The Newest Health Tracker is a Mirror

Smart refrigerators, smart thermostats, smart toothbrushes – everyone is trying to create new digital health markets. While intriguing, it is sometimes hard to see how they will improve my health or quality of life. Until now: Sandra Rosenbluth, a student in Mobile Health Design, is revolutionizing the mirror.

Everyone has a mirror; they vary in size and quality, but none are smart until now. And smart in a way that might change how people think about diet and fitness, moving away from weight or BMI as a measure of success or failure.

Sandra describes how she conceived of the SmartWatch Mirror and how it works:

I was scrolling through my Facebook news feed one day, when I read a status that truly horrified me. A friend had written, “Since I started working out, I feel better and look better, but my weight on the scale hasn’t gone down, and I feel really sad.” This statement really stuck with me, even more so when she admitted she was addicted to her scale and couldn’t possibly throw it out. Therefore, when the time came to think of a smart device for my Mobile Health Design final paper, I designed the ShapeWatch Mirror.

The idea behind the ShapeWatch Mirror is straightforward: You can’t always rely on a scale to tell you whether a new diet or exercise plan is working, so rely on your mirror instead. The ShapeWatch Mirror has the ability to take a photo of the user, which it then sends to a phone or tablet. A contour outline is drawn around the outside of the user’s body, making a trace of his/her shape. That contour line can be merged onto previous outlines, showing the user exactly where his/her shape has changed. In other words, while the scale might show the same number, the contour lines can show loss of fat in the midsection and gain of muscle in the arms.
Using techniques I learned in Mobile Health Design, I was able to show how the ShapeWatch Mirror was truly aimed at its target audience by creating sample personas of potential users. By comparing the mirror to other smart devices, I was able to show how it utilized previous devices’ strengths, like tracking, while discarding weaknesses, like relying on weight as the sole measure of progress. Together, these techniques helped me design a strong product. To learn more about the ShapeWatch Mirror, read my full paper.

September 24, 2014 at 6:41 pm 2 comments

Why the #ALSIceBucketChallenge Went Viral: Almost the Perfect Storm

The ALS ice bucket challenge, better known as #ALSIceBucketChallenge or #icebucketchallenge, was almost the perfect storm for viral fundraising. In my course, Designing Health campaigns Using Social Media at Tufts University, we analyzed why the challenge went viral.

Not surprisingly, given its popularity, my students had all heard about it and watched challenge videos. About half had done it. Some researched amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, and including what they learned in their videos. While my students’ videos were undoubtedly shared, they did not have millions of views. The three most popular videos that I found in a search each had over 19 million views. Most popular was The Simpsons, an animation. Second was a compendium of fails, which included people who were supposed to pour water on someone and accidentally poured it on themselves. Third was Bill Gates, pulling the rope of a device he designed to dump water on himself.

The challenge videos were not only popular and entertaining, but resulted in a significant increase in donations. The ALS Association has received over $100 million from more than 3 million donors. They raised only $2.8 million in the same period last year hence had a 3,504% increase. Notably, the challenge was not started by them but by a person with ALS, 29-year old Peter Frates. A Boston-area resident, he posted his ice bucket challenge video on July 31 and the challenge spread mostly through the month of August 2014.

Time Magazine reported, “The Ice Bucket Challenge has been a social media phenomenon, grabbing the attention of millions of Americans including many celebrities and political figures. Some have speculated that it might forever change the way charities approach fundraising.” Bearing out that it was a social media success was not only video views but tweets. There have been more than 4.2 million tweets about the challenge, peaking at 1,877 tweets per minute.

An analysis of 1,500 randomly selected videos found that 20% of participants took the challenge indoors; 30% of participants were female; in 53% water was dumped by someone else; 26% of participants didn’t mention ALS; and only 20% of participants mentioned donating money. Given that many people used #icebucketchallenge without ALS in the hashtag, they may not have even connected the challenge to the disease. This is similar to Movember, which many men, including two of my students, participated in without knowing it was for prostate cancer and other men’s health issues.

