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HealthEngagement
        Barometer                  ™




        Health Influence in the
        Era of Public Engagement
HealthEngagement
        Barometer                      ™




Contents


Foreword
      Today’s challenging health environment demands public engagement, a deeper,
      more fluid connection between organizations and brands and their publics.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

1 People Want More Health Engagement
      Organizations and brands now face a challenge – and an
      opportunity – to meet people’s demand for health engagement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

2 A Highly Engaged Group Wields the Most Influence: the Health Info-entials™
      One out of every five people is a Health Info-ential who signals
      where the health conversation is headed.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

3 Trust and Health Engagement Form a Virtuous Circle
      A crucial conclusion: trust and effective health engagement fuel each other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

4 Effective Engagement is Personal and Complete
      People expect organizations and brands to directly address their
      personal health above all other concerns – and with transparency.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

5 Channels and Sources: Expertise and Personal Connection Drive Credibility
      As personal and health-expert channels rise in importance,
      people are turning to the New Second Opinion™. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

The New Rules of Health Engagement
      Suggestions and strategies for building trust with your publics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Suggested Resources
      For further reading and insight.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17



Methodology
The Edelman Health Engagement Barometer is a five-country study of people’s engagement in health and their expectations of engagement
by organizations, companies, products and services involved in health. In September 2008, StrategyOne conducted a 20-minute online
survey of the general population; the study sample included 5,183 adults, 18-75 years old. The chart below offers details on sample sizes in
each country studied, margins of error and representation. Contacts for more information, including country-specific data, are listed on page 18.

                                Global                  US                      UK                 GErmany                   rUSSia                   CHina
    Sample Size                   5,183                1,000                   1,078                   1,000                   1,081                   1,024
    Margin of Error: Total      +/- 1.4%              +/- 3%                  +/- 3%                  +/- 3%                   +/- 3%                  +/- 3%
    Margin of Error:
                                +/- 2.9%             +/- 6.9%                +/- 8.3%                +/- 6.5%                 +/- 5.1%                +/- 6.7%
    Health Info-entials

                                                  Gender, Age,                                                             Urban areas:            Urban areas:
                                                                          Gender, Age,             Gender, Age,
                                                                                                                           Gender, Age,            Gender, Age,
    Representative on:                         Income, Education,      Income, Education,            Income
                                                                                                                             Income                  Income
                                                 Region, Ethnicity          Region


Edelman Health Engagement Barometer was conducted by research firm



2
Foreword


Health is under extreme pressure. Over the past              publics appreciate the benefits of their products and
decade, aging populations, pandemics of infectious and       services, as well as the critical role that they play in
lifestyle-related diseases, and advances in medical          advancing personal and public health. This continuous,
technology have created a massive unmet demand for           reciprocal process of health engagement is key to
health and healthcare. And now the worst economic            building trust and has implications that extend far beyond
climate in decades is exacerbating this crisis.              communications to operations.

Concurrently, the digital revolution has exponentially       We created the Edelman Health Engagement Barometer
increased the interactions among disparate publics.          to guide the development of effective business strategies
People are now empowered to freely and fluidly discuss       in the rapidly evolving public engagement environment
business and societal issues that previously were not        for the health sector and others with business or product
part of popular culture and conversation.                    stakes in health. The only study of its kind, the Health
                                                             Engagement Barometer takes a global look at the
Together, these forces have created a new, complex
                                                             fundamentals of public engagement in health, how it is
operating climate for organizations involved in health,
                                                             evolving, and how people want companies, organizations,
one that is constantly being shaped by the public’s
                                                             brands and services involved in health to engage with them.
engagement in it. Because health is pivotal to personal
and societal well-being, everyone is not only a health       The public has rewritten the rules of health engagement.
stakeholder but also has multiple stakes in health (e.g.,    In the pages ahead, you’ll learn about the segment of the
as consumer, patient, citizen, professional, advocate,       public that is most influential in health; the best ways to
caregiver) and is a member of multiple health publics.       engage them and the general public to build trust; the
                                                             power of personal, expert, and complete information on
The new era of public engagement in health calls for
                                                             multiple channels; and the essential topics that must be
organizations and brands to make deeper, more fluid,
                                                             addressed to open the door to engagement.
and open connections with their publics; to engage with
individuals with cognizance of their multiple health         We hope that this study serves as a useful guide to
stakes; and to influence personal, professional and policy   operating and communicating effectively in health in the
decisions without seeking to control them. Health            new, public engagement environment. My colleagues
organizations and brands need to understand and              and I welcome your perspective; please feel free to
address the expectations of their particular publics (as     contact us directly or share your thoughts on our Health
well as society as a whole), while ensuring that their       Engagement Blog at www.engageinhealth.com.


                                                             NANCY TURETT
                                                             Global President, Health
                                                             Edelman
                                                             January 2009




3   HealthEngagement
            Barometer   ™
Study Findings


1 People Want More Health Engagement                                People view health engagement by companies,
                                                                    organizations and brands as increasingly important
The first task of the Edelman Health Engagement
Barometer was to understand to what extent people are               While 40 percent of people surveyed said they are

actively engaged in health and whether they feel it is              becoming more actively engaged with companies and

important that organizations and brands involved in                 organizations in health, 70 percent agreed that “it is

health engage with them. The study asked people to rate             increasingly important that health companies and

how engaged they are with health issues, with compa-                organizations engage with me.” Although less pro-

nies and organizations involved in health, and with health          nounced, a similar gap emerged when people were

products and services. (For the purposes of the study,              questioned about products and services. While 60

engagement was not pre-defined.)                                    percent of adults across all countries surveyed said they
                                                                    are becoming more actively engaged with health prod-
Globally, 63 percent of people said they are becoming               ucts and services, a full 75 percent agreed that “it is
more actively engaged in health issues; 60 percent are              increasingly important that health products and services
becoming more actively engaged with health products                 engage with me.”
and services; and 40 percent are becoming more actively
engaged with companies and organizations involved in                The gap between how engaged people feel they are and

health. Yet in all five countries surveyed, people said they        the engagement they crave confirms that while many

want more health engagement from companies, organi-                 companies and organizations in health have made a

zations, products and services.                                     concerted effort to engage the public, they must do
                                                                    more. Companies and organizations now face a chal-
                                                                    lenge – and an opportunity – to meet people’s demand
                         Desire for Health                          for health engagement more than halfway.
                       Engagement Is Rising
Please indicate how much you agree or disagree with the following   2 A Highly Engaged Group Wields Most
statements. (strongly/somewhat)                                     Influence: the Health Info-entials™
                                                                    To discover who is exerting the most influence over
    It is increasingly important that                               health, the Health Engagement Barometer asked people
    Companies & Organizations                           70%
                                                                    a series of questions about how much they are involved
    involved in health engage with me
                                                                    in health issues and how often they gather and share
                                                                    health information. People who said that they are highly
    It’s increasingly important that
                                                                    active in three distinct categories would be considered
    Health Products & Services                                75%
    engage with me
                                                                    the most influential.

                                                                    First, people were asked about their level of involvement
Base = Adults
                                                                    in health issues. Since health is a part of everyone’s life, it




4     HealthEngagement
              Barometer           ™
1 Out of 5 People Is a Health Info-ential                     tion more than once a week and share the information

Health Involved: Involved in health but not necessarily gathering or
                                                                       with others more than once a week. They represent
                 sharing information                                   about a third of the population.
Health Informed: Gather and share health information more than
                 once a week                                           Finally, people were asked a series of questions to
Health Engaged: Self-identify as actively gathering and sharing        determine if they consider themselves Health Engaged.
                health information, and advocating a point of view
                                                                       This group, comprising 39 percent of the population,
                                                                       actively seeks and shares information, or actively seeks
                                              Health                   and shares information and advocates a viewpoint.
                                                        In
                                                    3
                                                    fo
                                                      3%
                                                       rm




                                                                       Health Info-entials amplify trends in the
                                                          ed




                                                                       general population
                                                                       People who are highly Health Involved, Health Informed
                                                                       and Health Engaged are the most influential in health.
    Health I




                                                                       These Health Info-entials – one out of every five people
         80%olve




                                                                       – not only care about and take action on health issues,
             nv




                                                                       they also act as channels for information themselves.
                                                                ed
           d




                                                              %




                                                       39
                                                             ag




                                                                       Like a physician who acts as a “key opinion leader” for
                                                             ng




                                                           E
                                                      lt h             other doctors and influences their viewpoints, the Health
                                                   Hea
                                                                       Info-ential can lead others in a certain direction through
                                                                       his or her interest, actions and information-sharing.
             Health info-entials 22%                                   Health Info-entials can be viewed as signposts for where
Base = Adults
                                                                       the health conversation is headed.




is not surprising that most people – 80 percent – claimed
                                                                                   Health Info-entials Are Not
                                                                                   Defined by Demographics
to be somewhat or very involved in health issues. This
group is referred to as the Health Involved.
                                                                          No differences from          Slight differences from
Next, people were asked how often they gathered                           general population:           general population:
information about health issues and how often they                                 Age                          Gender
shared information about health issues that they viewed,                      Income levels                 Parental status
read or heard about. This group – the Health Informed                         Marital status              Employment status
– is made up of people who both read or gather informa-




