Archive for the ‘health.communication’ category

Palo Alto Medical Foundation: a social media success story

June 1, 2010

I first got to know Erin Macartney, of the Palo Alto Medical Foundation, during weekly Twitter chats for the health communication and social media #hcsm community. Since then, we’ve had numerous conversations and I am very impressed by not only what Erin has accomplished with social media but also her personal and professional commitment and passion. She kindly offered to share her organization’s social media strategy. What strikes me is her organization’s commitment to provide information to patients in the mode they wish to receive it – whether it’s through social media channels, traditional communications (patient newsletters and health education mailers), e-newsletters or other communications methods.

The Palo Alto Medical Foundation (PAMF) for Health Care, Research and Education is a not-for-profit multispecialty health care provider. PAMF is located in California’s San Francisco Bay Area. With more than 900 affiliated physicians and 4,300 employees, PAMF serves more than 655,000 patients at its medical centers and clinics in Alameda, San Mateo, Santa Clara and Santa Cruz counties.

Q: How does PAMF view social media?

A: We see social media as a natural extension of our two-way patient communications, ongoing conversation, information sharing and patient empowerment. Listening and having discussions helps us to continue to learn and improve upon the quality of our organization’s health programs and services.  Having these newer social media tools now available to us gives us another way to connect with people – in a way that they like to receive information – and allows us to hear from them, listen to them and respond more personally and in real-time

Palo Alto Medical Foundation FaceBook screen capture

Appreciative feedback means PAMF's FaceBook strategy works

Q: What are some keys to communication in health care social media?

Honesty, respect, accuracy, timeliness and trust – to name just a few. Open communication is important – in all directions.  When it comes to health news, it is important get your information out as responsibly as possible.

Q: What types of information does your organization share using social media?

A: Using social media, we share health articles and information, organizational news, wellness tips, class and lecture information and registration, physician videos and more. We try to include a variety of things that will appeal to people – whether it is targeted medical news, or a photo album of employees walking to raise money for the March for Dimes’ “March for Babies” event, or pictures and mention of our medical staff offering free breast health information at the Stanford women’s volleyball game during “Breast Cancer Awareness Month.” It’s all in there. We try to keep things friendly, informative, fresh and fun – and most of all, helpful.

Q: How does your organization integrate its social media strategy in our overall communications planning and activities?

A: Social media is a key component of health care communications at PAMF. So, over the past few years, we have repurposed many of our traditional communications activities as social media. We see social media activity as seamless with our traditional communications. Hopefully, they work jointly to help bring people health information and connections – in the way they want to receive and use them, so they can be active partners in their own health and health care team.

Q: Which department manages social media at PAMF?

A: The Public Affairs Department coordinates and manages our social media program and we include many other areas of the organization in idea sharing, information gathering and communication planning. We regularly tap into the expertise of our marketing and health education colleagues to broaden our team and reach. Ideally, we’re working towards everyone in the organization all acting socially in a coordinated way. Our goal is to offer useful information to people, to listen to them and have conversations that are meaningful – so we can better meet their health information and communication needs. We are patients too, so we always try to keep that in mind.

Q: In addition to social media, what are some of the traditional communication tools your organization uses to share health information?

A: In addition Facebook, Twitter and YouTube, we have a health and wellness newsletter, called “Foundation for Health,” that is mailed to patient and community households. We also produce patient e-newsletters that are delivered to subscribers’ inboxes. E-HealthNews is our largest patient e-newsletter with 75,000 e-mail subscribers. We also have a parenting e-newsletter and a South Asian Health e-newsletter that are delivered via e-mail subscription. Our “Community Highlights” mailer includes free health event and lecture information available at our different locations.

We try to combine traditional and online opportunities. Therefore, the PAMF health events and lectures are posted online on the website home page, health education website and promoted on Facebook and Twitter. People can also register for classes and events online via our website and Facebook page. Lectures and events are free and open to the community.

You can find the Palo Alto Medical Foundation on Facebook and Twitter. Erin Macartney is a public affairs specialist PAMF. You can follow her on Twitter at @emacartney.


