1. Preventing the Spread of HPV with Fact Check: HPV A Novel Facebook Application Christianne Johnson, MA, CHES Program Manager, Partnership for Prevention

2. Background  Difficult to reach population  Sharing information about stigmatized disease (STD) is a sensitive issue  Over 75% of adolescents and young adults have social networking profile page  Friends are credible source of information

3. Research Goals  Increase awareness of and promote HPV vaccination and prevention (regular Pap smears) among young women  Develop and pilot a novel application that allows people to anonymously shareinformation about HPV with friends on social networking sites  Relate knowledge of HPV to demographic characteristics and social network position  Evaluate effectiveness of various marketing/promotional strategies to drive users to the application  Assess interest in anonymous invites on social networking sites

4. About Fact Check: HPV  Interactive 8-question quiz to test users’ knowledge about HPV, cervical cancer, and genital warts

5. About Fact Check: HPV  Wanted to find out how information about a potentially stigmatized disease might spread using this social medium  Invite friends traditionally (identity known) or anonymously  New constraints made anonymous -sharing difficult—had to use email invitation

6. www.hpvfactcheck.org

7. Methods  Develop Fact Check: HPV with community and expert input. Assess usability and message clarity  Use data logging to capture activity (e.g.: quiz scores, resources clicked) and relate it to demographic characteristics and network position  Use social network analysis to evaluate the spread of the application through network and relate knowledge of HPV to network neighbors and centrality metrics  Determine how users accessed the application (e.g.: newspaper ad, Facebook ad, etc.)

8. Promotion and Dissemination  Facebook ads (2 ads, 10 days each)  Targeted to adolescent and young women age 13-25 in the U.S.  Best results—generated the most users  Promoted through advocacy and health groups—American Social Health Association, Advocates for Youth, American College Health Association, etc.  Outreach at University of Maryland  Promotional postcards distributed in classes at School of Public Health, iSchool, business school, and human sexuality courses  Posters in health center, student union, etc.  Ad in Diamondback newspaper (most expensive, least effective)

9. Findings and Evaluation  In three months (Oct.-Dec.) 1,022 people downloaded Fact Check: HPV, approximately 90% of whom were female  171 users (16.7%) uninstalled the application after using it  Of the users who continued through to the “invite” portion of the interface, 425 canceled out and did not send an invitation; 60 chose non-anonymous invite, and 33 chose anonymous invite  302 non-anonymous Facebook invitations were sent to download the app with an 8.6% acceptance rate  The average number of Facebook invites per inviter was 10, suggesting that those who were willing to send at least one invitation were willing to send many  17 anonymous email invitations were sent with a 47% acceptance rate

10. Discussion/Conclusions  The approach embodied in Fact Check: HPV allows anonymity without losing the trust embedded in existing social networks  The data we’ve collected has significant implications for identifying thought leaders and promoting healthy behaviors through existing social networks  Despite the technical limitations we encountered in implementing our anonymous invitations, we found support that the approach is one that can lead to increased acceptance rates  Identified successful (and unsuccessful) approaches for marketing social network applications  Demonstrated the viability of using Facebook applications as a platform for education about stigmatized conditions such as other STDs, HIV, addiction, and mental illness

11. Thank you  University of Maryland  Derek Hansen, iSchool  Vrushank Salaskar, iSchool  Savita Narsinghani, iSchool  Nancy Atkinson, School of Public Health  Denise Bellows, School of Public Health  Partnership for Prevention  Susan Maloney  Our Funders: The Fund to Prevent Cervical Cancer

12. Questions? Christianne Johnson cjohnson@prevent.org 202-785-4944