Kim Kardashian is a Spokesperson (Again) for a Public Health Issue...Will the Public Buy In This Time?

This afternoon I saw a tweet from Kim Kardashian that read "Recognizing Ovarian Cancer is the 1st step in fighting Ovarian Cancer- please watch and share this video". So my first thought was- "I wonder if this campaign will be more successful than her last?" As you may remember, in December 2010 I blogged about Kim and other celebrities that staged their digital deaths in order to raise money for World AIDS Day. In addition to my concerns about the campaign's design (which included a less than clear cue to action for the audience), its "success" was also questionable because it ended up taking much longer than intended to reach their 1 million dollar goal. So I was quite intrigued to view Kim's newest PSA on YouTube.

The event called "Super Saturday Live" is a collaboration between QVC and the Ovarian Cancer Research Fund (OCRF). On Saturday, July 30, 2011- designer clothes sold on QVC will be 50% off and the net proceeds will be given to OCRF. The PSA informs the audience that this money is necessary because there is currently no good early detection test for ovarian cancer.

I was pleasantly surprised by the PSA. It didn't feel too long (94 seconds). It kept my interest with minimal and appropriate statistics. For example, instead of scaring the audience, the music was upbeat and focused on the positive- a 92% 5-year survival rate when the cancer is detected early. The PSA also had information presented through both audio and visual channels. Finally (and most importantly)- as an audience member, I knew exactly what I was supposed to do. The cue to action was clear. I was to share the video- "like" it, post it, forward it. And finally, I should tweet about #supersaturday. This way the "trend" can get ahead of ovarian cancer.

In addition to the look and feel of the PSA, I think it is important to discuss the strength and popularity of the chosen spokesperson. Just as I mentioned in December, Kim Kardashian is an obvious choice if you are looking for a huge reach. As of tonight, she had 8,380,553 followers on twitter. The PSA already had 5,965 views on YouTube. However, I have my concerns about her genuine interest in this public health issue. Does she have a personal connection or does she just jump on the bandwagon (like in December) for any way to promote her "brand"? I ask because I have concerns due to how she behaves on her E! show- Keeping Up with the Kardashians. For example, just a few weeks ago on the show, Kim had her butt x-rayed to "prove to the media" that it was real (without butt implants). I watched this episode while on the elliptical machine at the gym and felt enraged. First of all, what type of terrible physician allows his time and resources to be taken up with such nonsense? Also, what type of terrible physician agrees to expose Kim, his patient, to needless radiation to help her prove this point? And how much extra time does she (and her sisters) have on their hands to participate in this silly trip to the doctor? If I were the Executive Director of OCRF, even with her extensive popularity, I doubt that I would choose her for a spokesperson.

So let's all check out Twitter on Saturday, July 30th...let's see if #supersaturday is trending and if Kim's "quantity" of followers can help balance out her sometimes lack of "quality" as a spokesperson.

In Honor of World AIDS Day: Can Celebrity "Digital Deaths" Prevent Real Deaths from HIV/AIDS?

Kim Kardashian, Ryan Seacrest, and Lady Gaga are all dead! No, not really...but they are considered "Digitally Dead" for today- World AIDS Day (December 1st). These celebrities and many more joined forces with a charity co-founded by singer Alicia Keys called Keep a Child Alive. The charity provides treatment, love, and support to families affected by HIV/AIDS.

For today's campaign, celebs were pictured in coffins, featured in "last video testaments", and pledging to stay digitally silent on their social media accounts (i.e., on Facebook and Twitter) until their lives were "bought back" by donors reaching a minimum of one million dollars total. Although the images of celebs in coffins were a little creepy, Keep a Child Alive co-founder Leigh Blake says:

"We're trying to sort of make the remark: Why do we care so much about the death of one celebrity as opposed to millions and millions of people dying in the place that we're all from? Its about love and respect and human dignity."

It is an interesting concept for a health communication/advocacy campaign. Usually when campaigns advocate via social media, it is done by bombarding their followers with messages and links to donate or sign up to assist the cause. Here, the campaign is trying to motivate donors by having an ABSENCE of the celebrities' voices. How powerful is that absence? Will the public really miss reading celebs tweets and facebook status updates? Apparently so. As of tonight on Twitter, Kim Kardashian had 5,467,107 followers and Ryan Seacrest had 3,683,658 followers. So whether we like it or not, the voices (and silences) of these celebrities matter in our communities.

