One or many; same or different? Optimizing a social media presence

MortonsNeuromaOne or many; same or different? These are the big questions in developing a social media presence especially for a small organization. A friend works at, and I looked at their website.
The Center for Morton’s Neuroma uses many forms of social media. The website displays an array of icons in the upper left for Facebook, Twitter, Google+, Pinterest, LinkedIn, and YouTube. Placement in the upper right is more typical, and, since they are only icons, there is no hint as to what you will see when you look at their social media sites. Besides the icons, there are tabs for testimonials and blogs. It seemed like a lot of social media!
The use of multiple forms of social media may increase the likelihood that someone finds the site through search or happenstance. At the same time, people are unlikely to follow all of these unless the content is quite different. This was confirmed by the number of likes, sharing, etc. that I observed. My overall sense was of considerable overlap and duplication.
The site has a link to Yelp but no reviews there, which was surprising since the site includes some patient testimonials. When I used “foot pain” for a search term and “Framingham, MA” for the location, they didn’t come up as a search result or paid ad, the former because they have no reviews, I suspect.
While how to find a provider has not been significantly advanced by social media, I wonder if the effort that went into social media could be better spent on a presence on review sites like Yelp, including asking subsequent people who want to provide a testimonial to do so on Yelp or Facebook.
Back to my original question: one or many; same or different? Most practices use too little social media or rarely update, but, for this center, my advice is fewer social media platforms with more distinct content. Repetition of content is never advantageous, but tailoring content to different platforms can be effective. My overall advice is to focus on more enticing use of Facebook and perhaps one or two other platforms; to encourage patients to provide reviews on Facebook and Yelp and remove the testimonial tab; remove the blogs and place that content elsewhere; and, finally, use likes, shares, and analytics to determine the types of content that are most popular and focus on those. Once this is all cleaned up, the center could consider an Ask the Expert column that people could submit questions to and that could be a way of linking to some of the more buried content.
Agree or disagree with my analysis?

March 21, 2016 at 10:00 pm Leave a comment

What are the Nutritional Needs of Cancer Survivors?

I am working with Fang Fang Zhang, MD, PhD, and other colleagues at Tufts University on the following study. The following is some information from Fang Fang about the survey goals and how to participate:

Cancer Survivors are highly motivated to seek information about food choices and dietary changes to improve their health. However, a recent study comparing cancer survivors’ dietary patterns to federal guidelines indicates that they often fall short. People who have survived cancer eat fewer green vegetables and whole grains than people without a history of cancer do. Survivors also weren’t getting enough fiber, vitamin D, vitamin E, potassium or calcium, and were taking in too much sugar, fat and sodium, as defined by the 2010 Dietary Guidelines for Americans issued by the Department of Agriculture and the Department of Health and Human Services.

Cancer Survivors Often Have Poor Diets, Which Cancer Affect Their Long-Term Health

What influences cancer survivors’ eating patterns?  The research team at the Friedman School of Nutrition Science and Policy of Tufts University is conducting a survey to understand cancer survivors’ nutritional needs and the challenges they are facing in making healthy food choices.

They Need Your Help! Visit to take a short survey (10 minutes) and contribute to this important research! Your support will help advance research to meet the nutritional needs of the growing population of cancer survivors.

If you have any questions or concerns, please feel free to contact the Tufts research team at, or through Twitter @CARE_study and Facebook (Cancer Survivors Heathy Eating – CARE Study).  Principal Investigator: Fang Fang Zhang, MD, PhD, Tufts University

February 10, 2016 at 1:12 am Leave a comment

Who are the Jailbitters and the Weapons of Mass Reduction: An Interview with Julia Ferguson about Workplace Wellness in Adams County, CO

As Fitbits and other wearable activity trackers become increasingly common for individual and group use, it is easy to wonder how successful they are at increasing and sustaining fitness. Kristen Daudelin and I were therefore excited to talk on June 25, 2015 with Julia Ferguson, Sustainability Coordinator at the Adams County Manager’s office in Brighton, CO, about the FitBitters Challenge program she coordinates for the county to use Fitbits to increase employee fitness. She told us about how her office set it up, what the County has learned so far, and how, part way through the initiative, the program has increased fitness, as hoped, and has also increased morale and comradery.

