Italian Social Marketing Network Newsletter 162 Marketing Sociale


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Italian Social Marketing Network Newsletter 161 Marketing Sociale


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Italian Social Marketing Network Newsletter 160


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Despite advances in behavioural science, there is no widely shared understanding of the ‘mechanisms of action’ (MoAs) through which individual behaviour change techniques (BCTs) have their effects. Cumulative progress in the development, evaluation and synthesis of behavioural interventions could be improved by identifying the MoAs through which BCTs are believed to bring about change…….. Conclusions: The BCT-MoA links described by intervention authors and identified in this extensive review present intervention developers and reviewers with a first level of systematically collated evidence. These findings provide a resource for the development of theory-based interventions, and for theoretical understanding of intervention evaluations. The extent to which these links are empirically supported requires systematic investigation.



Italian Social Marketing Network Newsletter 159


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In May 2018, the National Institutes of Health
(NIH) began enrollment for a vast medical research
cohort. Named “All of Us,” it’s meant to
include 1 million U.S. volunteers, who will be studied
over 10 years at a cost of $1.45 billion.
The project promises to “lay
the scientific foundation for a new
era of personalized, highly effective
health care,” a counterpoint
to previous “‘one-size-fits-all’ medicine.”
All of Us derives from a decade’s
worth of developments in
the research world. In 2011, the
National Academies of Sciences,
Engineering, and Medicine called
for a “new taxonomy of human
disease,” stating that “opportunities
to define diseases more precisely
and to inform health-care
decisions” were “being missed.”1
Five years later, President Barack
Obama launched the Precision
Medicine Initiative. The concept
was promoted by NIH Director
Francis Collins, who defined it
as “prevention and treatment strategies
that take individual variability
into account.”2 A bandwagon
effect followed, with marked shifts
in resources and attention toward
precision medicine.
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Italian Social Marketing Network Newsletter 158


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As AI becomes more pervasive in healthcare, can robots learn to show more empathy than doctors?

Except medicine requires more than just technical expertise: It needs empathy, too.

Empathy has been noticeably lacking in medicine as of late. In the past few decades, doctors have developed a reputation for being coldand aloof, for treating patients as numbers and objects, not human beings with valid lived experiences and unique histories. One of the most common complaints among patients today is the “clinical” attitude of their attending physicians. That word has become synonymous with detached, unempathetic, and impersonal treatment—everything many of us would much rather our attending physician not be.

The ECDC Fellowship Programme has the following programme objectives: To strengthen the surveillance and control of infectious diseases and other cross border health threats or  issues of public health concern in the EU/EEA Member States and at EU level, supporting the implementation of Decision 1082/2013/EU; To enhance response capacities for effective field investigation and communicable disease control at national and community level to meet public health threats; To strengthen the European network of public health professionals through use of shared standards and methods,  good practices and common public health objectives; To support cascading of training and capacity building within the Member States; To facilitate multi-disciplinary cooperation in the above fields. It has two paths: a path for field epidemiology and a path for public health microbiology Field epidemiology path (EPIET): This path focuses on training and practical experience in intervention epidemiology at the national and regional centres for surveillance and control of communicable diseases in the European Union. Public health microbiology path (EUPHEM): This path focuses on training and practical experience in laboratories with public health functions or training sites with a consortium of different laboratories in Europe.



Italian Social Marketing Network Newsletter 157


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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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Italian Social Marketing Network Newsletter 155


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The story so far

Since September 2016, TIME has been following three Syrian refugees as they prepared to give birth and raise a child in a foreign land. All of the women learned of their pregnancies on the road and none expected to deliver in a refugee camp, far from the homes they fled in Syria. These women are among the more than 1,000 refugees who gave birth in Greek refugee camps in 2016 alone. As babies, born of no nation, take their first steps, they face an uncertain future. Their parents continue their search for a home in a world that is increasingly hostile to refugees.
Follow us as the story unfolds daily on Instagram, watchHeln’s First Yearand see the journey mapped across the globe on Google Earth. Click here to find out how you can help.
This daily struggle plays out against the backdrop of Europe’s newest experiment to integrate hundreds of thousands of refugees, some into countries that have very little experience with outsiders. With our year-long multimedia project, “Finding Home,” TIME brings you their stories.

