AJPM Article of the Year, by One of Our Own

The American Journal of Preventive Medicine honors EdLogics advisor Dr. Brian Primack for his article on social media & loneliness.
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We’re proud. But we’re not surprised.

A study by the University of Pittsburgh’s Brian Primack, MD, PhD — an EdLogics advisor — has been named Article of the Year by the American Journal of Preventive Medicine (AJPM). The study, “Social Media Use and Perceived Social Isolation Among Young Adults in the US,” examines whether time on social media actually helps — or hurts — our personal connections.

From the journal: “The Article of the Year is selected by the AJPM editors and one representative from each of the journal’s two sponsoring professional societies, the American College of Preventive Medicine and the Association for Prevention Teaching and Research.” The honor was announced late last year.

Remember Dr. Primack?

Brian Primack, MD, PhDYou might recall our recent webinar, “Improving Health Literacy: What Works & Why,” featuring Dr. Primack and EdLogics advisor and health literacy expert Dr. Russell Rothman, MD, MPP, of Vanderbilt University. Dr. Primack made some illuminating, thought-provoking points on the effectiveness of gamification and game-based learning for improving health literacy.

In addition to being an EdLogics advisor, Dr. Primack is the director of Center for Research on Media, Technology and Health at the University of Pittsburgh. For this study, he and his colleagues surveyed 1,787 adults in the US ages 19–32, asking about their social media habits across 11 different social networks. They also asked about loneliness and isolation, gauging the correlation between social media use and feeling left out.

What they found surprised them.

Social media, social isolation

You’d think that social media connects us. That’s the point, isn’t it?

But the more people use social media, the more lonely they say they feel. In fact, those who used it more than 2 hours a day were twice as likely to report feeling socially isolated, compared to those who spent a half-hour a day or less.

“The people in the highest quartile of social media use [more than 58 visits a week] … had about 3 times the likelihood of having perceived social isolation,” Primack says. “Social media does not translate directly to better social connectedness.”

He goes on:

“It may be that people who are already socially isolated are turning to social media to try to fill that void. However, if that is the case, the results of this study would suggest that that self-medication is not working so well.

“On the other hand, it may be that people who use more social media are being exposed to highly curated messages suggesting that ‘everyone else has more connections, a better life than I do.’ And in comparison, people can feel sad or they can feel socially isolated. … It may be a combination of the two.”


American Journal of Preventive Medicine 2017 Article of the Year

Brian A. Primack, MD, PhD, from the University of Pittsburgh discusses “Social Media Use and Perceived Social Isolation Among Young Adults in the U.S.” This article was chosen by the editors of AJPM as the top article published in the journal in 2017.

But social media isn’t all that bad — necessarily.

It can depend on how you use social media. Primack is already making plans for future studies that get into more nuanced detail. That way, we can see what types of social media use correlate to feeling more — or less — lonely. We can see which social media behaviors correlate to which feelings.

Until then, Primack says, everyone can judge for themselves how social media affects them:

“Is their social media use making their lives better, is it inadvertently detracting from them?”

Further reading

The study: Social Media Use and Perceived Social Isolation Among Young Adults in the US

NPR: Feeling Lonely? Too Much Time On Social Media May Be Why

Today: Feeling lonely? How to stop social media from making you feel isolated

CBS (video): Study: More Social Media Use Tied To Increasing Feelings Of Isolation

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Webinar Recap: What the Experts Said About Improving Health Literacy

Watch the video and read the highlights
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Our October 3 webinar, “Improving Health Literacy: What Works & Why” — co-sponsored by EdLogics and Global Action Platform — got a great reaction from attendees.

Missed it? Watch the video below or on the EdLogics Newsroom, where you can also watch other videos, see past webinars, listen to interviews, check out our press kit, and more.

Improving Health Literacy: What Works & Why

Can anyone really lower the high costs of healthcare?

You can’t control many of the factors that contribute to high healthcare costs: expensive drugs, the cost of providers, rising insurance premiums. So, what can you do?

Improve health literacy, the ability to understand and act on health information.

Watch health literacy expert Russell Rothman, MD, MPP of Vanderbilt University and gamification guru Brian Primack, MD, PhD of the University of Pittsburgh outline problems with existing health education programs and describe real-life solutions.


Low Health Literacy Costs More, High Health Literacy Costs Less

Low health literacy costs more. High health literacy costs less.
EdLogics wants to improve low health literacy through education.

It’s not about avoiding medical care. It’s about getting the right care at the right time.

We want to empower people to make real changes in their day-to-day habits, so they can stay healthy and keep their families healthy, too.

We want to educate people to prevent sickness before it starts, to show them what to do and where to get care when they do get sick, and help them become well-informed, proactive healthcare consumers.

Ultimately, EdLogics wants to improve health outcomes, reduce the number of claims, and lower costs. For everyone.