The main criticism of the challenge was that it is an example of “slacktivism” in which people are more interested in bringing attention to themselves than to a cause while ostensibly participating. Other criticisms were that so many participants didn’t mention ALS, the waste of water, especially where there are droughts, and the lack of information about how the windfall will be used. In fact, the detailed analysis of where the ALS Association spends money was in Personally, what I thought was missing was more information about the disease itself, including advice on how to help people with ALS and their caregivers.

The main benefits are the increase in donations and the greater awareness of ALS. Possible side effects are that many people shot and uploaded a video for the first time, making it more likely they will do so again, and that some participants may have engaged in fundraising for the first time. However, does this mean they are more likely to again?

Undoubtedly every health organization is hoping to capture some part of the success of the challenge to increase donations and awareness of their health issue. The copycats are emerging, an example of which is Doubtfire Face for Suicide Prevention: Started by a supporter of the American Foundation for Suicide Prevention, it honors the late Robin Williams by replicating his pie-in-the-face scene from “Mrs. Doubtfire.“ Another one also uses a pie: Eat Pie for HI (Hyperinsulinism is abbreviated HI). And there are others, many involving a video and hashtag.

My students and I discussed why the challenge’s viral nature may be hard to replicate: fatigue, lack of novelty, and the difficulties of orchestrating virality. Fatigue is already occurring with the ice bucket challenge even though new videos are still appearing, albeit at a much slower rate. People like novelty and have limited attention spans, which is why the Livestrong yellow wristband spread until a rainbow of bracelets for every cause saturated the market. Another reason that the challenge may be hard to replicate is that it was not planned by the ALS Association but was something a person with ALS did that caught people’s attention. Most of what goes viral in social media is not orchestrated.

The challenge was almost the perfect storm. The factors contributing to this were:

  • The 24-hour time period to complete the challenge so little time for procrastination
  • Hot summer weather made it fun and refreshing to complete the challenge, reminiscent of childhood fun
  • Many people are on vacation, or have more flexible schedules, in August when it peaked
  • The challenge had very simple rules, low cost, and low risk making it easy to complete
  • At the same time there was a little vulnerability in appearing in a video and doing so under sub-optimal but not embarrassing circumstances
  • It could be done by all ages and abilities
  • The challenge connected people through the challenging process as well as the sharing of videos, in fact, many did the challenge with another person pouring or in a group with friends or colleagues
  • There was room for creativity, humor, and personal expression in how the challenge was completed yet also room to make a statement about ALS
  • ALS is a disease affecting as many as 30,000 Americans so most people participating in the challenge probably don’t have ALS or know anyone with ALS and can participate in a light-heartedly way that might not work for a more common or better known disease.

The ALS Association didn’t provide instructions, but did offer their thanks for donations and posted two warnings. One was that the challenge “may not be suitable for small children, the elderly, anyone in poor health or animals.” The other suggested thoughtful water usage.

What is next? As one of my students questioned, will the challenge migrate to the Southern Hemisphere as cooler weather arrives in the US? Can all these factors come together again and can a viral campaign be planned by a health organization? Probably not, because so many factors came together and contributed to the challenge’s success. Given the likelihood that health organizations are planning campaigns, they may achieve better success by working with, and supporting, the efforts of individuals like Peter Frates. My hope is that new campaigns have a great focus on awareness and prevention, and on how to help people who have a disease like ALS and their caregivers, not just on donations.