5      HealthEngagement
               Barometer    ™
Health Info-entials:                           This approach demands a more in-depth, precise
         More Stakes in Health and Equally                     understanding of what matters to them and why, and of
        Balanced Between Men and Women                         where, how, and with whom they communicate.
                       More likely to...
                                                               People share information across all channels, most
                                              Work in a        often with the people they know
    Be a caregiver
                                             health field
                                                               The Health Engagement Barometer asked respondents
                                                               who they are most likely to talk to about health. People,
                                           Have a severe or
Take prescription
                                            chronic health     and to a greater extent Health Info-entials, are most likely
   medicines
                                              condition
                                                               to share information and opinions about health issues
                                                               with friends and family members. “A person like me,”
Globally, Health Info-entials have more stakes in health       “colleagues,” and “my doctor or healthcare provider” are
but come from all walks of life                                also critical members of their sphere of influence.
Beyond quantifying Health Info-entials, the Health             Respondents also said that they share information or
Engagement Barometer sought to discover what the               their opinions with a wide range of people. To a lesser
people in this group have in common and how they differ        extent, the same is true for the channels through which
from other people.                                             they communicate. Conversations about healthcare are
Health Info-entials connect with health directly and           likely to be taking place on nearly every communication
personally. They are more likely to have more stakes and       channel, including online message boards, personal
more experience in health compared to the general
population. They also are more likely to have a severe or
chronic health conditions (41 percent vs. 34 percent),                  MORE HEAlTH INFO-ENTIAlS IN CHINA
work in the health field (26 percent vs. 18 percent), be a              While much of the survey data are consistent
caregiver (17 percent vs. 11 percent), or take prescription             across countries, this is not the case for Health
medications (47 percent vs. 41 percent).
                                                              40 30 20 10
                                                                  Info-entials.           10 20 30 40
However, there are no differences between Health
Info-entials and other people with regard to age, income
level or marital status. Their demographic differences                                                      35%
                                                                                 China
from the general population are minimal. Info-entials are
                                                                                                      23%
slightly more likely to be women (50 percent vs. 46
                                                                               Germany
percent), have children (41 percent vs. 35 percent) and
                                                                                                     21%
be employed (71 percent vs. 65 percent).                                        Russia
                                                                                                     20%
Companies and organizations that want to reach the
                                                                                 U.S.A.
people who are the most influential in health must
                                                                                               13%
connect with them through their actions and their
                                                                                  U.K.
experiences, rather than targeting them demographically.       Base = Adults




6    HealthEngagement
             Barometer   ™
blogs and social networking Web sites. Companies and                           Health Info-entials:
organizations in health must take all channels into                     More Engaged ➞ More likely To Act
consideration – even channels that they cannot control – if
                                                                 Thinking about companies and organizations involved in health that
they want to reach their publics.                                you 10 engaged 30 which, 50 of the following actions have
                                                                     are 20 with, 40 if any, 60 70 80
                                                                 you taken in response to a company or organization?

Engagement fuels action                                          Talked about it with friends, family members or peers
                                                                                                      55%
Not only are people paying attention to health companies,                                   41%
organizations, and issues, they also frequently take             Talked about it with my doctor or other healthcare provider
action, and the more engaged they are, the more likely                                   40%
                                                                                    28%
they are to act.
                                                                 Researched further information about it
                                                                                       34%
Leading the way, a full 83 percent of Health Info-entials                       23%
have taken action for or against health companies and            Chosen to purchase its products or services
organizations, while 66 percent of the general population                            34%
                                                                              23%
has taken action. These actions primarily take the form of
                                                                 Recommended one of its products or services
conversations with people they know, such as friends,                         28%
                                                                         18%
family, peers and providers. Actions can be positive and
                                                                 Shared information about it online
negative, but are more likely to be personal, not political.                     28%
                                                                          14%
Globally, people are more likely to act in response to a         Contacted the company or organization
health issue than to a company or organization involved                     19%
                                                                       12%
in health. Ninety-nine percent of Health Info-entials and
                                                                 Signed or initiated a petition about it
89 percent of the general population say they have taken               11%
action on health issues. Again, the most frequent action            6%
                                                                 Chosen to invest in it
is to start a conversation about an issue with a friend or           9%
family member.                                                     6%
                                                                 Supported or opposed legislation related to it
If an issue, company or organization catches the atten-             7%
                                                                   4%
tion of the public, some kind of action will likely follow.
                                                                 Contacted a politician about it
The most influential people in health use personal                  6%
conversations and talk on multiple channels. They will            3%
                                                                 Attended a protest or gathering in opposition to it
engage regardless of whether companies and organiza-
                                                                    4%
tions choose to participate in the conversation. Identify-        2%
ing and understanding these ongoing personal conversa-           Took no action
                                                                         15%                                  Health Info-entials
tions are critical for any health entity that wants to prevail                     28%                        Adults
in today’s environment.




7   HealthEngagement
            Barometer     ™
3 Trust and Health Engagement Form a                                Trust, Authenticity and Satisfaction Are
Virtuous Circle                                                  Top 3 for Health Info-entials in All 5 Countries
                                                                Thinking 0
                                                                         about 10 engagement you want to have with companies90
                                                                               the 20 30 40 50 60 70 80                               100
Trust fuels health engagement – and vice versa                  and organizations involved in health, which characteristics of that
                                                                engagement are most important to you?
Trust is the most important characteristic of engagement
with companies and organizations. Seventy-one percent
                                                                                                                       71%
of Health Info-entials and 67 percent of the general                                                                 68%
                                                                    Global                                     61%
population rank “trust” as most important. Sixty-eight
                                                                                                                           79%
percent of Health Info-entials and 58 percent of the                                                        54%
                                                                    U.S.A.                                52%
general population say “authenticity” is the next most
                                                                                                                           79%
important factor; and 61 percent of Health Info-entials                                                             67%
                                                                     China                                          66%
and 53 percent of the general population feel that
                                                                                                                          77%
“satisfaction” matters most in engagement.                                                           45%
                                                                        U.K.                       41%
These three characteristics of effective engagement rose                                                             71%
to the top among Health Info-entials in every country                                                                70%
                                                                Germany                                 48%
surveyed (although their order of importance varies by                                                                       82%
country). In the U.S. and the U.K., Health Info-entials                                                                    77%
                                                                   Russia                                         66%
want trust first and foremost; authenticity ranks highest
among German and Chinese Health Info-entials; and                                                                    Trust
satisfaction highest among Russian Health Info-entials.                                                              Satisfaction
                                                                Base = Health Info-entials                           Authenticity

Health Info-entials are more engaged and
more trusting
                                                                distrust what they hear. Among the general population,
One of the most crucial conclusions of the Health
                                                                trust drops to 58 percent and distrust rises to 36 percent.
Engagement Barometer is that trust and effective health
engagement fuel each other. Authentic engagement                The same trust-distrust pattern emerges in how much
builds trust and, in turn, trust builds effective engagement.   people say they trust what they hear from health prod-
The fact that Health Info-entials, the most engaged             ucts and services. Seventy percent of Info-entials and 61
people in health, are also more trusting than the average       percent of adults trust what they hear, and 28 percent
person, confirms this idea.                                     and 33 percent respectively distrust what they hear.
                                                                These patterns are consistent across all countries; survey
Respondents were asked to rank how much they trust
                                                                respondents in Germany were least trusting, while those
what they hear from companies and organizations in
                                                                in China were most trusting.
health and from health products and services. Sixty-nine
percent of Health Info-entials trust what they hear from        Clearly, a large part of the population still needs to be
companies and organizations in health while 29 percent          convinced about the trustworthiness of the information




8   HealthEngagement
            Barometer   ™
Health Info-entials: More Engaged ➞ More Trusting
Please indicate how much you agree or disagree that you “trust what you hear from companies and organizations involved in health/…from
health products and services?” (strongly/somewhat agree vs. strongly/somewhat disagree)

40 30 20 10
    Distrust
                                 10 20 30 40 50 60 70
                                     Trust                                              Distrust                       Trust
       Global                                                                    U.K.

Companies and Organizations                                                  Companies and Organizations
   36%                                               58%                       38%                                          53%
       29%                                                  69%                 36%                                            60%
Products and Services                                                        Products and Services
      33%                                             61%                        35%                                        54%
         28%                                                70%                  36%                                           61%


       U.S.A.                                                                    Germany
Companies and Organizations                                                  Companies and Organizations
        34%                                          58%                      43%                                          51%
         30%                                               68%                44%                                           53%
Products and Services                                                        Products and Services
     33%                                             59%                       43%                                         51%
       30%                                                 68%                44%                                          52%

       China                                                                     Russia
Companies and Organizations                                                  Companies and Organizations
               26%                                          72%                38%                                              58%
                  19%                                              80%                  26%                                             73%
Products and Services                                                        Products and Services
           22%                                                    77%           37%                                               61%
             17%                                                    82%                 23%                                                76%

                                                                                                                       Adults
                                                                                                                       Health Info-entials

                                  Everything Matters to People’s Health and Well-Being
                                                “Health” is defined by a large set of factors
                                                                         0     10 20 30 40 50 60 70 80 90
Thinking about your overall health and well-being, how important would you say each of the following factors plays in influencing it?
(extremely/very important)

                                                        Physical health                                                                 94%
                                               Mental/emotional health                                                               91%
                                 Personal appearance/hygiene/self-care                                                            87%
                                                       Financial health                                                        82%
                                         Social connections with others                                                     79%
                                 Level of achievement/accomplishment                                                 68%
                                                 State of the economy                                              64%
                                                  State of your country                                            64%
                                         State of your local community                                         57%
                                                            Spirituality                                      57%
Base = Health Info-entials




9   HealthEngagement
            Barometer        ™
they receive from health companies, organizations,                        If You Want to Engage People,
products and services. The existence of the more engaged,                   Give Them the Whole Story
more trusting Health Info-ential proves that distrust can          10 20 30 start with “their” health80
                                                                          And 40 50 60 70
be overcome through effective health engagement.               In which of the following ways do you want companies and
                                                               organizations involved in health to engage with you?

