVERAGE TO CREATE MULTI MILLION DOLLAR BUSINESSES, AGENCIES HERE UTILIZE SOCIAL MEDIA IN POSITIVE
WAYS, MEDICAL JOURNALS HAVE BEGUN GETTING MORE INVOLVED ON DISSEMINATING CONTENT ON
SOCIAL MEDIA. SO THIS WHOLE SPACE IS OBVIOUSLY MOVING FORWARD.
IN TERMS OF MEDICINE AND SOCIAL MEDIA, MAJOR PLAYERS INCLUDE MAJOR JOURNALS, OUR SOCIETIES,
PROFESSIONAL SOCIETIES, ORGANIZATIONS, THOUGHT LEADERS, COLLEAGUES, AND OF COURSE OUR PATIENTS
ARE ACTIVELY USING SOCIAL MEDIA. THE SCREEN SHOT ON THE RIGHT IS THE HASHTAG
#WLS COMMUNITY, WEIGHT LOSS SURGERY COMMUNITY. UNBEKNOWNST TO MY COLLEAGUES THEY HAD NO IDEA
PATIENTS WERE SHARING BEFORE AND AFTER PHOTOS, DEVELOPING COMMUNITIES, AND IT GOES TO SHOW
PATIENTS ARE REALLY USING SOCIAL MEDIA TO CONNECT AND LEARN ABOUT EACH OTHER’S JOURNEYS.
SO I KNOW THERE’S A STIGMA AROUND THE WORD “INFLUENCER” BECAUSE WE THINK OF KIM KARDASHIANS
OF THE WORLD BUT TRUTH IS I LIKE TO THINK OF US IN SOME WAYS AS SPOKESPEOPLE FOR OUR
AREAS OF EXPERTISE SINCE THAT’S WHERE MY CLINICAL TRAINING IS.
AND WITH THE RISE OF THE INFLUENCER OVER THE PAST SEVERAL YEARS ESPECIALLY WITH THESE MORE
IMAGE OR VIDEO BASED SOCIAL MEDIA PLATFORMS, OVER THE PAST TWO OR THREE YEARS OR SO I WOULD
SAY THAT THERE HAVE BEEN MANY, MANY MORE HEALTH PROFESSIONALS GETTING ONLINE THEMSELVES AND
BECOMING INFLUENCERS AS WELL. AND I’LL GET INTO THIS IN A LITTLE BIT BUT
AS INFLUENCERS THERE COMES THIS WE’RE OFTEN APPROACHED WITH SPONSORSHIP OPPORTUNITIES
AND SORT OF PEOPLE WANT TO USE OUR NETWORKS AND OUR AUDIENCES THROUGH US, TO CONVEY CERTAIN
MESSAGES OR PROMOTE CERTAIN PRODUCTS AND THINGS LIKE THAT.
IT’S REALLY THAT WHOLE INFLUENCER MARKET THAT IS A BILLION DOLLAR INDUSTRY, IS REALLY ENCROACHING
INTO THE HEALTH CARE SPACE AS WELL. SO CHANCES ARE IF YOU’RE NOT ON SOCIAL MEDIA
YOU’RE PROBABLY ALREADY USING IT BECAUSE THERE’S SO MANY DIFFERENT SOCIAL MEDIA PLATFORMS OUT
THERE KNOW. THESE GRAPHICS ARE GOING TO SHOW SOCIAL MEDIA
USE HAS GROWN OVER TIME, SPANNED ALL AGES, AND IT’S ONLY BECOMING MORE COMMON ESPECIALLY
IN AGE GROUPS WE DON’T OFTEN SOCIAL WITH SOCIAL MEDIA USE.
THE TIME WE SPEND ON SOCIAL MEDIA IS HOURS PER DAY, AT LEAST ON AVERAGE, ACROSS SOCIAL
MEDIA USERS. SO THERE’S SIGNIFICANT AMOUNT OF TIME THAT
WE’RE BEING EXPOSED TO INFORMATION THROUGH SOCIAL MEDIA AS WELL.
SO I JUST WANT TO TALK ABOUT WHAT MOTIVATED ME.
SO WHEN I WAS GOING THROUGH MY MEDICAL TRAINING, IT BECAME VERY APPARENT TO ME, VERY QUICKLY,
THAT MY PATIENTS WERE NOT GETTING THEIR MEDICAL INFORMATION OR KNOWLEDGE THROUGH OUR ONE ON
ONE ENCOUNTERS THAT WERE LASTING 10, 20, 30 MINUTES IN THE CLINIC.