September 23, 2014 at 9:01 pm 1 comment

Preventing Workplace Bullying: An Interview with Greg Sorozan, Massachusetts State Coordinator of The Healthy Workplace Bill

“Bullying is part of the spectrum of abusive behaviors that exist in this world. I know about child abuse, child neglect, sexual abuse, domestic violence, substance abuse, and now adult abuse at work. They all work together to create many, if not most, of the health and mental health problems we have,” said Greg Sorozan. Greg is President of SEIU/NAGE Local 282 and Massachusetts State Coordinator of The Healthy Workplace Bill, working to prevent bullying in the workplace. I read about his work in a Boston Globe article and his MA legislative activity and asked to interview him about his work as a patient activist.

Lisa Gualtieri: Why did you become a patient activist?

Greg Sorozan: I was bullied at work more than 20 years ago.

LG: Was there a specific incident or series of incidents?

GS: The mistreatment caused one half of the Work Unit to quit. Productivity went down. My job duties (Sr. Training Coordinator) were changed almost daily. Resources and time were denied me. My health started to be effected. Sleep became difficult.

LG: What were the steps you took?

GS: My Union had no contract language to deal with the form of discrimination and abuse that was being perpetrated. Because I was in the rare position of knowing everyone in the administration of the large state agency, I forged alliances with people who would listen and who had a vested interest in the success of our Unit – in Legal, Policy, Finance, IT.

LG: Were there barriers such as stigma or privacy at specific points that you had to overcome?

GS: “Chain of Command” was the first and foremost barrier. Orders came from the Director/Bully. To not follow these orders was tantamount to insubordination. Only when “orders” were shared with other parts of the agency did Administration look differently upon this person. An example is how I was brought in, late, to consult with the “Developers” (Deloitte & Touche) on their newly designed Training Registration System. They wanted my “input”. I told them it would not work and why. I then asked them why they had designed it in the particular way. I was told that my Director had been insistent upon it. My response was: “This is why it is wrong”. The project was never completed. It cost the Commonwealth about $1 million in developer’s fees. There were other projects-all ruined by this person.

LG: What have you done that has the greatest impact?

GS: I am a social worker at heart. I’ve allied with the two most influential people in America on the topic of Bullying in the Workplace: Gary Namie, Ph.D.,(The Workplace Bullying Institute, Bellingham, WA.) and Professor David Yamada, Suffolk Univ. Law. (Minding the Workplace blog). With their guidance and help I found language to deal with Bullying in the Workplace. I negotiated that into our Contract Bargaining Agreement with the Commonwealth of MA., and have helped hundreds of people over the course of the last five years. Concurrently we have drafted legislation and have introduced that legislation for adoption into Law. We will not stop until the Healthy Workplace Bill is passed. You can ask any of the 5000 Healthy Workplace Advocates who have joined with us in working to get the law passed.

LG: What are the mechanisms you use, such as speaking, writing, and social media, for communication and outreach?

GS: We have developed a core team of talent who reach out to the public via social media, the web, and person to person. Meetings, training workshops and informal gatherings continue to be planned. Our website: is the primary attractor of people looking for help and understanding of what they have been experiencing in the workplace. We are continuing to involve Advocates in activities designed to spread awareness and educate others – including their legislators.

LG: What are the primary sources of satisfaction you experience related to your activism?

GS: My affiliations with Gary Namie, David Yamada, Deb Falzoi, and others (my NAGE brothers and sisters) who help me to keep my focus in a violent world.

LG: What are the primary difficulties or frustrations you experience related to your activism?

GS: We’ve introduced the Healthy Workplace Bill three times. January 2015 we will do so again. Getting a law passed is not as simple as it appears. Politics does not take a straight line toward enactment. I have several paid lobbyists at my disposal. They’ve given me quite an education.

LG: What do you think could help non-activists voice their innovations and experiences on health care issues relevant to themselves?

GS: My first thought is to develop a website that would serve as an “exchange” for ideas and problem areas. Get people communicating and learning that they are not alone. Develop opportunities for others, with resources, to join/guide/support and help foster needed changes.

LG: What advice would you give to patients who are not currently activists?

GS: It helps your recovery to actively participate in activities that promote positive change.

