Thursday, February 28, 2008

Contextualizing Contest

An inter-seminar contest, for chocolate, Milky Way or Reese's/Kit-Kats.
One article says SES doesn't change mortality.
One says health insurance is related.
One says health behaviors and health insurance coverage can be controlled for, but still there is a connection between SES and health.
One followed that smoking, alcohol use, physical activity, BMI can be controlled and still show connection between SES and health.
One (echoing tonights exercise) blames lack of housing for homelessness.
One says individual factors dictate who will be homeless, but housing is the fundamental determinant.
One identifies the context of risk factors as important.
One denies the idea that risk factors are not causally related.
One affirms that risks of risks and social conditions for risk are both important.

I haven't done the readings (yet). I haven't missed a question.

Now chocolate:
From Cacao, Almond Joy has nuts, Violet Beauregard became a blueberry, Water for Chocolate in Mexico, Chocolate fights Dementors, and Epidemiology can study risk factors for risk factors - Social Epidemiology.

Second Exercise

Traditional Risk Factor Epidemiology - The Hidden Danger
Numbers don't tell us what causes problems.
Siegel is standing in front of the projector, with the "No Signal" image now glowing on his face.
There is still trickery - the numbers don't give the answers. This example is more heavy-handed than the last.

In-Class Exercise

"This was a trick! I'll admit it, this was a trick."

Commercials

Clip of advertisement trying to get cigarette advertising on agenda:
Teens&Tobacco - CNN. 16 year old girl can't stop reading cigarette adds. Has smoked since she was 14. Tobacco companies are still targeting teens, despite legal agreement not to. CNN spelled Siegel's name wrong - Siegal.
Framing smoking in bars as workers' health:
1. Sepia toned diner - "It's not easy to quit a fifteen-year smoking habit, especially when it's not yours." - Not everyone can walk away from secondhand smoke.
2. Full House Clip? Siegel recorded that, frequently? An accident, but damning.
3. Clip of people - diners and waiters pleased 16 months after the ban are pleased. Restaurant workers 1.5 times greater risk, "no-smoking" sections don't reduce harm. Bar owner thinks business has dropped off (not associated with smoking?) and think it should be his decision to let people smoke or not. Also, Siegel is Rick Moranis-esque on tv.

Welcome to Lecture 7

Dr Phil just couldn't handle that Siegel stole his show, and according to the National Enquirer, is "Falling Apart."
This is going to be the tone of the night.
Fabulous prizes! Colorado Avalanche license plate and wallet, for making a play in SPH softball. "You probably don't have a car to put it on or money to put in it." - Siegel.
Calculator time: I'm waiting for someone to show a ten-key. I have a pad of paper.
Most basic - TI-something simple. - Hershey's bar, plain.
Winner - variants on TI-89s. Hershey's bar, extra dark with lots of fruit and such.
I own this.

Thursday, February 21, 2008

Tension

They did take it personally.
Also, does anyone think lactation rooms might be a "white tent"?

Seminar 3 Results

We're live with the "Dr. Phil" show - interesting migration from Phil Donohue to Dr. Phil.
We have an awkward panel of people, (all of whom) who seem unprepared for a talk show format.
Actually, this is just awkward. And one group is totally over-attacked.
And we're all ganging up on two people who don't care about their position enough to fight about it. It's not them. I hope they're not taking this personally.

Public health and selling sneakers – are they really all that different?

Li-Ning - Chinese brand of shoes being sold with Shaq as spokesman. Logo is New-Balance meets the Swoosh, and Shaq's guy dunking (a knockoff of the Air Jordan silhouette).

Also, Siegel looks just like his sister.

Lies about Truth

Tobacco companies killed Truth by lobbying Jeb Bush to stop funding.
The official line, as opposed to this one, is that the huge tobacco settlement that was required to pay for Truth dried up. Truth was the most expensive campaign against youth smoking, period, and they ran out of money because their funding came from tobacco company legal penalties.

