Italian Social Marketing Network Newsletter 156

 


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Background: The aim of the study is the application of the techniques and tools of social marketing to improve the awareness about HIV transmission and encourage young students between the age of 18 and30 to access at HIV testing given that 85% of new diagnosis in 2016 may be attributed to unprotected sex (Italian National Health Service ISS-2016). The number of young people that take the test is low, making the risk of late presenters much higher; for that reason a survey was addressed to a sample of 200 Alma Mater Studiorum students.
Material and methods: To realize the project’s goal we implemented a “Social Marketing Plan” in order to stimulate changes in the approach to the issue and induce changes in individual behavior; but there are still many barriers facing the achievement of this goal from lack perception of the risk and the stigma that the illness carries with it. To implement the study we planned a partnership with the “Plus Association” given their expertise in the execution of the “fast HIV test “and counselling in the “Blq Checkpoint Center” that was chosen as reference point for the students.The center is easily accessible by our target, guarantee the execution of the “fast HIV test” and counseling in a welcoming environment out of the hospital but in connection with the hospital for the “second level” assessments and treatments. Once the strategy was outlined, the next step was to reach the target, both, online and offline. Social networks were the “pillar” for
online promotion, must of all Facebook and the “testatHiv page” through which we shared “information pills” about prevention in formats easily to absorb. Moreover, the “TestatHiv page” was the promoter of the offline work; this consisted in face to face interviews with students between 19 and 30,who were asked the knew the difference between AIDS and HIV, the ways of transmission and if they had ever taken the test. The goal
of interviews was the highlighting of the poor knowledge about the issue, influence behaviors and stimulatestudents to go to the “BLQ  CheckPoint Center” and get tested. Most of the students interviewed showed a lack of knowledge about the prevention issue; the 73.3% of the students had never taken the test.
Results and Conclusions: Thanks to our initiative and the overtime opening of the “BLQ Checkpoint Center“to make easier access during the “European Testing Week”, 61 students under the age of 30 went to the “BLQ Checkpoint Center” to take the HIV test (29 heterosexuals and 32 homosexuals). The great increment
of accesses that went much further the “European Testing Week” showed that this Social Marketing Strategy is successful and can produce positive cognitive and behavioral changes in this specific target group.
A recent Fortune article on big data in healthcare quoted Dr. Brennan Spiegel, a physician-scientist at Cedars-Sinai Medical Center as saying, “Digital health is not a computer science or an engineering science; it’s a social science and a behavioral science,” in the context of a discussion on the hype-evidence gap in digital health. He tweeted the same line back in August, eliciting hundreds of retweets and shares.
Spiegel has cited his own failure experience from attempting to build health technology whilst not addressing behavioral factors like patient motivation, engagement, and long-term adherence. He has elaborated, “Creating the tech isn’t the hard part. The hard part is using the tech to change patient behavior.“ As behavioral scientists, we are encouraged to see increasing value placed on behavioral science in a space that has generally been a slow adopter of it—after all, chief behavioral officers in digital health companies are still unicorns.
Come per Uber nel campo dei taxi, le innovazioni Uber-like in sanità mettono a nudo l’incapacità e il ritardo del sistema – e soprattutto dei professionisti – nel venire incontro alle legittime esigenze degli utenti. Perché è così difficile contattare il proprio medico telefonicamente? Perché non è possibile comunicare con lui via email o via skype? Perché fare una coda e perdere mezza giornata per la banale ripetizione di una ricetta? Organizzazioni più attente all’innovazione – guarda caso diffuse proprio nei pressi della Silicon Valley, cioè in California – come Kaiser Permanente da anni hanno introdotto modalità di rapporto tra medici e pazienti più dirette e più comode, basate sull’uso delle tecnologie e di internet4. …Ma la medaglia di queste innovazioni ha l’altra faccia, assai meno amichevole e rassicurante. Quella della polverizzazione dell’offerta sanitaria in un caotico mercato sanitario, dove il basso prezzo delle prestazioni ha come corrispettivo il basso salario, talora lo sfruttamento, dei professionisti, dove overdiagnosis e overtreatment sono quasi sempre la regola, dove la qualità non è quasi mai controllata, dove si possono facilmente annidare frodi e abusi. 
3.3. Sprechi e inefficienze Dopo i riferimenti culturali che hanno caratterizzato la sanità degli scorsi decenni (efficacia negli anni ’70-’80, EBM e costo-efficacia negli anni ’90, qualità e sicurezza negli anni 2000), oggi la crisi di sostenibilità dei sistemi sanitari, in particolare quelli a finanziamento prevalentemente pubblico, impone di riconoscere nel value il driver della sanità del XXI secolo. Il value, definito da Michael Porter come il «ritorno in termini di salute delle risorse investite in sanità», risulta dal rapporto tra outcome di salute rilevanti per il paziente (esiti favorevoli – effetti avversi) e costi sostenuti e può essere stimato a vari livelli: intero percorso assistenziale, singolo intervento sanitario, tempo/uomo, etc.
“Le nostre stime indicano  che il 19% della spesa pubblica e il 45% di quella privata non producono alcun ritorno in termini di salute” Nino Cartabellotta – Italia oggi
Digital therapeutics are a new category of apps that help treat diseases by modifying patient
behavior and providing remote monitoring to
improve long-term health outcomes. These apps
can help hypertension patients lower their blood
pressure, reduce dependence on opioids for those
with chronic pain, and help diabetics monitor their
blood sugar.
“For blood pressure, diabetes, cholesterol, obesity
– lifestyle-related chronic illnesses – the foundation
of good care is behavioral change,” says dermatologist
Dr. Joseph Kvedar, vice president of connected
health at Partners HealthCare in Boston and a
board member of the Personal Connected Health
Alliance. Digital therapeutics is an especially powerful
tool when it sends personalized messages that
motivate people to make healthier choices, he adds.
The digital therapeutics market is forecast to
grow from $1.7 billion in 2016 to $9.4 billion by
2025, according to Grand View Research Inc. The
increase is driven by improving technology and
data algorithms, the openness of patients using and
wearing technology, and research showing the
e. ectiveness of technology in improving health.
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