Social media 101 for health educators

April 25, 2010

In a poll, participants in a forthcoming IHA conference on health literacy identified a fascinating list of issues to explore. I neither have all the answers nor can we cover all these issues in a 90 minute session but we can continue this interesting conversation beyond the conference via social media tools! For an overview of some of these issues, participants new to social media can review these resources.

This is of course representative not comprehensive. Please use the comment feature to  share your thoughts and suggest other resources.

Researching social media and health communication

January 9, 2010

This week, I had the privilege of meeting with Erin, my colleague who is taking an  MA in Communications at Royal Roads University, to discuss potential thesis topics. Erin is interested in social media and health communication which is ideal because it ties in so closely to our work.  In my biased view, of course, she could not have selected a better research area.

I was very excited when she invited me to help her brainstorm possible topics. The timing is excellent  because I am preparing to present a session on social media and health literacy at the IHA conference in May so this is doubly valuable for me. I am quite familiar with the two areas of social media tools and health literacy but I need to spend more time looking at the intersection of the two. In other words, there is an assumption that social media are excellent tools for disseminating health information but are they always? Could they present barriers?

As Erin is only starting to explore the concept of social media, our discussion was a broad brainstorm of possible directions.  For some background, I recommended that she look at:

As she gets familiar with the different social media, she will identify areas of interest and narrow her focus to a manageable scope – such as the use of a particular tool (Twitter, Facebook, blogs?); a particular population (patients, physicians?); a particular use (health promotion campaign, patient-to-patient communication?) etc. Possibilities include:

  • An ethnographic study of patient bloggers
  • A critique of the social media strategies/policies of particular agencies
  • Analysis of what is being done with what tools
  • Issues around the use of social media for health: accessibility, disparities, media literacy…

It would be ideal for her to locate a supervisor or an expert in qualitative methodology as this may be an interesting approach appropriate for an ethnographic study or similar research.

One of the fantastic outcomes of working with Erin on this, is that she now appreciates the value of the social media tools that I have been promoting to my colleagues all along. For example, we will use our delicious account to tag the useful links for her research.

Our first meeting was so productive and engaging that three hours flew by. Over the next few months, we will crystalize these initial ideas into concrete research questions. Please use the comment function to share your insights or suggest social media & health communication research questions that we could explore.

Promoting medication safety in community spaces

November 22, 2009

In our outreach to parents of children under 6, we have visited different community groups to promote medication safety with respect to non-prescription cough and cold products. It’s been truly fascinating to interact with parents and their children in diverse community settings and to learn how the audience and context impact our message and its delivery. So far we’ve done 20 talks to 185 parents of over 200 children under 6 years of age. What’s amazing is that only 24 (13%) parents were aware of the important message that: over the counter cough & cold products are not safe. Those who were aware learned through the media (7), doctor’s office (6), day-care (1)  pharmacist (5), relatives who are health professionals (4), community centre (1)

Some of the places we have been to include:

  • Community drop-in programs where parent groups drop in to learn about community resources. Some of these have been excellent because they offer child-minding thus allowing parents to focus on the presentation. Mobile child minding has been extremely valuable in these venues. In some of the programs, the children are in the same room but on the side. Some parents even bring a grand-parent to mind the children so that they can focus on the talk.
  • Diverse language programs: it was a really rewarding experience to present to three Chinese speaking groups. The translation factor may be challenging but overall, it was clear that they understood and valued the message. We verified that there is a Chinese word that distinguishes viruses from bacteria – which was excellent. It was particularly helpful to learn about the medication practices in the Chinese community and the need to promote safety through culturally sensitive workshops.
  • Preschool oriented programs aimed at children: these have been a really effective way to connect with the parents. It is quite possible that the parents who are aware of this programs and motivated to bring their children may not be typical parents. They have proven knowledgeable and engaged in learning about their children’s health. This makes us wonder about the characteristics of parents that we are not reaching through these venues.
  • Community health centres: these are groups facilitated by a nurse. These have been excellent because the facilitator is a health professional who can prompt us to address the questions that matter to the parents. For example, one nurse asked us to come back and address the topic of drugs and breastfeeding – an excellent topic for her group.
  • Libraries: These have been really interesting because they are key centres of learning in the community. One approach has been to visit story-telling programs that libraries organize for families. The story-time is based on a health theme after which we talk to the parents. The challenge here of course is to engage both the young ones, who are the central audience and the parents. Children’s librarians can help us with creative ideas to keep the little one’s interested in our message as well. The other approach has been to organize a standalone program aimed at parents of young children. Where well promoted in advance, this has been very successful as parents come eager to listen to the message and able to stay for the entire length of the presentation. Less successful has been the attempt to offer our presentation in the place of a story program. Since not all parents attend all the sessions, they were not aware that we were offering a different presentation from their regular program.