Commercials!

Wildly homoerotic wrestling, sweaty dudes, half naked men, "when you're young, you're gold."
If you couldn't tell from the hair, it's Abercrombie and Fitch.
Selling youth, the appeal of young men (to older men?).
Winning, success, freedom, independence? - How about a play on "golden age," and an appeal to intergenerational relationships? (The targets of this ad being the predominant buyers of Abercrombie clothing: Frat boys, gay college students, and gay forty-year-old men.)

"Abercrombie and Fitch does not try to sell clothes." No kidding, their ads feature almost no clothing. They should advertise through clever slogans based upon sophomoric jokes "Abercrombie jeans -they look good piled on the floor of your bedroom."

We're back to Nike selling control. Will we breach the notion that Nike is marketed to people who may be socioeconomically oppressed? People who may have to "take" control if it isn't sold to them with a pair of $200 shoes?

Second Commercial: It's supposed to be about beer.
You want a high life man. "An investment in the high life is an investment in your future."
This is an ironic commercial, not marketing beer to women, but to people who buy High Life and realize that it's cheap, crappy beer that will get you drunk. The idea of a woman who can control her husband, thinking she can buy different beer, or change beers, to change her husband, is absurd.
How about sparking rebellious feelings in unmarried men who drink crappy beer to get drunk? "She thinks she can control me by buying different beer. I'll show her, I'll puke in the sink."
That's what the ad is selling.
Score one for the straw man.

Session 6 - Intro

Another mom, another day of Fabulous Prizes! Bring a parent, get two free shirts.
Mass Media class sounds fantastic - 3-4 word answers for their midterms.
Also - Philip Morris is the Enemy. "They." Also Bacardi - it's got to be that creepy bat.
Captains of Consciousness - "Advertising offered itself...as a way of homogeneously controlling...the public consciousness, mass consumers."
"Control instinct through mass media to create universal appeal."
"They believe they can control you. You are just pawns." If you did the Truth reading, this is the same model of "creating rebellion" in teenagers used by that campaign.
Harry Potter - book four, the Goblet of Fire. We get a bit on Pansy Parkinson - this is completely unnecessary. We're listening to a BU professor read and analyze Harry Potter to demonstrate how Pansy Parkinson is bullied into "hiding" her love of unicorns, because they're not evil enough. (Also, it cost you about $6 to hear it.)

Thursday, February 14, 2008

What does every commercial promise you?

Sex. (Way to go, back row.)

What is Michael Jordan doing?
It.

Nike is selling Control. Michael Jordan is in control, in a way that is impossible. If you have control, you can do anything, you can fly, you can stay in the air, just like Michael Jordan.
What more can people possibly aspire to except control?

Lusk, WY Commercial
People are using technology to keep their town just the way it is. "Microsoft."
Commercial makes an incredible promise - you can stop change by changing.

Anti-Smoking Commercial

truth campaign:
Jerky camera work, gritty, edgy material, anti-establishment megaphones, young people against blurred faces in suits - anti-establisment, man.
This is paid for by funds from the Tobacco Master Settlement Agreement. So you have "tobacco executives" in the commercial who paid a bunch of teenagers (actors in their 20s?) to heckle them at work. This is the beauty of the market.