THEY ARE GETTING ALL THEIR MEDICAL KNOWLEDGE THROUGH THE TRADITIONAL MEDIA, SOCIAL MEDIA,
AND SO I WANTED TO SPEND TIME WHEN I WAS GOING THROUGH TRAINING AT ABC NEWS TO UNDERSTAND
THE PROCESS WHERE MEDICAL JOURNALS, HOW THE MEDICAL LITERATURE WAS VETTED BEFORE MAKING
ITS WAY TO THE EVENING NEWS. I WANTED TO KNOW HOW SUDDENLY WHEN WE’RE WATCHING
THE EVENING NEWS WHY THERE’S A BREAKING REPORT, BIG BREAKING NEWS REPORT ABOUT THE LATEST
STUDY THAT SHOWS X, Y, OR Z. IN THAT PROCESS I SAW HOW ABC NEWS WAS USING
SOCIAL MEDIA, REPRESENTATIVES OF ORGANIZATIONS WERE INVOLVED IN THESE CHATS, AND SO I DECIDED
I WANTED TO USE SOCIAL MEDIA PROFESSIONALLY HAVING BEEN A SOCIAL MEDIA USER, HAVING GROWN
UP IN THIS FACEBOOK GENERATION, AS WELL. AND OVER TIME, I STARTED LIVE TWEETING MILLION
CONFERENCES I WAS ATTENDING, STARTED GETTING INVOLVED WITH ESPECIALLY IN MY ACADEMIC GASTROENTEROLOGY
WORLD PROBABLY ONE OF THE FIRST TEN ACADEMIC GASTROENTEROLOGISTS ON TWITTER.
FROM THERE IT’S REALLY EXPANDED BECAUSE THE PROFESSIONAL SOCIETIES WANTED TO LEVERAGE
SOCIAL MEDIA AS WELL. I’VE BEEN HELPING ALL OF OUR PROFESSIONAL
SOCIETIES WITH SOCIAL MEDIA, WITH THEIR SOCIAL MEDIA EFFORTS, AND FROM THERE THAT’S WHAT
LED TO MY CURRENT ROLE AT JEFFERSON HEALTH, ENTERPRISE WIDE, AS CHIEF MEDICAL SOCIAL MEDIA
OFFICER WHERE I’M TRYING TO GET MORE CLINICIANS TO BE PRESENT ONLINE TO BE AN ACCURATE SOURCE
OF INFORMATION. SO THAT’S SORT OF MY STORY IN A NUTSHELL.
AND I REALIZED ESPECIALLY BEING ACTIVE SOCIAL MEDIA USER THAT THIS IS A SCREEN SHOT ON THE
LEFT, FROM THE MEDICAL MEDIUM, I DON’T KNOW ANY OF YOU WHO IF YOU KNOW OF THE MEDICAL
MEDIUM, HE HAS TWO MILLION FOLLOWERS ON INSTAGRAM, HE BASES HIS MEDICAL KNOWLEDGE FROM A UNIQUE
ABILITY TO CONVERSE WITH THE SPIRIT OF COMPASSION, WHICH PROVIDES HIM WITH EXTRAORDINARILY ACCURATE
HEALTH INFORMATION. AND HE CLEARLY HAS A LOT OF BELIEVERS, AND
SOME INFORMATION HE PUTS OUT THERE ISN’T EVEN SO SCARY IN THE WAY HE’S PUTTING OUT THERE,
IT’S COMMENTS I READ WHERE HIS FOLLOWERS ARE TRYING TO JUSTIFY THE MECHANISM OF HOW CELERY
JUICE CAN CURE CERTAIN DISEASES. SO THIS IS REALLY WHAT WE’RE UP AGAINST.
SO WHAT I DISCOVERED OVER TIME IS OBVIOUSLY THERE’S A LOT OF ERRONEOUS INFORMATION ON
SOCIAL MEDIA. CLINICIANS AND THOUGHT LEADERS WITHIN THE
FIELD NEED TO BE ON SOCIAL MEDIA TO BE HEARD, OTHERWISE OTHER PEOPLE WILL DOMINATE THE CONVERSATION,
BUT WE ALSO NEED INCENTIVES TO PARTICIPATE ON SOCIAL MEDIA, WE’RE OBVIOUSLY BUSY HEALTH
PROFESSIONALS WITH CLINICAL DUTIES. AND THIS HASN’T REALLY BEEN PRIORITIZED IN
THE PAST. WE ALSO HAVE BETTER GUIDANCE ON HOW TO USE
SOCIAL MEDIA, DEVELOPING AND AUDIENCE, USING SOCIAL MEDIA LIKE INFLUENCER IS DIFFERENT
THAN CASUALLY USING SOCIAL MEDIA. AND USING IT RESPONSIBLY SO WE ARE NOT FURTHER
ERODING TRUST WITH THE GENERAL PUBLIC IS REALLY IMPORTANT.
THIS IS AN EXCERPT FROM DR. RUSHMAN, WHO SPOKE EARLIER, ABOUT SPEAKING ABOUT THE AUTOMATED
BOTS THAT WE’RE UP AGAINST AS CLINICIANS. AND I’M JUST GOING TO SKIP OVER THIS SLIDE
QUICKLY. I WANT TO SHOW YOU SOME SCREEN SHOTS OF MY
PRESENCE ON SOCIAL MEDIA BECAUSE I’M ACTIVE ON ALL PLATFORMS.
