1. Evidence to support crowdsourcing challenges
Weiming Tang
University of North Carolina Project-China
University of North Carolina at Chapel Hill
SESH (Social Entrepreneurship to Spur Health) Global

2. OUTLINE 1 2 Evidence from systematic reviews and scoping reviews
Evidence from randomized controlled trials 2
“Testing saves lives”
Crowdsourcing to improve condom use
Eight city community trial
“HepTest Contest”

3. OUTLINE 1 2 Evidence from systematic reviews and scoping reviews
Evidence from randomized controlled trials 2
“Testing saves lives”
Crowdsourcing to improve condom use
Eight city community trial
“HepTest Contest”

4. Searching We found 84 reviews on PubMed (Since 2013)
Included 3 reviews in this report (Two reviews from the SESH Study Team)
These reviews summarized the areas that crowdsourcing had been used
Image source: PubMed

5. 1. Mapping of Crowdsourcing in Health: Systematic Review
202 relevant studies used crowdsourcing, including 9 RCTs
Crowdsourcing was used in
Health promotion (I.e. Sexual+Health)
Research (RCTs on evaluating)
Care
4 most frequent areas:
public health
psychiatry
surgery
oncology
Crowdsourcing was used in health promotion (91, 45.0%), research (73, 36.1%), and care (38, 18.8%) The 4 most frequent areas were: public health (67, 33.2%), psychiatry (32, 15.8%), surgery (22, 10.9%), and oncology (14, 6.9%)
Half of the reports (49.0%) referred to data processing, 34.6% referred to surveying, 10.4% referred to surveillance or monitoring, and 5.9% referred to problem-solving.
Figures: SESH team; Crequit P et al, 2018, JMIR

6. 2. Crowdsourcing in Health and Medical Research: A Systematic Review
86 studies identified:
effectiveness
feasibility
cost
Most common purposes were:
to evaluate surgical skills
to create sexual health messages
to provide layperson CPR out-of-hospital
4 studies used a challenge contest to solicit HIV testing promotion materials and increase HIV testing rates
2 studies found this approach saved money
Figure: SESH; Han et al, LSHTM, 2018

7. 3. Ethical Concerns of Crowdsourcing Contests and Innovation Challenges: Scoping Review
Crowdsourcing poses several ethical concerns along the steps
Lessons learned will help us to avoid the failure of future contests
Organizing:
excluding community voices
Soliciting:
overly narrow participation
Promoting:
divulging confidential information
Judging:
biased evaluation
Recognizing:
insufficient recognition of the finalist
Sharing:
Not implemented/
Not widely disseminated
Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems
Organizing: potential for excluding community voices;
Soliciting: potential for overly narrow participation;
Promoting: potential for divulging confidential information;
Judging: potential for biased evaluation;
Recognizing: potential for insufficient recognition of the finalist;
Sharing: potential for the solution to not be implemented or widely disseminated
Tucker JD et al, 2018, JMIR

8. OUTLINE 1 2 Evidence from systematic reviews and scoping reviews
Evidence from randomized controlled trials 2
“Testing saves lives”
Crowdsourcing to improve condom use
Eight city community trial
“HepTest Contest”

9. 1. Crowdsourcing HIV Test Promotion Videos: A Noninferiority RCT in China
Intervention arm: an one-minute crowdsourced video
Control arm: an one-minute health-marketing video
721 never tested MSM were recruited online and randomized
Key findings
HIV test uptake was similar between the crowdsourced arm (37%, 114/307) and the health marketing arm (35%, 111/317)
35% HIV+
Cost saving
Above figure: Distribution of the participants; Left figure: crowdsourcing contest poster
Tang et al, 2016, CID

10. 2. Reimagining Health Communication: A Non-Inferiority RCT of Crowdsourcing in China
Intervention arm: an one-minute crowdsourced video
Intervention arm: an one-minute crowdsourced video
Non-inferiority in three weeks: difference: +1.3%, 95%CI: -4.8 to 7.4%
In three months: difference: +2.5%, 95%CI: -4.5 to 9.5%)
Similar HIV testing rates and other secondary outcomes
Cost saving
Participants: MSM who engaged in condomless sex in 3 months
Key findings
Left figure: contest promotion; Tang et al, 2017, Lancet, abstract

11. 3. Crowdsourcing to Expand HIV Testing Services: A Closed Cohort Stepped Wedge RCT in China
Final intervention:
multi-media HIV testing campaign
an online HIV testing service
local participatory activities tailored for MSM
Evaluated using a closed cohort stepped wedge RCT in 8 Chinese cities
Recruitment: Blued, 8 cities
The proportion differences of HIV test: 8.9% (95% CI 2.2 to 15.5)
the intention-to-treat analysis: RR= 1.43, 95% CI
Left figure: Intervention VS control periods;
Right figure: Intervention strategy
SESH study team, 2017, Trial

12. Intervention improved self-reported testing rates of:
4. Crowdsourcing to Expand Hepatitis B/C testing: an online RCT in China
Intervention improved self-reported testing rates of:
556 men recruited,
Online RCT
Solicit short descriptions of hepatitis B and C testing (Video and images)
*HBV *HCV *HIV
*Chlamydia *Gonorrhoea
Fitzpatrick T , 2018, Unpublished

13. SESH website: www.seshglobal.org
Acknowledgements
We thank the audience for their time and patience, and thank the people who contributed to this workshop.
Funding Support: NIH (NIAID 1R01AI114310; FIC 1D43TW009532)and UNC CFAR (NIAID 5P30AI050410)
SESH website: