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Communicating Health Lecture 2009

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LSBU lecture 2009 …

LSBU lecture 2009
Communicating Health in the Ehealth Era

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  • Question: What is Ehealth?? – what do group already know?? Generally when we think about Ehealth what springs is the internet. This is probably because this is the technology that is most commonly used to access all sorts of information. When we think of the internet we predominantly think of static websites which deliver specific pieces of information about a certain topic area and are info heavy and delivered by professionals to their consumers with the information that we think that the need. There are a range of opportunities on the internet to produce real time dialogue opportunities which deliver health messages in creative and cultural relevant ways including Social network sites such as facebook, bebo and myspace, Media sharing sites such as Youtube and Flikr, Instant messaging protocols such as msn and chat protocols on social group sites Blogs and micro blogs such as walkertracker and voomaxer And virtual worlds such as Second life Although the internet is a major part of Ehealth we need to think about all of the new technologies that are used to communicate health messages. Including mobile phones, which can be used to develop health message delivery vie SMS, Bluetooth or WAP/mobile internet. Podcasting and the use of mp3 to develop health message reception. Digital TV and recreational activities such as Excergaming, including DDR, WiiFit and the eyetoy.
  • There is a great temptation to be seduced into believing that Ehealth is the way forward in delivering health messages and that because of this we should be aiming to use all the technologies available to us, rather than looking at the messages that we are wanting to convey, the audiences that we are trying to reach and the cultural relevance of the technologies we are wanting to use. It makes as little sense to use podcasting to population groups that don’t use MP3 players as it does giving leaflets to groups of people who access most of their information via the internet.
  • The theoretical context of communicating health messages in the revolution of Ehealth has its basis in communication theory. Particularly the process models of communication which explore how messages are sent and received. The interactivity element of communication is a key feature of Ehealth message communication. Recommend reading the chapter on linear or process models in Fiske. Process models are not only concerned with the process of sending and receiving messages but a range of factors including how behavioural actions are affected, how mind state is effects message reception and how we encode and decode messages. It is important that we recognise that the way in which we send messages also affects the way in which the messages are received. We need to recognise that the technology that we use, the language style and the way in which messages are recieved affect the behavioral affect of the message. We also need to understand that technology adds its own messages to what we are trying to communicate which can change the way in which the message is received or used by the consumer. This concept is described as ‘noise’ and was explored by shannon and Weaver in 1949, it is explored in the fiske text. A lot of the ways in which we communicate through technology have their grounding in the theoretical concepts of mass media. Although mass media has been criticised as not being able to effectively deliver health messages which ellicit behaviour change because of the nature of many of the new technologies available to us we need to understand that there is an interplay between the communicator and the receiver which allows for reflection and the relaying of opinion and ideas from both the communicator and the reciever.
  • The way in which we are communicating has changed. The use of technology to send and receive messages has developed enormously in the past 5 years and is almost unrecognisable to traditional communication. We have become people who are happier to communicate and receive messages via technology almost more than we are prepared for face to face contact. How often have you heard people say ‘email me that’ or even ‘facebook me’ rather than arranging face to face contact. We are clearly living in a digital age
  • We really are living in a digital age? Although this data is from 2006 we can see that access to technologies is high.
  • Household internet access is increasing
  • What people use the Internet for Seeking health info = 27%
  • Internet use by age
  • The mobile phone has become increasingly less of a luxury item and increasingly a necessity for communication. Many people feel lost and unable to communicate of they forget there mobile phone and there have been increasing studies recounting how some people panic if they do not have access to their mobile phones. In 2005 a study by Helen Haste researched the use of mobile phones by young people who described the mobile as something they ‘could not live without’ The different uses of the mobile phone do differ with age with text messaging being the surprise new form of communication. Originally text messaging was put on mobiles for business purposes and increasingly became the most used form of mobile communication, even spawning it’s own language. As mobile phones become more powerful so does the range of communication opportunities. Bluetooth affords the opportunity for low power, low range, free communication and is used by many techno savvy mobile users for the transfer of small pieces of data such as pictures, music and contact information. Increasingly mobiles have full access to the internet via a range of mobile systems allowing us to check our email, facebook profile or even surf wikipedia on the bus.
