Blogging, Mobile Phones, and Public Health
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[Erin Edgerton] Thank you for joining me for this edition of health marketing and interactive media. I'm your host, Erin Edgerton. Today I'm talking with Craig Lefebvre. Dr. Lefebvre is a research professor in prevention and community health at George Washington University, a blogger on social marketing and social change for the past four years, and an expert consultant in social media. Welcome, Craig.
[Dr. Lefebvre] Thanks, Erin. Good to be here.
[Erin Edgerton] Let's start with the definition of a blog, since you're a blogger. What exactly makes a blog a blog?
[Dr. Lefebvre] The easiest way to think about a blog is as a publishing tool that anybody can use to get their voice heard around the world by the Internet, and so what most blogs consist of is a space for people to write notes, news, commentary, what have you, make a diary of their day, and on most of the software platforms that you put a blog on, there's lots of other applications or widgets that people put on them to kind of customize them and personalize them to their own taste and to just make it a little more interesting and entertaining.
[Erin Edgerton] There are lots of spaces online where you can talk and interact and post comments, but what makes a good blog?
[Dr. Lefebvre] Well, usually it's gonna have some interest and appeal and curiosity to some audience. Sometimes blogs are…personal blogs in particular…are just written for the person. Other blogs are written as a way of communicating with a larger group of people, so you'll see many blogs that are almost news focused, commentary focused, but, again, have a point of view. Blogs that try and be objective, impartial, and scientific, or journalistic typically don't do very well in the blogosphere. It's the ones that do have this point of view, this sense of an authentic voice, that are talking about, oftentimes, current events or things of interest to people, whether that be a hobby or whether that be politics. You know, the third most popular type of blog are what are called "mommy blogs," that are simply done by mothers who are living at home who just talk about the every day challenges and provide tips and resources for other moms to tap into and then also to be talking back and forth with each other about various topics that are coming up in their lives.
[Erin Edgerton] And what strategy do you use for your own blog? How do you pick what topics to write about? How do you encourage participation?
[Dr. Lefebvre] I tend to write for people who I imagine are practicing social marketing, so the first thing there is to kinda have some idea of what the audience is I'm trying to attract. A lot of it's driven by current news, some commentary, some perspective on what's going on with different public health issues that may be, you know, part of the public commentary. Sometimes it's simply, you know, the thoughts…I've just been sitting here thinking about chaos theory and what that has to do with behavior change, and so rather than simply leave it in my head, the blog's a nice place to write it all down and retrieve it. In fact, you know, one of the primary reasons I got into the blog to start with was a place to put everything. Rather than having a written journal and putting spiral notebooks up on a bookshelf, I have a blog where I can just be posting my notes and thoughts and collecting ideas and just be building on those ideas over the three, four years.
[Erin Edgerton] How important is it to link to other information online, other sources, other bloggers within your blog?
[Dr. Lefebvre] Many people in social media believe that it's the linking that's the most attractive feature of blogs…it makes that a completely different media than other types of media where you can actually not go into every single detail but, simply, link to the news article, which is what I do quite a bit, link to a new report that’s just come out from the C-D-C or W-H-O, and just provide the commentary on it so that if readers want to dig in and find the details, it's literally a click away for them to do that. And when you think about the blog as an information tool, and all the people who are up on the Internet searching for information about various topics, the more links that you have, and the more frequently you're posing about anything, frankly, the more likely you are to become a major player in search rankings on various types of topics and, I usually, for instance, wind up in the top or first page of many different types of search results simply because those are topics that I've either talked about a lot, but particularly because I link to other types of sites and have a lot of links going back and forth that raise my search algorithms in places like Google and Yahoo.
[Erin Edgerton] What are the best ways to promote a blog, to get followers and subscribers and drive traffic to your page?
[Dr. Lefebvre] One is to have a point of view that can be controversial; that always helps. Two is that, again, word-of-mouth networks, even offline word-of-mouth networks work very well. Another thing that works is linking to other bloggers, and that's probably the most important thing to do early on, is to get other bloggers aware of what you’re doing, people who publish in similar types of topic areas and say, "Hey, I'm here!" Make sure that you're linking to some of their stories and commenting on their stories right away and start building some type of trust and reciprocal relationship with them, so you're both exchanging links with each other which drives traffic to both of your sites up, and you create those kinds of win-win situations with them. Other times, reporters will find you because a lot of reporters, when they're doing news stories, are looking for perspectives on things and so they'll wind up on your site, again, because they've been in Google or someplace searching and up you've popped. It's another point of view for them to explore as they're writing their own pieces.