I REALLY USE DIFFERENT PLATFORMS IN DIFFERENT WAYS BECAUSE ON TWITTER, FOR INSTANCE, THE
MAIN AUDIENCE I’M ENGAGING WITH ARE MY COLLEAGUES. SO IT IS AN ECHO CHAMBER BUT IT’S WHERE A
LOT OF ACADEMIC DISCUSSION IS HAPPENING AND WHERE A LOT OF COLLABORATIONS, PROFESSIONAL
COLLABORATIONS, ARE BEING BORNE OUT. AND THERE ARE A LOT OF DIFFERENT FUNCTIONS
THAT WE CAN UTILIZE WITH EACH SOCIAL MEDIA PLATFORM TO BETTER ENGAGE WITH AUDIENCE, WHETHER
POLLING OR DOING Q&A SESSIONS OR LIVE STREAMING, AND WHAT NOT.
THESE ARE SOME SCREEN SHOTS OF TWITTER, LINKED IN, FACEBOOK, YouTube, CLEARLY THERE’S DIFFERENT
AESTHETIC AND APPEARANCE TO HOW I’M CURATING MY CONTENT AND STRUCTURING THE CONTENT ON
YouTube. I’M NOT TALKING ABOUT THE SCIENTIFIC SORT
OF NITTY GRITTY. I’M ANSWERING MORE GENERALIZED QUESTIONS,
THINGS THAT I THINK PATIENTS WOULD WANT TO KNOW THAT ARE MUCH BROADER OR MEDICAL TRAINEES
WOULD WANT TO KNOW. THIS IS MY INSTAGRAM PRESENCE, WHERE I DO
SOME EDUCATION, I CAN EXPOUND ON MY THOUGHTS THROUGH THE CAPTIONS A LITTLE BIT MORE AND
UTILIZE FUNCTIONS AS YOU SEE ON THE RIGHT, Q&As, POLLS, LIVE STREAMS.
MORE RECENTLY ON TIK TOK THERE’S AN INFLUENCE OF HEALTH PROFESSIONALS, I WAS PROBABLY ONE
OF THE FIRST FEW PHYSICIANS ON TIK TOK. YOU MIGHT KNOW TIK TOK IS THE FASTEST GROWING
SOCIAL MEDIA PLATFORM IN THE PAST YEAR, 500 MILLION ACTIVE USERS NOW, REACHING A YOUNGER
DEMOGRAPHIC, THERE’S BEEN A LOT OF MEDIA ATTENTION AROUND THIS.
I DIDN’T KNOW IF ANY OF THESE VIDEOS WOULD PLAY BUT MY COLLEAGUE HERE, DR. BALDWIN, SHE’S
A PEDIATRICIAN AND SHE ACTUALLY DID A VACCINE, INFORMATIVE VACCINE TIK TOK, USUALLY SET TO
MUSIC AND DANCE. AND THIS ACTUALLY BLEW UP AND I THINK GOT
MAYBE OVER 11 MILLION VIEWS AND SPARKED A LOT OF CONVERSATION.
I’LL GET INTO A LITTLE BIT OF HOW THAT BECAME PROBLEMATIC BUT MANY OF US ARE ON THERE TO
REALLY USE IT FOR EDUCATIONAL PURPOSES AND REACH A YOUNGER AUDIENCE.
YOU CAN SEE WE WERE COVERED BY THE “NEW YORK TIMES,” GOOD MORNING AMERICA YESTERDAY CONFERRED
OH. IT’S PLAYING ALL AT ONCE.
I’M SORRY. THEY WERE SUPPOSED TO PLAY INDIVIDUALLY.
IT’S VERY CHAOTIC, YOU GET THE IDEA. IT’S WHAT MANY YOUNGER AUDIENCES ARE GOING
TO. I WILL TELL YOU THAT I THIS PAST WEEK SAW
MY FIRST PATIENT IN CLINIC WHO WAS SELF REFERRED FROM TIK TOK.
ALL MY COLLEAGUES AND THEIR CHILDREN HAVE BEEN EXPOSED TO MY CONTENT, AND THE DIFFERENCE
BETWEEN TIK TOK AND OTHER SOCIAL MEDIA PLATFORMS ON TWITTER, FACEBOOK, INSTAGRAM CONTENT WE’RE
SEEING IS FROM PEOPLE THAT WE’RE FOLLOWING OR ASSOCIATED ACCOUNTS FROM PEOPLE THAT WE’RE
FOLLOWING. TIK TOK FORCES CONTENT IN FRONT OF PEOPLE
WHO OTHERWISE WOULDN’T SEE OUR CONTENT AS LONG AS IT’S ENGAGING AND POPULAR.
IT GIVES US AN OPPORTUNITY TO REACH OUT TO AUDIENCES WHO MAY OTHERWISE NOT BE INTERESTED
IN HEALTH INFORMATION. OR LOOKING FOR THIS SORT OF INFORMATION.
WE’VE BEEN TALKING ABOUT VAPING, REPRODUCTIVE HEALTH, ALL SORTS OF TOPICS, VACCINES INCLUDED,
ON TIK TOK. SO AS I MENTIONED, THIS IS A GRID THAT JUST
SHOWS FOR EVERY SOCIAL MEDIA PLATFORM THERE’S A DIFFERENT PURPOSE, SERVING A DIFFERENT AUDIENCE.