  • Given the alarmingly small proportion of parents who are aware of this message, it is clear that a multi-pronged strategy is required to reach parents with this important information. The message needs to be available in languages other than English and French (Canada’s official languages).
  • To simplify things, we emphasized the message: most colds are caused by viruses and there is therefore no cure; over the counter cough & cold medications are not safe and it is safe to give plain pain-killers only (not combination products) to manage fever. However, parents wanted to know the reason why these products were no longer safe for children under 6. Particularly concerned, were those who had older children and had used these products before. It was important to explain that these drugs were released back in the 60s and 70s and since then, there had been no evidence to support their effectiveness. At the same time, there was clear data to show that children metabolized these drugs differently from adults and there were reports of serious side effects not only in Canada but in Europe, US and elsewhere. This reinforces the value of understanding how adults learn and supporting that when conveying messages.
  • The discussion of non-medicinal remedies was essential for supporting actionable behavioural change. It would have been unrealistic to expect parents to follow this recommendation without a clear alternative for handling cough and cold symptoms. Encouraging parents to share their own experiences of successful remedies was empowering and effective. Many of them were knowledgeable and played the role of peer educators.
  • The parents posed thought-provoking questions some of which were based on their cultural background and traditional practices. Others sought clarification while some stemmed from common beliefs and conceptions that need to be validated by evidence. For example, how do I tell the difference between a bacterial and viral infection? Are there safe homeopathic remedies? Are these effective? Does applying alcohol on the child’s body bring down fever? Does massage therapy help with cold symptoms? Is it okay to cut an adult’s Tylenol pill into half for a child? My child is x pounds. How much of drug y should I give him? Are antihistamines okay for allergies? Why call it baby aspirin and yet it’s not safe for kids under 20?
  • Our Fortune Teller was very popular as it was a lot of fun: everyone enjoys folding it and we can’t keep up with the demand.
  • The most valuable information we can give consumers is how to find health reliable information – such sources as BC health guide.

Preschool parents learn about managing colds

October 22, 2009

The BC Strong Start program is a free program that provides early learning activities for preschool children. As the parents are required to accompany their children, this was an excellent forum for us to educate parents about Health Canada’s advisory against over-the-counter cough and cold products for children and how best to manage the symptoms. The Strong Start program at Parkside Elementary School is run by a dedicated facilitator who occupied the little ones as we spoke to their parents. An informal talk rather than do a formal Powerpoint presentation , it worked better for this group.  Of the eight participants, three were aware of Health Canada’s advisory – which was better than most groups we have talked to so far. One got this message from a pharmacist which underscores the important role of community pharmacists in promoting drug safety.

The parents were very knowledgeable and asked a lot of questions which generated good conversation:

  • The doctor said that cough and cold medication is safe if properly used. Is this true? Answer: No. While true that these medications are often associated with misuse and overdose, they are no longer considered safe. There is no evidence that they work and they could cause serious harm.
  • Why have these medications suddenly become unsafe? Most of these products are early generation drugs that were mainly tested in adults. There is clear evidence that children do not metabolize medication in the same way as adults and this is why many countries have decided to bar their use in children.
  • Are safer products for children going to be developed? Answer: Only manufacturers can answer those questions
  • Are antihistamines for allergies safe? The advisory applies to the use of antihistamines being used for coughs and colds – not allergies.
  • What is safe for fever? Answer: acetaminophen (Tylenol) is the safest to use for fever and pain as it has been around for the longest. It is really important to use plain Tylenol – not for colds. Ibuprofen (Advil, Motrin) is good if there is also inflammation in addition to fever and pain but is harder on the stomach and should not be used in children under 6 months. ASA (Aspirin) should not be used in children under 20 years old as it could cause Reye’s syndrome. 
  • One parent said that her friend always gave her child slightly more than the recommended dose because she thought that it would not be strong enough to be effective. All parents agreed that this was very unsafe indeed. Always go by the recommended dose, using the right measuring device. Good medication information is found in the BC Health Guide
  • Good non-medicinal methods suggested included: elevating with pillows, honey (available in honey sticks), vapour/steam, Vicks for children. One parent said that the humidifier did not work for her child.