[Erin Edgerton] There are a number of organizational blogs that have popped up over the past couple years. They don't have as much of a personal voice. Can you give us your opinion on how successful the personal narrative blogs are versus an organizational blog?
[Dr. Lefebvre] Well, I think, you know, some recent data that has come out suggests that, you know, many people who are blog readers, and I think we should also make clear that, you know, there are people who read blogs and people who don't, but people who read blogs are very finely tuned to the idea of that personal voice and that story telling type of perspective, so that when you bump into a corporate blog or a blog that maybe looks like it's written by a person but actually, behind the scenes, may be written by a committee or four or five different people, that comes through very quickly, and in the way that sentences are put together, the way ideas are expressed, and you start getting that, what I call, the 'French courtesan court' feel to the words and the phrases and you say, "This isn’t a person talking in real life, this is very heavily scripted" and, you know, the truth detector goes up and people respond pretty negatively to those things many times and, in fact, corporate blogs that go up particularly to try and advance a particular side of an issue that is the corporate position get ‘outed’ quite a bit, and there's been a number of circumstances in the blogosphere where corporate blogs have been kind of exposed for what they've been trying to do to advance a public relations agenda as opposed to this idea of trying to establish a honest and truthful relationship and communication with an audience.
[Erin Edgerton] You mentioned that there are people who read blogs and people who don't. What do we know about blog readers? Are there characteristics that define who they are?
[Dr. Lefebvre] I haven't seen any systematic research on who's a blog reader and who isn't. I mean, we know that younger people, obviously, tend to go to blogs more often than others. We know in the political arena, political blogs are the most popular…the most widely read blogs in the universe at this point in time, so you see a lot of people I would call opinion leaders of various sorts who are very much engaged, again, in getting these other perspectives and getting their story out in particular types of ways. But I think what a blog reader is looking for is someone who shares a common interest or passion in a topic area and who they feel like is either offering a perspective they haven’t seen before, or is sharing tips and ideas and interest with them in an entertaining way, and hopefully in an engaging way, that keeps bringing them back.
[Erin Edgerton] Obviously there are a lot of blogs out there and it's a very popular type of social media, but there are many types of social media that are becoming mainstream. We have blogs, we have social networks, virtual worlds are increasingly visited, and public health communicators often wonder, with all the choices, what are the types of social media they can be involved in that have the biggest impact?
[Dr. Lefebvre] Well, when you ask the question in terms of biggest impact, I don't think we have any evidence that suggests which is gonna be the biggest impact at this point in time. What I suggest to people is that blogs is a fairly straightforward way of getting into the social media world in a fairly controlled manner. That is, you can start putting your message out there, you can start telling your story to people and make that as engaging, in terms of having comments coming back from people, as you’d like it to be. The idea that you actually are out there just monitoring blogs and posting comments on other people's blogs, is a way of getting engaged in the blogosphere…getting your story out there without having to go through the hoops of setting up your own. I mean, the podcast is certainly a way of controlling communications in a very social media-oriented way. It can go to a lot of people who might otherwise not do it. I think social networks is the next big step for a lot of us to be taking in terms of understanding how do we engage in the networks that already exist, and tapping into those and, then, how do we start creating our own networks to advance things forward? I mean, right now I'm involved in several projects developing wikis, communities of practice; we're setting up networks of health professionals who share common interests and common topics that they’re trying to do public health interventions on can actually share, in real time, a lot of different types of information that up until now hasn't really been available to people, especially in rural areas, people who are working in underserved areas, or who are working, basically, by themselves, trying to, you know, advance issues around the use of social media or the use of social marketing in public health practice.
[Erin Edgerton] Clearly, blogs have enormous communication potential. For public health communicators, what other types of social media should they be keeping an eye on or investigating?
[Dr. Lefebvre] Well, I think podcasts, again, is a very low-cost entry point into working with social media, but I think the social networks…getting engaged with existing social networks, and creating new social networks around various public health topics is something that I’m very interested in as well. I think we’ll see, you know, the wiki platforms and the communities of practice become a much more common feature in a lot of our work in the years ahead.
[Erin Edgerton] I know you're also involved a lot in mobile. Can you talk about mobile technologies?
[Dr. Lefebvre] Sure, you know, mobile technologies is that very personalized mass media that's been gaining more and more popularity here over the years. You know, for me, looking at it as a behavior change instrument…for example, the idea that it's there 24 hours a day, 7 days a week, you know, people literally go to sleep with it…just offers enormous opportunities to support people in making behavior changes, cueing them for things to do differently, and engaging in a two-way conversation with them, whether that's by voice, whether that's by text, or using, you know, mobile Web applications to, I think, really achieve scalable behavior change through this personalized mass media channel.