                                                                Help me address health issues that affect me personally
4 Effective Engagement Is Personal                                                              54%
                                                                                         42%
and Complete
                                                                Communicate both positive and negative news to me
The Health Engagement Barometer sought to discover                                           52%
                                                                                         44%
how people want companies and organizations in health
                                                                Inform me about health conditions that I am concerned about
to engage with them, as well as the kinds of engagement                                        52%
they prefer. First, to gain insight into the mindset through                            41%
                                                                Inform me about the risks and benefits of their products and services
which they approach “health,” the study asked people to
                                                                                               50%
identify the most important influences on their personal                                   43%
health and well-being.                                          Communicate with me openly and transparently
                                                                                         48%
Across the globe, people indicated that “health and                                  41%
                                                                Actively listen and respond to my concerns and requests
well-being” means much more than their physical health.
                                                                                              47%
It also encompasses personal factors like emotional health,                             37%
financial health and social connections, and societal           Inform me about how to prevent a disease that their products and...
                                                                                             46%
concerns like the state of the country and the economy.                                36%
                                                                Inform me about how to properly use their products and services
                                                                                        43%
Complete information, positive and negative, is essential                            36%

Fifty-four percent of Health Info-entials and 42 percent of     Ensure I have access to their products and services
                                                                                       40%
adults want companies and organizations involved in                                34%
health to “help me address health issues that affect me         Offer a variety of ways for me to communicate with them
                                                                                      35%
personally” and to inform them about the health condi-                             28%
tions they care most about.                                     Inform me about the science and technology behind their products and...
                                                                                     34%
But they don’t want just basic information. They want to                        26%

know the whole story – information that helps them              Help me address health issues affecting the world today
                                                                                 32%
understand both the benefits and the risks of specific                     21%
products and services. They want the good news and              Have an active presence on popular social networking sites where I...
                                                                             23%
the bad. They also want information about how to                       14%
prevent disease that specific products and services treat.      Partner with other organizations to address issues important to me
                                                                              21%
Less important ways to engage include giving people                      16%
                                                                Allow employees other than the CEO or spokespeople to communicate
information about the science and technology behind a
                                                                         16%
company’s products or services or partnering with other                12%
                                                                                                             Health Info-entials
organizations to address health issues that matter to
                                                                                                             Adults


10   HealthEngagement
             Barometer   ™
People Want Most Engagement From Rx, OTC Products and Hospitals
                                                                        10 20 30 40 50 60 70 80
Please rate each of the following on how engaged you want them to be with you. (very/somewhat)



                Healthcare products I purchase with a prescription                                                    85%
                                                                                                               76%

                                                         Hospitals                                                    83%
                                                                                                              73%
                                                                                                                    81%
             Healthcare products I purchase without a prescription
                                                                                                           69%

                                                                                                               76%
                                              Companies in health                                    61%

                                                                                                               74%
                                     Government health agencies                                        63%

                                                                                                             72%
             Nonprofit health organizations and foundations/NGOs                                     58%

                                                                                                             Health Info-entials
                                                                                                             Adults



them. They want engagement from companies and                         care products (Health Info-entials, 81 percent; adults, 69
organizations to be direct – and directly focused on them.            percent). Less important is engagement from entities that
                                                                      have less of a personal impact, such as companies,
Overall, people are demanding transparency – a more
                                                                      government agencies and nonprofit organizations.
open, interactive and personal relationship with compa-
nies and organizations involved in health. They want
                                                                      “My health” more important than “our health”
companies and organizations in health to actively listen
and respond to their concerns and requests. They will                 People’s engagement is highest on the issues that matter
most likely reject or dismiss an attempt to engage that is            most to their personal health. Seventy-four percent of
thin or one-sided, or that doesn’t give them the “whole               Health Info-entials are highly engaged with the issue of
story” about the subject at hand.                                     maintaining health and well-being; 66 percent are highly
                                                                      engaged with the issue of chronic health problems; 61

Highest desire for engagement from products and                       percent with preventing disease; 58 percent with
services that touch people physically                                 providing access to affordable healthcare; and 54
                                                                      percent with access to health information.
The majority of people surveyed named products and
services that involve their bodies and are critical to health         The power of this personal-first approach to health is
as their highest priority for engagement. Highest ranked              universal. Every country surveyed showed this pattern of
were pharmaceutical products (Health Info-entials, 85                 highest engagement with the most personal issues –
percent; adults, 76 percent); hospitals (Health Info-en-              maintaining health and well-being, solving chronic health
tials, 83 percent; adults, 73 percent); and OTC health-               problems, and providing access to affordable healthcare



11   HealthEngagement
             Barometer    ™
“My Health” Is More Important Than 30 40 50 60 70 80 90
                                                                0 10 20 “Our Health”
Which, if any, of the following best describes your typical engagement with the issue of …?
(high engagement = actively seek out/share info or actively seek out/share info and advocate point of view)

                                             Maintain health and well-being                                                74%
                                              Solve chronic health problems                                          66%
My Health




                                                            Prevent disease                                     61%
                                     Provide access to affordable healthcare                                   58%
                                               Access to health information                                   54%
                             Addresses impact of environmental change                                    47%
                                                               Reduce risks                            44%
Our Health




                             Understand benefits of alternative medicine                              43%
                                              Ensure high ethical standards                           43%
                                                       Fostering innovation                         41%
                                                             Protect privacy                        40%
                                        Eliminate global infectious diseases                       38%
Base = Health Info-entials




– typically topping the list. These personal health issues                     society needs to address today and the issues that they
trump a number of societal issues that companies and                           believe have the largest impact on their lives. They were
organizations in health commonly hold out as important                         also asked to rank health issues by how much they
to people. Only 41 percent of Health Info-entials actively                     believe companies and organizations should get involved
engage on the issue of fostering innovation; 44 percent                        in each.
engage on risk reduction; 43 percent on ensuring ethical
                                                                               When asked to identify the most important public health
standards; and 40 percent on protecting privacy.
                                                                               issues, Health Info-entials chose issues that directly
                                                                               aligned with their personal health priorities: providing
Health priorities are aligned for people, society and
                                                                               access to affordable healthcare, solving chronic health
organizations and brands
                                                                               problems and preventing disease. Health Info-entials also
Which personal health issues matter most to people?                            cited these three issues as the ones they expect compa-
Which societal issues matter most? To what extent do                           nies and organizations involved in health to engage in.
they want companies and organizations to address                               These issues are the “price of entry” to engagement –
them? And how much overlap is there?                                           companies and organizations must address them first
To find out, the Health Engagement Barometer first                             before Health Info-entials will welcome their engagement
asked people to rank the health issues that they believe                       on other issues.




             HEAlTH PRIORITY EquATION


Personal Health Concerns                   = Public Health Priorities = Expectations of Companies and Organizations

12           HealthEngagement
                     Barometer   ™
Three Health Priorities Are Price of Entry to Engagement

                                     Affordable Healthcare
                              Preventing Disease
                       Solving Chronic Health Problems

5 Channels and Sources: Expertise                               Personal and health-expert channels are rising
and Personal Connection Drive Credibility                       in importance

Although information is a cornerstone of today’s health         Next, the study looked at which channels are becoming
environment, it’s not likely that every information source is   more – and less – important to Health Info-entials.
considered credible. To explore this element of engage-         Overall, people’s preferences reveal that content that
ment, the Health Engagement Barometer asked respon-             offers personal connection and health expertise matters
dents to rate the credibility of 20 different sources of        more than the channel through which it is delivered.
information. By focusing on the responses of Health             For example, the net emerging importance (difference
Info-entials, who exert the most influence on health            between increasing and decreasing importance) of
today, we can point to where effective health information       “conversations with my doctor” is 30 percent,
is – or should be – going.                                      “conversations with friends and family members” is 22
Health Info-entials rank 10 sources most highly. Ninety-        percent and “health expert blogs” is 10 percent. A wide
six percent of all Health Info-entials rate their doctor or     range of other sources are considered increasingly
healthcare professional as a highly credible source of          important, including medical journals, government
information. But Health Info-entials do not rely solely on      agencies, consumer and health advocacy Web sites, and
clinical expertise. They also regard as credible the            “conversations with someone like me.” These channels
information they get from people with non-clinical              deliver content that is either personal in nature, offers
in-depth health knowledge, and from people with whom            health expertise, or both.
they have a personal connection. “My friends and family”        The net emerging importance of corporate and product
are rated by 91 percent of Health Info-entials as credible,     advertising is negative (-34 percent), as it is for a variety
as are “a person like me” (88%) and “someone personally         of social media applications, including Web-based video
affected by a disease or medical condition” (88%).              sharing sites (-22 percent), social networking Web sites
                                                                (-18 percent) and personal blogs (-16 percent). Health
                                                                company Web sites also have a negative net emerging
                                                                importance (-3 percent). These findings indicate that
                                                                information sources that are non-expert or less personal
                                                                in nature are becoming less important.



