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Do Health Awareness Days Actually Impact Behavior?

Big Data research says a ‘quit smoking’ call-out is at least one such day that works

March 31, 2016
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Take a glance at the calendar: World Autism Awareness Day is just around the corner. As are World Health Day, World Lupus Day and many more. One federal catalog lists 212 separate health-focused awareness days.

Health awareness days are ubiquitous. But does dedicating a day to a serious disease or to healthy living habits actually make a difference in the lives of people who hear about the occasion? That’s been difficult to determine because traditional methods, like telephone surveys, usually aren’t effective in gauging the effect of a single event occurring on a single day. A recent review of awareness days, for instance, found virtually no evidence of their impact.

But a new study, published today in JMIR Public Health and Surveillance by researchers from Johns Hopkins University and other institutions, used modern Big Data analyses to confirm that at least one annual health awareness day does indeed trigger behavior among many of the people who hear about it.

The team of public health and computer science experts measured the impact of the Great American Smokeout, one of the longest-running awareness events, held annually on the third Thursday of November to promote smoking cessation.

Reviewing data collected since 2009, the team analyzed news reports on smoking cessation and tweets encouraging cessation emerging from the United States to see if the Great American Smokeout’s message was heard and shared. Then they checked if Americans engaged with that message by seeking resources on Google and Wikipedia to aid smoking cessation, or by calling quitlines that offer live counseling on how to quit.

Compared to what would be expected on a normal day, the Great American Smokeout typically coincided with a 61 percent increase in news reports on cessation and a 13 percent increase in tweets encouraging cessation. In practical terms, this was the second-highest daily news coverage of smoking cessation in several years, including the last three, only falling short of New Year’s Day.

Cessation-related Google searches, like “help quit smoking,” typically increased by 25 percent on the Great American Smokeout, with visits to the Wikipedia cessation page and calls to quitlines typically increasing by 22 and 42 percent, respectively. This public engagement with smoking cessation translated into about 61,000 more instances of unique Google searches, Wikipedia visits and calls to quitlines annually than expected.

Mark Dredze

The research at Johns Hopkins was supervised by Mark Dredze, an assistant research professor in the Whiting School of Engineering’s Department of Computer Science. He said the advent of the Big Data era not only impacted the team’s ability to understand awareness days, but also potentially increased their impact.

“For the first time in history, the public can access and share information immediately, and instantaneously engage in improving their health via their smartphones, as we observed,” said Dredze, the data architect and a co-author for the study.

He added that this research showcases an effective new method for teasing out the impact of awareness days with Big Data.

“This strategy allowed us to observe how awareness days typically unfold in both the media and in the minds and actions of individuals,” said study co-author Benjamin Althouse, who earned his doctorate in 2013 from Johns Hopkins’ Bloomberg School of Public Health. “We can track how a cessation message moves across news and social media, and ultimately how the public reacts by seeking out additional information on how to quit.”

Althouse, currently a research scientist at the Institute for Disease Modeling and the Santa Fe Institute, was lead analyst for the study.

First author of the study was John W. Ayers, a research professor at San Diego State University Graduate School of Public Health who earned his doctorate in 2012 from the Bloomberg School.

“The Great American Smokeout is having a significant impact that far eclipsed our expectations for awareness days,” Ayers said. “But just as important, our study shows how we can rapidly and efficiently evaluate hundreds of awareness days, many for the first time.”

Lee Westmaas, a scientist with the American Cancer Society and a co-author, added that newly available data mean awareness days can have even larger impacts going forward.

“The Great American Smokeout is one of the nation’s oldest and most well-known awareness days,” Westmaas said. “Yet these data finally allow us to understand the reach of our efforts and make improvements.”

These findings, moreover, reinforce the role of awareness days. “A cost-efficient and well-focused message coming from the public on a single day, like the Great American Smokeout, can potentially yield impacts just as large as paid media campaigns,” said Eric Leas, a student of health communication at the University of California San Diego and a study co-author. For example, Google searches for cessation during the Great American Smokeout rivaled those observed in the team’s latest evaluation of the CDC’s Tips from Former Smokers campaign. “More work remains ahead, but these are some optimistic findings and implications.”

Still, not all awareness days may be similarly impactful. For instance, there are nearly a half-dozen awareness days that promote smoking cessation alone, like Kick Butts Day. What is the impact of replicate days? Do all awareness topics similarly resonate across the public? These and similar questions are now open to study for the first time, according to Adrian Benton, a computer science doctoral student at Johns Hopkins and a co-author. “Public health can readily adopt and expand our approach to evaluate like campaigns, and make data-driven decisions for planning and targeting awareness days,” Benton said.

“All this means that those pesky days filling up your calendar may be having an impact, and we can know for sure very soon,” Ayers said. In fact, the team is crowdsourcing funds to continue investigating additional awareness days through Benefunder.  “More must be done to evaluate and improve awareness days,” Ayers said.

The study’s other co-author was Yunqi Chen, who served a summer internship with Dredze’s Johns Hopkins lab team.

Funding for some of the work involved in this study was provided by Grant RCA173299A from the National Cancer Institute and the FDA Center for Tobacco Products.


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