Improving Health through Improving Health through Communication, Communication, Marketing, and Media, and Media

Jay M. Bernhardt, PhD, MPH

US Centers for Disease Control and Prevention

Twitter: @jaybernhardt

Centers for Disease Control and Prevention

• 2009 H1N1 Flu Pandemic

• Strengthen CDC’s:

– Surveillance and Epidemiology

– Support to State and Local Health Departments

• Provide Leadership:

– Community Prevention

– Global Health

– Health Policy and Reform

Thomas Frieden, MD, MPH

CDC Director

Health Reform - A New Manifesto for the CDC

“Determining the CDC's role in health

system reform is a major priority. Little

progress can be made in health-care cost

containment, improved access, and

enhanced quality without public health

having a seat and voice at the reform

table.”– The Lancet, Vol. 373. June 6, 2009

Health Professionals

– 1,000+ Health Departments

– 1,000+ Partner Organizations

The “Public”

– 300+ million Americans

– Populations in 50+ countries

Policy Makers & Stakeholders

CDC’s Diverse Customers: Wholesale and Retail

What Influences Health Behaviors?

http://www.curcuitcity.com

http://www.paintmyweb.com/images/web-logos.jpg

Average informed person reads or listens to 7 sources of information daily (Pew, 2008)

Health Consumers in 2009

Empowered

Overwhelmed

InfoSeeking

InfoAvoiding

We Can Learn from the Experts

Coca-Cola should always be “within an arm’s reach of desire.”

– Robert Woodruff

Source: Coca-cola website image library

Effective Public Health Means…

Providing health information and

interventions when, where, and

how people want and need them to

inform healthy and safe decisions

Our Goal: Public Health

within an arm’s reach of need

Principles of Effective Health Communication, Marketing, and Media

• Use customer-centered strategies

• Make information accessible and relevant

• Mix high repetition with deep engagement

• Combine high-tech with high-touch

Customer-Centricity through Data

http://www.cdc.gov/healthmarketing/resources.htm

Health Literacy and Accessibility

• The capacity to obtain, process, and understand basic health information

• Only 12% of US adults have “proficient health literacy.”

• 14% of US adults (30 million people) have “below basic health literacy.”– More likely to report

poor health (42%)

– More likely to lack health insurance (28%)

http://www.cdc.gov/healthmarketing/resources.htm

Tailored and Targeted Health Information

• Relevance increases Central Processing

• Multilingual services– e.g., CDC en Espanol

• Multi-cultural comm.• Target vulnerable

populations to reduce health disparities

http://www.cdc.gov/CDCTV/EyesOfTheEagle

The Power of Narrative

• Storytelling aids persuasion

• Television is most common source of health information

• Entertainment-Education can impact knowledge, attitudes, and behaviors

http://www.kff.org/entmedia/upload/7803.pdf

The Power of Social Media

TraditionalMedia (vertical)

Social Media(horizontal)

Most trusted =People Like Me

- Edelman trust barometer

Aim for the“Sweet Spot”

Social Media and Consumers

Social Media and Health

Social Media at CDC

http://www.cdc.gov/socialmedia

Social Media at CDC

http://www.facebook.com/CDC http://twitter.com/CDC_eHealth

Streaming Media at CDC

http://www.cdc.gov/CDCTV

http://www.youtube.com/user/CDCStreamingHealth

CDC Island in Second Life

Mobile Health Communication and Marketing (mHealth)

Mobile Health Communication and Marketing (mHealth)

• Mobile emergency risk communication

• Mobile behavior change campaigns

• Mobile treatment compliance reminders

• Mobile social network messaging

• Mobile community empowerment

• Public health within an arm’s reach

http://m.cdc.gov/

mHealth Apps & Campaigns

“Mobile phone subscribers have almost tripled in developing countries over the last five years, and now make up some 58% of mobile subscribers worldwide.”

-- United Nations Conference on Trade and Development, 2008

Global mHealth Opportunities

2008 Salmonella Outbreak and Peanut Product Recall

eCards

Graphical Buttons

Blogs

Twitter

Widgets

Integrated Health Marketing Campaign: Seasonal Influenza Vaccination (2007 –

2009)

2009 Novel H1N1 Influenza

“In the next influenza pandemic, be it now or in the future, be the virus mild or virulent, the single most important weapon against the disease will be a vaccine.

The second most important will be communication.”