While I do think the campaign will have large reach, I will say that their coffin posters left room for improvement. I've analyzed health communication campaigns on this blog before, and the key is always- "What is the cue to action? Does the audience know what they are supposed to do after seeing the poster/brochure/PSA?" Well- when I first saw this poster of Kim Kardashian, I had no idea what it was about. I had to Google and read the narrative about the World AIDS Day campaign for Keep A Child Alive. For this blog post, I had to blow the image up over 100% to read the text on the bottom of the poster. It reads,

"Kim sacrificed her digital life to give real life to millions of others affected by HIV/AIDS in Africa and India. That means no more Facebook or Twitter until we buy her life back". Then the charity website and text number were provided to accept donations. In future campaigns, they would want that text to be much bigger. It should not take the audience several minutes, a Google search, and a magnifying glass to figure out what they are supposed to do to help poor Kim get out of that coffin.

Overall, I give this campaign a B+ for creativity in using the "absence" of social media messages and targeting celebrities with a huge following and reach to potential donors.

"Starving Secrets": Does Lifetime's New Reality Show on Eating Disorders Offer a Path to Recovery or a How-To Guide to Disordered Eating?

Last night, a public health colleague (@bethg24) tweeted about the new Lifetime reality show called "Starving Secrets". The show will be hosted by Tracey Gold (who had her own very public battle with an eating disorder) and feature real individuals struggling from anorexia, bulimia and other eating disorders.

According to the National Eating Disorders Association (NEDA), as many as 10 million females and 1 million males suffer from an eating disorder in the United States. Therefore, it is a serious and relevant public health problem that (not surprisingly) gets media attention. "Starving Secrets" is not the first movie or television show to take a documentary-style approach to portraying those that suffer from these disorders:

1. MTV's series "True Life" (which I have long admired for their portrayal and stigma reduction efforts regarding various medical conditions...I have been less impressed by episodes like "I'm a Jersey Shore girl"). True Life aired "I have an eating disorder" on April 3, 2003.
   
2. HBO documentary "Thin": This special followed four women during their in patient stays at the Renfrew Center in Coconut Creek, Florida. It premiered on November 14, 2006. I remember this being both incredibly powerful and difficult to watch.
3. E! "What's Eating You?": Admittedly, I only watched one episode of this show. True to E! form (Ahem- Kim's Fairytale Wedding), they are more about sensationalism versus journalism and stigma reduction as compared to other networks.

As with the portrayal of other mental health disorders in the media, I hope that these shows will do something positive. Specifically- reduce the stigma around these disorders and normalize help seeking behaviors.



However, I am also greatly concerned that shows like "Starving Secrets" will actually endanger vulnerable audience members by offering a "how-to guide" to having an eating disorder. The concern stems from research on pro-eating disorder websites. They can offer "thinsperation" to stay skinny by the images portrayed. They can also give tips and strategies for hiding/refusing food or getting rid of it. Sometimes people don't realize that by telling their story in vivid detail, they are actually sharing their "creative tips" for sustaining an eating disorder.


That said, I will definitely be setting the DVR on December 20 to see the show and assess it more accurately. What do others think? Do reality shows like these have the potential to endanger the public's health? Or do their "pros" (e.g., stigma reduction) outweigh the risks?

#NoHomos on Twitter, "50/50" looks at Cancer, Johnny Depp's Rape Comments, Chris Christie's Weight, and Steve Jobs: What Am I Reading This Week?

Whew- it has been a busy week for Pop Health! Here are the top 5 stories I've been reading:

1. Twitter is no place for #NoHomo: Should Twitter take a more proactive stance regarding hate speech that can result in trending topics?

2. "50/50"- A Hollywood movie takes on cancer: Cancer has been a theme in many movies (e.g., "Funny People") and TV shows (e.g., "The big C" on showtime)- how does this movie compare?

3. Johnny Depp offers apology for rape remarks: Depp offers an apology for comparing being chased by paparazzi to being raped. Forgivable?

4. Chris Christie's Weight- Big problem or none of our business?: Although Gov Christie has recently announced that he will not run for President in 2012, the conversation continues about his weight and its influence on his ability to be a successful Governor or President. What do you think?

5. Steve Jobs and Pancreatic Cancer: There have been many stories about the death of Steve Jobs and the contribution of pancreatic cancer to his passing. I thought Celebrity Diagnosis did a nice job of guiding readers through his diagnosis.

Please use the comment box to tell me what you think about these stories and about others that you are reading this week!

