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Nedra Kline Weinreich, MSWeinreich Communications
National Conference on Health Communication, Marketing and MediaAugust 17, 2010
Nedra Kline Weinreich, MSWeinreich Communications
National Conference on Health Communication, Marketing and MediaAugust 17, 2010
Using Social Media to Improve Adolescents' Health Literacy
Improve the health literacy of adolescents regarding their health insurance, health plans, and health providers
Increase adolescents’ level of engagement in their health care and their own health
Develop a health literacy training intervention to encourage adolescents aged 13 – 17 to utilize their health care plan more effectively
1) Test the feasibility of creating and maintaining interactive communication technology (ICT) health literacy training materials for a Medicaid adolescent population
2) Evaluate the effectiveness of the ICTs and social media materials produced
3) Evaluate the effectiveness of the intervention on behavioral health records linked to study condition
4) Increase adolescents’ health literacy about their health care rights and responsibilities
5) Test how adolescents use online and social media health information resources with content specific to their health needs and health plan
6) Assess differential intervention impact
based on predisposing participant characteristics
7) Test associations between increased health literacy and e-health literacy and outcomes of quality and quantity of care received
Adolescents 13–17 years old, living in California
Insurance coverage under Medi-Cal or Healthy Families Program managed by Health Net
88% of adolescents in California currently have health care insurance.
Nearly one in three (30.9%) of children in California is now covered by Medi-Cal or Healthy Families.
Among California adolescents, 85% have a usual source of care, with Latinos and Native Americans less likely to report usual source of care than Caucasians, Asians and Pacific Islanders, and African Americans.
Source: California Health Interview Survey, 2001
Traditional: degree to which individuals have the capacity to obtain and understand basic health information
Expanded: wide set of competencies and skills to process health information more generally and learn how to navigate our complex system of health care Set appointments, get referrals, fill out forms, and advocate
for appropriate care Individual empowerment/increased health decision-making Includes e-health literacy
77% of California teens saw a doctor for a routine physical exam in the last year
21-25% reported visiting the emergency room
Paradoxically, teens with health insurance were more likely to visit an ER than those without insurance
Source: Pew Internet, 2009
Recruitment PoolN=56,000*
Recruitment (3 waves)N=5,600
Comparison Complete StudyN=1,960
Comparison GroupN=2,800
Intervention Complete StudyN=1,960
Intervention GroupN=2,800
10% response rate
70% retention rate
*Excluding siblings, randomly selected
Study populationN=155,000
Baseline Survey
Follow-up Survey
Randomization
Recruitment PoolN=56,000*
Recruitment (3 waves)N=5,600
Comparison Complete StudyN=1,960
Comparison GroupN=2,800
Intervention Complete StudyN=1,960
Intervention GroupN=2,800
10% response rate
70% retention rate
*Excluding siblings, randomly selected
Study populationN=155,000
Baseline Survey
Follow-up Survey
Randomization
Round 1 Focus Groups: Teen Health Issues
Conducted 12 focus groups around California
Explored teen health issues including:
1) Attitudes towards access to health care2) Health promotion and disease prevention behaviors3) Health literacy, including patient rights and
responsibilities4) Internet and social networking behaviors
Round 2 Focus Groups: Design and Content Review
Conducted 2 focus groups Reviewed specific design and content of website Refined branding of website Elicited overall feedback on focus of website
Key informant interviews with adolescent providers
Conducted 8 key informant interviews Explored teen health concerns from perspective of
provider Patient / parent interaction, difficulties / barriers Patient recruitment / retention, staff incentives
Most important health issues for teens: Sex (including STDs and pregnancy) Drugs and alcohol Obesity
Prevention not a major emphasis Many barriers/hassles in going to the
doctor Confused about insurance issues Some understanding of their rights and
responsibilities Get some health information online, but
can be confusing Use a variety of social networking sites
Social Activity
Theme Activity
Domain Activity
Appearance Sex / STDs / Pregnancy
Stress / Depression
Infectious Disease
Obesity / Weight
Fitness / Sports
Violence / Gangs
Relationships / Family
Driving
Safety / Injury
Drugs /Alcohol /Smoking
1) Annual Well Care Visit
2) Patient-Doctor Relationship
3) Navigate Healthcare System
4) Benefits, Rights & Responsibilities
5) Healthcare-Seeking Information
Testing launch – August 2, 2010
Full site launch – September 1, 2010
Recruitment/Baseline Survey
Review/analysis – October/November 2010
Ongoing monthly monitoring
Follow-up survey – Approx. August 2011
Deborah Glik, P.I.Michael Prelip, P.I.
Abdelmonem Afifi Philip MasseyElaine Quiter Gabriel Stover
Sharon Nessim, HN P.I.Elaine Robinson-Frank
Diana CarrMaya GumatayKelly KonoVinia PanganCarol Spencer Hoa SuNancy Wongvipat Kalev
Michael FioreElissa Vaidman
Nedra Kline Weinreich
Nedra Kline WeinreichWeinreich Communications
weinreich@social-marketing.comwww.social-marketing.com310.286.2721Twitter @Nedra