WHENEVER I RECOMMEND TO MY CLINICAL COLLEAGUES HOW TO UTILIZE OR WHAT THEIR SOCIAL MEDIA
PRESENCE HOW TO CRAFT IT, THEY NEED TO THINK ABOUT WHAT THEIR PURPOSE IS BEING ONLINE AND
WHO THEIR AUDIENCE IS. I WANT TO EMPHASIZE THE FACT THROUGH MEDICAL
TRAINING WE HAVE NO MARKETING BACKGROUND, COMMUNICATION TRAINING, P.R., NOTHING.
AND WE’RE EXPECTED TO STORY TELL AND EXPECTED TO IMPACT PUBLIC HEALTH.
YET WE’RE NOT REALLY TRAINED TO DO SO. WE’RE TRAINED TO BE EXPERTS IN SCIENCE.
WE’RE TRAINED TO, YOU KNOW, TRY TO COMMUNICATE ON A ONE ON ONE BASIS, BUT TO THE GLOBAL COMMUNITY
OUT THERE WE’RE NOT SO GOOD AT THAT. SO A LOT OF US WHO HAVE BEEN ACTIVE ON SOCIAL
MEDIA LEARN FROM TRIAL AND ERROR, FROM EACH OTHER, AND WE’RE HOPING WE CAN GET THE MESSAGE
OUT THERE A LOT BETTER. IT DOES TAKE A LEAP OF FAITH.
I GET SCARED EVERY TIME I TRY AND USE A SOCIAL MEDIA PLATFORM.
A HUGE LEARNING CURVE. BUT WE DO HAVE TO UNDERSTAND THAT WE WANT
TO SERVE AN APPROPRIATE AUDIENCE, IDENTIFY THE RIGHT AUDIENCE WE’RE SERVING, SOCIAL MEDIA
HAS TO BE SOCIAL, YOU CAN’T JUST POST SOMETHING AND EXPECT IT TO GO VIRAL.
THAT’S NEVER HOW IT WORKS. IT’S USUALLY A COORDINATED EFFORT.
AND WE’VE DEFINITELY DONE THAT FOR, YOU KNOW, VACCINE MESSAGING AS WELL.
AND I SUGGEST TO MY COLLEAGUES TO FIND A ROLE MODEL BECAUSE THERE ARE A LOT OF US OUT THERE
NOW DOING THIS. AND THERE ARE A LOT OF WAYS TO AMPLIFY OUR
MESSAGES USING HASHTAGS AND CAMPAIGNS AND REALLY THESE PLATFORMS REALLY PROVIDE ANALYTICS
WHERE WE CAN REFLECT ON WHEN TO BEST ENGAGE WITH OUR AUDIENCE AND WHO EXACTLY THE DEMOGRAPHICS
OF THE PEOPLE ENGAGING WITH OUR CONTENT. AND THESE ARE SOME BENEFITS THAT I LIKE TO
EMPHASIZE TO MY COLLEAGUES OF BEING ON SOCIAL MEDIA, WHETHER IT’S GETTING NOTIFIED IN REAL
TIME OF NEWS, WITHIN THE MEDICAL FIELD, BEING PART OF THE DISCUSSION, PROFESSIONAL DISCUSSION
ONLINE, NETWORKING WITH PEERS, DISPELLING MISCONCEPTIONS ABOUT OUR FIELDS, A LOT OF
PEOPLE THING I’M A GASTROENTEROLOGIST AND ONLY DEAL WITH COLONOSCOPIES AND POOP.
I WORK WITH PANCREAS AND BILE DUCT, I LIKE TO SHOW ESPECIALLY ASPIRING DOCTORS THAT’S
NOT ALL THERE IS TO MY FIELD. COMBATING THIS INFORMATION, BOOSTING INSTITUTIONAL
REPUTATION. ON TWITTER AT AN INSTITUTION WITH “U.S. NEWS
& WORLD REPORT” RANKING, A LOT OF INSTITUTIONS ARE PAYING ATTENTION TO THAT.
HUMANIZING THE PROFESSION IS A HUGE, HUGE ELEMENT TO THIS.
THAT PART OF REGAINING THE TRUST OF THE GENERAL PUBLIC, I THINK, IS TO SHOWCASE THE FACT THAT
WE’RE HUMAN BEINGS TOO. WE HAVE THE SAME STRUGGLES AND INTERESTS AND,
YOU KNOW, WE LIKE TO BE FUNNY AND ENGAGE WITH OUR AUDIENCES AS WELL.