(Dis)Connected: MTV Explores the Impact of Digital Drama on the Health and Safety of Young People

On Sunday October 10, 2011, MTV will premiere "(Dis)Connected". The movie will explore the experiences of four young people. They have never met in-person, but their lives collide online and are forever changed by their digital interactions.

The film supports the network's "A Thin Line" campaign which empowers youth to stand up against digital abuse of all kinds (e.g., bullying, discrimination, etc).

The movie is inspired (in part) by the tragic death of Abraham Biggs in 2008. Biggs, a 19-year old college student, live streamed his suicide on the internet, with some users egging him on and some trying to talk him out of it.

(Dis)Connected supports an ongoing discussion in public health regarding the question: "Does technology help us or hurt us when it comes to issues such as bullying or suicide?" The answer is not clear. There are examples on each side. One year ago today, I wrote the post "Bullying: Is Technology Helping Us or Hurting Us?" The post was inspired by the dialogue of how technology may have contributed to the suicide of Tyler Clementi but also how it was being used in a positive way to prevent bullying in the aftermath (e.g., the "It Gets Better" project).

On her blog "Promoting Hope, Preventing Suicide", Elana Premack Sandler writes about research and advice for preventing teen and adult suicide. Just in the past year, she has extensively explored the issue of technology/social media and its impact on suicide prevention. Some example posts include: Facebook Support Networks (September 21); YouTube Prevents Suicide? (May 4); and Promoting Hope Through Social Media (April 13).

Let's all check out (Dis)Connected on October 10 and let the dialogue continue.

If you or someone you know is in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK or visit their website here.

Celebrities and their Health Causes: What Happens When They Do More Harm Than Good?

Often on this blog I have spoken about the role of celebrities as the spokesperson or "champion" for various public health issues. Many celebrity names are synonymous with particular health causes (Katie Couric- Colon Cancer; Michael J. Fox- Parkinson's Disease; Lance Armstrong- Testicular Cancer; to name a few).

Over the past few weeks, several stories have emerged which beg the question, "what happens if celebrities do more harm than good?" Those in the public eye have such a broad and extensive platform to communicate with the public...what if they disseminate erroneous information or even worse- cause a panic?

The week of September 12 was quite busy! In the Republican Presidential Debate (in the context of discussing mandated HPV vaccines for children), Rep. Michelle Bachmann claimed that the HPV (Human Papillomavirus) vaccine is linked to mental retardation. To support her claims, Bachmann repeatedly told the story of being approached by a woman whose daughter suffered mental retardation after taking the vaccine. As those of us in science well know, one self-reported story does not equal a true incident. Even if true, one incident does not equal a trend or an epidemic. This story has been quickly picked up by scientists who are even offering money if it is proven true.

This same week, Dr. Mehmet Oz of the Dr. Oz Show (you may remember him from numerous appearances on the Oprah Winfrey Show), claimed that apple juice contains unsafe levels of arsenic. These claims followed research conducted by the Show which had a laboratory examine three dozen samples from five different brands across the United States. The samples were compared to the limits of arsenic set for drinking water by the EPA. Since the claims, many scientists have spoken out regarding concerns about the study's protocols and conclusions (for example, not differentiating between organic and inorganic types of arsenic). Many were concerned about the widespread panic caused by these claims and likened it to shouting "fire" in a crowded theater.

Of course, this is not the first time celebrities have caused a scandal following potentially false and dangerous claims. Jenny McCarthy has dedicated her life to proving the cause between childhood vaccines and autism. Shortly after Brooke Shields released her book, "Down Came The Rain", which chronicled her battle with postpartum depression- actor Tom Cruise (a Scientologist) publicly criticized her for taking antidepressant medication.

So what happens when these celebrities cause more harm than good? What happens when their claims are misguided, misinformed, and/or not based on evidence or science? The answer: they can have huge and far-reaching public health consequences. For example, as we begin to see illnesses like measles reappear- we have to wonder- "Is this the Jenny McCarthy effect?"

"What's Your Weapon?": Billie Jean King, Arthritis Foundation, Ad Council, and USTA Launch Arthritis Campaign

Before Twitter and the U.S. Open was a flutter this afternoon with the news of Venus Williams withdrawing due to the diagnosis of the autoimmune disease- Sjogren's Syndrome, the U.S. Tennis Association was focused on another health related issue. Today the press release went out that tennis legend Billie Jean King was joining the Arthritis Foundation, the Ad Council, and the US Tennis Association (USTA) to launch a public service campaign against arthritis (the leading cause of disability in America).



