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We know that many innovations require a sea change in the culture of organizations or society. This is particularly so when trying to spark innovations that can transform our health care system. On January 26th, the Centers for Medicare and Medicaid Services (CMS)held an Innovations Summit that they hoped would spark new ideas for achieving the “triple aim” of better health of people, better health care, and lower health care costs. But there were signs that the cultural change that is needed to turn around our dysfunctional health care system maybe more engrenched thatn we thought.

The first sign of trouble was the “networking breakfast” where nary a piece of fruit–not even fruit juice–or speck of protein was available amidst the plates of muffins and other pastries. So much for walking the talk about health eating. Good thing Michelle wasn’t there…

The second sign of trouble was the opening presentation by Don Casey, chief executive officer of West Wireless Health Institute, who providing an opening commercial for his organization. The commercials were interspersed throughout the day when some speakers spoke about their companies’ innovations. Granted, Acting Administrator of CMS and nurse Marilyn Tavenner (her credentials were not included in the program, although all of the physicians had their MD credentials included and Atul Gawande even listed his MPH) noted that the way forward would be through public and private partnerships.

The third sign of trouble became apparent by lunch.

We know that many innovations require a sea change in the culture of organizations or society. This is particularly so when trying to spark innovations that can transform our health care system. On January 26th, the Centers for Medicare and Medicaid Services (CMS)held an Innovations Summit that they hoped would spark new ideas for achieving the “triple aim” of better health of people, better health care, and lower health care costs. But there were signs that the cultural change that is needed to turn around our dysfunctional health care system maybe more engrenched thatn we thought.

The first sign of trouble was the “networking breakfast” where nary a piece of fruit–not even fruit juice–or speck of protein was available amidst the plates of muffins and other pastries. So much for walking the talk about health eating. Good thing Michelle wasn’t there…

The second sign of trouble was the opening presentation by Don Casey, chief executive officer of West Wireless Health Institute, who providing an opening commercial for his organization. The commercials were interspersed throughout the day when some speakers spoke about their companies’ innovations. Granted, Acting Administrator of CMS and nurse Marilyn Tavenner (her credentials were not included in the program, although all of the physicians had their MD credentials included and Atul Gawande even listed his MPH) noted that the way forward would be through public and private partnerships.

The third sign of trouble became apparent by lunch.

sgk-logo_topNews of the Susan G. Komen Foundation’s decision – and quick reversal – to cut off funding to Planned Parenthood was a textbook case of the power of social media. Tweet after tweet, post after post on Facebook, the blogosphere, You Tube, reader comments on hundreds of message boards, discussion groups, chat rooms – almost every type of social media tool available was a delivery channel for emotional advocacy of the two organizations.

The New York Times reported that by week’s end, some 1.3 million tweets relating to the funding issue had been sent. Facebook users by the thousands shared links declaring “I Still Stand with Planned Parenthood.” or passed along the message “Don’t Throw Planned Parenthood Under the Bus.”

One website that tracks Facebook estimated some 20 posts per minute were made for and against the two organizations. Planned Parenthood advocates charged that the decision was based on politics and increased pressure by staunch conservatives. Komen pointed to a policy that negated funding for organizations that were under investigation. Many Komen supporters, however, including grassroots affiliates, strongly disagreed with the organization’s stand. Supporters were angered that breast cancer screening was becoming such as sectarian issue.

breastexamsign-e1328568852603The Facebook posts I saw last week communicated a sense of outrage. Planned Parenthood provides breast cancer screening services for low-income and minority women – those that are often most vulnerable and least able to obtain quality care. It was more than a so-called “pro-choice” vs. “pro-life” argument. The broad support shown by so many people, across multiple social media platforms was a clear statement that women’s health issues matter.

Online users on both sides of the issue, who had never considered themselves activists,  joined in this virtual conflagration; messages flew back and forth so fast that it was hard to keep up at times. It was really amazing to watch all of the activity unfold in real time. Many who commented also followed up with financial donations to these organizations; Planned Parenthood reported they raised over $3 million in just a few days, well beyond the roughly $700K they would have lost from Komen. Big names like the Fikes Foundation and New York Mayor Michael Bloomberg made news by pledging substantial financial support.

After just a few days of unrelenting criticism that even reached into Congress, Komen did an about face. Planned Parenthood’s current funding was reinstated and the organization will be eligible for future grant considerations. Once again, social media buzzed loudly with opinions on the news — did Komen executives “cave in” as conservatives charge, or was the online noise so overwhelming that they had no other option?

The Komen Foundation will be dealing with the fallout from this incident for quite some time. It is a real-time case study of social media’s effectiveness. Twitter, Facebook, and other Web 2.0 tools have again shown their value – helping to bring down dictators, overthrow governments, keep people connected during natural disasters.. as well as PR disasters generated by organizations that still underestimate their noise.

News of the Susan G. Komen Foundation’s

May May Leung, PhD, RD is an assistant professor at the CUNY School of Public Health at Hunter College.

may-may-leungHave you ever heard of a community-based participatory method called photovoice?  Researchers and community practitioners alike have used this method to empower people and conduct needs assessments for different communities and a variety of public health issues, such as tobacco policy and homelessness.

Photovoice entrusts cameras into the hands of community members, who often do not have a voice, to “enable them to act as recorders and potential catalysts for change, in their own communities.”  It has three main goals, which include: 1) Enabling people to record and reflect their community’s strengths and concerns, 2) Promoting critical dialogue and knowledge about important issues through large and small group discussion of photographs, and 3) Reaching policymakers.

I was fortunate enough to have conducted a photovoice project myself in Beijing, China a few years ago where I worked with 12 boys and girls from migrant families to better understand how they viewed their nutrition and physical activity environment in the city after having recently moved from a rural province.  Similar to other countries, migrants in China tend to lead very different lives from their middle-class neighbors as they often have restricted access to job opportunities, social services, and education.

In our project, disposable film cameras were distributed to the participants and they were asked to take photos of what they thought were environmental barriers and facilitators related to diet and fitness.  Some of the children had never used cameras.  Not only did they learn how to take pictures, but also how to express their thoughts through the lens of a camera.  The photos provided a unique platform to promote critical group discussions.

Photovoice gives researchers and health professionals “the possibility of perceiving the world from the viewpoint of…people who lead lives that are different from those … in control of the means for imaging the world”.  The images that are taken allows some of the most vulnerable populations to voice their concerns and for researchers to understand the “real local needs” with the goal of ultimately working together to provide the greatest positive impact in the community.

May May Leung, PhD, RD

May May Leung, PhD, RD is an