Dr. Primack:
“In the US, 1 in 3 Americans can’t follow directions on a drug label. And I have to say, even with a medical degree, I sometimes get a prescription for one of my kids or something and I have to look at it pretty carefully with that small print and the code that it’s in. So it’s not surprising that it’s a challenge for many different people.”

For each low literacy patient, extra healthcare costs $8k/year on average

Dr. Primack:
“When someone, for example, just has an ankle sprain — if they can access and follow good information that they have — then they very well might be the kind of person who will say, ‘You know, I don’t need to go the emergency room. I can wait.’

A couple days later, they’ve already improved with ice, elevation and rest — all things that are free.

Whereas another person who is having more difficulty understanding or accessing information might decide to go to the ER for the same condition, and the second they get through the ER door, already they’ve racked up very high costs. They’ve put themselves at risk for getting some kind of a hospital-acquired infection or some additional problem.

Even though this is one small example, when we start quoting issues like ‘90 million Americans have poor health literacy, and this costs an extra $150-200 a year,’ you can see how these numbers add up.”


Improving Health Literacy Makes a Difference

Knowing what to do to prevent chronic disease, how to take medications, and where to go when you’re sick — and acting on that knowledge — can have a huge impact on both personal health and the number of costly healthcare claims.

  • Improved knowledge of health issues
  • Improved behaviors
    • Medication adherence
    • Vaccines
    • Childhood obesity prevention
    • Diabetes self-management
    • Asthma management
  • Improved outcomes for:
    • Diabetes
    • Heart failure
    • Obesity prevention
    • Depression

Dr. Rothman:
“Even after you take into account a patient’s education level, their income, their insurance, and a host of other factors, we find that their literacy level is an independent predictor of how they do with their health.”


The Problem with Existing Health Education Programs

Of course, health education programs trying to raise people’s health literacy already exist.

But are they actually making a difference?

Health literacy improvement is important, but not everything is effective.
Pamphlets: Often don’t make it from the doctor’s office to the car.

Health websites: Too high-literacy, not personalized, and not always trustworthy.

Doctor visits: Patients may misunderstand, forget instructions, or feel too embarrassed to ask questions.

Dr. Rothman:
“And, unfortunately — and I say this as a primary care physician [laughing] — but there’s also a lot of variation in how well doctors communicate with their patients and their families. If you ask most clinicians we would, of course, tell you that we’re excellent communicators, and our patients all nod their heads and seem to understand everything that we say to them.  … Some studies suggest patients only recall about 20% of what’s said to them by the time they get home.

So we like to think we’re all good communicators as clinicians, but a lot of us struggle — using a lot of jargon that might be hard for patients to understand, maybe speaking at too high of a literacy level without enough plain language, and giving people too much information to try to take in during one single visit. We often don’t assess patient understanding before they leave.”

Poorly designed games: Many focus on the wrong goal.

Dr. Primack:
“So there would be hamburgers and pieces of pizza, and you are supposed to shoot those, but the salad you are supposed to let live. You can probably imagine the next step, which was that they studied this and they found that being exposed to this game and playing this game a lot didn’t actually make people change their diet in any way.

It’s just a caution that even though sometimes gamification is really valuable, if the game is poorly designed, that’s just not a magic quick fix.”


Improving Health Literacy: What Actually Works

It’s one thing to learn more health facts.

It’s another thing to change your daily habits — the one thing that has more of an effect on health than any other single factor.

  • Gamification and game-based learning
    • Key principles:
    • Competition, leaderboards, and peer comparisons
    • Teamwork, shared goals
    • Leveling up, increasing challenges, improving skill and knowledge
    • Interactive content for better retention than passively-consumed content
    • Unique incentives, cash drawings, charitable contributions, other benefits

Dr. Primack: 
“The question is: Can we take principles of gamification and game based learning — the interactivity, the unique incentives — and can we use that to leverage for positive change? And what we have found is that, especially in the area of health literacy, there is a lot that we can do.”

  • Multiple formats: words, pictures, videos
  • Personalization: Content is tailored to the individual user based on age, gender, health conditions, interests, and family roles like caregiving
  • Motivation and sustainability: Keep people engaged for real-life behavior changes
  • Community resources: Further education and support

Dr. Rothman:
“What we really need to think about more is how to link people to other social support mechanisms to help them with their health. We have lots of studies now that really demonstrate that patients who have strong social support do much better with their health. There’s actually an epidemic of loneliness going on in a lot of countries.

And even when people are with their family, they may not have social support for disease that they’re dealing with.

So it can be really helpful to help a patient or employee and their family link to community resources — maybe to disease-specific organizations if they have a certain disease, or to a community organization that provides peer support. Or we can help them gain access to exercise or healthy food. Even to help them with getting additional support from their own family.”


