Summary

Do No Harm?

It’s estimated that 75% of healthcare is self-care. And, competent clinicians inform and activate people about what works and where to find it (Wagner, 1998). Yet, in 2020 Dr. Halsted Holman of Stanford University School of Medicine sounded the alarm:

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. When will we awaken?

For instance, 1 in 3 adults have insomnia. Yet, many don’t know about CBT-I (the gold standard) or that it’s accessible digitally – for FREE!  Our collective silence may lead millions to:

• Spend TENS of billions on misguided solutions
• Take pills that warn of deadly driving accidents
• Stay hooked on pills that cease to work.

The ‘Ask your doctor’ message has had phenomenal success. Don’t we wish we had a way to flood the zone with messages about evidence-based practices like Big Pharma does?

In fact, the Clinical Prevention & Population Health Curriculum specifies the need to learn to use social media to promote evidence-based healthcare – preferably via interprofessional hands-on experience. But, programs – MD, NP, PA, PT, OT, Pharmacy, Psychology, Social Work, Public Health – don’t offer collective social media training.

As a Georgetown University Sleep Clinic Fellowship faculty member & a former USU Medical Psychology Course Director & Practicum Coordinator, I believe that our pilots give hope that educators can have the collective efficacy to close this training gap.

Internship-Led Platform Pilot

Questions:  Can an unpaid, online-based internship attract interns to develop & manage a platform (interprofessionally) – to inform & engage the public on an issue?
Could those interns develop 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 a wide array of community engagement internships – for 3 and 6 credits. Over 50 interns – from diverse programs (e.g., Sociology, Politics, Geographic Science) – took a risk on a new, unpaid, totally online internship.

From 2018 to 2023, they led the People’s Platform for Democracy  (the non-profit, non-partisan US onAir Network) to inform & engage their community.  Without any prior tech background and collaborating virtually, each cohort of US onAir interns learned just enough about Zoom, YouTube, Canva, & WordPress to:

1.  Create & curate Profiles (e.g., US Representatives, US Senators)
2.  Create & curate Posts: (e.g.,  ’22 US House races, Democracy)
3.  Schedule and produce 1 on 1 ‘interview’ videos (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 Aircasts (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.  Develop & promote the first ‘SPEAK UP’ Challenge

Paul and Joe used the platform to prototype a ‘Speak Up’ Challenge where students could compete to have the most impact, via their 1-minute video addressing their local representative about what mattered to them. They created:  1) a ‘Speak Up’ post (with Google Docs for registration & a database), (2) a promotional poster, and (3) a YouTube playlist of 10 model entry videos.

Intern Evaluations:

The vast majority of interns were enthused by:

• Learning new knowledge and skills (digital media, communication, leadership)
• Becoming more visible in their field of interest
• Meeting local and national leaders
• Leading & building a new ‘learner-led’ platform that informs & engages the public on democracy and the potential impact that could ensue.
  • One intern wanted to extend the Network – to develop ‘India onAir’
  • Several other interns remained as advisors (no credit/no pay) after graduation.

Service-Learner Led Challenge Pilot

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

One of the foremost health communication campaigns – VERB – has taught us that it must be ‘easy, fun, & popular’ for people to join. So, we used those parameters as guides in pilots led by GMU Distinguished Professor Gary Kreps.

Over the span of 3 semesters (2010 – 2011), a group of graduates and undergrads from 4 classes opted into service-learning projects for the pilot. They chose to target ‘Freshman 15’ and designed & piloted a physical fitness challenge.

COMM 820:  One student reviewed the literature to learn about 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:  Using 404’s challenge design, half the class competed with the other half, to win the most Wizit points.

Evaluations:

• Most students chose these course projects based on personal interest (i.e., weight gain).
• COMM 200:  (1) Earning service-learning credit made it easy to compete; (2) Having ‘bragging rights’ about winning made it fun enough to compete (the $25 prize was nominal for a team).
• Most strongly believed they could use social media to make the Challenge popular among GMU peers. 
• Most strongly believed that future service-learners could develop an annual intercollegiate fitness competition – which they saw as March Madness for Total Fitness.
• In addition to being fun, faculty indicated 2 main reasons educators might participate:
  • Faculty who already include service-learning or a student-selected project in any relevant course could easily offer the campaign as an option.
  • Tenure-seeking faculty who combine community-engaged research with a service-learning course option would be attracted to the campaign. This project enabled several scholarship-related opportunities.