LG: What do you believe organizations could do to engage non-activists to provide feedback on and promote healthcare innovations?

GS: Develop models for outreach and ideas from the public. Actively solicit responses while understanding that some people are more deeply effected than others by traumatic events.

LG: What could organizations do to more effectively promote initiatives to patients?

GS: Change the “frame” away from patient to more of a “fellow journeyer”.

LG: What do you see as the ultimate measure of your impact in terms of the number of people you reach or the changes resulting from your work in people’s lives, in health policy, and in medical practice?

GS: Gary Namie’s meta-research shows the promise of great savings in health care costs, increased productivity at work, more creativity, and lots of other great stuff whenever people like doing what they are paid to do! I’ve personally seen that all happen, already, with groups I have helped. I believe that Bullying is part of the spectrum of abusive behaviors that exist in this world. I know about child abuse, child neglect, sexual abuse, domestic violence, substance abuse, and now adult abuse at work. They all work together to create many, if not most, of the health and mental health problems we have. I think that our society needs to take a step back and be more civil. Easily said. Makes me think of the search for the unifying particle in Physics. Lots of theories, but at least they are looking for a unifier.

September 5, 2014 at 6:22 am 1 comment

Interview with Jessie Gruman: “We want to get better and get back to our lives”

Jessie Gruman, who sadly died July 14, 2014, was someone I greatly admired as a person and as a patient activist.I interviewed her in late April for research I was conducting on patient activism, and she graciously allowed me to publish the interview, wanting, not surprisingly for those who knew her, to do everything she could to use her experiences to help others.

Lisa: Why did you become a patient activist? Was there a specific incident or series of incidents?

Jessie: I worked on patient engagement for many years prior to speaking as a patient. My original impetus to work on these issues was probably receiving my first diagnosis of cancer at age 20 and being shocked at how non-compliant I was, even though my best chance of surviving depended on me behaving myself. How could this be?

I didn’t feel particularly pressed to speak from the perspective of a patient until my third cancer diagnosis in 2004, when I realized that the patient voice I was hearing in the media and around health care was unrealistic and tended to depend on war metaphors. Those patients who were speaking out with their “can-do” attitude based on limited experience with serious illness  in no way represented my experience of having to work so hard to find the right care for me and to go through difficult surgeries and treatment regimens while feeling really bad and wondering if I was going to live.

I was astounded at how much of my care I had to organize and direct – more with each of my five cancer diagnoses. How do people who know less and have fewer resources manage this? It was this astonishment – and my realization that our ability to engage effectively in our care constitutes an equity problem for all of us – that motivates me.

Lisa: What were the steps you took?

Jessie: I started an organization with unrestricted support from the John D and Catherine T MacArthur Foundation to address these concerns. I have been successful in raising over $27m of mostly unrestricted money for this organization.

Lisa: Were there barriers such as stigma or privacy at specific points that you had to overcome?

Jessie: I have always believed in “in for a penny, in for a pound,” i.e., if I am going to speak as a patient, nothing patient-y is off the table.

I think many patient activists are by definition undervalued and their knowledge under-rated. I have spent my entire career working in and around health policy, health voluntary organizations, the NIH, AHRQ and the IOM. While not deep, my knowledge of the processes of medicine and health care and training and publishing, etc., is broader than many health experts and I am a good arguer and formidable patient representative. Just ask around.

Lisa: What have you done that has the greatest impact?

Jessie: To frame patient engagement as an equity issue.

Lisa: What are the mechanisms you use, such as speaking, writing, and social media, for communication and outreach?

Jessie: CFAH (my organization) has run the Health Behavior News Service since 1996. Working with the print, digital and broadcast media, we raise the visibility of new peer-reviewed research findings relevant to people making decisions about their health and health care. I did a lot of public speaking (20-35 speeches/ year) until my most recent diagnosis. I maintain a daily curated Twitter feed on the topics of equity, evidence and engagement and have an active presence on Facebook and LinkedIn.

