This is Colon Cancer

Mar 11

March is National Colorectal Cancer Awareness Month. I write this in honor of my husband, John, whom I miss intensely every day. Hopefully our story can help someone else.

John and the kids in West Virginia during happy times

John Anderson, my husband of fifteen years, died in September after a fierce five month battle with colon cancer. He leaves behind our two children ages five and nine, and a 32-year old daughter from his first marriage. John was 59, and no, he never had a colonoscopy.

Why, despite knowing the facts about colorectal cancer screening didn’t he? That question will plague me for the rest of my life. And it tortured John from the moment he was diagnosed until the day he died.

The good news: colorectal cancer screening rates have increased since 2002, perhaps due in large part to significant resources the federal government and others have put into effective awareness campaigns. Yet despite this, and a documented increase in knowledge about colorectal cancer, approximately one-third of people age 50 or older have not been screened.

The disconnect between knowledge and certain behaviors is one that challenges social marketers every day. And while we’ve made tremendous strides in creating evidence-based programs that yield positive results, there are still (and will always be?) people whom we can’t reach. John was one of them.

Behaviors can be so illogical and complex, and John, a PhD level behavioral scientist, is the perfect example of how that plays out in real life.

When John turned 50 I reminded him to get a physical and colonoscopy. He got his physical but no colonoscopy. We had the same conversation half a dozen times over the years. He had physicals. Each time he came home with a fecal occult blood test kit and colonoscopy prescription. But he never followed through with either.

To encourage him, I would invoke our family (“Do it for the kids…they need you.”), my own screening habits (“How would you feel if I didn’t get my annual mammogram?”), the data (he was a scientist after all), the Katie Couric effect (a celebrity whom he liked and respected), and his risk factors (age, weight, diet). In the end was my nagging just noise?

Typical screening barriers (not knowing risk, no physician reminder, no health insurance, or fear of the test) didn’t really apply to John. So what was his barrier(s), and could addressing it have made a difference?

One month shy of his 59th birthday, John finally got that colonoscopy. It was after side pain led to a sonogram, which revealed tumors on his liver. His diagnosis: stage 4 colon cancer with inoperable liver tumors. Unless he responded to treatment, there wasn’t much hope. He didn’t respond, and died five months to the day that he began chemotherapy.

I knew it was like salt in a wound. And I knew there would be no answer that would ever heal a thing or make a difference. But still, I had to ask.

“Why didn’t you get a colonoscopy?”

I desperately wanted an answer that would make sense of this awful truth that in many ways would define the rest of our lives.

He didn’t have a definitive answer. And said that he didn’t think it was that complicated. Said he felt invincible, didn’t have the time, didn’t have cancer in his family…

None of it really made sense, he admitted. And our hearts broke with the reality that there really was no answer that mattered because, in the end, there was no excuse.

His oncologist kindly waived it away and said not to go there. We’d never know. John’s cancer was very aggressive. It’s possible that a colonoscopy or other test wouldn’t have made a difference.

But we knew the truth. Colorectal cancer screening saves lives. And it might have saved John’s.

I also asked John if I could have done anything that might have made a difference. After a pause, he half-jokingly said “well, maybe if you withheld sex”. As quickly as we laughed it off, it occurred to me that maybe he really was on to something. But what, I’m not quite sure.

Withholding sex is not the answer, but maybe it begs a bigger question…what are we competing against with people who, despite having the knowledge, still don’t get screened? What’s so important that if they were confronted with it, they might change their behavior? If we figured that out, could we use it successfully to reach them?

So I’ll leave you with this…in the end, for John, it was all about his family. That’s what devastated him the most. Not being there for or with us. Not watching his children grow. That’s what mattered.

So what do you suggest I do with that?

Potential Changes to Social Media in North Korea

Mar 07

For the first time, North Korea’s sole mobile service provider, Koryolink, allowed visiting foreigners to bring their phones into North Korea and have access to the internet on the 3G network. This same wireless internet is not yet available to North Koreans since they are governed by separate telecommunication rules. It is unfortunate that North Koreans do not have this freedom, but it opens up a new world to outsiders and will allow us to see more of the country that many regard as one of the most isolated nations in the world.

To give you a point of reference that illustrates how monumental this is, AP’s David Guttenfelder recently made his 20th trip to North Korea. During his first trip, he was prevented from taking photos from the bus and even his hotel window was covered with a black plastic sheet. Fast forward to recent months, where he has had the ability to instantaneously post geolocated instagram pictures from inside North Korea. Although there are still quite a few restrictions, allowing real time photographs is ground breaking, especially for the American culture who expects transparency and immediacy.