Case Study: Always #LikeAGirlAlways needed a way to appeal to a next generation of consumers in the face of growing competition from rivals that were gaining traction with Millennial girls via social media. The award-winning response was the Always #LikeAGirl campaign, that turned a phrase that had become an insult into an empowering message.
Together Leo Burnett Chicago, Holler and Always scooped up a Black Pencil 2015 Award for their #LikeAGirl campaign. The BriefAlways’ commitment to empowering girls through puberty education dates back decades. Yet in 2013, P&G realised the brand’s purpose wasn’t apparent to the new generation of consumers. Always’ brand communications had remained focused on product performance, while its main rivals had moved on. The challenge was to build a fresh and more meaningful understanding of confidence which would resonate with the next generation of consumers….
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Italian Social Marketing Network Newsletter 154


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Adham Elmously, MD, Arash Salemi, MD, and T. Sloane Guy,MD

The use of social media by surgeons is not only encouraged, but should be seen as an obligation to patients and colleagues to help disseminate impor-tant information. In a rapidly expanding digital revolution, engagement in social media allows surgeons to network with the community and leverage content to a wide audience while owning their online presence.

It has been over a decade since the conception of social media, and despite its nearly ubiquitous use in modern life, many phy-sicians have opted out of participating in this platform. The main barriers to social media use for physicians seem to be lack of time, lack of perceived value, as well as concerns about personal and patient privacy.1 Currently, Facebook has over 1 billion active users and Twitter has over 300 million active users, with studies demonstrating that 84% of adults use the Internet and spend an average of 6 hours per week on social media,2,3 figures that are rising each year (Fig. 1).

Overall, consumers cite three key things that could improve the doctor-patient relationship: greater connectivity, better convenience via text and online tools, and more time with the doctor. Brands and marketers alike have many things to consider in today’s ever-changing healthcare landscape. Are patients happy with their relationships with their healthcare providers? How likely are they to switch doctors? What could be improved with the doctor-patient experience? How do people want to be communicated with by their providers’ offices?
Among the three generations, Millennials are the least satisfied with their doctors and are most likely to switch practices. Not surprisingly, the researchers found that they are also the generation that is most likely to want to receive e-mail and text communication from offices.
Generation X
Many Generation Xers control healthcare decisions across multiple generations, and their preferences and satisfaction levels both fall somewhere between younger and older consumers. Overall, the researchers found that they are fairly similar to Millennials, with an openness to digital communication and to switching providers.
Baby Boomers
Baby Boomers, the biggest consumers of healthcare services, are the least likely to switch doctors. However that doesn’t necessarily mean they’re happy: less than half are satisfied with their current providers. Boomers are also the generation least interested in receiving communications from doctors’ offices digitally.

Secondo il pensatore tedesco Hans Jonas l’uomo si realizza in un sano pensiero filosofico, evitando gnosticismo e storture scientiste Per non diventare delle «formiche tecnologiche»
«Che l’immagine dell’uomo non vacilli, si offuschi e sbiadisca, che gli uomini non si riducano a formiche tecnologiche o edonisti senza anima o marionette frastornate dal nostro furibondo potere». A cosa attingere per evitare questa deriva? All’uso adeguato della filosofia che instrada verso la vita buona e all’esercizio della virtù? Sono dilemmi che hanno il sapore dell’attualità benché sollevate da Hans Jonas nel 1955. Potrebbe d’altro canto essere diversamente se «le questioni filosofiche – puntualizzava il pensatore sei anni prima – si ripropongono ad ogni nuova epoca tanto daccapo, quanto alla luce della loro intera vicenda storica antecedente?». Le citazioni provengono dalle annotazioni del filosofo appartenenti alla sua stagione canadese, dal 1949 al ’55.