Lisa: What are the primary sources of satisfaction you experience related to your activism?

Jessie: Knowing that I’m right.

Lisa: What are the primary difficulties or frustrations you experience related to your activism?

Jessie: Knowing that it doesn’t matter whether I’m right or not to the people who are shaping health care today. Patient concerns are – rhetoric to the contrary – simply a low priority for the delivery of health care except for those deluded souls who believe that health care will be cheaper if we patients are more engaged, i.e., the more risk that can be shifted to us, the more likely we are to refuse expensive care. This isn’t going to happen and is also frustrating: being engaged in one’s care doesn’t mean compliance with it.

Lisa: What do you think could help non-activists voice their innovations and experiences on health care issues relevant to themselves or to government agencies or health-related organizations including the “patient voice”?

Jessie: I think a post-visit questionnaire like I get from Open Table for every restaurant reservation would help people feel like they have an opportunity to contribute to change that matters to them.

The vast majority of us have no interest in changing “the system” or our hospital or even our clinic. We just want our doctor to call us back when we are worried about a rash from our new medication or get a prescription re-fill without having to go into the clinic again. Really – most people aren’t interested in being a patient voice. We want to get better and get back to our lives.

Lisa: What advice would you give to patients who are not currently activists?

Jessie: Find the right doctor or nurse practitioner to work with you. Negotiate a care plan that you can follow and if you can’t figure out how to check in with your clinician. Feel better.

Why should anyone aspire to become an activist? I would never encourage anyone to do so.

Lisa: What do you believe organizations could do to engage non-activists to provide feedback on and promote healthcare innovations?

Jessie: Who cares about healthcare innovations? Most of us are mostly healthy most of the time. Going to the doctor constitutes quite enough innovation, thank you. We don’t know what’s new and what’s old and it doesn’t concern us. We have other things to do, like work, play with our kids, go shopping, and fix the truck. We want experts—professionals—to use their expertise to help us get better. Expecting me to help health professionals to do their job more effectively unfairly presumes my interest, devalues my time and asks me to provide charity for them.

One of the biggest problems I have observed with those who are smitten with “the patient voice” is a tendency to want to rely on the least powerful and least educated involved in health care to solve their problems.

Lisa: How could organizations more effectively promote initiatives to patients?

Jessie: I don’t want an initiative. I want the right information and the right care and then I want to go home and not think about the doctor until I get sick again.

Lisa: What do you see as the ultimate measure of your impact in terms of the number of people you reach or the changes resulting from your work in people’s lives, in health policy, and in medical practice?

Jessie: There is no ultimate measure. My role is to represent a realistic view of what it is like to be a patient these days so that stakeholders who say they are interested in patient-centered care (or reforming care in the direction of serving patients generally) can respond to solid information / data rather than this odd collection of notions that all we need is a good pair of Jimmy Choo stilettos for our chemo treatment, and with our sense of social commitment intact, we’ll conquer even the most fearful, tedious, painful conditions, bend the cost curve and solve the problems that have eluded experts for all these years.

My role is not to find other stakeholders’ solutions. In a market economy, I am the customer.

My job as someone who wants people to be able to get better value from their health care is to describe what it now takes for me and my fellow patients to find good care and make the most of it: what barriers and limitations we face and what skills and resources seem to be required to overcome all those obstacles…and then ask / beg / beseech / make the case that the different stakeholders with their different domains of accountability and expertise address these deficits.

July 22, 2014 at 7:44 am Leave a comment

Happy Father’s Day. Here’s a Fitbit.

Father’s Day ads, cards, and store displays are everyplace. Now many retailers are pushing activity trackers as the perfect present, such as the Fitbit, the Nike+ Fuelband, and other device. They track number of steps taken per day and more. But, is there any stigma associated with gifting an activity tracker with the implication that the recipient is out of shape? Is there any difference in usage patterns between activity trackers purchased for oneself or given as gifts?