How the Program Started

The Office of Performance, Innovation, and Sustainability started planning in February 2015 and the six-month challenge launched April 1. The Office obtained roughly $15,000 funding to purchase the devices and incentives for the program.  The $100 Fitbit Flex were purchased for $80 each with a discount from Fitbit, and employees were asked to contribute $20 towards their portion of the device; the County covered the remainder of the cost.  Employees were also required by law to be taxed on the benefit, which was approximately another $20. Employees keep their Fitbit at the end of the program, or even if they drop out.

Employees were notified about the program, and a web form was available for signing up. When it was made available, at 8 am, 30 people signed up in 10 seconds. The cut off for signing up was at 120 participants, but 180 registered before the form could be shut down.

Employees were allowed to participate using their own device, resulting in 242 total participants in the Challenge, out of 1800-2000 employees (a number that fluctuates since some are seasonal). The only requirement, besides signing up quickly enough, was that employees had to be benefit eligible.

The County used a third party vendor for the pre- and post-assessments, which are optional, as required by their legal department. For the 188 participants who choose to have them, they record weight, BMI, body fat percentage, blood pressure, and waist circumference (how often are health assessments repeated, only beginning and end? Yes, just a pre- and post- assessment). The County receives aggregate data regarding the health assessments from a third party vendor in a HIPAA compliant fashion. Demographics of participants: 35 men and 153 women, most in their 40s, followed by 30’s, and then 50’s.

What Happened the First Three Months

Julia provided an orientation sheet for participants. She provided training as needed to help people to set up their Fitbits and encouraged them to join teams. They used Fitbit’s app (with their own branded site for the county? No, just the dashboard. Unfortunately at the time we started the program there was no way to brand it for corporate/company programs. I believe Fitbit is working on developing that capability. ) to set up their teams of 4-6, and over 200 of the 242 participants joined teams.

Over the past few months, Julia set up monthly challenges and sent out encouraging, lighthearted, weekly emails. Each competing group used a group page and a personal page. Several teams have very clever names, including:

  • Jailbitters (from prison workers)
  • Weapons of mass reduction
  • Fit to be fabulous
  • Thin to win
  • Lean and mean
  • Blister sisters
  • 6 ferociously fit females
  • Preventative maintenance (custodial workers)

How the Program Will End

Julia and her office’s efforts included everything from promoting the program, troubleshooting and training for participants, monitoring use, and planning incentives and prizes. Teams will have until the end of September until the competition closes and prizes are distributed.

Participants receive entry into prize drawings when certain challenges are achieved.  These challenges become progressively more difficult over time. Julia has noticed that people are not asking about the prizes but are instead self-motivated and encouraging towards others.

Forms of Assessment

The vendor is supplying reports of aggregate data while Julia is careful to make sure that legal and communication teams work together. So far, a few people have expressed concern and a few people have dropped out; the few people who have dropped out have done so because they have stopped working for the county such as for retirement. Only 3-4 participants have otherwise left.

What Julia Has Learned So Far

Julia personally has learned a lot in the process including workplace labor laws and HIPAA compliance. The Office of Performance, Innovation, and Sustainability is interested in individual versus group motivation and other intangibles, such as how to motivate and engage employees. Even though this is a voluntary program, Julia learned that she could not offer prizes for activities to ensure that everyone has the same opportunity to get prize entries.

On a larger scale the County has surmised that employees are very self-motivated. In addition to the tools provided through the FitBitters Challenge, employees are using mobile devices and Fitbit forums. Furthermore Julia notices colleagues walking more even when they aren’t participating in the program. People say that it is helping them motivate their families to increase their fitness and that they are meeting people at work they would normally not come in contact with, so there are social as well as fitness benefits. A post survey will include some of these less quantifiable metrics, also attitude workplace.

What Julia Would Do Differently

Adams County has learned several lessons in regards to effective pilot program implementation using ‘wearables’ that will inform future program development. More effective communication at the beginning about the web form and being able to stop it when the goal number reached is the first. Also, some people didn’t have the access to emails and couldn’t participate because they were not part of roll-out. Next time around, the County would utilize a dummy account so that the coordinator would not need to spend hours subtracting her own data as a participant for each group. For larger programs that are beyond the pilot phase and cost is not a constraint, other options include opening the program to all employees and hold more events such as a field day or nutritionist talks.

Advice from Julia

Julia had a lot of valuable advice for us. She told us to be careful when communicating about the intent of the program and deciding how devices are distributed. Due to the popularity of these devices, people may enroll and then lose interest in participating, so it is important to encourage people to enroll only if they will remain active participants.  She inferred that possible issues might be encountered outside the 18-34 age range when it came to troubleshooting the technology. Julia suggested reaching out to sustainability coordinators and asking participants for donations as well as reaching out to Fitbit in hopes of getting returned or unwanted Fitbits. Other suggestions included reaching out to Target, Sports Authority and Best Buy with a vinyl sticky that could go on cases of devices or electronic recycling programs. Julia also suggested reaching out to gyms.