Engaging young parents at community health centre

October 22, 2009

Talking to parents at a community health centre about Health Canada’s advisory and over-the-counter cough and cold medicines was a very rewarding experience. This is a program run by a public health nurse and aimed at parents of children under 1 year old. All except one were first time parents. We talked to 2 groups:

  1.  14 English speaking participants (one dad accompanied the baby’s mother) 
  2. 4 Chinese speaking mothers

As the babies were so young, it was possible to do the full powerpoint presentation with minimal disruption. We first went around the room and asked them to introduce themselves, their little one and what they did when they had coughs and colds. This worked very well. Unlike other groups, this one is facilitated by a health professional and their knowledge level reflected this. Three had heard about the advisory from the news. They were aware of non-drug techniques for managing cold and cough symptoms – saline solution and humidifiers. The nurse added that saline solution can safely be used in babies from birth – it makes them sneeze but that is good for them.

Questions included:

  • Why should the humidifier be cool and yet hot vapour is good for colds? Answer: Heat may encourage the growth of  bacteria unless thoroughly cleaned so humidifiers that run continuously are best kept cold. Vaporizers and steamers can be used for short periods and turned off.
  • Nurse asked what medications are safe for breastfeeding mothers. Answer: Always ask the pharmacist
  • Are throat lozenges okay? Answer: Depends on whether they have a medicinal ingredient. If just zinc or lemon, they are okay.
  • Why is Advil not appropriate for kids under 6 months? Answer: they are too young to metabolize it safely

The nurse convening the Chinese group made a really insightful comment about the value of medication safety presentations for the Chinese community. For many of them it is acceptable to mix up different medications in the same container. There are many communities that may have peculiar medication practices and cultural sensitivity will help us promote safe drug use.

Delta parenting group shares cold management tips

October 9, 2009

A session with a Delta parenting group on our pediatric cough and cold management topic went very well. In this group, none of the parents were aware of the Health Canada advisory. In attendance, were 14 parents with eight children under 6 years of age.

A wonderful provision was child minding in a nearby room. The organizers are able to arrange child-minding on-site so that the parents can focus on their learning undistracted.  As a result, we were able to go over the entire Powerpoint presentation and the lively group had the opportunity to non-medicinal cold management techniques:

  • Use of a humidifier
  • Saline drops
  • vapor
  • Placing hot towel on child’s chest

The parents’ asked a lot of good question including:

  • How do you distinguish a viral from a bacterial infection? Answer: a viral infection results in clear secretions while a bacterial infection will produce green/yellow mucous/sputum
  • What were the serious side-effects reported in the use of over the counter cough and cold medications in children under six? Answer: loss of consciousness, seizures, death in some cases
  • As some of these adverse effects were associated with over-doses, is it okay to use over the counter cough and cold medications, so long as you are careful with dosing? Answer: No. The risks outweigh the benefits – and this is why the manufacturers have been asked to relabel them (to indicate that they are not to be used in children below 6)
  • What do you do when child is unable to sleep because throat hurts from coughing? Answer: Try a pain reliever
  • Are health food store/natural products okay for children? Answer: there is a perception that all these natural products are harmless but always consult a doctor
  • What’s the different between a humidifier and a vaporiser? A vaporizer produces steam – caution required. A humidifier produces cold moisture.

Directing parents to reliable sources of information for answers to their questions is highly valuable. From this group, it was clear that in addition to the information we presented, the parents were able to learn from one another as well. One parent said that the doctor had advised using steam to help clear her child’s congestion but she wondered how to safely do this. Another parent explained that running hot water in the bath would quickly fill the room with steam which the child could safely inhale.