13   HealthEngagement
             Barometer   ™
Personal and Health Expert Channels Are Becoming More Important
                                40 30 20 10                   10 20 30 40
For each of the following sources of health information, please indicate whether that source is becoming more important to you, less
important to you, or remaining the same. (Net = becoming more important – becoming less important)

                         Conversations with my doctor                            30%
       Conversations with friends and family members                       22%
                                        Medical journals                   21%
                           Consumer health Web sites                      19%
                                  Government agencies                  17%
                  Conversations with someone like me                 14%
              Google or other Internet search engines               11%
                                     Health-expert blogs         10%
                               Health-related newsletters        8%
               Nonprofit or health advocacy Web sites           6%
                                                Wikipedia       6%
Publications or brochures from nonprofit orgs or NGOs          5%
                                                   Books       4%
                                                       -3%   Health companies’ Web sites
                                                   -5%       TV news coverage
                                                   -6%       Articles in magazines
                                                  -7%        Web sites for specific brands of medication
                                                 -8%         Films or documentaries
                                                 -9%         Online message boards, forums, or newsgroups
                                                -10%         Articles in newspapers
                                              -11%           Radio news coverage
                                          -16%               Personal blogs
                                         -18%                Social networking web sites                   Base = Health Info-entials

                                       -22%                  Web-based video sharing sites                      Net becoming more important
                                     -34%                    Corporate and product advertising                  Net becoming less important



The New Second Opinion™
As much as Health Info-entials trust information from
                                                                                  THE NEW SECOND OPINION™
experts like their doctors, they still turn to other sources
for validation. Eighty-eight percent of respondents noted
that they turn to their physicians to validate online
information, and the same number turn to other sources                            88%                                  88%
to validate information from their doctor.                                        “I usually turn to                  “I usually turn to
                                                                                   my physician to                     other sources to
No single source of information stands out or stands                               validate info I                     validate info I get
alone. This finding signals that to ensure that their                              get online.”                        from my doctor.”
information is relevant and effective, companies and



14   HealthEngagement
             Barometer     ™
organizations involved in health must engage across a                       Health Info-entials also cited a few negative implications
wide range of channels.                                                     of digital technology, such as having more difficulty
                                                                            determining the accuracy of information or being over-
Digital: changing the dynamics of health                                    whelmed by the sheer amount of information, further
                                                                            confirming the high value that Health Info-entials place on
Digital technology has fundamentally changed health by
                                                                            expert health information. Interestingly, very few Health
changing how people receive and share health informa-
                                                                            Info-entials (7 percent) felt that technology resulted in less
tion. Forty-two percent of Health Info-entials say the
                                                                            face-to-face sharing of information.
most important impact of this change is that it provides
more immediate access to information.



      THE REAl-TIME REquIREMENT: DIGITAl INFORMATION10 DEMAND
                                                    ON 20 30                                       40 50 60 70 80

      Which, if any, are the THREE most important ways that digital communications (e.g. e-mail, the Internet, mobile phones) has changed
      how you receive or share information about health issues?

                                  Access to more up-to-date information                                                        42%


                                              Access to new information                                                     40%


                         More immediate access to health information                                                       38%


                   Easier to communicate with people who care about                                    19%
                                                similar health issues

                 More difficult to determine the accuracy of information                               18%


                        More likely to receive contradictory information                           17%

                   More empowered to take action on health issues or
                                personal health topics I care about                              15%

                 Increased communication with my friends and family
                members about health issues or personal health topics                            15%


      Increased communications with my doctor or healthcare provider                             15%


     More overwhelmed with the sheer amount of information available                       12%

                       More empowered to express my opinions about
                              health issues or personal health topics                   10%

Made me more concerned about the privacy of my health information
                                                                                        10%

                                 Less face-to-face sharing of information
                                                                                      7%
Base = Adults




15    HealthEngagement
              Barometer      ™
The New Rules of Health Engagement


Public engagement has changed the way health influence happens. To engage effectively, particularly with the
Health Info-entials, follow the new rules of health engagement:

1 Provide deep content. People want to know the               6 Take a holistic approach to health and
whole story—complete information that helps them              well-being. Health and well-being encompass physi-
understand the benefits and the risks of products,            cal, mental, emotional and even financial health; personal
services and issues. Filtering information can be per-        appearance; and social connectivity. Remember that
ceived as paternalistic.                                      people who have a disease or health condition can still
                                                              feel a sense of health and well-being.
2 Be transparent. People will dismiss or reject an
attempt at health engagement that seems one-sided,            7 Address people’s multiple stakes in health,
vague or evasive. They want organizations and brands in       including their personal ones. All of your publics
health to proactively convey important information and        are part of “the public,” so don’t view any of them
respond authentically to their concerns.                      through only one dimension of their engagement in
                                                              health—for example, as “patient,” “regulator,” “payor,”
3 Inform in real time. Organizations and brands               “physician,” or “investor.” Factor in all of a person’s
involved in health need to become more nimble in              personal and professional stakes in health when engag-
disseminating information. In the digital era, people         ing with him or her.
expect organizations to provide information rapidly, and
they view any delay with skepticism.                          8 Be personal. People want to be engaged on the
                                                              topics that matter most to them personally and through
4 Join the conversations, online and off.                     sources and channels that enable interactions with
Information about your organization or brand is now           individuals, not faceless entities.
freely gathered, shared and validated across multiple
channels, both online and offline, and inside and outside     9 Engage through health-expert channels and
the specific topic area. Participate actively in conversa-    sources. Connect with people through channels and
tions across multiple channels so that you don’t cede to      sources that are seen as health-expert. Health expertise
others how you and your business are defined.                 can mean deep personal experience as well as medical
                                                              or scientific degrees and credentials.
5 Engage in prevention, chronic health
problems and access to health care. These are                 10 Consider the risks of not engaging.
priorities for personal and public health, and they are the   Recognize the risks of not engaging, including having
“price of entry” to engagement—they are the top issues        your message defined by others, squandering an
that people expect organizations and brands to address        opportunity to build trust (or worse yet, losing trust), or
before engaging on other issues. Your engagement on           failing to motivate your publics to take positive actions on
these priority issues should be aligned with your business    your behalf.
and content expertise.




16   HealthEngagement
             Barometer     ™
Suggested Resources


Brain, David and Thomas Martin. Crowd Surfing.               Lacey, Russell. “Relationship Drivers of Customer
London: A & C Black Publishers Ltd., 2008.                   Commitment.” Journal of Marketing Theory and Practice
                                                             15.4 (2007): 315–333.
Cavanaugh, Melissa. “The Evolution of Online Media.”
Strategy + Business July 15, 2008.                           National Working Group on Evidence-Based Care. “The
                                                             Role of the Patient/Consumer in Establishing a Dynamic
Cook, Scott. “The Contribution Revolution: Letting
                                                             Clinical Research Continuum: Models of Patient/
Volunteers Build Your Business.” Harvard Business
                                                             Consumer Inclusion.” August 2008.
Review October 2008.
                                                             Pisano, Gary and Roberto Verganti. “Which Kind of
Deloitte Center for Health Solutions. “2008 Survey of
                                                             Collaboration is Right for You?” Harvard Business Review
Health Care Consumers.” March 2008.
                                                             December 2008
www.deloitte.com/centerforhealthsolutions
                                                             Ramani, Girish and V. Kumar. “Interaction Orientation
Edelman. “The Edelman GoodPurpose Study.”
                                                             and Firm Performance.” Journal of Marketing 72.1
http://www.goodpurposecommunity.com
                                                             (2008): 27-45.
Edelman.”The Edelman Trust Barometer.”
                                                             Sarasohn-Kahn, Jane. “Right Here Right Now: Ten
http://www.edelman.com/trust/2008/
                                                             Telehealth Pioneers Make It Work.” California HealthCare
Fox, Susannah. “The Engaged E-Population.” Pew and           Foundation. November 2008.
Internet Life Project, August 2008.
                                                             Sarasohn-Kahn, Jane. “The Wisdom of Patients: Health
Fox, Suzannah and Mary Madden. “Participatory                Care Meets Social Media.” California HealthCare
Medicine: How user-generated media are changing              Foundation. April 2008.
Americans’ attitudes and actions, both online and
                                                             Stromberg, Chloe.”How Consumers Use Social
offline.” Pew Internet & American Life Project, June 2008.
                                                             Computing for Health.” Forrester Research Inc.
Hibbard, Judith H. and Peter J. Cunningham. “How             April 2007.
Engaged Are Consumers in Their Health and Health
                                                             Arthur W. Page Society. “The Authentic Enterprise.”
Care, and Why Does it Matter?” Research Brief No. 8,
                                                             http://www.instituteforpr.org/files/uploads/The_
Center for Studying Health System Change. October 2008.
                                                             Authentic_Enterprise_White_Paper.pdf
Johnmar, Fard. “From Command & Control to Engage &
                                                             Tu, Ha and Genna Cohen. “Striking Jump in Consumers
Encourage: A New Healthcare Communications Strategy
                                                             Seeking Health Care Information.” Center for Studying
for a Social Media World.” Envision Solutions. 2006.
                                                             Health System Change Tracking Report No. 20,
Jones, Kathryn. “In whose interest? Relationships            August 2008.
between health consumer groups and the pharmaceutical
industry in the UK.” Sociology of Health & Illness 30.6
(2008): 929–943.