Community Engaged Scholarship

The combination of service-learning and community engaged research resulted in:  3 conference presentations, 1 book chapter, and 1 grant application.

We presented this health communication campaign poster at the 2010 mHealth Summit.

We presented at the  2011 Teaching Prevention conference of the Association for Prevention Teaching & Research – Leveraging Technology to Impact Health in the Community symposium.

We wrote a chapter in Mary Gregerson’s edited,  Technology Innovations for Behavioral Education (2011).

Retired US Air Force Lt. Colonel Mark Bates, PhD and I presented the pilots as a way to translate the DoD’s ‘Total Force Fitness’ culture to civilian campuses at George Mason’s 2012 Living and Leading with Resilience Conference.

Finally, Dr. Kreps and I submitted a Robert Wood Johnson Foundation grant application, as well.

Conclusion

The fitness challenge pilots showed how educators can link their courses across semesters and years – combining service learning and scholarship – to work together toward one community-based goal. The Internship pilots showed how learners can work together as one to build one common digital platform to inform and engage the public on what matters.

I hope these pilots give promise for the next step. That is, to demonstrate how the academic community can have the social efficacy to work together on one of its most important goals: To train learners to increase health consumer awareness & demand for evidence based practices and resources.

Especially in this time of radical medical misinformation, isn’t it time for the healthcare academic community to LEAD?

Proposed Next Step

1. When healthcare providers refer to digital resources, patients are 3 times more likely to use them.

Educators at any level (e.g., undergraduate, graduate, internship, residency, fellowship) could task learners to go to Speak Up, a non-profit learner-led platform. They would learn how to compete in a social media challenge (‘Speak Up for Insomnia’) to promote ONE evidence-based course (SleepEZ).  Speak Up interns would issue a certificate of completion, when learners:

1. Post their SleepEZ promotion on a social media network
2. Submit their SleepEZ post to the Speak Up Challenge
3. Submit their impact (using Speak Up-defined metrics)
4. Share (brag) about their results on social media, urging school peers to increase their team’s impact.

Speak Up interns would update the leaderboard, spotlighting the current top performers – individuals, schools, health professions. Ultimately, a sustained intercollegiate, interprofessional competition could enable healthcare learners – anywhere, anytime – to compete to have the most impact. And, we’d all share bragging rights for collectively increasing traffic to SleepEZ.

By the way, high-impact outsourced digital training isn’t new to schools of health professions. Many require QI certificates from the online IHI Open School – where service-learners have documented saving millions of lives!  Take note, the Open School primarily grew in popularity by medical and nursing students enthusiastically posting (bragging?) on social media about their QI projects. We believe that’s how ‘Speak Up’ would become popular as well.

Educators … are you preparing your students to be network literate enough to be found or be an influencer in the health information stream that is predicted by Kaiser Permanente’s CEO to be delivered to patients by phone … on-demand?

Are your students prepared to “make social media a standard of care” in health promotion, the stated goal of the Mayo Social Media Health Network?

Isn’t it time to create the ONE Social Practicum so we can all learn and serve together?  From anywhere, educators could integrate the ONE Social Practicum for hands-on interprofessional training into any course. Learners would serve by promoting health via their own Hub posts and social media. Curators would spotlight the best posts – on open networked topical Hubs. Public Health leaders could blend service learning and community-engaged scholarship to build health communication campaigns. Capstone projects could sustain annual health competitions among communities.

Will you and your students help us promote what works for insomnia? Please share your thoughts below or contact DrCary@mac.com.

Meredith Cary, PsyD has over 20 years experience in academic health centers, is a member of the Mayo Social Media Network, the Institute for Health Improvement I-CAN, Societies for Participatory Medicine, Health Psychology, and Media Psychology and Technology, and is the behavioral sleep consultant to the Sleep Center at MedStar Georgetown University Hospital in Washington DC.  Disclosure: Dr. Cary is a donor of the Neuroscience Knowledge Network – a non-profit social enterprise for open access in knowledge sharing.