Recipe for Change: Wrap Up of the Society for Nutrition Education and Behavior’s (SNEB) Annual Conference

Jul 17

The Society for Nutrition Education and Behavior (SNEB) recently held its 2012 Annual Conference in Washington, DC, July 14-16.

SNEB is a community of professionals involved in nutrition education and health promotion from across the world. Members join from academia, government agencies, cooperative extension, communications and public relations firms, the food industry, voluntary and service organizations, and other educational nutrition and health organizations.

“Energy from Synergy” was the theme of this years’ conference, which highlighted innovative nutrition and behavior research, as well as new consumer-focused education materials.

One of the conference’s popular sessions was a screening of the new documentary “Cafeteria Man.” The film tells a compelling story of one Baltimore, MD, school district working to overhaul a dysfunctional and unhealthy nutritional system feeding over 83,000 students each year.

The film chronicles Tony Gareci, a food services director for the city’s public schools, and his quest to reform the system.  A trained chef from New Orleans, LA, Gareci, envisions a transformed food system including school gardens providing fresh produce, meals designed by students, and more nutritional education in the classroom.

The documentary serves as a nice analogy to this year’s SNEB conference.  SNEB is working to educate consumers, healthcare providers, and government agencies about the importance of nutrition and behavior change to reinforce healthy eating around the country.  Changing the way Americans view food and nutrition in schools through education is a central message carried through the ‘Cafeteria Man’ and echoed by the film’s Gareci, who says: “We need a recipe for change.”

Courage and Creativity in Social Marketing: Learning from the life of Lyn Lusi

Jul 09

I was deeply moved by the Economist’s obituary of Lyn Lusi. I had not heard of her or of her work running the hospital, HEAL Africa, in the Democratic Republic of Congo. I did not know both George Clooney and Hilary Clinton are among her admirers. I did not know that she was responsible for ensuring the treatment of thousands of women with genital fistula and returning these women not only healed but capable, to families that would have otherwise abandoned them.

I am in awe of her courage, dedication and tremendous heart.  Most of us will never achieve what she has, but we can certainly do what we can, and learn from her.

Reading about her life and work made me want to be a better social marketer, and here are but two of the many thoughts I have not been able to put to rest:

  • Lusi’s work was desperately needed but in many ways unwelcome. Genital fistula is frankly, a horrific condition, both physically and socially, and efforts to address it are challenged by severe political and cultural barriers. I think we need to be reminded that very often social marketing work is at its core, unwelcome. It’s easy for us, and our clients to assume that communities want to change, that our messages will be embraced. It’s very hard to hear they don’t and won’t, and even harder to find the alternative approach.
  • Lusi’s work was comprehensive. Lusi employed women in the community to welcome patients and taught patients valuable skills. If she only advertised that her hospital would treat fistula it surely would been less complicated, more prudent—and also less effective. Social marketers often make the mistake of attacking the problem from only one angle (often the communications angle). Working at Ogilvy, I’m proud to say we strive for comprehensive approaches. However, clients can be afraid to go out of their comfort zone, and it’s easy to let that restrict creativity.

Lyn Lusi was a French language teacher from England who faced fistula in Africa, challenging and working around enormous barriers and her own humble self-perceptions. We can (and should) be braver and more creative in our own way for our clients.

I hope you’ll take the time to read about Lyn Lusi. What might you do more of, or differently (professionally, or personally) after learning about her work?

Social Media in Disaster Preparedness and Response

Jul 05

If you’ve ever doubted how wired and connected we’ve become, take a look at the faces of people around you as a flight attendant announces that all portable devices must be turned off prior to takeoff.  It’s a scurry to check e-mail or Facebook just one last time.   And as that plane touches down, it’s a similar response—a mass reach for the mobile device to see what may have transpired while we were unplugged for the last 90 minutes.

We communicate online.  For many people, the first they will learn or hear of an important news event or incident is through their computer or mobile device.

Those in the emergency preparedness and response community—from elected officials and non-profits to the media and the military—are realizing that social media has the power to transform the way emergency communications and operations are managed before, during and after the event.

On June 26th, I had the pleasure of moderating a discussion at Ogilvy Washington—along with partners Defense Daily and Northrop Grumman—on the Expanding Use of Social Media in Disaster Preparedness and Response.  Our panel included Delaware Governor Jack Markell, Suzy DeFrancis (Chief Public Affairs Officer at the American Red Cross), Jason Samenow (Chief Meteorologist and Founder of the Washington Post’s “Capital Weather Gang”), and Lt. Cmdr. Chris Servello (Director, Navy Newsdesk, U.S. Navy).

