Summary

Do No Harm?

Nearly 75% of healthcare is self-care. That’s why the Chronic Care Model teaches health consumers need to be informed about ‘what works’ & activated to find it. However, Stanford’s Halsted Holman decried the training gap of our time …

“Sixty years ago, a new and dominating health problem emerged: chronic disease. It has now reached epidemic proportions, affecting 50% of the population and consuming 86% of health care expenditures. The fundamental responsibility of the medical profession is to create a health care system and a practice of medicine that meet the needs of current illnesses and patients. The profession has not done so.”

Case in Point:  One in 3 adults have sleep problems. Too few know: (1)  CBT-I is the FIRST thing to try for insomnia, (2)  Pills can be unsafe, (3) Online CBT-I is FREE  & offered responsibly as a good first step.

But, by the time people see me, their issues have quintupled – Insomnia AND Substance Use AND Anxiety AND Depression AND hopeless self-fulfilling beliefs. Usually, they have …

• Spent years and too much money on misguided solutions
• Gotten hooked on pills they didn’t need to start & that no longer work
• Been convinced they can’t sleep without a sleep aid; they tried ‘everything’ and ‘nothing’ works.

It’s a choice. We can waste billions & get sicker. Or, we could stop the madness – use tools to unite & fight – to fix our failures:
– FAILURE to fight the hype
– FAILURE to fight mis- or disinformation
– FAILURE to inform & activate people to find what works.

Closing the training gap
As a former GU Sleep Clinic faculty member & USU Medical Psychology Course Director & Practicum Coordinator, I believe that our GMU pilots showed possible ways to leverage – collective community-engaged education & research – to use social media to inform & activate the public to find what works (advised by the Healthy People Curriculum).

1 – Intern-Led Media

Pilot Questions:  Can an unpaid, online-based interprofessional internship develop & manage a platform – to inform & engage the public on an issue?
Could interns create a challenge for peers to compete to raise awareness and have the most impact (i.e., Speak Up GMU)?

US onAir Internship

George Mason University programs offer undergrads community-engaged internships – for 3 and 6 credits. Over 50 interns (2018 – 2023) from diverse programs (e.g., Sociology, Politics, Geographic Science) took a risk on a new, unpaid, totally online internship.

Interns led the People’s Platform for Democracy (the non-profit, non-partisan US onAir Network) to inform & engage their community.  With no tech background and collaborating virtually, each cohort of US onAir interns learned just enough about Zoom, YouTube, Google, Canva, & WordPress to:

1.  Curate profiles (e.g., US Representatives, US Senators)
2.  Curate posts: (e.g.,  ’22 US House races, Democracy)
3.  Schedule & produce 1 on 1 interviews (e.g., in-person, online)
4.  Create brief ‘explainer’ videos (e.g., candidates, About Virginia onAir)
5.  Plan, schedule, produce, & and host livestream discussions, aka onAircasts (e.g., with government representatives; with subject matter experts on issues of interest)
6.  Direct one of the 50 State Hubs on the platform (e.g., Virginia, Georgia, Michigan)
7.  Develop social media channels (i.e., VA onAir, US onAir)
8.  Establish a School Chapter
9.  Promote & run in-person events (e.g. Posts,  Livestream Videos)
10.  Promote the internship to other schools (e.g., recruitment video).
11.  Design & prototype a video-based ‘Speak Up’ Challenge

Paul and Joe initiated a ‘Speak Up’ Challenge for students to compete to address their representative about what mattered to them. They created:  1) a ‘Speak Up’ post (with Google Docs for registration & a database), (2) a promotional poster, (3) a YouTube playlist of 10 model entry videos.

Intern Feedback:  Most expressed appreciation …

– Learning skills (digital media, communication, leadership)
– Being more visible in their field of interest
– Meeting local and national leaders
– Planning new hubs in the network (e.g., ‘India’ onAir).

2 – Service-Learner-Led Challenge

Pilot Question:  Can service-learners collaborate – across courses and semesters – to design & pilot ONE health communication campaign?

GMU Distinguished Professor Gary Kreps led the communication campaign pilot to target ‘Freshman 15’ weight gain. Guided by the success factors of VERB. the goal was to make the challenge ‘easy, fun, & popular’ to join.  Spanning 3 semesters, 4 classes, and 3 professors (2010 – 2011), a group of service-learners completed it.

COMM 820:  One student reviewed the literature on campus fitness competitions.
COMM 391  A few students surveyed 100 Freshmen to identify how to make it ‘easy, fun, and popular’ to join.
COMM 404:  Using survey data, four students designed the challenge using: a cash prize, credit-based participation, and an App (Wizit) with QR codes to verify laps between the campus and Starbucks.
COMM 200:  Half the class competed with the other half.