NOW SOME CHALLENGES OF SOCIAL MEDIA, THERE ARE MANY CHALLENGES AND A LOT OF PITFALLS,
PROFESSIONAL PITFALLS, WHETHER IT’S DEALING WITH PROTECTING PATIENT PRIVACY ONLINE, WITH
HIPAA, AVOIDING INDIVIDUALIZED MEDICAL ADVICE, HOW DO WE HANDLE SPONSORSHIP AND ENDORSEMENT
OF PRODUCTS, FIVE YEARS AGO WEREN’T APPROACHED, NOW THOSE OF US WITH FOLLOWING ARE BEING APPROACHED,
DISCLOSING CONFLICTS INTEREST ON LINE, PROFESSIONAL CONCERNS AMONGST EACH OTHER AND ALSO, YOU
KNOW, HOW WE PORTRAY OR FIELD. THERE’S BEEN A LOT OF ARTICLES ESPECIALLY
ON TIK TOK HOW SOME INDIVIDUALS, NURSES AND DOCTORS, HAVE MADE FUN OF PATIENTS, THEY HAVE
BEEN TRYING TO BE, YOU KNOW, HUMOROUS AT THE EXPENSE OF PATIENTS, AND THAT’S CAUSED AN
UPROAR OVER THE PAST MONTH. MISREPRESENTATION AND MISLEADING THE PUBLIC,
THE HASHTAG #VERIFY HEALTH CARE I STARTED A LITTLE OVER A YEAR AGO WAS THAT I STARTED
NOTICING INDIVIDUALS CALLING THEMSELVES DOCTOR ONLINE, WHETHER SOME OF THEM WERE ACTUALLY
MEDICAL TRAINEES, NOT FULL FLEDGED PHYSICIANS YET.
NOT EVERYONE ON THEIR WHO SAYS THEY ARE A DOCTOR IS NECESSARILY A DOCTOR.
THOSE OF US WITH DECENT SIZE FOLLOWINGS, I ENCOURAGED THEM TO SHARE CREDENTIALS AND FOLLOWERS
SHOULD DOUBLE AND TRIPLE CHECK WHO THEY ARE FOLLOWING ONLINE, A MOVEMENT WE STARTED THAT
RESONATED WITH OUR AUDIENCES. I TALK ABOUT PSYCHOLOGICAL STRAIN ON THOSE
OF US WHO USE SOCIAL MEDIA A LOT AND THE FACT IT’S A TIME COMMITMENT.
I WANT TO EMPHASIZE PERSONAL SAFETY AND WELL BEING IN THE CONTEXT OF THIS VACCINE DISCUSSION
BECAUSE DR. BALDWIN HERE AND SOME OTHERS BECAUSE OF HOW QUICKLY THEIR MESSAGE ABOUT VACCINES
SPREAD WITH THEIR TIK TOKs, ACTUALLY WERE ATTACKED BY SOME MAJOR NON VACCINATORS ONLINE,
AND THEY WERE VERY CONCERNED FOR THEIR PERSONAL SAFETY.
AND THEIR PROFESSIONAL SORT OF WELL BEING BECAUSE THESE GROUPS WOULD SWARM THEIR GOOGLE
REVIEWS AND GIVE THEM ONE STAR RATINGS. THAT COULD AFFECT THEIR PROFESSIONAL THEIR
CAREERS. SO THERE’S THIS GROUP, MAYBE SOME OF YOU KNOW
ABOUT SHOTS HEARD AROUND THE WORLD, THAT HAVE DEVELOPED SORT OF A TOOLKIT TO HELP OTHER
CLINICIANS WHO FACE THESE THREATS AND HOW TO HANDLE THEM, BUT I THINK THAT WE REALLY
NEED TO BE MORE CONCERNED ABOUT HOW TO GO ABOUT THIS.
WE COULD USE MORE GUIDANCE, THOSE WHO ARE ACTIVELY USING SOCIAL MEDIA IF WE’RE GOING
TO PUT OUT INFORMATIVE VACCINE RELATED CONTENT WE NEED TO BE PREPARED TO FACE THE BACKLASH
AND KNOW HOW TO DEAL WITH SOME OF THE SAFETY CONCERNS WE MIGHT HAVE.
SOME OF THE THINGS THAT WE ENCOUNTER AS INFLUENCERS THESE DAYS ARE THINGS I NEVER THOUGHT ABOUT
FIVE YEARS AGO. PEOPLE ARE USING OUR PICTURES ON DATING WEBSITES,
USING OUR PICTURES TO PROMOTE PRODUCTS WITHOUT OUR PERMISSION.
WE HAVE NO WAY OF CONTROLLING THAT AT THE MOMENT.
[ MUSIC ] OH.
CONFUSING AUDIO EARLIER.>>SO, THE GREAT THING ABOUT TIK TOK IT CAPITALIZE
IT’S ON SHORT ATTENTION SPANS, 10 TO 15 SECONDS, WE CAN UTILIZE THAT SORT OF BENEFIT.
TAKEHOME POINTS, SOME ARE REDUNDANT FROM PREVIOUS SPEAKERS, BUT SOCIAL MEDIA PROFESSIONALS MAY
REDIRECT, BE LIKE THE MOMMY BLOGGERS BUT FROM A PHYSICIAN’S PERSPECTIVE.
SOME OF MY COLLEAGUES ARE MOMMY BLOGGERS AND PHYSICIANS.