Each of these individuals brought a very unique perspective of what it means to communicate online in the face of an unfolding emergency or disaster response scenario.  They were extremely frank in sharing what worked well, where they need to improve, and how they are learning to weave social media into their organizations’ operations.

I invite you to watch the highlights video from the event below.

A big pill to swallow? FDA approves new diet pill

Jun 29

This week, the Food and Drug Administration (FDA) approved the first new prescription diet pill in 13 years, providing a new option for the roughly one-third of American adults considered obese. This approval was covered widely due not only to the opportunity that it provides for some people trying to lose weight to bridge the gap between using diet and exercise to lose weight or using surgery, but also because of the rocky history of diet pills and the potential pitfalls of relying on a pill to achieve a more healthful lifestyle.

With over 1/3 of the American population overweight or obese, is this new diet pill the silver bullet? Or will it still come down to a matter of behavior modification to address this epidemic? With diet pills coming soon to a store or doctor’s office near you, is there still a role for social marketing in preventing overweight and obesity?

For me the answer is overwhelmingly yes. There is no one answer to changing an individual’s behavior to better their health, and ultimately reduce the incidence of overweight and obesity. While a diet pill may aid in weight loss, ultimately it still comes down to an individual’s choice to eat better and get more exercise – the old adage that it’s all about calories in and calories out still applies. So in fact, in some ways, we’re all working in partnership, whether it be the manufacturers making a diet pill or those of us working to affect positive behavior change to prevent overweight and obesity as a public health imperative.

Tackling obesity isn’t just about any one thing or one approach. It’s about changing perceptions and attitudes about health. And for that, it’s all hands on deck!

It Takes Two to Treat

Jun 22

When was the last time you openly questioned your doctor’s advice?

Think about it. When was the last time your doctor prescribed a treatment, and you said, “Well, I don’t think that’s best for me. Let’s talk about what other options are available”?  If you’ve never said those words, you’re not alone.

As a society, we put a lot of emphasis on personal responsibility for maintaining health and preventing disease: eat healthy foods, exercise, get screened for cancer. But what happens when we get sick? Suddenly, it seems that expectation for personal responsibility evaporates. Instead, we look to our doctor to provide the answers—to tell us what we should do, which treatment is best, and how it will affect us.

A recent study published in Health Affairs found that most patients felt they couldn’t talk to their doctors about treatment options—they were worried about angering or upsetting them, and some even worried that they would receive worse care if they questioned their health care provider.  As a post on the New York Times’ Well Blog put it:

The participants responded that they felt limited, almost trapped into certain ways of speaking with their doctors. They said they wanted to collaborate in decisions about their care but felt they couldn’t because doctors often acted authoritarian, rather than authoritative.

Image Credit: hang_in_there, Flickr

I can understand those patients in the study. I too have sat on that exam table, ready to ask questions and get advice—and then promptly clammed up when the doctor finished her rushed exam and looked up.  It’s not an environment that invites engagement; and the hurried nature of most medical appointments makes it hard to get a word in.

I’m not saying that doctors aren’t the experts—they are.  But we do ourselves a disservice when we don’t speak up about our treatment preferences—never asking if there may be a more effective treatment, or one with fewer side effects or a lower cost, never challenging our doctors to see us as individuals.  When we rely solely on our doctors’ opinions, we run the risk of getting care that doesn’t address our individual needs.

In public health, our campaigns often urge people to “talk to your doctor” about various disease or treatments. But, perhaps it’s time for us to focus not only on starting the conversation, but empowering patients to participate in meaningful, two-way conversations with their doctors—helping patients believe that they have the right (and the responsibility) to ask questions, assert their opinions, and challenge themselves and their doctors to a higher standard of care.

Come Dance With Me

Jun 14

Me: “Hi, I’m Alex and I’m a ballerina.” Other: “Ballet, huh? Uhh, I’ve seen ‘Black Swan!’”