17   HealthEngagement
             Barometer   ™
Contacts


For more information, including country-specific data, contact:   About Edelman
Global
                                                                  Edelman is the world’s leading independent public relations firm
Nancy Turett
                                                                  and the leader in public engagement, with more than 3,200
+1 212 704 8195
                                                                  employees in 54 offices worldwide. Edelman was named
nancy.turett@edelman.com
                                                                  PRWeek’s “2008 Large Agency of the Year,” Holmes Report’s
Bruce Hayes                                                       “2008 Global Agency of the Year,” and listed as top-10 firm in
+1 212 704 4503                                                   Advertising Age’s “2007 Agency A-List,” the first and only PR
bruce.hayes@edelman.com                                           firm to receive this recognition. In 2007, CEO Richard Edelman
Carolyn Paul                                                      was honored as “Agency Executive of the Year” by Advertising
+44 20 3047 2105                                                  Age, and he was cited in 2007 and 2008 as “Most Powerful PR
carolyn.paul@edelman.com                                          Executive” by PRWeek. For more information about Edelman
                                                                  visit www.edelman.com.
united States
Susan Isenberg
+1 212 704 8159
                                                                  About Health At Edelman
susan.isenberg@edelman.com                                        With deep engagement across topics, channels and publics,
                                                                  Edelman helps the world’s leading organizations and brands
Europe
                                                                  thrive in the business of health. Our global staff of more than
Mike Kan
                                                                  400 health experts has collaborated with clients to engage on
+44 20 3047 2126
                                                                  important health issues, including disease prevention, manage-
mike.kan@edelman.com
                                                                  ment of chronic disease, the health technology revolution,
Asia Pacific                                                      wellness, infectious disease pandemics, biomedical science,
Margaret Key                                                      and access to healthcare. Edelman’s Health offering includes
+82 2 2022 8210                                                   specialties in Rx Health, Personal Health & Wellness, Health
margaret.key@edelman.com                                          Policy & Public Affairs, Corporate & Organizational Health, Life
Canada                                                            Sciences, Public Health, Health Alliances, Health Media, and
Scott Evans                                                       Clinical Development, as well as BioScience Communications,
+1 416 979 1120                                                   our full-service medical relations, education and publishing
scott.evans@edelman.com                                           company. Join Edelman in the conversation about advancing
                                                                  health engagement at www.engageinhealth.com.
latin America
Zerene Kahan
+52 55 5350 1515                                                  About StrategyOne
zerene.kahan@edelman.com                                          StrategyOne is a full-service research firm that provides
                                                                  customized and targeted opinion research (qualitative and
BioScience Communications
                                                                  quantitative), strategic consulting, and in-depth media analysis –
Mark Deitch
                                                                  including corporate reputation evaluation, PR & advertising
+1 212 704 8142
                                                                  effectiveness analysis, brand positioning, and communications
mark.deitch@bioscicom.net
                                                                  assessment. StrategyOne analysts have backgrounds in
David Noble                                                       political research and polling, journalism, public relations,
+44 20 3047 2250                                                  advertising, and consulting and have directed and analyzed
david.noble@edelman.com                                           public opinion and market research projects for a range of
StrategyOne                                                       corporate, association, political and international organizations.
Laurence Evans                                                    Our evidence-based approach of using proprietary market
+1 212 704 8286                                                   research to deliver strategic communications counsel sets us
laurence.evans@strategyone.net                                    apart from other market research firms.



18   HealthEngagement
             Barometer    ™

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Health Engagement Barometer Reveals Public Demand for Deeper Connections in Health