A cura di Piergiorgio Ferretti, Maurizio Gottin – ASL TO4

1) RunKeeper – RunKeeper sfrutta il GPS dello smartphone per raccogliere informazioni sulla corsa: inoltre è possibile attivare un “allenatore virtuale” per migliorare il tempo di corsa con un programma di allenamento specifico, ricevendo messaggi incoraggianti. RunKeeper può anche impostare passeggiate, contare i passi, misurare gite in bicicletta, canottaggio, sci e altro ancora; in generale è adatta per controllare qualsiasi sport di spostamento lungo un percorso.
2) Runtastic – App gratuita per iPhone e Android ideale per lo sport all’aperto. Come un personal trainer permette di programmare gli allenamenti e controllare i risultati nella corsa e nel ciclismo. Anche questa App sfrutta il GPS per registrare i percorsi ed i progressi delle sessioni di corsa nel tempo. Di questa applicazione esiste inoltre una versione non gratuita progettata per il fitness e gli esercizi di ginnastica e palestra da fare anche a casa: Runtastic Results – .

An announcement on January 24 didn’t get the large amount of attention it deserved: Apple and 13 prominent health systems, including prestigious centers like Johns Hopkins and the University of Pennsylvania, disclosed an agreement that would allow Apple to download onto its various devices the electronic health data of those systems’ patients — with patients’ permission, of course.
It could herald truly disruptive change in the U.S. health care system. The reason: It could liberate health care data for game-changing new uses, including empowering patients as never before.
Since electronic health records (EHRs) became widespread over the last decade, there has been growing frustration over the inability to make electronic data liquid — to have it follow the patient throughout the health system and to be available for more sophisticated analysis in support of improved patient care and research. Most efforts to liberate and exchange health data have focused on getting doctors and hospitals to share it with one another. Those efforts continue, but progress has been slow.

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Italian Social Marketing Network – Newsletter 153


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ObjectivesGiven the degree of public mistrust and provider hesitation regarding the human papillomavirus (HPV) vaccine, it is important to explore how information regarding the vaccine is shared online via social media outlets. The purpose of this study was to evaluate the content of messaging regarding the HPV vaccine on the social media and microblogging site Twitter, and describe the sentiment of those messages.Design and SampleThis study utilized a cross-sectional descriptive approach. Over a 2-week period, Twitter content was searched hourly using key terms “#HPV and #Gardasil,” which yielded 1,794 Twitter posts for analysis. Each post was then analyzed individually using an a priori coding strategy and directed content analysis.ResultsThe majority of Twitter posts were written by lay consumers and were sharing commentary about a media source. However, when actual URLs were shared, the most common form of share was linking back to a blog post written by lay users. The vast majority of content was presented as polarizing (either as a positive or negative tweet), with 51% of the Tweets representing a positive viewpoint.ConclusionsUsing Twitter to understand public sentiment offers a novel perspective to explore the context of health communication surrounding certain controversial issues.

Digital Health is a cultural transformation, not just a set of new technologies. Written by e-Patient Dave deBronkart and Dr. Bertalan Meskó. ………………………………………………………………..
The root problem is that many digital health writers know plenty about apps but nothing about medicine. A secondary problem is a resulting sense that digital health is for idiots: imagine a trusting reader (you?) who goes to a doctor and mentions the article. The doctor concludes that e-health is stupid and the patient is naive….
It is essential that health and care achieve their potential, which cannot be done based on false understandings. This is why I asked Dave to contribute with his revolutionary ideas and vision. Whenever I saw him speak, there was a standing ovation. If this article helps you see what Dave and I independently observed in our travels despite our completely different backgrounds, we will be grateful.

The use of social media (SM) in healthcare has provided a novel means of communication in line with a more modernised approach to care. For physicians, SM provides opportunities for enhancing professional development, networking, public health, and organisational promotion, among others. For patients, SM provides potential for taking a more active role in health, sharing information, and building virtual communities, especially in the case of chronic and/or rare diseases. SM has the potential to bring patients and physicians closer together, beyond the walls of clinics; however, the interaction between physicians and patients on SM has received mixed feelings, especially from the physicians’ perspective. On the one hand, the potential for a more enhanced, albeit remote, communication has been viewed positively, especially in an era where digital technologies are fast expanding. Conversely, concerns around breaches in professional boundaries and ethical conduct, such as mishandling of patient-sensitive information on these platforms, have fuelled heavy criticism around its use. From this viewpoint, issues arising from the use of SM in healthcare, with a focus on the patient–physician interaction, discussing the potential benefits and pitfalls are covered in this article.