[Erin Edgerton] And how many people in the U.S. can we really reach with mobile? Is it a technology that a lot of people have and use every day?
[Dr. Lefebvre] Yes, I think that's the reason I get more focused now on mobile than even the social networks is that, you know, the latest data we have suggests that, you know, there's 265 million subscribers to cell phones in the United States. That represents about 84 percent of every American household has a cell phone in it, so we're way beyond diffusion at this point in time; we're getting to the point of saturation. Look at countries like South Africa; they're literally 1.2 cell phones for every person in South Africa, and in many countries 100% penetration is not unusual.
[Erin Edgerton] And people do more than just make phone calls on their cell phones. What else do they use them for?
[Dr. Lefebvre] Well, clearly text messaging is the big issue. In fact, in the last six months, among people under the age of 35 years of age, the data now show they make more text messages a month than actual voice phone calls, so it's becoming a completely different communication environment and message environment than we're used to. Many people are using cell phones for locator services. GPS, it looks like, would be the next big thing that's coming along. People are starting to access the Web much more regularly than we used to. The iPhone has been a great accelerant for people going on the Web, and we now have probably over 35 million people accessing the Web through their mobile phones and, in the United States, it's one of the highest penetration rates for Internet access that we see in the world right now.
[Erin Edgerton] How can mobile technologies be used as health information delivery tools?
[Dr. Lefebvre] Well, there's two ways, at least. The first is we see groups like the Mayo Clinic who are making all their medical information in their library available to people online through their mobile technologies, so you can literally go on your phone, search the Mayo Clinic, and get some answers to your questions quickly. The second thing we see is in the health care delivery sector itself…is that we have health promotion agents in various African countries who will go out and make the home visits, as paraprofessionals, who are then in contact, via their cell phone, with people back at the central office who can provide them any guidance and direction should they come across any unusual symptoms, if the family reports any change in condition, if there seems like there needs to be a change in medications. All that can be handled in real time through cell phones and actually reduce the cost of providing health care.
[Erin Edgerton] And how can mobile technologies be used for behavior change interventions?
[Dr. Lefebvre] Well, two examples come to mind. I mean, in the obesity area, we see mobile technologies being used where people can actually take pictures of their food before they eat it, send it wirelessly to a central location where a nutritionist can actually do a very quick and brief caloric analysis of what's on your plate, talk to you about serving sizes, and relay that information back to you by texting. You also use that same service to create your food diary and keep track of your diary on a real-time basis, so you're actually entering the information into your phone while you're there looking at your food and not having to wait until you get home to enter it onto your computer on your desktop. In the physical activity area, we're seeing cell phones used for cueing physical activity, we're seeing it used for, again, setting up your physical activity diary and doing that wirelessly through your phone. And so the whole idea of data collection, the whole idea of cueing, providing you with other types of support systems that you can use through the mobile phone rather than through a Web-based social support system, are all areas under active investigation.
[Erin Edgerton] Blogs, social networks, mobile phones…really all social media…how are these technologies changing communication?
[Dr. Lefebvre] Well, I hope the most important way they're gonna change communication…'cause I'm not sure exactly what they're doing right now…is that people will step away from the idea that what we've got here is another communication channel and another tool that we're gonna use, just like we use television, just like we use radio, or what have you…that what I try and get across in my talks and with people I work with is that social media really is a change of mind about how you think about the people we used to call an audience. You have to be open to the idea that you have to be authentic. You have to be willing to really listen to what the other person has to say, and that you're also prepared for that engagement, to have that dialogue with people, to accept in many cases the people formally known as your audience as co-producers in the type of activities you're engaged in as a health communications person or in health promotion in general. That's the big challenge, and I think the big thing we have to look forward to is how do we harness the power of the audience to help us be bigger and better at the way we do our work?
[Erin Edgerton] Thank you very much for joining me today.
[Dr. Lefebvre] Thank you.
[Erin Edgerton] Thank you for joining me for this edition of Health Marketing and Interactive Media. For more information about this podcast series, please visit the CDC's health marketing website at www.cdc.gov/healthmarketing.
I'd also like to remind our listeners that the use of tradenames or commercial sources during this podcast is for informational purposes only and does not constitute an endorsement by the U.S. Department of Health and Human Services or the Centers for Disease Control and Prevention. Views expressed by guests are not necessarily the views of the CDC. Thank you.
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