Sunday, June 10, 2012

CDC, You've Created a Monster (Pun Fully Intended)

At work the other day, I heard a radio ad for Illinois's Click-It-Or-Ticket campaign, in which they discuss the importance of wearing seatbelts in case of a zombie attack (hiding and waiting for unsuspecting drivers before jumping out at their cars - yeah, seriously). People are fascinated with zombies recently and public health organizations are no exception. For instance, CDC released a disaster preparedness campaign last year, in which they discuss the preparations individuals and families should make to prepare for a zombie uprising. Though the purpose of this campaign was to get people thinking about disaster preparedness for less supernatural reasons (floods, tornadoes, etc.), it also was meant to get people's attention - and it worked, though the response on the internet was perhaps more "WTF, CDC?" than "Wow, I never thought about disaster preparedness like that."

Besides, wouldn't wearing a seatbelt be a bad idea if zombies suddenly jump in front of your car and cause you to wreck? I mean, you want to get out of there quickly after wrecking, right? If you're surrounded by a zombie hoard, you're probably not moving very quickly anyway. And now that I think about it, if they wait to jump in front of your car so they can make you wreck and get some food (sounds suspiciously like fishing), wouldn't that involves things like patience, thinking power…? Not exactly what zombies are known for.

But I digress.

Public health organizations are doing whatever they can to get people's attention these days. And the CDC campaign, although weird and random, got attention and perhaps that's all it needed to do. After all, mass media campaigns for public health are generally really expensive to implement but have small effects. Really, any campaign intended to simply educate does little to actually change behavior - in fact, it does little to even change attitudes about a behavior, and even if it does change attitudes, a lot of psychological research demonstrates that attitudes are poor predictors of behavior. That's right, people can hold very strong beliefs and behave in ways completely counter to them. It drives me nuts when people say that psychology research just confirms common sense, but seriously - does this actually surprise you?

How about now?
By using something currently popular, like zombies, they increase the chance that mainstream media will pick up the story and help pass on the message, which could exponentially increase the campaign's reach. But does capitalizing on the current trend actually weaken the message? Does it mean that, once zombies are no longer "cool", the campaign will lose its effect and possibly even have the opposite effect in the long run? I tried to find some research on this - it's what I do.

There's definitely been research on what makes public health campaigns effective, but the focus is more on things like tone (e.g., fear appeals) than content. One exception is a review by Randolph and Viswanath, which examined studies of public health campaigns to determine which factors most clearly related to effectiveness. They identified as the most important factor: "successful manipulation of the information environment by campaign sponsors to ensure sufficient exposure of the audience to the campaigns messages and themes (influencing the information environment and maximizing exposure)." Okay, so perhaps CDC's (and even Illinois's Click-it-Or-Ticket) idea was a good one - do something that gets attention and is picked up by other media outlets. Fine fine, moving on in the list… 2) use social marketing to develop messages appropriate to a specific audience and get the message to that audience (meaning there may need to be more than one message for different demographic groups), 3) create an environment in which the target audience can carry out the recommended change, 4) use sound health behavior theory, and 5) conduct process as well as outcome evaluations to understand the campaign's effect.

But there is a bigger question here. Could CDC have legitimized some people's beliefs that a zombie apocalypse is upon us?

Four or five years ago, I discovered a web group devoted to surviving zombie attacks. As a long-time horror movie fan (see previous blog posts - part 1 and part 2), I figured this was a group run by fellow horror movie fans who would discuss different zombie movies… sadly no. This was a group of people who genuinely believe a zombie apocalypse is imminent, and spend their time 1) posting news stories supposedly providing evidence that zombies are among us, and 2) devising plans to survive attacks. I received quite a few, "This is not what our group is about" messages in response to some of my posts about great movies, or even when I said that my survival approach would depend on if these were slow-moving, Night of the Living Dead zombies, or fast-moving, 28 Days Later zombies. I can imagine that this group must be pretty active given the media's recent focus on particularly heinous attacks involving cannibalism (and I choose each of those words very carefully - no, these recent events are not, in my opinion, evidence of zombies, but rather evidence that, "If it bleeds, it leads" is still the approach taken by mainstream media, and that, given our recent focus on zombies in popular culture, the media IS biased in what stories it chooses to cover).

I come from a behaviorist background - my undergraduate psychology department head was a behaviorist and for the better part of my undergraduate career (and a not-insignificant chunk of my graduate career), I was like a mini-Skinner, arguing that everything could be explained by contingencies of reinforcement. Though I lean more toward cognitive psychology these days, I still remember many of the things I was taught in my behavior classes and believe these topics are still very relevant for understanding human behavior.

One important thing to keep in mind is unintended consequences. When trying to reinforce a certain behavior, you have to watch for other behaviors you may be inadvertently rewarding (or punishing). For example, I had a professor in college who hated it when people showed up late for class. When people would come in late, he would stop class and spend a minute or two interrogating the person about why they are late, lecture them about why their behavior is unacceptable, etc., etc. He would also take points off for tardiness - the same number of points he would take off for an absence. Basically, people who showed up late once never did it again - because after that, if they were going to be late for class, they just skipped. I'm sure if this professor were aware that his punishment, though decreasing tardiness, was actually increasing absences, he would have changed his approach. But I doubt he ever examined his tardiness and absence data to look for this pattern.

The same goes for interventions intended to change human behavior - you want to examine behaviors that might have been affected by your campaign, whether those were behaviors you were hoping to change or not. It is unclear what effect the CDC campaign had on things like belief in zombies, but if I were performing an evaluation of this campaign, that would be something important to assess.

In fact, CDC spoke to a reporter at Huffington Post about the recent events, and said that CDC is aware of no virus or toxin that could cause the reanimation of dead tissue. So perhaps they recognize that selecting zombies for their campaign was a bad idea.

Still, the blame cannot be placed entirely on CDC. As I said earlier, zombies were already getting lots of attention, and this is probably why CDC selected that topic to frame their disaster preparedness campaign. What do you think? Did CDC add an air of legitimacy to the supposed "zombie apocalypse"? Or just capitalize on the zeitgeist?

Thoughtfully yours,

Thursday, June 7, 2012

Trivial Only Post - On the Insanity of FSoG

I haven't posted in forever. I'm working on a new post, but it's gotten rather deep, and is taking a while to put together. So I've decided to try something new. In addition to my deeply trivial posts, I occasionally think things that are best described as trivial only. Hence, the trivial only post. These will be short, to the point, likely very snarky (who am I kidding? - that describes all my posts) and on rather ridiculous topics. Let's see how this goes.

The more I learn about the author of Fifty Shades of Grey, the more I think she's actually completely out of her mind, and rather than recognizing and treating her mental illness, we're heralding her for writing such compelling drama. The most recent thing I heard about Fifty Shades of Grey (hereafter referred to as FSoG, pronounced Fih-Sog, if you don't mind) that makes me think that?: Spotify was advertising the FSoG playlist, which contains tracks "inspired by the book everyone is reading."

First, not everyone is reading the book, but whatever. Second, last time I checked, "I'm on Fire" by Bruce Springsteen, The Flower Duet from Lakme, and "Toxic" by Britney Spears were written long before this book. I think someone needs to check their dictionary and make sure they're really clear on the definition of "inspired". Honestly, we should explain how the space-time continuum works, but that might be asking too much.

After all, what can you expect from a book that was "inspired" by Twilight?

Trivially yours,