Emerging Digital Media Forms for Increasing Engagement in Health Messages Across Diverse Communities Susan J. Robinson National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Communication Across Borders July 2008 Susan J. Robinson National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Communication Across Borders July 2008

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Overview eHealth evolution Emerging Technologies Mobile media: texting and peer-generated video Engagement Evaluation design Tangible media: responsive objects, surfaces, and spaces Key Research Questions eHealth evolution Emerging Technologies Mobile media: texting and peer-generated video Engagement Evaluation design Tangible media: responsive objects, surfaces, and spaces Key Research Questions

eVolution of eHealth 2005 Interactive Tailoring – Individual-level Personalization 2008 Networked Peer-to-peer -- Group level/social Participation Networked Peer-to-peer -- Group level/social Participation

Theory Behind Tailoring* Increase information processing Attention Effortful processing Self-reference Peripheral processing Emotional response Increase information processing Attention Effortful processing Self-reference Peripheral processing Emotional response Impact behavioral determinants Behavioral intention Skills Self-efficacy Attitudes/expectancies Normative perceptions Source: Hawkins et al. Understanding tailoring in Cancer Communication, eHealth Summit 2005.

Social Networks Social Networking Sites: Improve user reach Improve customer satisfaction Promote products and services Facilitate knowledge sharing Increase brand awareness

World AIDS Day / Know It Campaign – bloggers

Mobile Phone Use More adults in the U.S. adults (85%) own a mobile phone, as compared to those (71%) who have a landline or home phone. About 200 million text messages are sent on the average day (2007), up from 75 million per day in the same period the year before (2006). An estimated 8 million people viewed mobile videos in May 2007 More adults in the U.S. adults (85%) own a mobile phone, as compared to those (71%) who have a landline or home phone. About 200 million text messages are sent on the average day (2007), up from 75 million per day in the same period the year before (2006). An estimated 8 million people viewed mobile videos in May 2007

Texting: Evidence of Effectiveness Smoking cessation Weight managemnet Diabetes management Asthma control HIV awareness Smoking cessation Weight managemnet Diabetes management Asthma control HIV awareness

Text Messaging and Internet Zip Code Finder Mobile Texting Campaign: KnowIt To encourage users to know their HIV status and to locate HIV testing facilities nearby Mobile phone users text their zip code to “KNOWIT” (566948) and within seconds they receive a text message with an HIV testing location near them. This mobile phone service connects users with CDC’s testing database found at Localization

KnowIt – Texting Hits (World AIDS Day 2007)

Engagement with HIV Prevention: A Mobile Media Experience Engaging target audience in the making of the message Ensuring diversity of participants – brought together through a problem in common First Department-level clearance for peer- generated mobile content PPSAs available on YouTubeYouTube From more information about the event, see: Event Sponsored by the University of Georgia, CDC, Verizon, Nokia, AIDS Research Consortium of Atlanta, and many others. Personal Public Service Announcements: PPSAs

Peer-Generated Process: 2 Days Diverse students – state liberal arts, state engineering universities and historically black college/university Received briefing on HIV science, epidemiology, & effective health message “platforms” (tested messages) Heard from/interacted with HIV positive gay men working in AIDS prevention Pitched ideas & received feedback from experts on message translation before shooting/production Produced messages entirely on mobile phone equipment (phones & bluetooth microphones) Edited PPSA’s on personal computers Diverse students – state liberal arts, state engineering universities and historically black college/university Received briefing on HIV science, epidemiology, & effective health message “platforms” (tested messages) Heard from/interacted with HIV positive gay men working in AIDS prevention Pitched ideas & received feedback from experts on message translation before shooting/production Produced messages entirely on mobile phone equipment (phones & bluetooth microphones) Edited PPSA’s on personal computers

The Lens of Contact Theory Equal status? Cooperation over superordinate goals? Close, meaningful contact? Institutional support? Willingness to participate? Equal status? Cooperation over superordinate goals? Close, meaningful contact? Institutional support? Willingness to participate?

Distribution: WWW & Mobile (VCast, Ads) (

Evaluation Centers for Excellence in Health Marketing Pretesting with high-risk year olds for message effects, attention-getting, positive effects Compare cell phone and YouTube channel formats effects, willingness to pass to friends Study process and impact of peer-to-peer distribution of the messages Performance of promoted behavior (txt zip to KNOWIT) Campaign metrics analysis (mobile ad buy) Centers for Excellence in Health Marketing Pretesting with high-risk year olds for message effects, attention-getting, positive effects Compare cell phone and YouTube channel formats effects, willingness to pass to friends Study process and impact of peer-to-peer distribution of the messages Performance of promoted behavior (txt zip to KNOWIT) Campaign metrics analysis (mobile ad buy)

Tangible User Interface (TUI): Definition [Ishii & Ullmer 1997] TUIs give physical form to digital information by seamlessly coupling the dual worlds of bits and atoms… Digital information [bits] Everyday physical objects and spaces [atoms] This means we can… Use physical spaces, surfaces, and objects as both controls and representations of digital information Enable co-located collaborative user interactions with digital information [Ishii & Ullmer 1997] TUIs give physical form to digital information by seamlessly coupling the dual worlds of bits and atoms… Digital information [bits] Everyday physical objects and spaces [atoms] This means we can… Use physical spaces, surfaces, and objects as both controls and representations of digital information Enable co-located collaborative user interactions with digital information Marble Answering Machine Royal College of Art, Interaction Design Durrell Bishop, 1992

Tangible Media [Dourish 2001] "Where the Action Is: The Foundations of Embodied Interaction“ Emphasizes how social action is embedded in settings - not only material, but also the social, cultural and historical - focusing on the social construction of meaning. [Dourish 2001] "Where the Action Is: The Foundations of Embodied Interaction“ Emphasizes how social action is embedded in settings - not only material, but also the social, cultural and historical - focusing on the social construction of meaning. WikiTUI Digital Annotation of Physical Books Synaesthetic Media Lab, Andy Wu & Ali Mazalek, 2008

Making Contact? Tangible tabletop stories that can be told from many different perspectives, understood in many different ways Storytelling workshop at the Boston Museum of Science Computer Clubhouse, 2001

Experiments: Multi-Viewpoint Stories KinoPuzzle Documentary Collage Synaesthetic Media Lab, Robinson & Ali Mazalek, 2008 Insert architales Architales Experimental Media Class 2008

Source: A. Badre. Design the interface Identify possible improvements Test and Analyze interface utilization Use the interface The Iterative Development Cycle

Key Research Questions What are potential application domain areas for tangible media in health interventions? How can we engage affected communities in designing interventions (problem solving)? How would we evaluate these interventions, e.g. identify comparison conditions and groups? What is the type and magnitude of effects that can be expected from tangible interventions versus traditional digital media? For border health issues (e.g. environment) could tangible media increase the feeling of significant contact? What are potential application domain areas for tangible media in health interventions? How can we engage affected communities in designing interventions (problem solving)? How would we evaluate these interventions, e.g. identify comparison conditions and groups? What is the type and magnitude of effects that can be expected from tangible interventions versus traditional digital media? For border health issues (e.g. environment) could tangible media increase the feeling of significant contact?

Contact Information Susan J. Robinson NCHHSTP Health Communication Science Office Thanks to: Ann Aikin Division of eHealth Marketing National Center for Health Marketing Centers for Disease Control and Prevention Susan J. Robinson NCHHSTP Health Communication Science Office Thanks to: Ann Aikin Division of eHealth Marketing National Center for Health Marketing Centers for Disease Control and Prevention