  • Application: the internet The internet has changed: it has become much much more user friendly, the development of what is called web 2.0 has allowed for the development of community and information sharing in real time. Instead of websites being written in code, which is only understood by few who are true computer geeks the development of personalised websites through ‘What You See Is What You Get’ protocols has become possible. The ability to develop web based content on sites such as myspace, facebook, youtube and blog sites has become possible even for the most pedestrian internet user. We have started to understand the true potential of the internet fro sharing information and developing communication in real time with instant message protocols and chat rooms. We have also ventured into virtual worlds that can inform our reality with internet based programmes such as second life. We are now going to look at how we can use some of these opportunities for communicating health.
  • Static sites Usually built by a webmaster Allow targeted content Require some opportunities for interactivity but this is limited e.g. Condoms by post scheme / csp postal kits
  • Static self build sites Community focused Easy to update Limited format Targeted Good for promotion Easy for feedback Increased interactivity
  • Social networking Interactivity Targetted Easy to update Instant Communication
  • You tube Videos show befitt video
  • Behaviour change Community Topic focused Positive reinforcement Honesty Encouragement
  • Second life Virtual world Virtual community Information feeding into real life CDC island
  • +ve acceptability for info seeking – Haste – 78% of YP comfortable texting to ask a friend a question 58% = text as 1 st prefereance most acceptable means of asking questions Self harm and suicide: opportunity to communicate with someone who wants help but does not want to engage in conversation
  • A podcast is a series of audio or video digital-media files which is distributed over the Internet by syndicated download , through Web feeds , to portable media players and personal computers . Though the same content may also be made available by direct download or streaming , a podcast is distinguished from other digital-media formats by its ability to be syndicated, subscribed to, and downloaded automatically when new content is added.
  • Although it is exciting to think that we can use new technologies to deliver health messages there are some significant challanges that we need to understand before undertaking health communication in this way. The technical challanges are obvious, as health promoters we are not always the most techno savvy people and we will need to spend some time understanding how the technology works before we can use it. This does mean that we need to spend time playing with technology, understanding its scope and how we can use it. And most of all how the people we are trying to target use the technology. For example if we are using social networking sites such as facebook, we need to understand that most users log on, on a daily or weekly basis and we need to be prepared to update our profiles or pages regularly in the same way that our clients do. As well as understanding the technology we need to understand that we have to use technology in a way that targets specific communities, as we have already explored there is no point trying to engage the older generation using something like second life, but there may be other internet based groups that can target these groups, such as the behaviour change websites like walker tracker. We must also recognise that the use of these technologies can build communities and can communicate with them in different ways to traditional communication of messages. Sites such as GAYDAR allow us to communicate sexual health messages to communities that may never access other more traditional forms of health education for this target group. This community focus also relates to the acceptability of the technologies we use. We need to research the acceptability of delivery of messages in different formats for different communities. The principles of diffusion of technology which have been explored by Rogers, explores the notion of ‘early adopters, who accept technology first, after that there is majority acceptance of technology and then laggard acceptance of technology. We can see that in some technologies such as the mobile phone we are towards the end of that process, but the uses of the mobile are still different dependent on your use as an early adopter or a laggard. We need to remember that new technologies are not the be all and end all of health communication. We need to take a multi channelled approach to communicating health were we make information available in a range of formats which are both community focused and acceptable to all our communities. We need to recognise that there is still a digital divide that excludes some people from accessing information via new technologies, although this divide is narrowing it still exists. And finally we need to be congruent in what we do, we need to use technology because we believe that we can use it well and that we can assimilate it in to the work that we are doing, rather than using new technologies because we think it is cool or that we should be doing it.