SOCIAL MEDIA IS CRITICAL IN PUBLIC HEALTH MESSAGING.
IT MAY PLAY A ROLE IN SHAPING PERCEPTION OF HEALTH PROFESSIONALS.
THERE ARE MANY RISKS AND CONCERNS CONSTANTLY EVOLVING WITH THESE PLATFORMS AS THEY KEEP
ON ROLLING OUT DIFFERENT FEATURES AND AS THEY COME UP WITH NEW PLATFORMS AS WELL.
WE ALSO NEED MORE INCENTIVES AND GUIDANCE. SO JUST A LAST STEP IS THAT THAT WHOLE CONVERSATION
ABOUT VERIFY HEALTH CARE AND MISREPRESENTATION ON SOCIAL MEDIA LED TO MANY OF US COMING TOGETHER
TO CREATE ASSOCIATION FOR HEALTH CARE SOCIAL MEDIA.
WE FOUNDED LESS THAN A YEAR AGO. WE LIKE TO SAY WE’RE THE FIRST NON PROFIT
PROFESSIONAL SOCIETY FOCUSED ON HELPING HEALTH PROFESSIONALS UTILIZE SOCIAL MEDIA.
NOT ONLY IN UNDERSTANDING HOW TO PUT A MESSAGE OUT THERE AND BUILD AN AUDIENCE BUT ALSO TO
BE AWARE OF ALL THE CHALLENGES AND POTENTIALLY COMING UP WITH WAYS TO ADDRESS THAT.
OUR PRIMARY PRIORITY IS TRYING TO DEVELOP BEST PRACTICES, IN HOW TO USE SOCIAL MEDIA.
OF COURSE I THINK THERE’S A LOT OF DIFFERING OPINIONS THAT WE NEED TO SORT THROUGH.
WE HAVE OUR FIRST ANNUAL MEETING COMING UP THIS MAY IN PHILADELPHIA WE’RE TRYING TO,
YOU KNOW, TREAT LIKE OUR FIRST CONFERENCE OF SORTS.
WE HAVE LECTURE SERIES, WE HAVE ABSTRACT SUBMISSION PROCESS, WE’RE TRYING TO GET THE WHOLE MEDICAL
COMMUNITY TO SEE THIS IS AN IMPORTANT PART OF WHAT WE DO, AND OUR OBLIGATION AS CLINICIANS,
AND OUR ORGANIZATION IS OPEN TO NOT ONLY PHYSICIANS BUT NURSES, DENTISTS, ALL SORTS OF HEALTH
PROFESSIONALS, WHO ARE USING THEIR VOICE ONLINE TO TALK ABOUT HEALTH.
HOPEFULLY THIS IS AN EFFORT WILL CONTINUE TO GROW AND MAYBE COULD USE YOUR HELP AS WELL.
SO I THINK THAT IS IT. THANK YOU VERY MUCH.
>>THANK YOU, DR. CHIANG AND MEMBERS OF THE PANEL.
ANY QUESTIONS FROM MEMBERS OF THE COMMITTEE? DEBRA, SINCE I CUT YOU OFF EARLIER YOU GET
TO START.>>THANK YOU SO MUCH FOR THOSE PRESENTATIONS
AND REALLY IMPORTANT WORK. IT’S FASCINATING AND IMPORTANT.
I JUST WANT TO COMMENT THAT IN NEW YORK AS PROBABLY EVERYBODY KNOWS WE HAD A LARGE MEASLES
OUTBREAK IN A RELIGIOUS COMMUNITY THAT DOES NOT USE SOCIAL MEDIA.
SO, I AM FASCINATED TO SEE HOW THE IDEAS PROMOTED ON SOCIAL MEDIA WERE PRESENT IN THE COMMUNITY.
IT WOULD BE A FASCINATING AREA TO SEE HOW SOCIAL MEDIA IDEAS LEAK INTO THESE RELIGIOUS
COMMUNITIES THE AMISH COMMUNITY, THEY ARE INFILTRATING AND PROMOTING, JUST A COMMENT.
>>MARY ANNE?>>THANK YOU FOR THE PRESENTATIONS.
I THINK MY QUESTION IS FOR DR. BURKE GARCIA BUT ANYONE ON THE PANEL, RELATES TO WE’RE
THINKING ABOUT INFLUENCERS, HOW IMPORTANT IT IS TO BE MULTI GENERATIONAL.
I THINK SCARY MOMMY WAS MENTIONED. THAT SPECIFICALLY TARGETS MILLENNIAL MOMS
AS VERY PRO MESSAGING FOR VACCINES FOR INSTANCE. SO HOW IMPORTANT IS IT TO NOT ONLY TARGET
THE MILLENNIALS BUT OTHER GENERATIONAL CATEGORIES AND HOW CAN THAT HAPPEN?
>>YEAH, SORRY. I THINK IT’S REALLY, REALLY IMPORTANT BECAUSE
MILLENNIALS HAVE GROWN UP WITH SOCIAL MEDIA IN MOST CASES.
AND BUT, YOU KNOW, THE 45 TO 55 GENERATION ARE HEAVY USERS OF SOCIAL MEDIA.