  • 1. HealthEngagement Barometer ™ Health Influence in the Era of Public Engagement
  • 2. HealthEngagement Barometer ™ Contents Foreword Today’s challenging health environment demands public engagement, a deeper, more fluid connection between organizations and brands and their publics.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 People Want More Health Engagement Organizations and brands now face a challenge – and an opportunity – to meet people’s demand for health engagement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 A Highly Engaged Group Wields the Most Influence: the Health Info-entials™ One out of every five people is a Health Info-ential who signals where the health conversation is headed.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 Trust and Health Engagement Form a Virtuous Circle A crucial conclusion: trust and effective health engagement fuel each other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 4 Effective Engagement is Personal and Complete People expect organizations and brands to directly address their personal health above all other concerns – and with transparency.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 5 Channels and Sources: Expertise and Personal Connection Drive Credibility As personal and health-expert channels rise in importance, people are turning to the New Second Opinion™. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 The New Rules of Health Engagement Suggestions and strategies for building trust with your publics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Suggested Resources For further reading and insight.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Methodology The Edelman Health Engagement Barometer is a five-country study of people’s engagement in health and their expectations of engagement by organizations, companies, products and services involved in health. In September 2008, StrategyOne conducted a 20-minute online survey of the general population; the study sample included 5,183 adults, 18-75 years old. The chart below offers details on sample sizes in each country studied, margins of error and representation. Contacts for more information, including country-specific data, are listed on page 18. Global US UK GErmany rUSSia CHina Sample Size 5,183 1,000 1,078 1,000 1,081 1,024 Margin of Error: Total +/- 1.4% +/- 3% +/- 3% +/- 3% +/- 3% +/- 3% Margin of Error: +/- 2.9% +/- 6.9% +/- 8.3% +/- 6.5% +/- 5.1% +/- 6.7% Health Info-entials Gender, Age, Urban areas: Urban areas: Gender, Age, Gender, Age, Gender, Age, Gender, Age, Representative on: Income, Education, Income, Education, Income Income Income Region, Ethnicity Region Edelman Health Engagement Barometer was conducted by research firm 2
  • 3. Foreword Health is under extreme pressure. Over the past publics appreciate the benefits of their products and decade, aging populations, pandemics of infectious and services, as well as the critical role that they play in lifestyle-related diseases, and advances in medical advancing personal and public health. This continuous, technology have created a massive unmet demand for reciprocal process of health engagement is key to health and healthcare. And now the worst economic building trust and has implications that extend far beyond climate in decades is exacerbating this crisis. communications to operations. Concurrently, the digital revolution has exponentially We created the Edelman Health Engagement Barometer increased the interactions among disparate publics. to guide the development of effective business strategies People are now empowered to freely and fluidly discuss in the rapidly evolving public engagement environment business and societal issues that previously were not for the health sector and others with business or product part of popular culture and conversation. stakes in health. The only study of its kind, the Health Engagement Barometer takes a global look at the Together, these forces have created a new, complex fundamentals of public engagement in health, how it is operating climate for organizations involved in health, evolving, and how people want companies, organizations, one that is constantly being shaped by the public’s brands and services involved in health to engage with them. engagement in it. Because health is pivotal to personal and societal well-being, everyone is not only a health The public has rewritten the rules of health engagement. stakeholder but also has multiple stakes in health (e.g., In the pages ahead, you’ll learn about the segment of the as consumer, patient, citizen, professional, advocate, public that is most influential in health; the best ways to caregiver) and is a member of multiple health publics. engage them and the general public to build trust; the power of personal, expert, and complete information on The new era of public engagement in health calls for multiple channels; and the essential topics that must be organizations and brands to make deeper, more fluid, addressed to open the door to engagement. and open connections with their publics; to engage with individuals with cognizance of their multiple health We hope that this study serves as a useful guide to stakes; and to influence personal, professional and policy operating and communicating effectively in health in the decisions without seeking to control them. Health new, public engagement environment. My colleagues organizations and brands need to understand and and I welcome your perspective; please feel free to address the expectations of their particular publics (as contact us directly or share your thoughts on our Health well as society as a whole), while ensuring that their Engagement Blog at www.engageinhealth.com. NANCY TURETT Global President, Health Edelman January 2009 3 HealthEngagement Barometer ™
  • 4. Study Findings 1 People Want More Health Engagement People view health engagement by companies, organizations and brands as increasingly important The first task of the Edelman Health Engagement Barometer was to understand to what extent people are While 40 percent of people surveyed said they are actively engaged in health and whether they feel it is becoming more actively engaged with companies and important that organizations and brands involved in organizations in health, 70 percent agreed that “it is health engage with them. The study asked people to rate increasingly important that health companies and how engaged they are with health issues, with compa- organizations engage with me.” Although less pro- nies and organizations involved in health, and with health nounced, a similar gap emerged when people were products and services. (For the purposes of the study, questioned about products and services. While 60 engagement was not pre-defined.) percent of adults across all countries surveyed said they are becoming more actively engaged with health prod- Globally, 63 percent of people said they are becoming ucts and services, a full 75 percent agreed that “it is more actively engaged in health issues; 60 percent are increasingly important that health products and services becoming more actively engaged with health products engage with me.” and services; and 40 percent are becoming more actively engaged with companies and organizations involved in The gap between how engaged people feel they are and health. Yet in all five countries surveyed, people said they the engagement they crave confirms that while many want more health engagement from companies, organi- companies and organizations in health have made a zations, products and services. concerted effort to engage the public, they must do more. Companies and organizations now face a chal- lenge – and an opportunity – to meet people’s demand Desire for Health for health engagement more than halfway. Engagement Is Rising Please indicate how much you agree or disagree with the following 2 A Highly Engaged Group Wields Most statements. (strongly/somewhat) Influence: the Health Info-entials™ To discover who is exerting the most influence over It is increasingly important that health, the Health Engagement Barometer asked people Companies & Organizations 70% a series of questions about how much they are involved involved in health engage with me in health issues and how often they gather and share health information. People who said that they are highly It’s increasingly important that active in three distinct categories would be considered Health Products & Services 75% engage with me the most influential. First, people were asked about their level of involvement Base = Adults in health issues. Since health is a part of everyone’s life, it 4 HealthEngagement Barometer ™
  • 5. 1 Out of 5 People Is a Health Info-ential tion more than once a week and share the information Health Involved: Involved in health but not necessarily gathering or with others more than once a week. They represent sharing information about a third of the population. Health Informed: Gather and share health information more than once a week Finally, people were asked a series of questions to Health Engaged: Self-identify as actively gathering and sharing determine if they consider themselves Health Engaged. health information, and advocating a point of view This group, comprising 39 percent of the population, actively seeks and shares information, or actively seeks Health and shares information and advocates a viewpoint. In 3 fo 3% rm Health Info-entials amplify trends in the ed general population People who are highly Health Involved, Health Informed and Health Engaged are the most influential in health. Health I These Health Info-entials – one out of every five people 80%olve – not only care about and take action on health issues, nv they also act as channels for information themselves. ed d % 39 ag Like a physician who acts as a “key opinion leader” for ng E lt h other doctors and influences their viewpoints, the Health Hea Info-ential can lead others in a certain direction through his or her interest, actions and information-sharing. Health info-entials 22% Health Info-entials can be viewed as signposts for where Base = Adults the health conversation is headed. is not surprising that most people – 80 percent – claimed Health Info-entials Are Not Defined by Demographics to be somewhat or very involved in health issues. This group is referred to as the Health Involved. No differences from Slight differences from Next, people were asked how often they gathered general population: general population: information about health issues and how often they Age Gender shared information about health issues that they viewed, Income levels Parental status read or heard about. This group – the Health Informed Marital status Employment status – is made up of people who both read or gather informa- 5 HealthEngagement Barometer ™
  • 6. Health Info-entials: This approach demands a more in-depth, precise More Stakes in Health and Equally understanding of what matters to them and why, and of Balanced Between Men and Women where, how, and with whom they communicate. More likely to... People share information across all channels, most Work in a often with the people they know Be a caregiver health field The Health Engagement Barometer asked respondents who they are most likely to talk to about health. People, Have a severe or Take prescription chronic health and to a greater extent Health Info-entials, are most likely medicines condition to share information and opinions about health issues with friends and family members. “A person like me,” Globally, Health Info-entials have more stakes in health “colleagues,” and “my doctor or healthcare provider” are but come from all walks of life also critical members of their sphere of influence. Beyond quantifying Health Info-entials, the Health Respondents also said that they share information or Engagement Barometer sought to discover what the their opinions with a wide range of people. To a lesser people in this group have in common and how they differ extent, the same is true for the channels through which from other people. they communicate. Conversations about healthcare are Health Info-entials connect with health directly and likely to be taking place on nearly every communication personally. They are more likely to have more stakes and channel, including online message boards, personal more experience in health compared to the general population. They also are more likely to have a severe or chronic health conditions (41 percent vs. 34 percent), MORE HEAlTH INFO-ENTIAlS IN CHINA work in the health field (26 percent vs. 18 percent), be a While much of the survey data are consistent caregiver (17 percent vs. 11 percent), or take prescription across countries, this is not the case for Health medications (47 percent vs. 41 percent). 40 30 20 10 Info-entials. 10 20 30 40 However, there are no differences between Health Info-entials and other people with regard to age, income level or marital status. Their demographic differences 35% China from the general population are minimal. Info-entials are 23% slightly more likely to be women (50 percent vs. 46 Germany percent), have children (41 percent vs. 35 percent) and 21% be employed (71 percent vs. 65 percent). Russia 20% Companies and organizations that want to reach the U.S.A. people who are the most influential in health must 13% connect with them through their actions and their U.K. experiences, rather than targeting them demographically. Base = Adults 6 HealthEngagement Barometer ™