The Mobile Health Design class at Tufts University School of Medicine investigated the question: How do we market these gifts so they are meaningful, cherished, and used? They found three theory-based categories to help market fitness trackers for dads:

Emotional Appeal: Dads are especially sentimental around Father’s Day. There is an opportunity to show a father how valuable they are in their family’s life. Just like they kept their children safe and active while they were young, it is time for them to remain safe and active with a fitness tracker.

Social Support: Have bundled trackers so child and father can both participate together. People are much more likely to engage in a behavior if others around them are participating – especially when it is competitive, like between a father and child!

Instrumental Support: Purchase an activity tracker with equipment for an activity that the father enjoys – golf clubs, a new bowling ball, or new running shoes. It will reduce the barriers for engaging in activity and both tools will reinforce each other’s use.

Bradley Moore, MPH, co-course director for Mobile Health Design, culled these from the responses to the “challenge” we gave students in class. (Thanks, Bradley!)

My idea was to bundle activity trackers with Father’s Day cards: Remember when we used to _ (hike, go to the playground, …) Dad? Let’s go for a walk together!

Overall, activity trackers are like many products where the manufacturer’s goal is to sell as many as possible. What we like to think about is behavior change, how people will respond to the gift and what they might do with it the first time they use it – if they get to that point. One student told us about a Fitbit that was about to be regifted, collecting dust in the unopened package. That’s what our challenge – and the great ideas students had – hopes to avoid.

June 11, 2014 at 5:49 pm 1 comment

Everyone has a wonderful story but not everyone knows how to tell it: CancerForward survivor stories

Many health websites include stories, but some have richer sets of well-written stories than others. After seeing the stories in CancerForward™, I spoke to Beth Sanders Moore, the founder, to ask her why they include stories and how they solicit them.

ImageBeth (left) is herself a thirteen-year breast cancer survivor, her mother is a thirty-two-year breast cancer survivor, and her grandfather was a cancer survivor. Through these experiences she has seen how the experience of being a cancer patient has changed, with people asking questions and evaluating treatment options now in a way they didn’t even thirteen years ago. Beth has also seen a change in what survivors want, and CancerForward was created to meet this need, with survivorship stories being one of the most important components, both for the people who read them and those who tell them. Beth sees many ways that people try to make a difference – volunteering, making donations, or telling their story – and all provide a way to give back or pay it forward.stories in CancerForward™, I spoke to Beth Sanders Moore, the founder, to ask her why they include stories and how they solicit them.

Since people are drawn to celebrities, the stories include those of high-profile survivors, like Cokie Roberts, but most of them are of people from all walks of life who have survived cancer. Having seen that the site includes a link to “Share Your Survivor Story”, I asked Beth about their process. When someone contacts them through this form, a writer works with them to help them tell their story. Beth said that some people submit stories that need little editing, while others need assistance because they don’t know how to express their experiences clearly or they become too caught up in emotions when recounting their story.  Beth said that people process their experiences differently:  some tell their stories soon after treatment, and some wait a long time into their survivorship.  The completed stories are catalogued on CancerForward’s site by both cancer type and by practical, physical and emotional issues common to most survivors.

Interestingly, many stories shared with CancerForward are sent in the evening.  Beth suspects that with fewer distractions of daily life, most people have more time for self-reflection at night and may also grow lonely and want to reach out by sharing their stories.  She notes that far more people go on the CancerForward site and read stories than submit them.  Some begin the “share” process and don’t finish it.  The average time a site visitor stays on the site is about five minutes; some are less than a minute and some are for hours.  If site visits are an indicator of popularity, the stories of high-profile women survivors are most popular, followed by the self-written stories submitted by women.  That trend tracks with survivorship information consumption in general, says Beth.  Historically, women discuss their experiences more openly and more often than men.