  • Transcript

    • 1. Andrew Smith [email_address]
    • 2.
      • The theoretical background
      • The scope of Ehealth
      • Application of Ehealth
        • The Internet
        • Mobile technologies
        • Podcasts
        • Excer-gaming
      • Taking the Technology Forward
    • 3.  
    • 4.
      • Ehealth is the use of emerging information and communication technology, especially the Internet to improve or enable our health and healthcare.
      • Eng (2001)
      • Rather than Ehealth being a specific list of technologies used for health message delivery, the process of Ehealth is an intrinsic way of thinking which utilizes and improves the application of Information Technology (IT) for health.
      • Eysenbach (2001)
    • 5.
      • Theoretical context in communication theory.
      • How are messages are sent and received
      • Does the way we send messages affect the reception
      • Mass media and behaviour change
    • 6.  
    • 7.
      • Mobile phone ownership in 2006 = 80%
      • Home computer in 2006 = 80%
      • Internet access in 2006 = 57%
      • Access to Digital TV in 2006 = 64%
      • Avery et al (2007)
    • 8. Per Cent Number of GB Households Percentage Change on Previous Year 2002 46 11.0m - 2003 50 11.9m 8 2004 51 12.2m 3 2005 55 13.3m 9 2006 57 13.9m 5
    • 9. UK Male Female Per Cent Searching for information about goods and services 83 88 79 Using Email 80 81 80 General browsing or surfing 72 75 68 Searching for information about travel and accommodation 71 72 69 Playing or downloading games, images or music 45 51 40 Internet banking 42 47 37 Reading or downloading on-line news (inc newspapers or news-magazines) 35 43 27 Activities related specifically to employment (inc current of future job) 32 35 28 Seeking health related information 27 26 28 Activities related to school, college or university course 27 24 30 Looking for job or sending job application 24 26 23 Listening to web radios / watching web TV 23 33 13 Downloading software other than games 23 33 13 Other communication e.g. chat rooms, message boards 20 23 18 Post educational activities (e.g. leisure activities) 18 20 16 Selling goods or services 17 22 13 Telephoning over the Internet/Video conferencing 10 13 7
    • 10. Every day or almost every day At least once a week (but not every day) At least once a month (but not every week) Less than once a month Per Cent Men 64 26 6 4 Women 54 28 12 5 All 59 27 9 4 Age Groups 16-24 60 26 9 5 25-44 63 26 8 4 45-54 62 24 10 4 55-64 49 33 13 5 65+ 43 34 13 11
    • 11.
      • @60+ 31% used Internet for health seeking behaviour
      • @U60 53% used Internet for health seeking behaviour
      • Gender divide in health seeking behaviour
      • Use of Internet to seek health information regarding disease rather than health promotion and prevention.
    • 12.
      • The most widely used of contemporary ICT
      • Link between use and age
        • 55+ use mobiles for emergencies
        • U35 use mobile phone for social reasons
        • U25 predominant use – text messaging
      • Text messaging
        • Surprise development of the mobile phone
        • Crucial method of social interaction
        • Privacy
      • Bluetooth
        • WPAN
        • Free message delivery system
      • Internet on Phone
        • Newest of mobile technologies
        • 2006 – 30% of households have mobile phones that can access the Internet
        • 2006 – 11% of people had accessed internet by phone
    • 13.  
    • 14.  
    • 15.  
    • 16.  
    • 17.  
    • 18.  
    • 19.  
    • 20.  
    • 21.  
    • 22.  
    • 23.
      • Introduction of the Smartphone
      • The Market leader – IPhone
      • Not just text and talk
      • Synchronisation to the Internet
    • 24.
      • Most frequent form of communication for young people
      • Personal
      • Privacy
      • Positive acceptability for info seeking by text
      • Text for Health
        • CSP – Text by results
        • Sweet Talk – Diabetes Education
        • Self Harm and Suicide
    • 25.