John Barry, Author of The Great Influenza in Nature (May 2009)

2009 Novel H1N1 Influenza Communication

2009 H1N1 Pandemic Response

• Risk Communication Goals:– Provide timely, accurate, and credible information

about the 2009 H1N1 threat and prevention actions – Increase public awareness, knowledge, and adoption

of flu prevention and mitigation recommendations– Guide public expectations for change and variability

related to prevention and mitigation– Protect public and individuals’ health while minimizing

social, economic, and educational disruption

• Strategy: Two-way comm. thru multiple channels and partners and target vulnerable populations

2009 H1N1 Web Stats

4,889,611 Email Updates: H1N1 Flu Emails Sent

223,176 Email Updates: Subscribers to H1N1 Updates

3.49 M H1N1 Flu Pages in Espanol: Page Views

4.53 M CDC.gov in Espanol: Page Views

115.85 MH1N1 Flu Pages: Page Views

349.66 M CDC.gov: Page Views

4,889,611 Email Updates: H1N1 Flu Emails Sent

223,176 Email Updates: Subscribers to H1N1 Updates

3.49 M H1N1 Flu Pages in Espanol: Page Views

4.53 M CDC.gov in Espanol: Page Views

115.85 MH1N1 Flu Pages: Page Views

349.66 M CDC.gov: Page Views

Totals (Apr 22 – Sept 10)

H1N1 Content Syndication and RSS

• More than 22 million views of H1N1 Content via CDC RSS Feeds through 9/10/2009• More than 164,000 views of CDC H1N1 content via Content Syndication

• More than 2,000,000 YouTube views

• More than 680,000 Podcast downloads

• More than 106,000 CDC-TV views

2009 H1N1 Streaming Media

• Fewer than 3,000 followers before H1N1

• Now more than 884,000 followers on 3 CDC Twitter profiles

• More than 429,000 click throughs to CDC.gov content from links posted on Twitter through September 10, 2009

2009 H1N1 and Twitter

3.80 million views of H1N1-related widgets through 9/10/2009

www.cdc.gov/widgets

2009 H1N1 Widgets

2009 H1N1 CDC-INFO Stats

20,797 Emails: Emails Answered Related to H1N1 Flu

0:50 Min Wait Times: Avg. for Spanish Emergency Queue

0:17 Min Wait Times: Avg. for English Emergency Queue

48,570 Calls: Calls Answered Related to H1N1 Flu

20,797 Emails: Emails Answered Related to H1N1 Flu

0:50 Min Wait Times: Avg. for Spanish Emergency Queue

0:17 Min Wait Times: Avg. for English Emergency Queue

48,570 Calls: Calls Answered Related to H1N1 Flu

Totals (Apr 22 – Sept 10)

Steps Americans Have Taken in Response to the H1N1/Swine Flu Outbreak

25%

35%

55%

27%

67%

Taken any steps to avoid being near someone who has flu-like symptoms

Harvard Opinion Research Program, Harvard School of Public Health, May 5-6, 2009.

% saying in response to reports of H1N1/swine flu, they/member of their household has…

Avoided places where many people are gathered together, like sporting events/malls/public transportation

Washed hands/used hand sanitizer more frequently

% saying in response to reports of H1N1/swine flu, they personally have…

Made preparations to stay at home if they or family member is sick

Avoided air travel

Steps Americans Have Taken to Avoid Contact with Others

12%

14%

35%

Stopped hugging/kissing close friends/relatives

Stopped shaking hands with people

Taken any steps to avoid being near someone who

has flu-like symptoms

Harvard Opinion Research Program, Harvard School of Public Health, May 5-6, 2009.

% saying in response to reports of H1N1/swine flu, have personally…

Americans’ Satisfaction with Health Officials’Response to the H1N1/Swine Flu Outbreak

88%

84%

The information public health officials have been providing about the H1N1/swine flu outbreak

The way public health officials have been managing the response to the H1N1/swine flu outbreak

% very/somewhat satisfied with

Harvard Opinion Research Program, Harvard School of Public Health, May 5-6, 2009.

“…The CDC is clearly making an effort to provide site visitors with multiple ways and formats to consume this serious content, from video explan-ations to podcasts featuring health domain experts…

…So yes, swallow your pride. We can learn from the ‘big, fat, impenetrably slow and bureaucratic’ agencies out there. Suck it up and take action.”

-- Pete Blackshaw Advertising Age

Feedback from Media & Experts

Feedback from Media & Experts

“As the government tries to get in front of the rapid spread of information, it's learning some important lessons about how social media is used in crisis situations.”

---National Public Radio

"When it comes to swine flu, the Feds are maintaining full online alert. As news about the epidemic has burned up all corners of the Web, the Centers for Disease Control and Prevention and the Department of Health and Human Services have been using Twitter and YouTube, among other sites, to disseminate information.”

--Washington Post

Improving Health through Communication, Marketing, and Media

• Apply best-practice principles– Use customer-centered strategies– Make information accessible and relevant– Mix high repetition with deep engagement– Combine high-tech with high-touch

• Expand research and evaluation efforts

• And most importantly…

For more information go to: http://www.flu.gov

Thank you from the CDC

Web: http://www.cdc.gov/healthmarketing

Blog: http://blogs.cdc.gov/healthmarketingmusings

Twitter: http://www.twitter.com/jaybernhardt

Email: jbernhardt@cdc.gov