ACTUALLY YOU DO SEE EVEN OLDER GENERATIONS GRAVITATING TO SOCIAL MEDIA TO STAY IN TOUCH
CAN FAMILY, SEE PICTURES OF THE GRANDKIDS. WE IMMEDIATE TO TAKE A MULTI GENERATIONAL
APPROACH. SCARY MOMMY IS WELL KNOWN, KIM KARDASHIAN
ARE WELL KNOWN. INFLUENCERS ARE LESS WELL KNOWN TO A GENERAL
AUDIENCE. BUT THEY ARE INCREDIBLY INFLUENTIAL IN THEIR
ONLINE COMMUNITIES. I THINK THAT, YOU KNOW, WE THE INFLUENCERS
WE INTERVIEWED IN OUR STUDY RANGED FROM I THINK I SAID 27 TO 53.
AND THEY ALL ARE HEAVY SOCIAL MEDIA USERS. THAT’S WHY WE CHOSE THEM.
AND SO THEY ALL REACH NETWORKS OF MOMS SIMILAR IN AGE AND HAVE CHILDREN OF VARYING ONE OF
OUR MOMS HAD NINE CHILDREN. SO HER YOUNGEST WAS MAYBE 3 MONTHS, OLDEST
WAS 22. SO YOU’RE REALLY TALKING ABOUT FINDING INFLUENCERS,
READING THEIR BLOG, GETTING TO KNOW THEIR CONTENT AND WHO THEY WHAT THEIR STORY IS.
AND THEN THEY WILL OFTEN SHARE INFORMATION THAT IS RELEVANT TO PEOPLE WHO THEN FOLLOW
THEM, RIGHT? SO IF THEY ARE SHARING INFORMATION ABOUT CHILDHOOD
VACCINATION OR CHILDHOOD VACCINES, BECAUSE THEIR KIDS ARE GOING THROUGH THAT, IT’S LIKELY
THEIR AUDIENCE WILL WANT TO SEE THAT INFORMATION AND BE OF THAT SAME KIND OF POPULATION.
I THINK IT’S IMPORTANT TO KNOW WHO THEY ARE, WHAT THEIR STORYS HOW OLD THEIR KIDS ARE AND
HELP TELL YOU A STORY WHAT KIND OF THINGS THEY WILL TALK ABOUT AND WHO THEY WILL REACH.
A LOT OF IN FACT THESE INFLUENCERS KNOW WHO AUDIENCES ARE, THEY DO DATA COLLECTION, AND
THE NETWORKS, WE WORK THROUGH THE MOTHERHOOD, THEY HAVE DATA ON THEM AS WELL.
SO YOU CAN ACTUALLY, IF YOU GET TO KNOW THEM OR WORK THROUGH A NETWORK THAT KNOWS THEM,
YOU CAN FIND OUT MORE ABOUT THEIR DEMOGRAPHICS AND WHO THEY REACH.
AND THAT WOULD BE HOW I WOULD APPROACH THAT QUESTION.
>>AND I WANTED TO EXPAND ON THAT JUST A LITTLE BIT.
NOT ONLY GENERATIONALLY SENSITIVE BUT ALSO CULTURALLY SENSITIVE.
THERE WERE NOT A LOT OF EXAMPLES UP THERE THAT FOR INSTANCE WERE AFRICAN AMERICAN, RELIGIOUS
COMMUNITY, WHICH CAN BE VERY INFLUENTIAL, ESPECIALLY IN IMPACTING VACCINE DISPARITIES.
AND IF YOU’LL COMMENT ON THAT. THANK YOU.
>>YEAH, SO THE STUDY WE RAN AGAIN WE WERE TRYING TO FIND SPECIFICALLY ONLINE INFLUENCERS
WHO WERE ANTI VACCINATORS, THAT WAS THERE WAS A LARGER POOL THAT WE HAD TO WORK WITH
AND SOME WOULDN’T TALK WITH US. SO WE WENT WITH THE ONES WHO WOULD TALK WITH
US. THAT HAPPENED TO BE A MAJORITY WHITE, YOU
KNOW, LIKE I WENT THROUGH THE SAMPLE DEMOGRAPHICS. HAVING SAID THAT SHOW I COMPLETED A STUDY,
NIH FUNDED STUDY LAST YEAR, NOT ON VACCINATION, IT WAS ON ENVIRONMENTAL RISK FACTORS FOR BREAST
CANCER BUT WE DID HAVE A DIVERSE POOL OF INFLUENCERS AS PART OF THAT INTERVENTION BASED STUDY.
AND WHAT WE ASKED THEM TO DO WAS TAKE THE EVIDENCE BASED MESSAGES, WEAVE THEM INTO A
BLOG POST THAT TOLD THEIR OWN STORY AND DID A CONTROL EXPOSED READER SURVEY TO EVALUATE
IMPACT IN TERMS OF AWARENESS AND INTENTION TO CHANGE BEHAVIOR.