The ads, launched at the U.S. Open today, feature King (who has osteoarthritis- OA) and highlight the power of movement and exercise as "weapons" in the fight against arthritis. King tells viewers "tennis is my weapon" against arthritis. The ad then asks viewers, "what is your weapon against arthritis?" and directs them to the campaign's website in order to find out: Fight Arthritis Pain. On first view, I was not terribly impressed. The brief ad (33 seconds) does not tell you very much (e.g., King says tennis is her "weapon" but nothing is said about the benefits of movement). The goal of the ad simply appears to be motivating viewers to visit the website for additional information.



The other thing that is not clear in the ad (but clarified in the press release and website) is that this campaign is targeting OA specifically. While OA is the most common type of arthritis, it is not the only type. For example, in contrast to OA which breaks down cartilage, rheumatoid arthritis (RA) (a chronic autoimmune disease) causes inflammation of the lining of the joints. Would the exercise recommendations be the same no matter what type of arthritis? I would say that distinction is unclear for viewers.



However, I did feel better when I read the press release and saw that these ads were tested in focus groups by the Ad Council. Testing your images and messages with your target population is incredibly important. It is reported that participants felt that the concept of "having a weapon" against arthritis was powerful and motivating. That is good news considering formative research by the Ad Council found that only 16% of OA sufferers surveyed felt "very confident" that they could manage their pain. Therefore, if an ad can make viewers feel empowered and confident- that is a good thing.



The press release did not describe the demographics of the focus group participants, but I am assuming they were similar to those originally surveyed (adults age 55+ with OA). If so, it would mean that Billie Jean King was an appropriate "Champion" for the cause and someone that audience admired, having watched her in the 1960s-1970s, her prime competitive years. However, I wonder if she would be the best choice for ads targeting arthritis sufferers in a younger demographic? After all, different types of arthritis can affect people of all ages. Again, this is another reason that I would have wanted to see a clearer definition of the audience for these ads. If we are focused on older adults with OA, then it is a great choice. If we are focused on people of all ages with all types of arthritis, then maybe not.



Overall, I give this campaign a "B". The impetus of the campaign is good in that it is based on research...research that shows that arthritis suffers are too sedentary and do not feel like they have control over their pain management. The campaign aims to address these barriers by empowering viewers with a "champion" who they admire and can model. The campaign also links them to a website with all the information they need about the benefits of exercise for arthritis. However, the execution of this campaign is not as strong as its foundation. It would have benefited from a more clearly defined audience and message.

From The West Wing to the National Health Care Debate

Anyone who knows me well knows that "The American President" is one of my favorite movies. If it is a favorite of yours as well, you may recognize that the actress who plays Press Secretary Robin McCall also plays National Security Advisor Dr. Nancy McNally in "The West Wing". The actress is Anna Deavere Smith.

This week in my "Qualitative Research Methods in Community Health" class, we discussed ethnography. Specifically we discussed Ms. Smith's work as an example of performance ethnography. For over a decade, she has interviewed people across the country and used the "data" to develop a one-woman show. Her newest play is called "Let Me Down Easy" and its goal is to show the human side of the national health care debate. I highly recommend viewing the 10-minute excerpt and interview here.

I'm so sorry that I missed her play when it came to Philadelphia earlier this year because I think it is an amazing example of the richness of data collected using qualitative methods. It is often argued that qualitative methods are too "soft" and limited in view. I've heard them described as "basically just journalism". However, I would argue that qualitative methods are essential to the success of public health.

Instead of surveys and databases, these methods collect data via interview, discussion, and observation. The research is meant to discover the complex relationship between personal and social meaning, individual and cultural practices, and the material environment or context. In contrast to what we have learned since grade school science about the scientific method and generalizability of findings- here the focus is on obtaining a deeper understanding of a population or phenomenon.

Ms. Smith conducted over 300 interviews for "Let Me Down Easy" and ultimately condensed her findings to show the experience of contemporary health care through the eyes of 20 individuals. These kinds of stories are incredibly powerful in public health. They open our eyes to challenges that we never would have found via survey...because we wouldn't have known to ask the right questions. They allow us to share stories with policymakers so they can see the impact of their decisions beyond the sterile statistics often cited. They can allow us to explore experiences or illnesses that occur in too small a population to survey.

Ideally, quantitative and qualitative methods should be used together to create the strongest public health research design possible. It should not be us vs. them...but instead a joint effort. I encourage us all to see the human side of health care reform when Ms. Smith's play airs on PBS "Great Performances" next season.