Effective Health Literacy Education

  • Personalized and engaging
  • Addresses readiness for behavior change
  • Applies principles of motivation for goal setting
  • Activates participants
  • Sets concrete, feasible goals
  • Promotes follow-up for sustained behavior change
  • Provides community resources for support

4 Things to Remember:

  1. Health literacy is a major problem in the US.
  2. Improving health literacy benefits everyone.
  3. We need a multi-faceted approach.
  4. There is no quick fix — but there IS hope.

Dr. Rothman:
“Health literacy is a major problem in the United States. We have at least 90 million Americans with only basic or below basic literacy skills. Even patients with good literacy skills can struggle to navigate what’s become a very complex healthcare system when trying to take care of their health or the health of their family.

We have found that by addressing health literacy issues, we can improve care for patients with low literacy. Studies have suggested that using good forms of health communication and addressing health literacy can even improve knowledge and behavior for people with high health literacy. So improving how we educate and communicate can be of great value to everyone.”

Dr. Primack:
“There are so many challenges here. If it were easy, we wouldn’t have 90 million Americans with low health literacy. But I think that it’s important to end on a positive note and say that we really are moving the needle. There have been studies that show that using the kind of principles that we talked about today really do help and change people’s lives. I think that that is what we need to hold up as we move forward.”

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Can Anyone REALLY Lower the High Costs of Healthcare?

Yes — but the solution may surprise you.
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You can’t control many of the factors that contribute to high healthcare costs: expensive drugs, the cost of providers, rising insurance premiums. It may seem like there’s not a lot anyone can do, other than pay up. So what can you do?

On the surface, the solution is simple. Less illness. Fewer claims. Better use of the healthcare system. Easier said than done — but it can be done. How?

By improving health literacy, or the ability to understand and act on health information. Sign up for our free webinar and we’ll show you how.

Register now! Improving Health Literacy: What Works & What Doesn’t. Wednesday, October 3, 2018.

Consider the facts:

  • 1 in 3 Americans can’t read a drug label.
  • Only 15% of adults with low health literacy know how to find good medical info online.
  • People with low health literacy are more likely to go without flu shots, mammograms, and other preventive care.

Knowing what to do to prevent chronic disease, how to take medications, and where to go when you’re sick — and acting on that knowledge — can have a huge impact on both personal health and the number of costly healthcare claims.

Low health literacy costs more. High health literacy costs less.

How do you improve health literacy?

Learn how by signing up for our free webinar! Join health literacy expert Dr. Russell Rothman and gamification guru Dr. Brian Primack as they discuss real-life strategies for improving health literacy. Find out what works — and what doesn’t.

Improving Health Literacy: What Works & What Doesn’t
Wednesday, October 3, 2018

Register now! Improving Health Literacy: What Works & What Doesn’t. Wednesday, October 3, 2018.

Even if you can’t make it, sign up anyway. We’ll send you a recording of the webinar. Invite your friends, too — and anyone who could benefit from lower healthcare costs!


Brian Primack, MD, PhDBrian A. Primack, MD, PhD
Dean, University Honors College
Professor of Medicine and Pediatrics
Director, Center for Research on Media, Technology, and Health
University of Pittsburgh

Dr. Primack has received many awards for research, teaching, and overall achievement, including the highest awards for emerging researchers offered by the Society of Adolescent Health and Medicine and the Society of Behavioral Medicine. His TEDTalk, “Staying Healthy Might Be All Fun and Games” — given at the 2014 TEDMED conference in San Francisco — shows how video game principles can inspire changes in health behavior. His work has been cited in international news publications like The New York Times, NPR, U.S. News and World Report, the BBC, and The International Herald Tribune.

Russell L. Rothman, MD, MPPRussell L. Rothman, MD, MPP
Vice President for Population Health Research
Director of the Center for Health Services Research
Vanderbilt University Medical Center
Nashville, Tennessee

Dr. Rothman’s research focuses on improving care for adults and children with diabetes, obesity, and other chronic diseases. His work addresses health communication, health literacy and numeracy, and other social and behavioral factors to improve health. He has been the Principal Investigator on over $50 million in funded research and has authored over 130 manuscripts.


Fred S. GoldsteinFrederic S. Goldstein
President and Founder
Accountable Health
Jacksonville, Florida

Fred’s consulting practice focuses on Population Health and the intersection of health system design, data, and analytics and behavior change. He serves on the Graduate Faculty of the John D. Bower School of Population Health at the University of Mississippi Medical Center, the editorial board of the journal Population Health Management, the founding Advisory Board of Population Health News, the Best Practices Review Panel for the Institute for Medicaid Innovation, and as a judge for the Health Value Awards.

Register now! Improving Health Literacy: What Works & What Doesn’t. Wednesday, October 3, 2018.

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