COMM 200 Feedback

• Earning credit made it easy to develop the pilot & to compete
• Competing for ‘bragging rights’ made it fun  (no need for cash prize)
• They believed that they could make it popular – leveraging social media to develop an annual intercollegiate fitness competition – March Madness for Total Fitness.
  • Faculty Feedback
  • It was easy to add this service-learning project to their course.
  • It could enable a line of community-engaged research.

Community Engaged Scholarship

Service-learning projects resulted in presenting at 3 conferences, writing 1 book chapter and 1 grant application.

We presented a poster at the 2010 mHealth Summit.

• At the 2011 Teaching Prevention APTR annual conference we presented at a symposium – Leveraging Technology to Impact Health in the Community.
• In 2011, I contributed a chapter in Technology Innovations for Behavioral Education.
• At a 2012 GMU Resilience Conference, retired US Air Force Lt. Colonel Mark Bates, PhD and I presented the pilots as a way to bring the DoD’s ‘Total Fitness’ culture to campus
• Dr. Kreps and I submitted a Robert Wood Johnson Foundation grant application.

Conclusion

Animals unite to fight predators. But, we seem powerless and ‘learned helpless’ against health mis- or disinformation.  Our pilots show how the academic community COULD … unite, fight, and LEAD.

1. An online internship can develop a platform to inform and activate the public on an issue, including a communication competition.
2. Using service-learning credit, multiple educators can contribute to one project.
3. It was easy & fun for faculty & learners to participate.

NEXT:  Can an online ‘Speak Up for Sleep‘ Internship – enable ANY educator to ‘unite & fight’ –  LEAD a social media challenge to collectively impact sleep consumers?

Path to Better Sleep is a free suite of 4 VA-developed courses: a sleep screen, healthy sleep tips, CBT-I self-help, and sleep apnea tips.  Studies indicate that providers need help to prescribe these tools.  When they do … people are 3 times more likely to use them.

New Internship: ‘Speak Up for Sleep’

Question:  Can a new online ‘Speak Up’ Internship (1) develop the platform, & (2) design, create, and pilot the ‘Speak Up for Sleep’ social media challenge in which service-learners anywhere compete to promote the Path to Better Sleep to have the most impact?

Worldwide, healthcare educators assign online training for learners to get certificates of completion. These QI hands-on projects have saved millions of lives.

For this pilot, educators would offer credit for a service-learning online project to get hands-on interprofessional practice in ‘collective’ health promotion. Learners would compete to have the most impact – individually & for their teams (class, school, profession).

To earn a certificate of completion, learners acquire skills to promote Path to Better Sleep:

1. Post on social media
2. Stimulate their team (class, school, profession) and others to re-share their post
3. Use defined metrics to measure & post their impact

Interns would develop the ‘no code’ platform:

1. Inform learners about insomnia, CBT-I, apnea, Path to Better Sleep, and social media strategies
2. Activate learners to promote Path to Better Sleep in the competition they design, develop, promote & lead
3. Spotlight the posts of top performers (learner, course & professor, school, profession)
4. Promote the internship to recruit the next cohort
5. Use the platform to conduct and present their community-engaged scholarship.

Call to Action

In the future, civic entrepreneurship can launch this community-engaged project, as it has others. We envision a non-profit – the People’s Platform for Health Promotion – to improve:

Teaching:  Enable social media practice to ‘collectively prescribe & promote‘ what works
Research:  Test/Identify/Disseminate real-world best ‘collective social media‘ practices
Service:  Boost health consumer awareness & demand for what works.

The People’s Platform would enable ANY educator to assign ANY service-learner
to collectively leverage social media
to continuously compete
to … Inform & Activate … Patients & Populations
to find what works for:

• PREVENTION   (vaccines, fluoride)
• CHRONIC ILLNESS   (obesity, pain)
• HEALTH & WELL-BEING   (stress management)
• ADVOCACY   (gun safety, reproductive care).

It may be more – ‘easy & fun’ – than we think to Speak Up together.
Help us to responsibly, collectively & continuously close crucial training gaps as well as improve health consumer awareness & demand for what works.
Help us unite, fight, & LEAD.

Educators:  We seek partners to (1) give a Speak Up Internship an academic home, or (2) engage learners in the Speak Up Challenge … to create this pilot with collective efficacy.
Expertise in community-engaged education & scholarship, public health, sleep, communication, social media, technology, civic entrepreneurship, social marketing, & the Path to Better Sleep … is helpful.  See the platform to be built out.

Meredith Cary, PsyD  has over 20 years educating (Medical Psychology, Sleep Medicine, & Psychiatry) & over 30 years practicing clinical health psychology. Disclosure: Donations to the 501c3, the onAir Network – a ‘no-code’ People’s Platform to inform and engage the public.
Contact:  drcary@mac.com