Smoking Commercial

A play on Marlboro ads: People as cattle being herded by the Marlboro man, terrified, corralled, and then addicted. Pretty good commercial, using the Marlboro font (Illegal? Isn't that copywrighted?).
Good frames have been non-specific, and haven't relied on a lot of facts. This is advertising, don't let information/facts get in the way of the message.
Skirting the issue? Pulling the wool over people's eyes?
Argument: Do we need the facts if we're telling the truth? Do we need good facts to feel good about manipulating people?
To feel good about ourselves, clearly not to manipulate people.
Props to Miriam - Paternalism in public health advertising. You are the winner.
Siegel - Not coercion to advertise, not coercion for cigarette companies to advertise, not coercion to make people do something we think is good for them? Siegel understands the ethical argument as whether or not we lie to people when we manipulate.
Question from the front: Manipulate to act how one chooses - no, sorry. Manipulate people to act how the manipulator chooses, why else would we manipulate?
Comment from the back: This is only a difference of medium. Again, no. Comparing a list of facts to an emotional video, the fundamental difference is not list/video but fact/emotion.
Comment in the middle: Manipulation not a neutral tool (destruction of society? Way to throw that in.) shouldn't we try to educate people more instead of fighting fire with fire?
Media literacy training - teach children how media works, protect them from advertising to reduce susceptibility to tv, make them more susceptible to literature or other media. So you can convince them to shop at Whole Foods with a recycled paper flier posted in Starbucks.

Sex Commerical

The only way to protect yourself is abstinence. (And unlubricated condoms, the single man's choice - no sticky hands.)
This was actually an abstinence commercial. A guy sleeping alone, with red trojan condoms. He is abstinent, whether intentional or not.
"You're actually rebelling against authority by using condoms. You're reframing by changing the idea from abstinence to using condoms." And masturbating.

Framing Theory

Siegel shows the "Yes, We Can" Obama video. (Damn, that is an emotionally manipulative video.) Clearly an Obama man. We contribute the 3,921,922nd viewing. This has also been described as the greatest value in political advertising ever. (4 million views, $0). Also, it has John Legend.
Framing theory is a consumer theory - people buy an image, or behavior based upon its packaging. Another example of this, from the New York Times: Obama is the "Starbuck's Democrat"'s candidate, while Hillary is the "Dunkin' Donuts Democrat"'s candidate.
Framing is applying a metaphor to the subject (MLK, the Little Engine that Could, David and Goliath[?], a celebrity).
Works better on self-conscious teenagers/young people (who purchase a brand for identity).
Siegel makes a McCain joke: "No, You Can't."
A girl says she would be moved to be more patriotic by watching this video over and over again.
Nobody mentions the negative potential of framing.
Can framing be intellectual? -Good framing is emotional. Can emotions be tied to one's intellect, or can you tap people's feelings regarding intellect? (See "Are Americans Hostile to Knowledge?")

Fabulous Prizes are tainted?

Oh no! We've all been led: Fabulous prizes are only to set a precedent for answering questions.
Do you feel pavlovian? We may all drool when his voice lilts up for a question.
The Tipping Point in question-answering: People won't answer until other people answer.

Group Behaviors - Diffusion of Innovation

o Semester before Siegel began to teach SB721, sat in on class that had been getting poor evaluations
• Attendance of class – tipping point for people to not show up
• Now we have seminars, so we have to show up more often
• People didn’t skip until they had enough other people – established pattern – to follow
 $100 to stay ($400 per lecture. He realizes this.) and students wouldn’t walk out?
 15 people at second-to-last lecture
• People stop coming because they recognize that there are no negative consequences
 Not a rational weighing of individual behavior?
 A rational weighing of consequences to other people…
• To demonstrate this (and fashion is a good place to do this) you would have to demonstrate a reversal in behavior simply due to the amassed action of other people – such that the only data new to the individual is the number of other people performing an action

o Siegel doesn’t clean the board if the person before him doesn’t – this can’t be explained by individual actions?

o Empty lot (better metaphor is the sink full of dishes – do you wash your dish or add to the pile) – Siegel also litters if it’s into a lot that’s already dirty

o Speeding – if someone speeds past you, you speed?

Way to go class - attack the people are sheep theory by arguing for a rational weighing of individual consequences.