  • 7. blogs and social networking Web sites. Companies and Health Info-entials: organizations in health must take all channels into More Engaged ➞ More likely To Act consideration – even channels that they cannot control – if Thinking about companies and organizations involved in health that they want to reach their publics. you 10 engaged 30 which, 50 of the following actions have are 20 with, 40 if any, 60 70 80 you taken in response to a company or organization? Engagement fuels action Talked about it with friends, family members or peers 55% Not only are people paying attention to health companies, 41% organizations, and issues, they also frequently take Talked about it with my doctor or other healthcare provider action, and the more engaged they are, the more likely 40% 28% they are to act. Researched further information about it 34% Leading the way, a full 83 percent of Health Info-entials 23% have taken action for or against health companies and Chosen to purchase its products or services organizations, while 66 percent of the general population 34% 23% has taken action. These actions primarily take the form of Recommended one of its products or services conversations with people they know, such as friends, 28% 18% family, peers and providers. Actions can be positive and Shared information about it online negative, but are more likely to be personal, not political. 28% 14% Globally, people are more likely to act in response to a Contacted the company or organization health issue than to a company or organization involved 19% 12% in health. Ninety-nine percent of Health Info-entials and Signed or initiated a petition about it 89 percent of the general population say they have taken 11% action on health issues. Again, the most frequent action 6% Chosen to invest in it is to start a conversation about an issue with a friend or 9% family member. 6% Supported or opposed legislation related to it If an issue, company or organization catches the atten- 7% 4% tion of the public, some kind of action will likely follow. Contacted a politician about it The most influential people in health use personal 6% conversations and talk on multiple channels. They will 3% Attended a protest or gathering in opposition to it engage regardless of whether companies and organiza- 4% tions choose to participate in the conversation. Identify- 2% ing and understanding these ongoing personal conversa- Took no action 15% Health Info-entials tions are critical for any health entity that wants to prevail 28% Adults in today’s environment. 7 HealthEngagement Barometer ™
  • 8. 3 Trust and Health Engagement Form a Trust, Authenticity and Satisfaction Are Virtuous Circle Top 3 for Health Info-entials in All 5 Countries Thinking 0 about 10 engagement you want to have with companies90 the 20 30 40 50 60 70 80 100 Trust fuels health engagement – and vice versa and organizations involved in health, which characteristics of that engagement are most important to you? Trust is the most important characteristic of engagement with companies and organizations. Seventy-one percent 71% of Health Info-entials and 67 percent of the general 68% Global 61% population rank “trust” as most important. Sixty-eight 79% percent of Health Info-entials and 58 percent of the 54% U.S.A. 52% general population say “authenticity” is the next most 79% important factor; and 61 percent of Health Info-entials 67% China 66% and 53 percent of the general population feel that 77% “satisfaction” matters most in engagement. 45% U.K. 41% These three characteristics of effective engagement rose 71% to the top among Health Info-entials in every country 70% Germany 48% surveyed (although their order of importance varies by 82% country). In the U.S. and the U.K., Health Info-entials 77% Russia 66% want trust first and foremost; authenticity ranks highest among German and Chinese Health Info-entials; and Trust satisfaction highest among Russian Health Info-entials. Satisfaction Base = Health Info-entials Authenticity Health Info-entials are more engaged and more trusting distrust what they hear. Among the general population, One of the most crucial conclusions of the Health trust drops to 58 percent and distrust rises to 36 percent. Engagement Barometer is that trust and effective health engagement fuel each other. Authentic engagement The same trust-distrust pattern emerges in how much builds trust and, in turn, trust builds effective engagement. people say they trust what they hear from health prod- The fact that Health Info-entials, the most engaged ucts and services. Seventy percent of Info-entials and 61 people in health, are also more trusting than the average percent of adults trust what they hear, and 28 percent person, confirms this idea. and 33 percent respectively distrust what they hear. These patterns are consistent across all countries; survey Respondents were asked to rank how much they trust respondents in Germany were least trusting, while those what they hear from companies and organizations in in China were most trusting. health and from health products and services. Sixty-nine percent of Health Info-entials trust what they hear from Clearly, a large part of the population still needs to be companies and organizations in health while 29 percent convinced about the trustworthiness of the information 8 HealthEngagement Barometer ™
  • 9. Health Info-entials: More Engaged ➞ More Trusting Please indicate how much you agree or disagree that you “trust what you hear from companies and organizations involved in health/…from health products and services?” (strongly/somewhat agree vs. strongly/somewhat disagree) 40 30 20 10 Distrust 10 20 30 40 50 60 70 Trust Distrust Trust Global U.K. Companies and Organizations Companies and Organizations 36% 58% 38% 53% 29% 69% 36% 60% Products and Services Products and Services 33% 61% 35% 54% 28% 70% 36% 61% U.S.A. Germany Companies and Organizations Companies and Organizations 34% 58% 43% 51% 30% 68% 44% 53% Products and Services Products and Services 33% 59% 43% 51% 30% 68% 44% 52% China Russia Companies and Organizations Companies and Organizations 26% 72% 38% 58% 19% 80% 26% 73% Products and Services Products and Services 22% 77% 37% 61% 17% 82% 23% 76% Adults Health Info-entials Everything Matters to People’s Health and Well-Being “Health” is defined by a large set of factors 0 10 20 30 40 50 60 70 80 90 Thinking about your overall health and well-being, how important would you say each of the following factors plays in influencing it? (extremely/very important) Physical health 94% Mental/emotional health 91% Personal appearance/hygiene/self-care 87% Financial health 82% Social connections with others 79% Level of achievement/accomplishment 68% State of the economy 64% State of your country 64% State of your local community 57% Spirituality 57% Base = Health Info-entials 9 HealthEngagement Barometer ™
  • 10. they receive from health companies, organizations, If You Want to Engage People, products and services. The existence of the more engaged, Give Them the Whole Story more trusting Health Info-ential proves that distrust can 10 20 30 start with “their” health80 And 40 50 60 70 be overcome through effective health engagement. In which of the following ways do you want companies and organizations involved in health to engage with you? Help me address health issues that affect me personally 4 Effective Engagement Is Personal 54% 42% and Complete Communicate both positive and negative news to me The Health Engagement Barometer sought to discover 52% 44% how people want companies and organizations in health Inform me about health conditions that I am concerned about to engage with them, as well as the kinds of engagement 52% they prefer. First, to gain insight into the mindset through 41% Inform me about the risks and benefits of their products and services which they approach “health,” the study asked people to 50% identify the most important influences on their personal 43% health and well-being. Communicate with me openly and transparently 48% Across the globe, people indicated that “health and 41% Actively listen and respond to my concerns and requests well-being” means much more than their physical health. 47% It also encompasses personal factors like emotional health, 37% financial health and social connections, and societal Inform me about how to prevent a disease that their products and... 46% concerns like the state of the country and the economy. 36% Inform me about how to properly use their products and services 43% Complete information, positive and negative, is essential 36% Fifty-four percent of Health Info-entials and 42 percent of Ensure I have access to their products and services 40% adults want companies and organizations involved in 34% health to “help me address health issues that affect me Offer a variety of ways for me to communicate with them 35% personally” and to inform them about the health condi- 28% tions they care most about. Inform me about the science and technology behind their products and... 34% But they don’t want just basic information. They want to 26% know the whole story – information that helps them Help me address health issues affecting the world today 32% understand both the benefits and the risks of specific 21% products and services. They want the good news and Have an active presence on popular social networking sites where I... 23% the bad. They also want information about how to 14% prevent disease that specific products and services treat. Partner with other organizations to address issues important to me 21% Less important ways to engage include giving people 16% Allow employees other than the CEO or spokespeople to communicate information about the science and technology behind a 16% company’s products or services or partnering with other 12% Health Info-entials organizations to address health issues that matter to Adults 10 HealthEngagement Barometer ™
  • 11. People Want Most Engagement From Rx, OTC Products and Hospitals 10 20 30 40 50 60 70 80 Please rate each of the following on how engaged you want them to be with you. (very/somewhat) Healthcare products I purchase with a prescription 85% 76% Hospitals 83% 73% 81% Healthcare products I purchase without a prescription 69% 76% Companies in health 61% 74% Government health agencies 63% 72% Nonprofit health organizations and foundations/NGOs 58% Health Info-entials Adults them. They want engagement from companies and care products (Health Info-entials, 81 percent; adults, 69 organizations to be direct – and directly focused on them. percent). Less important is engagement from entities that have less of a personal impact, such as companies, Overall, people are demanding transparency – a more government agencies and nonprofit organizations. open, interactive and personal relationship with compa- nies and organizations involved in health. They want “My health” more important than “our health” companies and organizations in health to actively listen and respond to their concerns and requests. They will People’s engagement is highest on the issues that matter most likely reject or dismiss an attempt to engage that is most to their personal health. Seventy-four percent of thin or one-sided, or that doesn’t give them the “whole Health Info-entials are highly engaged with the issue of story” about the subject at hand. maintaining health and well-being; 66 percent are highly engaged with the issue of chronic health problems; 61 Highest desire for engagement from products and percent with preventing disease; 58 percent with services that touch people physically providing access to affordable healthcare; and 54 percent with access to health information. The majority of people surveyed named products and services that involve their bodies and are critical to health The power of this personal-first approach to health is as their highest priority for engagement. Highest ranked universal. Every country surveyed showed this pattern of were pharmaceutical products (Health Info-entials, 85 highest engagement with the most personal issues – percent; adults, 76 percent); hospitals (Health Info-en- maintaining health and well-being, solving chronic health tials, 83 percent; adults, 73 percent); and OTC health- problems, and providing access to affordable healthcare 11 HealthEngagement Barometer ™
  • 12. “My Health” Is More Important Than 30 40 50 60 70 80 90 0 10 20 “Our Health” Which, if any, of the following best describes your typical engagement with the issue of …? (high engagement = actively seek out/share info or actively seek out/share info and advocate point of view) Maintain health and well-being 74% Solve chronic health problems 66% My Health Prevent disease 61% Provide access to affordable healthcare 58% Access to health information 54% Addresses impact of environmental change 47% Reduce risks 44% Our Health Understand benefits of alternative medicine 43% Ensure high ethical standards 43% Fostering innovation 41% Protect privacy 40% Eliminate global infectious diseases 38% Base = Health Info-entials – typically topping the list. These personal health issues society needs to address today and the issues that they trump a number of societal issues that companies and believe have the largest impact on their lives. They were organizations in health commonly hold out as important also asked to rank health issues by how much they to people. Only 41 percent of Health Info-entials actively believe companies and organizations should get involved engage on the issue of fostering innovation; 44 percent in each. engage on risk reduction; 43 percent on ensuring ethical When asked to identify the most important public health standards; and 40 percent on protecting privacy. issues, Health Info-entials chose issues that directly aligned with their personal health priorities: providing Health priorities are aligned for people, society and access to affordable healthcare, solving chronic health organizations and brands problems and preventing disease. Health Info-entials also Which personal health issues matter most to people? cited these three issues as the ones they expect compa- Which societal issues matter most? To what extent do nies and organizations involved in health to engage in. they want companies and organizations to address These issues are the “price of entry” to engagement – them? And how much overlap is there? companies and organizations must address them first To find out, the Health Engagement Barometer first before Health Info-entials will welcome their engagement asked people to rank the health issues that they believe on other issues. HEAlTH PRIORITY EquATION Personal Health Concerns = Public Health Priorities = Expectations of Companies and Organizations 12 HealthEngagement Barometer ™
