Teen2Xtreme: Using Social Media to Improve Adolescents' Health Literacy


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Presentation at CDC's National Conference on Health Communication, Marketing and Media 2010
Atlanta, GA
August 17, 2010

Nedra Weinreich
Weinreich Communications

Published in: Health & Medicine
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  • Outcome measure: Specifically to increase the rate at which they receive an annual Adolescent Well Care Visit
  • Medical is CA version of Medicaid (100% FPL) Healthy Families extends to 250% FPL Photo: Jefferson Martina - http://www.flickr.com/photos/ghettocash/106403707
  • The 2001 California Health Interview Survey (CHIS) included a survey of 5801 adolescents aged 12-17 years that assessed teen self report data about adult supervision and parental monitoring, teen safety practices, diet and physical activity, tobacco, alcohol and marijuana use, and sexual activity, including pregnancy and disease prevention
  • E-health literacy: ability to seek, find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem Photo: http://www.flickr.com/photos/rosefirerising/3171311072/
  • Photo: http://www.flickr.com/photos/houseofsims/3100342933/
  • Ninety three percent (93%) of youth ages 12-17 report using the Internet (2009 PEW) Sixty three percent (63%) of teen Internet users go online every day (2009 PEW)
  • Initial recruitment mailings will be spread over a 6-12 week time period. Members who agree to participate and return the signed consent/assent forms as well as a completed baseline teen questionnaire, and have access to the Internet, will be randomized into the intervention and control groups Using a block size of 6 for balanced assignment.
  • Community Manager –manages team; weekly analysis and content/community goals; manages and organizes team; provides daily support Host – provides daily support; integrates external content, manages chat events Advisor –provide the bulk of the social activity in the site during the critical first few week; will have completed profiles prior to launch; dynamically assigned as friends (participation is incentivized) Community Leaders – roles that will be filled over time from general members; nominated by peers Role of Teen Advisors Add Appropriate Tone –content and feature specifics will be run past the board prior to implementation; final tweaks to language/features will be made in August by the board Example – the name of the badges that we will be associating with user accounts based on high point accruals will be recommended by board Example –chat events centered around TV programs (i.e. Glee) will be recommended/decided by the Advisory Board
  • Theme requirements: 4 polls (1 per week) 10 questions for trivia game 1 contest 4 weekly challenges Links, references Missions (for game resource) Questions for survey (assessment)
  • Teen2Xtreme: Using Social Media to Improve Adolescents' Health Literacy