Harry Potter

o Harry Potter
• “I invited J.K. Rowling, we’re using Harry Potter to teach social and behavioral sciences. She said no.”
• Four Houses:
 Hufflepuff, the dumb ones, are SB?
 Re-read: Gryffindor is group-serving, or at least willing to subordinate personal desires to the good of all (Harry’s desire to be normal, or to escape the conflict with Voldemort, not to die if that is necessary to defeating Voldemort) whereas Slytherin is self-serving above all (and therefore cast as evil)
• Draco Malfoy – born into Slytherin
 Cast as a dark wizard – WHOA. Spoiler alert.
 Malfoy’s actions are more due to the actions of the house he’s assigned to than to his personal convictions
• Someone brings up the Harry-in-Slytherin possibility
 Internal struggle with the external world
• Group-level or individual-level explanation for behavior
• Group-level Muggle vs. Group-Level Wizard is a better comparison
• Pansy Parkinson
 The ugly one. Malfoy’s girlfriend?
• (With Crabbe and Goyle?)
 These characters are “foils”
 Slytherin attached to monied families – rich people are evil?

Fabulous Prize for our expert: Harry Potter 20Q. Does it only know Harry Potter objects or answers? Siegel is amazed. (His first answer was spaghetti. Is it flat? Yes. Aren't spaghetti round? Cylindrical, if possible?) (Snake is next. Is there a theme here? Snakes, noodles?) (Public Health: Machine answers "sunshine." Siegel's mind is blown.)

Class Five!

Fabulous prizes!
Blue group (Flower model) gets a prize by popular demand. Who are these people? Who demands prizes for other groups? Or was this entirely a group-demand for prizes?
A promise for our Valentine's (Halloween?) to be worthwhile if spent in class - more prizes to come?
Former student: Automatic fabulous prizes.
And there are supposedly more. I'm almost bribed into silence. But this is still awful.
Vegan Options: Jolly Rancher Lollipops.
We've wasted 15 minutes of class. This class costs $80 an hour. Those are $20 lollipops. Enjoy.

Thursday, February 7, 2008

Seminar 2 Results

We have a Stairway reference, a mess, a model for creating addiction (no positive outcomes, Green?), outside factors for the trans-behavioral, a Blue Flower, a four-way, bottom-up, and two sapphire members in black.

Seminar Review:
Yellow Model: Stairway to Change
Renamed Trans-behavioral model
What
• Beliefs
Ooh…
• Plan for oops
• Plan for transition
Ready, Set
• Available resources
Go
• Social Support
• Self-efficacy
Got it!
• Oops… (failure/relapse)
Supports for each of the steps are indented

Purple Model: Mess
Perceived Social Reality
• Surrounds everything
Strategic Plan influenced by
• Perceived Social Norms
• Social Support
• Attitudes
o Vs. Perceived Benefits
• Costs/Access also influence
Plan receives feedback from social support, self-efficacy before becoming behavior (maintenance)

Green Model: Addiction Model
Genetic Family History
Individual
Active Intention
Social Environment
• Creates drug abuse

Red Model:
Stress, negative feedback – Negative influences for trans-behavioral
Support, resources, motivation – positive
Plus environment, culture, SES at all stages

Blue Flower Model:
• Environment, race, family structure – roots
• Media, Social support, SES +/- reinforcement, geography, modeling, education – Stem
• Social norm, costs, benefits, self-efficacy, intent, stages, trigger, access – petals
• Behavior change

Pink – Four-way
• Intention
• Internal/External Factors that influence this interaction
o Internal
• Knowledge
• Priorities
• Self efficacy
• Values
• Self-worth
• Pleasure
• Autonomy
o External
• Social norms/attitudes
• Social support
• Economic status
• Media
• Gov’t
• Education
• Behavior

Orange – Bottom-Up Theory
• Biology/Genetics
• Informed Decision
• Social Bundle
o Influences intent
• Internal/External Detractors
o To realize behavior

Sapphire: Self-Identification Model
• Intent – Maintenance – Behavior – Looped
• Factors affect each step
o Behavior influences intent through self-efficacy