While Guttenfelder plays it safe with every day pictures on his instagram feed, including restaurants, food, and cute children, he thinks it further bridges the connection between North Koreans and outsiders. During an interview with NPR he said, “You’ll see that from the outside and say, ‘Oh, I do that, too,’ and that’s a connection.”

David Guttenfelder's Instagram Picture - North Korean children play with AP camera at Mansu Hill in Pyongyang

David Guttenfelder's Instagram Picture - North Korean children play with AP camera at Mansu Hill in Pyongyang

That connection is an idea very much alive within the work we do. We consistently use social media to apply behavior-change theories, such as Social Learning Theory. We use social media platforms to model and reinforce actions and behaviors. When we see others doing something, we learn from it and it can encourage us to take that same action. For example, when you “like” something on Facebook or when you share lessons learned or success stories with your community of online friends, this helps to reinforce others’ behaviors. Seeing the effects of social media from a communications perspective alone is very impressive. We have seen the way social media has changed the way we do business, it’s made the scope of our work and jobs much larger. Though currently it is just for visiting foreigners, it is intriguing to think about how the access to wireless internet, and in turn, social media platforms may have an effect on North Korea.

With the rest of the world’s mastering of social media, in combination with an ever-evolving market, it is a break-through for an isolated country to allow wireless internet access. I look forward to seeing what Guttenfelder and others share with us, and can only hope that one day this advance will spread to North Koreans as well.

Workplace Diversity: A Priority for Social Marketers

Mar 04

Workplace Diversity: A Priority for Social Marketers

So, how do we ensure we continue to grow this precious collection of experiences that make our work rich and memorable?  We recruit colleagues who are different from us – whether it is their upbringing, education, previous employment, gender, ethnicity or race.

It’s Just Habit…

Mar 01

How many times have you heard someone explain their healthy behavior—jogging after work or taking a multivitamin every morning for example—as “habit”?  Do you often wonder how your family members, peers, and coworkers form these healthy habits but you struggle to permanently adopt them as your own?

I am one of those people who is often awe struck by a friend’s diligence in going to the gym every morning, or a coworker’s ability to pass up a cupcake from the bakery below our office, no matter how appealing it may look.

When I read a review of Charles Duhigg’s book, The Power of Habit: Why We Do What Do in Life and Business, I immediately downloaded a copy onto my kindle, hoping to get some guidance on how to create healthier habits both in my personal life, but also as a marketer working with clients to harness the power of behavior change to encourage individuals to change—or develop new—habits to live healthier lives.

In The Power of Habit, award-winning New York Times business reporter Charles Duhigg exposes the science behind habits; how we form them, how we can change them, and how we keep them for the long term. He exposes habits adopted by successful companies, professional athletes, and religious leaders.

After reading only a few of Duhigg’s case studies, we find commonalties between all of the stories showing us the role Duhigg’s described “Habit Loop” plays in healthy/effective behaviors. He hypothesizes that every habit works the same way triggered by a “cue”, like a time of day or daily activity, or emotion like boredom or stress. After we experience a “cue,” or trigger, he explains that we partake in a routine behavior in response. Ultimately, our routine, or our behavior, results in a “reward” completing the loop.

If we can “diagnose” our habits and find out what reward we are ultimately craving, we can assess what cues and routines are getting us there. We can then in a sense change our habits by interrupting the loop—altering it.

This book is an absolutely fantastic read especially for those of us whose business is behavior change. Knowing our audience inside and out—their location, socioeconomic status, ethnicity, and income is not enough anymore. We have to look deeper into the habits of our audiences. What are their cues to conducting certain behaviors and how can we either reinforce or change their routines? How do we alter the loop of an individual or group of individuals for social good?

Gone in 6 Seconds: Instantaneous Visual Messaging

Mar 01

I have a 14-year-old sister who is much cooler than I am. She is always giving me fashion advice, speaking a language with her friends that I can’t understand, and updating me on Taylor Swift’s latest romantic woes. My parents recently bought her a cell phone and since then, the only time she’s not on the device is when my mother forcibly removes it from her hands.

The last time we were together, I noticed she was—what appeared to be—conducting a photo shoot; snapping a stream of pictures on her phone featuring herself in various poses. When I asked her what she was doing, she responded “Snapchatting, duh”. I immediately Google-d what she was talking about.

snapchat logo

Snapchat is an app that allows users to send messages or pictures to contacts that are only view-able for 10 brief seconds before disappearing. Over 60 million Snapchat messages are sent daily among the app’s 34 million users.

