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