"There is really no magic in the existing models."
In just 45 minutes you can create your own models, based upon personal knowledge and experiences.
Shameless promotion: "Many of your models are better than any of the existing models"
How these have improved upon existing models:
• Combining existing models
o Purple’s “Social Reality Encasement” Model
• Red
o Encapsulated stages of change model
• Yellow
o Stairway – traditional linear model now incorporates difficulty and progress of change
o Identified factors contributing to movement along staircase
• Green – active intent
• Blue – emphasizing biological connection/mechanism of factors at each level
o Some factors are deeply implanted
o Some develop from these factors, integrate
o Behavior influenced by both roots and weather
• Pink – Countervailing Locus
• Orange
o Bottom-Up – Internal/external detractors show why arrow connection isn’t direct
• Sapphire
o Behavior change as a triangle, within which factors affect interplay between corners

Learning only models can be detrimental, limiting thought

Explicitly think about what model to use – don’t blindly take and use model – we need to open up our vision.
Use any model, but first decide that it is appropriate and understand advantages and disadvantages of the model.

Returning Students!

Italo and some guy who took the class last semester are being graciously introduced.
Italo's email ibrown@bu.edu
Someone's parent is here - Ananta's mom - First Fabulous Prize of the night, a Matching yellow Challenging Dogma shirt.

Break for Seminar 2

Reminder: Up to now, there have been no fabulous prizes.

Our group was terrible and our model was ridiculed (for being ugly).

Session 4 - Developing Interventions

Welcome to Challenging Blogma - notes and commentary for SB721.

"I reviewed the syllabi from EVERY social behavioral public health class being taught in the United States."
Seven Models - limit our effectiveness in changing people's behavior
This is all a repeat of last week's class.
1. Health Belief Model
  • Rational Decision Making
    • A person weighs the benefits of a behavior against the costs, this dictates intention
  • Assumption - Intention equals behavior
  • Good things:
    • Perceived Susceptibility
    • Perceived Severity
  • Used: Demonstrate either susceptibility or severity, or demonstrate positive benefits of an action (quitting smoking)
2. Theory of Reasoned Action/Theory of Planned Behavior
  • Attitudes towards behavior affect one’s intentions (internal motivation)
  • Perceived social norms (external motivation)
  • Criticism based upon attitudes towards one's own capacity (self-efficacy)
    • Theory of planned behavior
  • Used: Demonstration of the possibility, widespread potential and social norms that encourage smoking
    • Commit Smoking Losenges
    • "Yes you can!" campaign
3. Social Learning Theory
  • Modeling Theory
  • You will model behavior, do what you see done
  • Used: Target adults to help kids, target people around the intended recipient of intervention
    • Another good idea would be a Quitting Coach – pair with someone similar who is successful quitting, learn from their actions/mistakes
      • Sort of an I Heart Huckabees idea (Jason Schwartzman/Marky Mark)
4. Social Cognitive Theory
  • Same developer as 3. - Decision whether or not to take action is based upon belief of capability
5. Social Networking Theory
  • Do what people around you do
  • Used: Peer education system, but must target key sources of influence, most prominent intervention
6. Trans-theoretical Model
  • Stages:
    • Pre-Contemplation (haven't thought about quitting)
    • Contemplation (thinking about quitting)
    • Preparation (quit date)
    • Action (attempt to quit)
    • Maintenance (picking up an aggravating chewing gum habit to stay off cigarettes)
  • Used: Quit-line - Get someone to start thinking about quitting, ask questions to assess readiness to quit.
    • Provide materials depending on answers
  • Precaution-Adoption Process Model
    • Pre-contemplation
      • Awareness (do you know smoking is bad?)
      • Engaged (do you care?)
    • Preparation
      • Decide to act
      • Decide not to act
Contention is that despite the length of these models, our interventions aren't working.
Therefore our models must not be complete or must not be accurate.
  • What's wrong? (Models are wrong.)
    • Is the two-week process leading up to this designed to challenge our dogma of education and learning? Could we not have simply said "Look at these. Are they good? Are there problems? Could we do better?" during the first class?
    • Or, even better, we could start by learning a good model? This is like learning the four humors before CPR.