After the weekend with my sister, I started to notice my peers and members of      Gen Y who seemed to be equally attached to their mobile devices, using similar platforms; whether it was a girl sitting next to me on the metro intently scrolling through her Instagram feed, watching someone send a “selfie”, or my friends pinning wish lists to their Pinterest boards. Instantaneous visual messaging from what I can tell, is a trend that’s here to stay.

For example, Instagram, a picture sharing platform recently acquired by Facebook, currently boasts 90 million monthly users and an average of 575 “likes” and 81 comments by users every second.

Twitter earlier this year released  its own video-creating platform, Vine. The app allows users to generate 6 second, looping videos (similar to .gifs) that will appear in Twitter and Facebook news feeds. Since launched in January, Vine has become one of the Top 100 most downloaded free apps.

These astounding numbers led me to think—how can we, as marketers, harness the power of visual, instantaneous messaging? How can we express our messages in a visual manner? And perhaps most importantly, how do we continue to stay relevant to a generation whose attention span is a 6 second video?

Top 5 Takeaways from Digital Health Communications Extravaganza

Feb 25

Top 5 Takeaways from DHCX

Last week I had the pleasure of attending the Digital Health Communications Extravaganza (DHCX) conference in sunny Orlando. The conference is completely focused on the intersection of digital technologies and health, my two favorite things. Speakers discussed everything from social media measurement, the mobile web, data mining, gamification, startups, and the ePatient, and I had the opportunity to meet some fascinating thought leaders in the digital health space. In sum, not only was the beautiful weather a treat (70 degrees!), so was the conference.

Here are my top 5 takeaways from DHCX:

  1. Social objects can be used to frame social media experiences. Craig Lefebvre of socialShift discussed how social objects are the things that drive people to talk to each other, and creating engaging digital experiences requires understanding of what your social objects are. What’s critical to remember when creating social media content is that messages aren’t social objects, things are. We need to use objects to get people to talk to each other, not expect the text we write to be a uniter. It won’t be.
  2. mHealth is everywhere. In nearly every presentation, the growth of gadgets that use the mobile web was discussed. Speaker after speaker (including myself) spoke to the importance of having health websites that are ready to accommodate visitors through the mobile web. Jeremy Vanderlan from ICF International spoke to the experience of creating AIDS.gov. By building the site in responsive design, users are able to see the site render properly on nearly any device that uses the mobile Web. Not only is the site accessible on a most mobile devices, it receives preferential treatment in Google search because it doesn’t have a separate URL for its mobile site (e.g., m.aids.gov).
  3. Gamification can work, but it must involve the users at every step of the creation process. A panel of experts discussed their experience creating games for health, including rehab, smoking cessation, physical activity, and HIV prevention. All the speakers discussed the importance of designing with the user in mind, and doing testing to ensure that the design, structure, and content works for both the end outcome and the user. Sheryl Flynn from Blue Marble Game Company discussed her experience creating games for rehab, and how initial progress assessments within the games were more subtle (so as to create a more positive user experience). However, health care providers administering the games wanted to embed gold standard assessments. Upon receiving this feedback, the company added both, and the providers are patients are able to choose which they prefer.
  4. Testing digital programs to build evidence of their efficacy is challenging, but possible. Success is more likely when you build on strategies you already know work. Many of the speakers discussed the challenges of completing randomized trials for digital technologies, given the high speed of technology and the slow pace of the trial process. Applying theories that have been shown to work off-line to the digital space can help ensure success given the lack evidence for digital programs. Jessica Hammer from Lit2Quit discussed how her team applied “breath therapy” (where breathing techniques are used to simulate the experience of smoking a cigarette to help people quit) to a mobile game. Breath therapy has been shown to work off-line, which helped her team know that it could work digitally as well. Testing could be conducted after launch to confirm efficacy of the app in helping people quit.
  5. Best of digital usually involves the blending of digital and physical experiences. Speakers discussed how combining digital and physical experiences can often be the most powerful. Bradley Kreit from IFTF, Ann Aikin from FDA, and Amy Heldman from CDC spoke to how campaigns can successfully do this. Movember (which Ogilvy Washington participated in this year) encourages men to grow moustaches (the physical) and then post about their ‘staches to their social networks to spread awareness of men’s health issues and fundraise (the digital). NASA brings people interested in science into its space center to give them a private tour (the physical), creating an insider experience the attendees will want to share with their social networks (the digital). Often, Aikin said, it can be challenging to convince people in public health that the digital can’t just be online actions—there must be an offline component to truly drive sharing. Their statements support what Lefebvre said about social objects, and I totally agree with them (see my previous post on how Saks did this is in their Christmas window display).