Now believe me, as a former ballet dancer, I am thrilled when the art to which I have dedicated years of my life in the studio is brought to the center stage of mainstream media. In the past few years, we have had an inundation of films and TV shows, which show dance through a somewhat unfiltered lens:  “First Position,” “Black Swan,” ABC Family’s “Bunheads,” CW’s “Breaking Pointe,” FOX’s “So You Think You Can Dance,” and Lifetime’s “Dance Moms.” The list goes on but their messages are myopic and more or less the same:  dance is hard, unforgiving, and the moms are crazy.

That’s why it was like a breath of fresh air when I saw this video posted to the New York City Ballet’s Facebook page a few weeks ago.

The song, “Man on Fire” is the lead single from the Indie-folk band Edward Sharpe and the Magnetic Zeros’ recently released album Here. Shot in New York City in May, it features just about every kind of dance from the New York City Ballet, NY Junior Destiny Allstars, National Double Dutch Junior League, Soul Steps, and Brooklyn Divas, among others. Also, let’s please take note of the portrayal of supportive parents and coaches.

Amidst the dramatic, exclusive, and competitive dance world we’ve seen so much of on TV lately, this video truly positions itself as separate from the mix, pointing to something beyond dance life in a studio.

With its faded colors and sparse composition, it doesn’t take itself too seriously.  Its message is simple and straightforward, yet powerful:  dance is everywhere, it’s transformative, and anyone can do it. Now I don’t mean to underestimate the work and commitment that goes into the pursuit and maintenance of a professional dance career, however, what ever happened to just dance—as exercise, as a mental and physical release, as an expression of spontaneity and personality?

One of my former dance teachers Liz Lerman, founding artistic director of Dance Exchange and a 2002 MacArthur “Genius Grant” Fellowship awardee, understood what Sharpe coveys in his video:

“Sometimes art achieves what therapy, medicine, or the best of health professionals cannot…inspiring motivation, engaging parts of people’s bodies or brains that they haven’t been using, or allowing them to transcend their environments for a little while.”

Lerman’s work, supported by MetLife Foundation Healthy Initiative, concentrates on two main areas:  1) arts in healthcare settings combining movement, verbal expression, creative challenge, and collaboration among patients with Huntington’s disease, brain injury, addiction, etc., and 2) integrating dance, which is easily adaptable for different bodies and ages, into activities for adults over 50.

In its third year, the MetLife Foundation Healthy Living Initiative at Dance Exchange has supported the incorporation of art programs, namely dance, into the medical and health/wellness fields to people nationwide. Arts integration has been shown to improve the quality of the healthcare experience for patients, their families, and for the health professionals who serve them, reporting benefits such as shorter hospital stays, less medications, and fewer complications.

This partnership between the Healthy Living Initiative and the Dance Exchange is a step in the right direction to making arts accessible to all ages and promoting dance as an art form that can enhance lives to be more productive and healthier for the mind and the body through the creative expression of movement.

To give some scientific backing, the National Institute on Aging funded a 2003 study published in the New England Journal of Medicine, reporting that in addition to the numerous physical benefits from dance, it is also the only physical activity to provide protection against dementia, and offered the greatest risk reduction of any activity studied, cognitive or physical.

Schools are also integrating dance programs—the National Dance Association’s work with First Lady Michelle Obama’s Let’s Move campaign, entitled Let’s Move in School, educates youth about the benefits of a creative, healthy lifestyle; and the Washington Ballet’s DanceDC has an in-school program which serves young people in all five wards of the District to offer extensive education, physical activity, and engagement through dance.

The bottom line is that dance doesn’t always have to be in a studio to be called dance.  Maybe you’ll turn on the radio and dance with your kids before dinner, maybe you’ll have a little dance party of your own while you’re washing the dishes, or who knows you may happen upon an alley in the middle of New York City with the corps de ballet of the New York City Ballet. Whatever form it’s packaged in, dance can achieve something unexpected and unparalleled for individuals and communities alike. So, come dance with me.

Making mHealth a Reality

Jun 14

We’ve all had at least one frustrating experience with the health care system. A moment where you’re left thinking: “There has to be a better way of doing this.” For me, these moments often come when the paper-filled world of health care doesn’t jive with my increasingly mobile-based lifestyle. (You can count me in the 35% of all U.S. adults who own a smart phone.)

Mobile health (mHealth) technology offers a potential solution to connecting an increasingly mobile population (83% of U.S. adults own a cell phone) to our experiences with the health care system.