I asked Beth how many story inquiries they receive and she said 2-4 every month on their website.  Many comments posted in connection with a story are essentially mini- stories. CancerForward maintains its Facebook page so that survivors and caregivers can make comments and/or post their stories there.  I asked Beth if she thought people had stigma or privacy concerns about submitting stories, and she said that she thought it was a very individual decision to share a story although less likely  in some cultures than others. She further thought that people feel good about sharing their story and receive support from others through the comments.

CancerForward-Website-young-adult-cancer-survivor-Tony-QuinnWhen asked if time and money were infinite what CancerForward would do differently, Beth immediately said they’d add more video stories, which people enjoy.   Producing high quality videos is costly, which has prevented CancerForward from creating as many as they would like.  Because of the uptick in smart phone video production, there is a project underway in 2014 to accommodate appropriate “selfie” videos and brief self-written stories on the CancerForward site.  Because the amount of the site’s educational information and story lines has grown so rapidly, CancerForward  is reworking its entire site to make navigating the site and locating content easier for visitors.

Beth and I discussed how every story has a message. Cokie Roberts’ message was that cancer was not going to stop her. While at one point CancerForward considered letting people create blogs on the site, they ultimately decided that blogs are too personal and detailed while the stories convey a clear message and are more hopeful. In our discussion we identified a taxonomy of health sites that incorporate stories. They range, at one extreme, from sites that request stories but have none displayed, to, at the other extreme, Weight Watcher’s success stories, which are very professionally done. CancerForward’s stories are near that end, because of their use of writers to work with people. Beth concluded, “Everyone has a wonderful story but not everyone knows how to tell it.”

I asked Beth if she has a favorite story on the site, a question for which she said there isn’t a simple answer. At one time or another, she’s read every story that’s been submitted whether it made it through the publication process or not. “They’re not all upbeat or hopeful, but they’re all real and to me, compelling.  There are so many, many facets to cancer survivorship and contexts in which people fight cancer.”  Beth admits that for inspiration, she’s drawn to the stories of adolescent and young adult survivors who’ve readjusted their sails, succeeded in forging a “new normal” in their lives, and are moving forward.  And, she concedes there is a story that she thinks about often that speaks to resilience and facing reality.  It’s the last conversation Beth had with her friend, Elizabeth Edwards about two months before Ms. Edwards died of breast cancer.  Believing it important that survivors speak openly about palliative care and preparing for death, Ms. Edwards allowed Beth to publish their personal conversation as a story for CancerForward.  It turned out to be the last “interview” Mrs. Edwards would give about her cancer and her life.

February 19, 2014 at 2:46 am 2 comments

5 Minute Social Media Makeovers: Stepka Family Dental

I presented 3 workshops on Social Media for Dentists at Yankee Dental Congress 2014 in Boston, where I met Joanna Stepka, who was at my workshop to learn more about how to use social media for her husband’s dental practice. Like most people in the workshop, she had a smartphone, but, unlike many people there, she was using it to tweet during the workshop. Impressed that she was live-tweeting during the workshop, I looked at the online presence of Stepka Family Dental after the workshop. Here is my 5 minute makeover.


Stepka Family Dental’s Facebook page had a “vanity url”, namely Easy to do, but not all dental Stepka Facebookpractices do it. The first time I looked the cover photo was bland but the new one (right), updated 2 days after the workshop, is great and I assumed was inspired by what I taught. The pictures are clearly not stock photos, which I recommended dental practices avoid because they are so bland, but ones of the staff.

Could this be improved? In the workshop I showed sites that use group shots instead of individual ones. The individual photos, however, are easier to update if there is turnover. I like seasonally appropriate imagery and these look like they were taken outside in the summer, not recently. Overall, they are great pictures and the staff look competent and approachable, which is what you want in a dental practice.