I had a great time geeking out this week with my fellow digital health nerds. DHCX attendees: what were your key takeaways?

Achieving Greatness

Feb 21

The Baltimore Ravens, Super Bowl Champions, achieved football greatness earlier this month. Roger Federer, often referred to as the GOAT of the tennis world – Greatest of All Time. And in a couple of weeks, Hollywood will spend an evening telling us who has achieved greatness on the big screen.

Greatness, a noun.  But, what exactly is it and how does it apply to social marketing?  Society tends to define greatness as being at the pinnacle of something, particularly in a sport or career.  But what about those small personal achievements, those little steps toward a goal, or just making some behavior change that can advance a healthier lifestyle?  Do we consider those achievements acts of greatness?  If we don’t, why not?  If we do, then are we clear in our communications and messaging to our target audiences, in saying loud and proud, “yes, [insert target audience name] you are doing great things; you are achieving greatness!”

So, where is all of this great rhetoric coming from?  Glad you asked.

Last year, during the 2012 Summer Olympic Games in London, Nike embarked on a new ad campaign, “Find Your Greatness.” There were a series of ads that ran, showing people doing various different types of activities such as a little boy trying to skate board like the big kids, teenage girls doing double-dutch at the playground, or a young gymnast tumbling in her front yard.  But one version I saw really stuck with me.  A 12-year-old boy, named Nathan Sorrell, from London, Ohio (town name is not a coincidence), lumbering down the street in this rural town.  Before you can actually see him, you just hear his feet shuffling with great effort down the pavement.  Nathan is 5’2” and 200 pounds, obese.  The voice over in the Nike ad says, “Greatness, it’s just something we made up.  A gift reserved for a chosen few – prodigies…superstars.  And the rest of us can only stand by, watching…” Wait! Is that true?  Greatness is only reserved for the special folks who can swim the fastest, catch the most spectacular pass, or give the Oscar-winning performance.  I beg to differ.  Greatness, as the voice continues, “…is not some rare DNA strand; it is no more unique to us than breathing.” Now, as you can imagine there was an outpouring of praise and criticism, alike for this ad.  Let me just cut to the chase. Was Nike exploiting this overweight child or were they making generous nod to those who have finally decided to Just Do It? Or was Nike actually making a statement toward the growing epidemic of childhood obesity – 1 in 3 U.S. kids are overweight – and subtly saying, we are redefining greatness.  You don’t have to be like Mike anymore.  The voice in the ad concludes, “…we’re all capable of it.  All of us.”

See the ad here:

Okay, where was I? Oh yes, I remember.  Are we applauding greatness, in all of its forms?  Perhaps as we put together our campaign tweets, Facebook posts and text reminders, we add a message about greatness, even if it is for the most minor of steps – shuffling feet.  For everyone we are trying to reach, whether it is in the childhood obesity campaigns we implement; or the message to take steps to lower your risk for heart disease; or saying to sit out this week’s football game because of the hard hit in the head you took last week; whatever it is, every small action, is a step toward greatness.  Let’s applaud both the two pound weight loss as much as the 40 pound weight loss.  We want to encourage everyone to start to find their greatness.

Read more about the ad and debated controversy in Time Magazine here.

Cupid’s Arrow

Feb 14

Social marketers are quite familiar with social norms. Many of our hard-fought efforts focus on bringing awareness to positive social norms—think seat belt-use, discouraging dangerous social norms—think underage-drinking, or creating new social norms—think the Cupid shooting arrowTruth campaign. But there are some social norms that are so ingrained in our society that we don’t even realize we’re conforming to a certain established behavior. There are many of these, but I’d like to talk about today’s red and pink, hearts and kisses, flowers and candy holiday—Valentine’s Day.

It’s a bit difficult not to get caught up in this quite-commercialized holiday, especially for women. Who doesn’t love the idea of receiving flowers at work, at being swept away on a romantic get-away, or surprised with jewelry? I’m certainly guilty of these feelings and actions. For example, I spent hours last night making home-made valentines for my son’s daycare class. Rationally, I know the little two-year old tots don’t care what it looks like, or the cute, catchy message, so long as there’s candy or cookies inside, but emotionally I felt compelled to have my son’s (or should I same my own) valentines admired.

For many people the holiday brings to the surface social norms in our society that we all work very hard to discourage. The assumption that people feel compelled to have a significant other for this “special day” and that if you don’t, you should be thinking about how you can be working to change that.