For me, this means a world where after you visit your doctor, the name and dosage of your prescriptions are transferred from your doctor’s electronic health record system to an application in your phone, along with the name of the condition you’re being treated for. The condition links over to a website trusted by the physician that has more information about that condition, which you can read on your own time. From there, you can send your physician additional questions you have through a secure messaging system. That same app would also allow you to enter your symptoms as you experience them, so you aren’t stuck trying to recall their frequency and intensity at your next appointment.

All of this and much more could be possible in the near future, according to a new report from PwC resulting from interviews with 1,805 patients, physicians and health care payer executives. Patients surveyed for the report said they thought mHealth would help improve the convenience (52%), cost (46%), and quality (48%) of their health care within the next three years. Sixty percent of the physicians and payers surveyed said that widespread adoption of mHealth is inevitable.

Despite agreement that mHealth is coming, people interviewed for the report noted there are substantial hurdles to jump through before we’ll see widespread adoption of mHealth solutions. According to the report:

  • mHealth will require a big shift in how the health care system operates—and most health care systems hate change. mHealth tends to focus on prevention and, unfortunately, most health care systems don’t reimburse enough for prevention.
  • Players within the health care system—health care providers, patients, payers—all have different interests in mHealth and these differing interests will make it challenging to implement solutions.
  • For mHealth adoption to become widespread, any solutions must appeal to payers, because patients are “highly sensitive to price” and won’t be willing to foot the bill for mHealth technology.

The report offers several recommendations for overcoming these hurdles. The two that resonated most with me:

  1. In developing mHealth solutions, focus on actually providing a solution to a business problem; don’t focus on what technology can do. In my work, we say this all the time: Don’t focus on the tactics, focus on the strategy. From there, the best tactics to achieve the strategy will follow.
  2. mHealth creators should build partnerships to create solutions that can be part of an mHealth ecosystem rather than stand on their own. These partnerships can help identify the best ways to implement a solution and move its adoption along. Interoperability with other mobile health solutions is one of the ingredients to a successful mHealth model, says the report.

All that said, even a perfectly designed mHealth solution requires something bigger to be successful: it requires behavior change on the part of everyone involved in the health care system. All physicians will need to be electronic so that data can be shared with their patients, and they’ll need to input quality data so patients understand what they are reading. Payers will need to provide incentives, likely financial, for physicians to be active participants in making these solutions work. Finally, patients will need to take an active role in their care: using mHealth solutions to track their symptoms, interact with their physician and research their conditions (in other words, become a “quantified patient”). All of this will take time, but like the people interviewed for the PwC report, I believe we will get there.

Photo credit: Alvimann from morguefile.com

Messages About Sun Protection and Skin Cancer Must Include People of Color

Jun 07

With the official start of summer approaching in the next two weeks the thought of outdoor events and relaxing vacations fill my mind. When the summer sun hits my skin I immediately feel happy. I’m ready to throw caution to the wind and hit the beach – which is exactly what I did last weekend. I had perfect beach weather in Fort Lauderdale, Florida.

After enjoying a day of lounging and playing in the ocean I noticed my friend, a fair-skinned African American woman, with a nice red glow. She’d forgotten to apply sun screen and had a pretty serious burn. Her painful predicament reminded me just how important sun protection is, and how sharing this message with everyone, especially people of color, can save a life.

Last month The Huffington Post posted the article, Skin Cancer and African Americans: Why You Shouldn’t Ignore It that focused on this topic.

According to the Skin Cancer Foundation, skin cancer comprises just 1 to 2 percent of all cancers among African Americans, but less than half of melanomas in African Americans are diagnosed at an early stage compared to 74 percent in Hispanics and 84 percent in Caucasians. Reggae music lovers may remember that reggae legend Bob Marley discovered a type of malignant melanoma under the nail of one of his toes, and the cancer ultimately spread to his lungs and brain causing his death 31 years ago.

While skin cancer is less likely in people of color, it is more deadly because it is most often caught in its later stage. The article also provides an interesting slide show to address the most common misconceptions about cancer in dark skin, such as black people don’t get skin cancer (we do!) and dark skin is a natural SPF (not entirely true!).

Even the American Medical Association (AMA) has adopted the cause. In 2010 the AMA established a policy to support and encourage efforts to increase awareness of skin cancer risks, skin cancer screening and sun protective behaviors in communities of color. The policy includes partnerships with the National Medical Association, the National Hispanic Medical Association and the American Academy of Dermatology to get the word out about the importance of sun protection.