SO I THINK IT DEPENDS ON QUITE FRANKLY THE SCOPE OF YOUR STUDY, THE DESIGN, HOW MUCH
TIME AND MONEY YOU HAVE TO DO IT WITH. FOR THIS STUDY, I ONE I TALKED ABOUT, WE WERE
WORKING ON A SMALL BUDGET, DOING A CONVENIENT SAMPLE OF WHO WE COULD GET ACCESS TO.
IN THE PRIOR STUDY I JUST MENTIONED WE DID WANT TO HAVE NOT A REPRESENTATIVE SAMPLE PER
SE BUT IT WAS A QUOTA BASED SAMPLE, WE COULD MAKE SURE WE TALKED TO ALL THE SUBGROUPS.
LET ME SAY THIS. IT IS VERY POSSIBLE TO FIND A DIVERSE POOL
OF INFLUENCERS FOR EITHER YOUR PROGRAM OR RESEARCH STUDY, THERE ARE NETWORKS FOR INSTANCE,
SPECIFICALLY FOCUSED ON HISPANIC MILLENNIALS, HISPANIC SIZE, BLOGALICIOUS IS INFLUENCERS
OF COLOR OF A VARIETY OF TYPES, THERE’S SHIP CON ABOUT HEALTH AND WELLNESS, BUT GREEN,
CLEAN, IN THAT NETWORK YOU WILL GET SOME OF THOSE KIND OF FOLKS THAT MAYBE SKEW INTO THE
NON VACCINATING LANE. SO THERE’S MANY, MANY DIFFERENT OPPORTUNITIES
OUT THERE. I THINK YOU HAVE TO BE AWARE OF THOSE AND
BE VERY CONCERTED IN MAKING SURE YOU HAVE A YOU APPROACH WHY A QUOTA BASE OR SOME KIND
OF REPRESENTATIVE APPROACH.>>ROBERT, YOU GET OUR LAST COMMENT OR QUESTION
FOR THE PANEL.>>THANKS AGAIN TO THE PRESENTERS.
I WAS STRUCK BY DR. BURKE GARCIA’S COMMENT ABOUT LACK OF RESIDENCE OF ALTRUISM OR BENEFITS
TO THE COMMUNITY, WONDERING IF THERE’S WAYS TO REFRAIN HERD IMMUNITY HERDS COMMUNITY ISSUES,
PERSONAL RISK, MANY PARENTS ARE CONCERNED ABOUT SECONDHAND SMOKE, FOOD SAFETY, AIR SAFETY,
AND SO AGAIN THERE’S A BALANCING, PERCEPTION OF VACCINE RISK AGAINST DISEASE RISK, WONDERING
IF THERE’S A WAY OF REFRAMING THE MESSAGES IN TERMS OF I DON’T WANT SOMEBODY COUGHING
ON MY CHILD, DON’T WAN SOMEBODY SPREADING X DISEASE TO MY CHILD.
>>YEAH, SO TWO THOUGHTS ON THAT. FROM THIS RESEARCH, THEY DON’T CARE.
LIKE LET ME SAY IT THAT WAY. THEY REALLY THESE PARENTS ARE THEY REALLY
THINK THEIR CHILDREN AND AUTOIMMUNE SYSTEMS WERE BUILT TO PROTECT THEM, THAT THERE ARE
OTHER WAYS THAT ARE HEALTHIER OR SAFER TO PROTECT AGAINST THESE DISEASES, AND/OR THAT
THE RISK OF THE DISEASE IS INFLATED, WHETHER THAT’S BY THE MEDIA OR BY GOVERNMENT AGENCIES,
OR BY PHARMACEUTICAL COMPANIES. AND SO I WOULD IT IS A FINE LINE TO SAY HOW,
YOU KNOW, HOW CAN WE REFRAME IT SO IT CAN BE A COMMUNITY ISSUE VERSUS LIKE HOW THEY
PERCEIVE IT RELATIVE TO THEMSELVES. HAVING SAID THAT, I THINK YOUR POINT IS REALLY
INTERESTING. ONE THING THAT WOULD BE NICE FOR US TO LOOK
INTO IN A FOLLOW ON, WHY IS THE ISSUE OF VACCINATION DIFFERENT IN THAT CASE THAN SECONDHAND SMOKE?
OR ENVIRONMENTAL RISK FACTORS FOR A VARIETY OF ISSUES.
THAT YOU HAVE GIVEN ME SOME THOUGHT AROUND MAYBE HOW YOU CAN PROBE ON THAT TO GIVE US
INSIGHT INTO HOW WE MIGHT REFRAME IT DOWN THE LINE.
>>I’D LIKE TO THANK OUR PANEL AGAIN. VERY INTERESTING AND INFORMATIVE, AND WE WILL
NOW ADJOURN FOR LUNCH. THANK YOU.
[APPLAUSE] WE WILL COME BACK PROMPTLY AT 1:15 AND START
OUR FIRST AFTERNOON DISCUSSION ON EXPERIENCES IN THE FIELD, HAWAII’S NEW VACCINE REQUIREMENTS
FOR SCHOOL ENTRY.

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