My challenge to all of you on this Valentine’s Day, and all those yet to come, is not to forget about the holiday, but to think about changing the social norm—just a little bit. It doesn’t just have to be about love with a significant other. Why not celebrate the love you share with your friends, your parents, your children, or maybe most importantly, love for the life you’re living?  And if you want to share the love even further, here are a few suggestions from Living Unapologetically to do so in a way that can truly make an impact on the lives of others.

  • If you feel obligated to spend money, buy a t-shirt and show some love for a child in need here.
  • Donate your time to spread your love. Find what you love and give back here.
  • Participate in a flash mob on Valentine’s Day to raise awareness and stop domestic violence and rape. Learn the dance and get involved here.
  • Send your love to our troops here.

‘Leave some love’ on this post and share what this chocolate-filled social norm means to you.

Understanding the Role Emotion Plays In Social Marketing

Feb 07

As a new mother, I have a million new things to worry about. Is my baby healthy? Is she sleeping and eating enough? Is she meeting all of her milestones? In addition to all of the recommendations I get from her doctor about what she should be doing and when, I also have to wade through countless other sources of information that are constantly bombarding me with advice on the best way to navigate this new world. Keeping up with all of this often has me feeling misunderstood and unclear on what is the right thing to do.

As social marketing experts, we realize that an important component to behavior change is emphasizing credible studies and recommendations released by trustworthy sources such as the Centers for Disease Control, Health & Human Services or in my case, the American Academy of Pediatrics. However, what is sometimes overlooked is understanding how a person feels about a particular issue and then addressing that in a sensitive way to help motivate behavior change.

A recent personal example:  Attempting to “sleep-train” my daughter. This essentially means putting her down in her crib at bedtime and not picking her up when she begins to cry. Instead, many experts suggest that I check on her periodically but let her “cry it out” so she can learn to put herself to sleep and self-soothe – skills that are critical to a child’s healthy development.  While I realized the importance of my daughter adopting these skills, it took me several months to actually pull the trigger on sleep training. The challenge for me was breaking MY habit of quickly picking her up the second she shed one tear and soothing her with my voice and touch – a natural reaction by most moms, I’m sure. When I consulted online sources initially, I wasn’t moved. This is because much of what I was reading was instructive about how to influence my daughter’s behavior, but didn’t exhibit empathy for how I was feeling when I listened to my child sob.  I felt that my daughter’s crying must be different and far more awful than others because what I was reading didn’t imply that other parents went through the same difficult process. After many more months of late nights and sleep deprivation, I finally turned to other sources such as mommy blogs and message boards and immediately felt a groundswell of support that encouraged me to successfully sleep train my daughter. The blogs and message boards proved to be credible sources for me because they addressed my behavior change need in addition to my daughter’s. While validating how I felt, these new sources also offered tips for how I could get through that initial rough period so I didn’t lose my nerve or patience.

As we apply social marketing theories to tackle various issues, we must consider emotion as a piece of the puzzle when helping prompt better understanding and action. Whether it’s a feeling of comfort, fear or joy, addressing how someone feels about an action or habit plays a big role in shifting their mindset. While data and studies may all point the target audience in one clear direction, if we don’t break the existing emotional barrier, all of the sound, credible information may fall on deaf ears.

What Social Marketers Make

Feb 05

Two of my college roommates were education majors. I vividly remember their student teaching days when after a tough day at school, they needed extra inspiration. Our entire apartment quickly became familiar with Taylor Mali’s “What Teachers Make.”

If you don’t have time to watch the full video below (and I highly recommend you find the 3 minutes, 3 seconds in your day), here’s the jist. When asked at a dinner party what teachers make, his answer isn’t a salary. Mali highlights how teachers have the power to make kids work harder than they thought they could; make children wonder, question, and criticize; and make a difference.

My colleague Cait Douglas’ recent New Year’s Resolution for Social Marketing post challenges us to better define and own our profession. In light of this, perhaps instead of telling your roommate or family member about the media plan or partnership outreach that defines our day-to-day, you can instead tell them what social marketers make – not a paycheck, but a difference.

The answer to “what do social marketers make?” depends on the day for me, but here are a few highlights from my Ogilvy social marketing colleagues highlighted in this blog over the past few months:

  • Inspire Americans to get out and vote. -Chris Beakey
  • Use humor to take on critical issues – like disaster preparedness – and still be effective. -Carrie Dooher
  • Create a culture of strong, smart young women nationwide. -Pamela Long
  • Improve communications between patients and health care providers. -Ashley Wolos

In your eyes, what do social marketers make? A paycheck? Or something more, like Taylor Mali found? Share your thoughts in the comments section below this post.