The Centers for Disease Control and Prevention provides the following tips on ways everyone can protect their skin from the sun:

  • Take precautions against sun exposure every day of the year, especially during midday hours (10 a.m. – 4 p.m.), when UV rays are strongest and do the most damage. UV rays can reach you on cloudy days and can reflect off of surfaces like water, cement, sand, and snow.
  • Seek shade, especially during midday hours.
  • Cover up with clothing to protect exposed skin.
  • Wear a hat with a wide brim to shade the face, head, ears, and neck.
  • Wear sunglasses that wrap around and block as close to 100 percent of both UVA and UVB rays as possible.
  • Put on sunscreen with broad spectrum (UVA and UVB) protection and a sun protective factor (SPF) of 15 or higher.
  • Avoid tanning beds and sunlamps. The UV rays from them are as dangerous as the UV rays from the sun.

I plan to share these tips with my friends and hopefully this weekend we’ll avoid sun burns!

What are sun protection habits you use regularly? Do you encourage friends and family to do the same?

With Summer Comes Hurricane Season

Jun 01

Today marks the first day of the Atlantic hurricane season, which lasts through November. Today the media is abuzz with the question “are you prepared?” with various experts explaining the steps individuals should take to prepare for hurricane season:

  • Build and emergency kit: In addition to your flashlights, batteries, and canned food, do you have a few days of any prescription medications? Food for your pets? A battery operated weather radio?
  • Make a family communication plan: Where will you meet if you get separated from your family? Do you have an out-of-town contact who can act as a communications liaison for your family?
  • Know your evacuation route: Do you know where you would go, if you need to evacuate? How about the best way to get there?
  • Determine your flood risk: Are you near a levee, dam, or body of water? Are you within a storm surge zone? Do you have flood insurance?
  • Have a plan to secure your property: as the folks at the Federal Alliance for Safe Homes (FLASH) will tell you, tape won’t protect your windows during a hurricane or tropical storm. Do you have storm shutters or plywood? Do you knave a place to tie down your patio furniture or a place to put it away?

There are a number of social marketing and risk communications efforts underway to help people understand and prepare for the hazards of hurricane season, from Ready.gov to the National Oceanic and Atmospheric Administration’s Hurricane Preparedness Week to FLASH’s Go Tapeless campaign. Each campaign takes a different approach to helping the public understand their risk and encouraging them to act. But each clearly employs foundational risk communication principles: a trusted source providing actionable steps the public can use to mitigate their risk.

But I wonder if more attention ought to be spent on understanding risk. In Florida, studies have shown that those at the highest risk underestimate their hazard, while those at low risk are more likely to overestimate the danger they face from hurricanes. Countless times, I have tried to explain to my parents that they live in a coastal area and ought to consider flood insurance. Every time they tell me that they can’t see the water from their house—it could never reach them. So if they have no incentive to prepare…are all these campaigns white noise to them? How do we educate people on risk, in order to get them to prepare?

Two questions remain. Do you know your risk? Are you prepared for hurricane season?

Kitty Harding at the National Hurricane Conference


Ride or be ridden.

May 31

Control diabetes or let it control you.  That’s a rallying cry for the “Red Riders” who cope with Type I and Type II diabetes and will be participating in the American Diabetes Association’sTour de Curethis weekend on June 3rd.

The group knows all too well the importance of exercise and staying in shape when dealing with this potentially deadly condition. They’re taking to the roads in Virginia with 1,500 other riders –including an Ogilvy Team!—to generate funding for diabetes research, advocacy, and information programs.

Last week, the news on diabetes could not have been more stunning.  A report published in the journal Pediatrics indicated that, in less than a decade, the numbers testing positive for diabetes or pre-diabetes jumped from nine percent to 23 percent of American teens. That’s nearly one in four.

The risks from diabetes are huge—kidney failure, vision loss, amputation, stroke, heart attack, and nerve damage.  It’s a heavy prospect for a person at any age.  But it’s particularly frightening to consider what such a large number of youth are facing so early in their lives.

The situation is one more resounding alarm for embracing a healthy lifestyle.  As a parent, it’s a reminder for me to be a good example to my kids; to get them to eat a vegetable by doing so myself; to lead from the front by dropping the bag of chips and jumping on the bike. Just like those Red Riders.