      • Short Range
      • Low Cost
      • Low Power
      • Low Data Transfer Rate
      • Free Wireless Transfe
      • 90.2% ofall mobile devices
      • Most widely used wireless personal area network
    • 26. How is Bluetooth Used Gender Male (n61) Female (n97) Total (n158) Music Transfer 52 (38%) [85.2%] 85 (62%) [87.6%] 137 (100%) {86.7%} Photo Transfer 51(36.4%) [83.6%] 89 (63.6%) [91.8%] 140 (100%) {88.6%} Message Transfer 9 (47.4%) [14.8%] 10 (52.6%) [10.3%] 19 (100%) {12%} Hands Free 9 (64.3%) [14.8%] 5 (35.7%) [5.2%] 14 (100%) {8.9%} Contact Information 9 (45%) [14.8%] 11(55%) [11.3%] 20 (100%) {12.7%} Something Else 3 (42.9%) [4.9%] 4 (57.1%) [4.1%] 7 (100%) {4.4%} (n=) – Number counted for gender. (%) – Percentage score based on total number using Bluetooth in this way. [%] – Percentage score of use by gender of those having access to Bluetooth. {%} – Percentage score based on total number having access to Bluetooth.
    • 27.
      • Use of Bluetooth
      • Acceptability
      • Economical assessment
      • Dissemination of messages
      • Use of a prompt to download
      • Multi Channelled approaches
      • Noise!!
      • Use to elicit behaviour
      • Next steps ........
    • 28.
      • Audio
      • Downloadable
      • Personal
      • iTunes
      • www.digitalpodcast.com
    • 29.  
    • 30.  
    • 31.
      • DDR
      • Wii (WiiFit)
      • Eye Toy
    • 32.
      • There is a great temptation in a study such as this to be seduced by ‘Tomorrows World’; to focus on what might be and assume that all the technological possibilities are both cost effective and accessible to all’
      • Gough & MuCulloch. (2006)
    • 33.
      • Technical challenges
      • Community focus
      • Acceptability
      • Principles of diffusion of technology
      • Multi channelled approaches
      • Digital Divide
      • Congruence
    • 34.
      • Avery V, Chamberlain E, Summerfield, C, Zealey L (2007). Focus on the Digital Age ONS.
      • Eng T R, The Ehealth Landscape: A Terrain map of emerging information and communication technologies in health and healthcare. Princetown. NJ. The Robert Wood Johnson Foundation.
      • Fiske J. (1990). Introduction to Communication Studies. (2 nd Ed) Routledge. London.
      • Eisenbach G. (2001) What is Ehealth? Journal of Medical Research 3:(2)
      • Gough, MuCulloch, (2006). Introduction. Vodaphone Policy Paper Series 4. March 2006. Vodaphone Plc.
      • Haste H. (2005) Joined up Texting: The role of Mobile Phones in Young Peoples Lives. Nestle Social Research Programme. London.
      • Health Communication Partnership. (2008) A Field Guide to Designing Health Communication Strategy. John Hopkins Bloomberg University
      • Rogers E. (1983) Diffusion of Innovations (3 rd Ed) The Free Press. Collier Macmillan Publishers. London.
      • http://www.slideshare.net/FITTmaxx/major-moves-2008-biray-presentation-presentation
    • 35.
      • www.facebook.com
      • www.getiton.nhs.uk
      • www.youtube.com
      • www.walkertracker.com
      • www.gaydar.co.uk
      • www. secondlife.com
      • www.winchesterlgbt.moonfruit.com
      • www.voomaxer.com
      • Yahoo images
    • 36. Andrew Smith [email_address]
    • 37.
      • From what has been discussed and what know about Ehealth plan a piece of health communication for a target audience using new technologies.
      • Be prepared to feedback to the rest of the group.

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