    1. 1. Nedra Kline Weinreich, MS Weinreich Communications National Conference on Health Communication, Marketing and Media August 17, 2010 Using Social Media to Improve Adolescents' Health Literacy
    2. 3. <ul><li>Improve the health literacy of adolescents regarding their health insurance, health plans, and health providers </li></ul><ul><li>Increase adolescents’ level of engagement in their health care and their own health </li></ul><ul><li>Develop a health literacy training intervention to encourage adolescents aged 13 – 17 to utilize their health care plan more effectively </li></ul>
    3. 4. <ul><li>1) Test the feasibility of creating and maintaining interactive communication technology (ICT) health literacy training materials for a Medicaid adolescent population </li></ul><ul><li>2) Evaluate the effectiveness of the ICTs and social media materials produced </li></ul><ul><li>3) Evaluate the effectiveness of the intervention on behavioral health records linked to study condition </li></ul><ul><li>4) Increase adolescents’ health literacy about their health care rights and responsibilities </li></ul>
    4. 5. <ul><li>5) Test how adolescents use online and social media health information resources with content specific to their health needs and health plan </li></ul><ul><li>6) Assess differential intervention impact based on predisposing participant characteristics </li></ul><ul><li>7) Test associations between increased health literacy and e-health literacy and outcomes of quality and quantity of care received </li></ul>
    5. 6. <ul><li>Adolescents 13–17 years old, living in California </li></ul><ul><li>Insurance coverage under Medi-Cal or Healthy Families Program managed by Health Net </li></ul>
    6. 7. <ul><li>88% of adolescents in California currently have health care insurance. </li></ul><ul><li>Nearly one in three (30.9%) of children in California is now covered by Medi-Cal or Healthy Families. </li></ul><ul><li>Among California adolescents, 85% have a usual source of care, with Latinos and Native Americans less likely to report usual source of care than Caucasians, Asians and Pacific Islanders, and African Americans. </li></ul><ul><li>Source: California Health Interview Survey, 2001 </li></ul>
    7. 8. <ul><li>Traditional: degree to which individuals have the capacity to obtain and understand basic health information </li></ul><ul><li>Expanded: wide set of competencies and skills to process health information more generally and learn how to navigate our complex system of health care </li></ul><ul><ul><li>Set appointments, get referrals, fill out forms, and advocate for appropriate care </li></ul></ul><ul><ul><li>Individual empowerment/increased health decision-making </li></ul></ul><ul><ul><li>Includes e-health literacy </li></ul></ul>
    8. 9. <ul><li>77% of California teens saw a doctor for a routine physical exam in the last year </li></ul><ul><li>21-25% reported visiting the emergency room </li></ul><ul><li>Paradoxically, teens with health insurance were more likely to visit an ER than those without insurance </li></ul>
    9. 10. Source: Pew Internet, 2009
    10. 12. <ul><li>Round 1 Focus Groups: Teen Health Issues </li></ul><ul><ul><li>Conducted 12 focus groups around California </li></ul></ul><ul><ul><li>Explored teen health issues including: </li></ul></ul><ul><ul><ul><li>Attitudes towards access to health care </li></ul></ul></ul><ul><ul><ul><li>Health promotion and disease prevention behaviors </li></ul></ul></ul><ul><ul><ul><li>Health literacy, including patient rights and responsibilities </li></ul></ul></ul><ul><ul><ul><li>Internet and social networking behaviors </li></ul></ul></ul>
    11. 13. <ul><li>Round 2 Focus Groups: Design and Content Review </li></ul><ul><ul><ul><li>Conducted 2 focus groups </li></ul></ul></ul><ul><ul><ul><li>Reviewed specific design and content of website </li></ul></ul></ul><ul><ul><ul><li>Refined branding of website </li></ul></ul></ul><ul><ul><ul><li>Elicited overall feedback on focus of website </li></ul></ul></ul><ul><li>Key informant interviews with adolescent providers </li></ul><ul><ul><ul><li>Conducted 8 key informant interviews </li></ul></ul></ul><ul><ul><ul><li>Explored teen health concerns from perspective of provider </li></ul></ul></ul><ul><ul><ul><li>Patient / parent interaction, difficulties / barriers </li></ul></ul></ul><ul><ul><ul><li>Patient recruitment / retention, staff incentives </li></ul></ul></ul>
    12. 14. <ul><li>Most important health issues for teens: </li></ul><ul><ul><li>Sex (including STDs and pregnancy) </li></ul></ul><ul><ul><li>Drugs and alcohol </li></ul></ul><ul><ul><li>Obesity </li></ul></ul><ul><li>Prevention not a major emphasis </li></ul><ul><li>Many barriers/hassles in going to the doctor </li></ul><ul><li>Confused about insurance issues </li></ul><ul><li>Some understanding of their rights and responsibilities </li></ul><ul><li>Get some health information online, but can be confusing </li></ul><ul><li>Use a variety of social networking sites </li></ul>
    13. 18. Social Activity Theme Activity Domain Activity
    14. 20. <ul><li>Appearance </li></ul><ul><li>Sex / STDs / Pregnancy </li></ul><ul><li>Stress / Depression </li></ul><ul><li>Infectious Disease </li></ul><ul><li>Obesity / Weight </li></ul><ul><li>Fitness / Sports </li></ul><ul><li>Violence / Gangs </li></ul><ul><li>Relationships / Family </li></ul><ul><li>Driving </li></ul><ul><li>Safety / Injury </li></ul><ul><li>Drugs /Alcohol /Smoking </li></ul>
    15. 21. <ul><li>1) Annual Well Care Visit </li></ul><ul><li>2) Patient-Doctor Relationship </li></ul><ul><li>3) Navigate Healthcare System </li></ul><ul><li>4) Benefits, Rights & Responsibilities </li></ul><ul><li>5) Healthcare-Seeking Information </li></ul>
    16. 24. <ul><li>Testing launch – August 2, 2010 </li></ul><ul><li>Full site launch – September 1, 2010 </li></ul><ul><ul><li>Recruitment/Baseline Survey </li></ul></ul><ul><li>Review/analysis – October/November 2010 </li></ul><ul><li>Ongoing monthly monitoring </li></ul><ul><li>Follow-up survey – Approx. August 2011 </li></ul>
    17. 25. Deborah Glik, P.I. Michael Prelip, P.I. Abdelmonem Afifi Philip Massey Elaine Quiter Gabriel Stover Sharon Nessim, HN P.I. Elaine Robinson-Frank Diana Carr Maya Gumatay Kelly Kono Vinia Pangan Carol Spencer Hoa Su Nancy Wongvipat Kalev Michael Fiore Elissa Vaidman Nedra Kline Weinreich
    18. 26. Nedra Kline Weinreich Weinreich Communications [email_address] www.social-marketing.com 310.286.2721 Twitter @Nedra