The branding for the practice is clear. The tagline is “Providing dental excellence to Rhode Island families since 1973. We specialize in treating your family like it’s our own.” It is a little long but welcoming and establishes credibility by showing that this is an established practice.

The Facebook page has 341 likes, which is much better than most of the dental practices with a Facebook presence that I showed during the workshop.Stepka signI suspected that the practice must inform patients that they are on Facebook. (In fact, Joanna emailed me the new sign for the waiting room, which is included to the right.)

The Facebook posts are of an appropriate frequency – around 6 a month at a glance. They do not seem to be on a schedule, but rather are occasional updates about office activities, seasonal information, and some dental humor and education. Some of the posts have likes and comments, showing that people are engaging with the content.

The website and other social media

The blog leads to the website, which has more information on the practice, the staff, testimonials, and work in the community. The other forms of social media are depicted with icons, including Google+, Pinterest, and Twitter. The website highlights the recent Facebook posts, which is great for letting patients know not just that Facebook is used but what is posted, which is more enticing than an icon.Stepka twitter

Of the other social media platforms, Twitter is the most heavily used after Facebook and, on the website the icon for Twitter should not be last since it is updated frequently. The profile on Twitter (right), “Providing dental excellence to Northern Rhode Island families since 1973,” a truncation of the Facebook tagline that maintains the consistent branding. The image is, I understand from Joanna, in the process of being updated. Currently there is text over text, which looks sloppy.

The tweets are great – like the Facebook posts, they are interesting, diverse, and quite human, which is very appropriate for a family dental practice. The frequency is a bit sporadic, but there are at least a few tweets every month, so anyone looking would never feel like it was an abandoned account (I had examples of those in my workshop) or one not worth following. There are fewer followers than on Facebook, so there are opportunities to inform patients about the account when they are waiting for or leaving an appointment or in any emails sent out. Also, some professional Twitter accounts will indicate who is tweeting, which Joanna might consider.


The other social media, besides Facebook and Twitter, seems more experimental, like Pinterest and the blog. While there is some overlap between what is posted on the different platforms, the messaging is never exactly replicated, which is good. And experimentation is good, not just from the perspective of what Joanna tries, but from that of seeing what reaches and appeals to their target audience. Certainly it would be better if the website and all social media used the same name, Stepka Dental or Stepka Family Dental, and the same banner imagery, but each type of social media has restrictions and limitations, making it hard to replicate branding.

While the posts and tweets were varied and interesting, more on the staff might be of interest. Even the fact that staff were at Yankee Dental Congress could be highlighted, since patients want their dentists and hygienists to be current in their knowledge. Other opportunities are to provide some additional educational materials targeting the needs of the different age groups they see, since it is a family practice, and to include more images  of the staff. They should consider featuring some patients, with permission, in short videos or pictures, and even add pictures where possible to the testimonials. These images could replace the stock photos currently in use on the website. Given that the posts have personality, the images should too. Since they are involved in the community, more of that would give “human interest”. They could consider the use of a quarterly newsletter or eCards sent by email for patient birthdays or for holidays like Valentine’s Day with dental care messages.

Finally, in a search on “North Smithfield dentist” they came up high, so clearly what they are doing is resulting in good visibility in search results. Their steady use of multiple social media platforms can only help with visibility. I say this without knowing their goals, their other forms of promotion, or their metrics.


My overall impression is very positive. Without knowing the Stepka photopractice’s goals, but assuming that they are trying to attract new patients and to keep current patients engaged and educated, I think they are doing a great job. I heard from Joanna, who is shown here with her husband, Dr. Greg Stepka, “I was definitely inspired by your workshop and knew that I could ‘tidy up’ our social media fairly quickly. I plan on implementing e-newsletters and inviting patients to follow our social media as well. I started Pinterest & Google + after your workshop so those are in their infancy.” This ended up not being as much of a makeover but a commentary on what is clearly a work in progress.

February 5, 2014 at 9:38 am 2 comments

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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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