Julia closed by saying that she was happy to share with others the cost effective $15,000 program that has had a huge impact on their county. Post assessments of health measures at the end of the program will provide more information about the value of the program in terms of reducing health care costs and improving health, but in the meantime employees are more motivated, more productive, and more active because of their participation!

My thanks to both Julia Ferguson, for her time, and Kristin Daudelin, my summer intern, for her assistance interviewing Julia and writing this with me.

August 12, 2015 at 7:01 am Leave a comment

This fall I’m a Tisch Faculty Fellow

I am honored to be selected to be a Tisch College Faculty Fellow this academic year. Jonathan M. Tisch College of Citizenship and Public Service is part of Tufts University. My initiative, RecycleHealth, is what I will work on as a fellow, and I believe it is public service. The goals of RecycleHealth is to collect unused wearable activity trackers from people who upgraded or are no longer using their devices, and give them to people who can’t afford them but are interested in increasing their fitness. We haven’t had our first meeting yet, but I am looking forward to it!

August 12, 2015 at 6:12 am Leave a comment

A Second Life for Unused Wearable Activity Trackers

If you have a Fitbit or other activity tracker and stop using it or upgrade, what do you do with the old one? There are few options to recycle or resell it. Enter RecycleHealth.

My hypothesis is that the people who are least likely to own wearables are those who might benefit most. I am requesting donations of unused wearables through RecycleHealth and then giving them a second life by using the refurbished, donated wearables in pilots with populations who rarely purchase and are unlikely to afford them.

RecycleHealth was described in the Boston Globe business section:

July 18, 2015 at 2:35 am Leave a comment

Emergency preparedness on campus: the amazing videos my students made

What makes an effective emergency preparedness video for college students? First, students have to want to watch it, then they have to like it enough to keep watching it, and finally they have to learn from it.

My students in Designing Health Campaigns Using Social Media conducted needs assessments that showed that videos needed to be short – generally under 1 or 2 minutes – and funny – but appropriately so. They also had advice from Mark Robertson that videos need a clear message and call to action.

Based on the plans they created, with goals, needs assessment, and competitive analysis, and having their choice of topic and tool, students created what I thought – and the class thought – were really effective videos. I was impressed not just by how well they handled their topics but by the creativity and unique approaches they used.

If you have feedback for them, please write a comment!


November 18, 2014 at 5:42 am Leave a comment

How to plan an emergency preparedness video for a university

Most people don’t think about the fine balance between making a point and entertaining people. Mark Robertson, Emergency Preparedness Coordinator, University of Nebraska – Lincoln (UNL), obsesses about it. He created a videos series for UNL Police on emergency preparedness. When preparing a lecture for Designing Health Campaigns Using Social Media at Tufts University, I looked on YouTube for examples of emergency preparedness videos from universities and started watching his. The animations are short, funny, and have a clear message.
Rather impressively, Mark creates the animations himself using GoAnimate in about an hour. He does the voice himself generally – which is why he sounded familiar when we spoke by phone. I asked him for advice for my students, and then realized this might be of broader interest.
Mark’s advice for planning emergency preparedness videos:
  1. Know what is the one message you want to get across.
  2. Humor is popular but it is dangerous too. If you are using humor, be certain that no one will take offense. Do not poke fun at students, faculty, or staff.
  3. Make your point and find a balance between making your point and entertaining people.
  4. Use sample audiences before publishing to make sure you aren’t hitting the wrong nerve and your point comes across.
  5. It is a challenge to get people’s attention for too long. Start out and pique people’s interest, and keep the video short.
  6. Even how you promote a video is important. Say something that piques their interest to get them to watch.
  7. Finally, be careful about your central characters because, if well-received, you will be stuck with them and may regret some of their eccentricities.

November 13, 2014 at 2:21 am Leave a comment

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Lisa Gualtieri, PhD, ScM

Lisa GualtieriLisa Gualtieri is Assistant Professor at Tufts University School of Medicine in the Department of Public Health and Community Medicine. She is Director of the Certificate Program in Digital Health Communication. Lisa teaches Designing Health Campaigns using Social Media, Social Media and Health, Mobile Health Design, and Digital Strategies for Health Communication. Contact Lisa:


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