  • 13. Three Health Priorities Are Price of Entry to Engagement Affordable Healthcare Preventing Disease Solving Chronic Health Problems 5 Channels and Sources: Expertise Personal and health-expert channels are rising and Personal Connection Drive Credibility in importance Although information is a cornerstone of today’s health Next, the study looked at which channels are becoming environment, it’s not likely that every information source is more – and less – important to Health Info-entials. considered credible. To explore this element of engage- Overall, people’s preferences reveal that content that ment, the Health Engagement Barometer asked respon- offers personal connection and health expertise matters dents to rate the credibility of 20 different sources of more than the channel through which it is delivered. information. By focusing on the responses of Health For example, the net emerging importance (difference Info-entials, who exert the most influence on health between increasing and decreasing importance) of today, we can point to where effective health information “conversations with my doctor” is 30 percent, is – or should be – going. “conversations with friends and family members” is 22 Health Info-entials rank 10 sources most highly. Ninety- percent and “health expert blogs” is 10 percent. A wide six percent of all Health Info-entials rate their doctor or range of other sources are considered increasingly healthcare professional as a highly credible source of important, including medical journals, government information. But Health Info-entials do not rely solely on agencies, consumer and health advocacy Web sites, and clinical expertise. They also regard as credible the “conversations with someone like me.” These channels information they get from people with non-clinical deliver content that is either personal in nature, offers in-depth health knowledge, and from people with whom health expertise, or both. they have a personal connection. “My friends and family” The net emerging importance of corporate and product are rated by 91 percent of Health Info-entials as credible, advertising is negative (-34 percent), as it is for a variety as are “a person like me” (88%) and “someone personally of social media applications, including Web-based video affected by a disease or medical condition” (88%). sharing sites (-22 percent), social networking Web sites (-18 percent) and personal blogs (-16 percent). Health company Web sites also have a negative net emerging importance (-3 percent). These findings indicate that information sources that are non-expert or less personal in nature are becoming less important. 13 HealthEngagement Barometer ™
  • 14. Personal and Health Expert Channels Are Becoming More Important 40 30 20 10 10 20 30 40 For each of the following sources of health information, please indicate whether that source is becoming more important to you, less important to you, or remaining the same. (Net = becoming more important – becoming less important) Conversations with my doctor 30% Conversations with friends and family members 22% Medical journals 21% Consumer health Web sites 19% Government agencies 17% Conversations with someone like me 14% Google or other Internet search engines 11% Health-expert blogs 10% Health-related newsletters 8% Nonprofit or health advocacy Web sites 6% Wikipedia 6% Publications or brochures from nonprofit orgs or NGOs 5% Books 4% -3% Health companies’ Web sites -5% TV news coverage -6% Articles in magazines -7% Web sites for specific brands of medication -8% Films or documentaries -9% Online message boards, forums, or newsgroups -10% Articles in newspapers -11% Radio news coverage -16% Personal blogs -18% Social networking web sites Base = Health Info-entials -22% Web-based video sharing sites Net becoming more important -34% Corporate and product advertising Net becoming less important The New Second Opinion™ As much as Health Info-entials trust information from THE NEW SECOND OPINION™ experts like their doctors, they still turn to other sources for validation. Eighty-eight percent of respondents noted that they turn to their physicians to validate online information, and the same number turn to other sources 88% 88% to validate information from their doctor. “I usually turn to “I usually turn to my physician to other sources to No single source of information stands out or stands validate info I validate info I get alone. This finding signals that to ensure that their get online.” from my doctor.” information is relevant and effective, companies and 14 HealthEngagement Barometer ™
  • 15. organizations involved in health must engage across a Health Info-entials also cited a few negative implications wide range of channels. of digital technology, such as having more difficulty determining the accuracy of information or being over- Digital: changing the dynamics of health whelmed by the sheer amount of information, further confirming the high value that Health Info-entials place on Digital technology has fundamentally changed health by expert health information. Interestingly, very few Health changing how people receive and share health informa- Info-entials (7 percent) felt that technology resulted in less tion. Forty-two percent of Health Info-entials say the face-to-face sharing of information. most important impact of this change is that it provides more immediate access to information. THE REAl-TIME REquIREMENT: DIGITAl INFORMATION10 DEMAND ON 20 30 40 50 60 70 80 Which, if any, are the THREE most important ways that digital communications (e.g. e-mail, the Internet, mobile phones) has changed how you receive or share information about health issues? Access to more up-to-date information 42% Access to new information 40% More immediate access to health information 38% Easier to communicate with people who care about 19% similar health issues More difficult to determine the accuracy of information 18% More likely to receive contradictory information 17% More empowered to take action on health issues or personal health topics I care about 15% Increased communication with my friends and family members about health issues or personal health topics 15% Increased communications with my doctor or healthcare provider 15% More overwhelmed with the sheer amount of information available 12% More empowered to express my opinions about health issues or personal health topics 10% Made me more concerned about the privacy of my health information 10% Less face-to-face sharing of information 7% Base = Adults 15 HealthEngagement Barometer ™
  • 16. The New Rules of Health Engagement Public engagement has changed the way health influence happens. To engage effectively, particularly with the Health Info-entials, follow the new rules of health engagement: 1 Provide deep content. People want to know the 6 Take a holistic approach to health and whole story—complete information that helps them well-being. Health and well-being encompass physi- understand the benefits and the risks of products, cal, mental, emotional and even financial health; personal services and issues. Filtering information can be per- appearance; and social connectivity. Remember that ceived as paternalistic. people who have a disease or health condition can still feel a sense of health and well-being. 2 Be transparent. People will dismiss or reject an attempt at health engagement that seems one-sided, 7 Address people’s multiple stakes in health, vague or evasive. They want organizations and brands in including their personal ones. All of your publics health to proactively convey important information and are part of “the public,” so don’t view any of them respond authentically to their concerns. through only one dimension of their engagement in health—for example, as “patient,” “regulator,” “payor,” 3 Inform in real time. Organizations and brands “physician,” or “investor.” Factor in all of a person’s involved in health need to become more nimble in personal and professional stakes in health when engag- disseminating information. In the digital era, people ing with him or her. expect organizations to provide information rapidly, and they view any delay with skepticism. 8 Be personal. People want to be engaged on the topics that matter most to them personally and through 4 Join the conversations, online and off. sources and channels that enable interactions with Information about your organization or brand is now individuals, not faceless entities. freely gathered, shared and validated across multiple channels, both online and offline, and inside and outside 9 Engage through health-expert channels and the specific topic area. Participate actively in conversa- sources. Connect with people through channels and tions across multiple channels so that you don’t cede to sources that are seen as health-expert. Health expertise others how you and your business are defined. can mean deep personal experience as well as medical or scientific degrees and credentials. 5 Engage in prevention, chronic health problems and access to health care. These are 10 Consider the risks of not engaging. priorities for personal and public health, and they are the Recognize the risks of not engaging, including having “price of entry” to engagement—they are the top issues your message defined by others, squandering an that people expect organizations and brands to address opportunity to build trust (or worse yet, losing trust), or before engaging on other issues. Your engagement on failing to motivate your publics to take positive actions on these priority issues should be aligned with your business your behalf. and content expertise. 16 HealthEngagement Barometer ™
  • 17. Suggested Resources Brain, David and Thomas Martin. Crowd Surfing. Lacey, Russell. “Relationship Drivers of Customer London: A & C Black Publishers Ltd., 2008. Commitment.” Journal of Marketing Theory and Practice 15.4 (2007): 315–333. Cavanaugh, Melissa. “The Evolution of Online Media.” Strategy + Business July 15, 2008. National Working Group on Evidence-Based Care. “The Role of the Patient/Consumer in Establishing a Dynamic Cook, Scott. “The Contribution Revolution: Letting Clinical Research Continuum: Models of Patient/ Volunteers Build Your Business.” Harvard Business Consumer Inclusion.” August 2008. Review October 2008. Pisano, Gary and Roberto Verganti. “Which Kind of Deloitte Center for Health Solutions. “2008 Survey of Collaboration is Right for You?” Harvard Business Review Health Care Consumers.” March 2008. December 2008 www.deloitte.com/centerforhealthsolutions Ramani, Girish and V. Kumar. “Interaction Orientation Edelman. “The Edelman GoodPurpose Study.” and Firm Performance.” Journal of Marketing 72.1 http://www.goodpurposecommunity.com (2008): 27-45. Edelman.”The Edelman Trust Barometer.” Sarasohn-Kahn, Jane. “Right Here Right Now: Ten http://www.edelman.com/trust/2008/ Telehealth Pioneers Make It Work.” California HealthCare Fox, Susannah. “The Engaged E-Population.” Pew and Foundation. November 2008. Internet Life Project, August 2008. Sarasohn-Kahn, Jane. “The Wisdom of Patients: Health Fox, Suzannah and Mary Madden. “Participatory Care Meets Social Media.” California HealthCare Medicine: How user-generated media are changing Foundation. April 2008. Americans’ attitudes and actions, both online and Stromberg, Chloe.”How Consumers Use Social offline.” Pew Internet & American Life Project, June 2008. Computing for Health.” Forrester Research Inc. Hibbard, Judith H. and Peter J. Cunningham. “How April 2007. Engaged Are Consumers in Their Health and Health Arthur W. Page Society. “The Authentic Enterprise.” Care, and Why Does it Matter?” Research Brief No. 8, http://www.instituteforpr.org/files/uploads/The_ Center for Studying Health System Change. October 2008. Authentic_Enterprise_White_Paper.pdf Johnmar, Fard. “From Command & Control to Engage & Tu, Ha and Genna Cohen. “Striking Jump in Consumers Encourage: A New Healthcare Communications Strategy Seeking Health Care Information.” Center for Studying for a Social Media World.” Envision Solutions. 2006. Health System Change Tracking Report No. 20, Jones, Kathryn. “In whose interest? Relationships August 2008. between health consumer groups and the pharmaceutical industry in the UK.” Sociology of Health & Illness 30.6 (2008): 929–943. 17 HealthEngagement Barometer ™
  • 18. Contacts For more information, including country-specific data, contact: About Edelman Global Edelman is the world’s leading independent public relations firm Nancy Turett and the leader in public engagement, with more than 3,200 +1 212 704 8195 employees in 54 offices worldwide. Edelman was named nancy.turett@edelman.com PRWeek’s “2008 Large Agency of the Year,” Holmes Report’s Bruce Hayes “2008 Global Agency of the Year,” and listed as top-10 firm in +1 212 704 4503 Advertising Age’s “2007 Agency A-List,” the first and only PR bruce.hayes@edelman.com firm to receive this recognition. In 2007, CEO Richard Edelman Carolyn Paul was honored as “Agency Executive of the Year” by Advertising +44 20 3047 2105 Age, and he was cited in 2007 and 2008 as “Most Powerful PR carolyn.paul@edelman.com Executive” by PRWeek. For more information about Edelman visit www.edelman.com. united States Susan Isenberg +1 212 704 8159 About Health At Edelman susan.isenberg@edelman.com With deep engagement across topics, channels and publics, Edelman helps the world’s leading organizations and brands Europe thrive in the business of health. Our global staff of more than Mike Kan 400 health experts has collaborated with clients to engage on +44 20 3047 2126 important health issues, including disease prevention, manage- mike.kan@edelman.com ment of chronic disease, the health technology revolution, Asia Pacific wellness, infectious disease pandemics, biomedical science, Margaret Key and access to healthcare. Edelman’s Health offering includes +82 2 2022 8210 specialties in Rx Health, Personal Health & Wellness, Health margaret.key@edelman.com Policy & Public Affairs, Corporate & Organizational Health, Life Canada Sciences, Public Health, Health Alliances, Health Media, and Scott Evans Clinical Development, as well as BioScience Communications, +1 416 979 1120 our full-service medical relations, education and publishing scott.evans@edelman.com company. Join Edelman in the conversation about advancing health engagement at www.engageinhealth.com. latin America Zerene Kahan +52 55 5350 1515 About StrategyOne zerene.kahan@edelman.com StrategyOne is a full-service research firm that provides customized and targeted opinion research (qualitative and BioScience Communications quantitative), strategic consulting, and in-depth media analysis – Mark Deitch including corporate reputation evaluation, PR & advertising +1 212 704 8142 effectiveness analysis, brand positioning, and communications mark.deitch@bioscicom.net assessment. StrategyOne analysts have backgrounds in David Noble political research and polling, journalism, public relations, +44 20 3047 2250 advertising, and consulting and have directed and analyzed david.noble@edelman.com public opinion and market research projects for a range of StrategyOne corporate, association, political and international organizations. Laurence Evans Our evidence-based approach of using proprietary market +1 212 704 8286 research to deliver strategic communications counsel sets us laurence.evans@strategyone.net apart from other market research firms. 18 HealthEngagement Barometer ™