Summary

Do No Harm?

Nearly 75% of healthcare is self-care. That’s why health consumers need to be informed about ‘what works’ & activated to find it, according to the Chronic Care Model. However, Stanford’s Halsted Holman MD decried the training gap of our time …

“Sixty years ago, a new and dominating health problem emerged: chronic disease. It has now reached epidemic proportions, affecting 50% of the population and consuming 86% of health care expenditures. The fundamental responsibility of the medical profession is to create a health care system and a practice of medicine that meet the needs of current illnesses and patients. The profession has not done so.”

Case in Point:  One in 3 adults have sleep problems. Few are informed: (1)  CBT-I is the gold standard for insomnia, (2) FREE  digital CBT-I is a good first step, (3) Pills are unsafe for those who most often take them, not to mention their side effects.

But, by the time people see me, their issues have quintupled – Insomnia AND Substance Use AND Anxiety AND Depression AND ‘learned helpless’ self-fulfilling beliefs.  Usually, they have …

• Been persuaded by commercial hype and misinformation
• Spent years and too much money on misguided solutions
• Gotten hooked on pills they didn’t need to start & that no longer work
• Been convinced: They can’t sleep without a sleep aid and they tried ‘everything’ and ‘nothing’ works.

Instead, we could stop the madness – unite & fight – to fix our failures:
– FAILURE to fight the hype
– FAILURE to fight mis- or disinformation
– FAILURE to inform & activate people to find what works.

Closing the training gap
Though the Healthy People Curriculum advises us to train in collective interprofessional health promotion of evidence-based practices … we don’t.  As a former Georgetown Sleep Clinic member & Uniformed Services U Medical Psychology Course Director & Practicum Coordinator, I believe that our pilots showed how the academic community could sustain collective civic-engaged education & research for health promotion.

Pilot – Intern-Led Network

Pilot Questions:  Can an unpaid, online-based undergraduate internship develop & manage a no-code network – to inform & engage the public on democracy?
Could interns create a challenge for peers to compete to raise awareness and have the most impact (i.e., Speak Up GMU)?

The Internship

George Mason University programs offer undergraduate internships – for 3 and 6 credits. Over 50 interns (2018 – 2023) from diverse programs (e.g., Sociology, Politics, Geographic Science) took a risk on a new, unpaid, totally online internship.

Interns led the People’s Platform for Democracy (the non-profit, non-partisan US onAir Network) to inform & engage their community.  With no tech background and collaborating virtually, each cohort of US onAir interns learned just enough about Zoom, YouTube, Google, Canva, & WordPress to:

1.  Curate profiles (e.g., US Representatives, US Senators)
2.  Curate posts: (e.g.,  ’22 US House races, Democracy)
3.  Schedule & produce 1 on 1 interviews (e.g., in-person, online)
4.  Create brief ‘explainer’ videos (e.g., candidates, About Virginia onAir)
5.  Plan, schedule, produce, & and host livestream discussions, aka onAircasts (e.g., with government representatives; with subject matter experts on issues of interest)
6.  Direct one of the 50 State Hubs in the network (e.g., Virginia, Georgia, Michigan)
7.  Develop social media channels (i.e., VA onAir, US onAir)
8.  Establish a School Chapter
9.  Promote & run in-person events (e.g. Posts,  Livestream Videos)
10.  Promote the internship to other schools (e.g., recruitment video).
11.  Prototype a video-based ‘Speak Up’ Challenge

Paul and Joe designed a ‘Speak Up’ Challenge for students to compete to address their representative about what mattered to them. They created:  1) a ‘Speak Up’ post (with Google Docs for registration & a database), (2) a promotional poster, (3) a YouTube playlist of 10 model entry videos.

Intern Feedback:  Most expressed these positives …

– Learning skills (digital media, communication, leadership)
– Being more visible in their field of interest (e.g., online profile)
– Meeting local and national leaders
– Planning new hubs in the network (e.g., ‘India’ onAir).

Pilot – Course-Led Challenge

Pilot Question:  Can service-learners collaborate – across courses and semesters – to collectively design & pilot ONE health fitness communication campaign?

GMU Distinguished Professor Gary Kreps led the communication campaign pilot to target ‘Freshman 15’ weight gain. Guided by success factors of the VERB campaign, the goal was to make the challenge ‘easy, fun, & popular’ to join.  Spanning 3 semesters (2010 – 2011), 3 professors teaching 4 classes, offered learners the option to run a series of pilots for-credit.

COMM 820:  One student reviewed the literature on campus fitness competitions.
COMM 391  A few students surveyed 100 Freshmen to identify how to make it ‘easy, fun, and popular’ to join.
COMM 404:  Using survey data, four students designed the challenge using: a cash prize, credit-based participation, and an App (Wizit) with QR codes to verify laps between the campus and Starbucks.
COMM 200:  Half the class competed with the other half.

COMM 200 Feedback

• Earning credit made it easy to collectively pilot & compete
• Competing for ‘bragging rights’ made it fun  (no need for cash prize)
• They believed that they could make it popular – leveraging social media to develop an annual intercollegiate fitness competition – March Madness for Total Fitness.
  • Faculty Feedback
  • It was easy to add this for-credit service-learning project to their course.
  • It could enable a line of community-engaged research.

Civic-Engaged Scholarship

Service-learning projects resulted in the following …

– At the 2010 mHealth Summit we presented this poster
– At the 2011  Teaching Prevention APTR  conference, we presented at a symposium – Leveraging Technology to Impact Health in the Community.
– In 2011, I contributed a chapter in Technology Innovations for Behavioral Education.
– At the 2012 GMU Resilience Conference, retired Lt. Col. Mark Bates, PhD and I presented the pilots as a way to bring the DoD’s ‘Total Fitness’ culture to campus
– In 2012, Dr. Kreps and I submitted a grant application.

Conclusion

As AI-generated disinformation is ‘becoming infinite,’ academic leaders are calling the rest of us to speak up.  Civic-engaged scholars & learners COULD unite us to LEAD – ‘collective’ health promotion – on a curated & connected network – we own.

• For 5 years, an online interprofessional undergraduate internship directed and curated a no-code ‘People’s Platform for Democracy’ – a digitally cloned & connected network of 50 States – to inform and activate the public.
• Courses with civic-engaged projects collectively produced one health fitness campaign.

Our pilots suggest that the first online Speak Up Internship COULD direct Speak Up for Sleep to pilot the first social media challenge to enable ANY educator to LEAD.

Path to Better Sleep is free and VA-developed. It is a suite of 4 modules:

• A sleep screen
• Healthy sleep tips
• CBT-I self-help
• Sleep apnea tips.

Sleep experts recommend digital CBT-I as a first step in ‘stepped’ care.
Digital health leaders say:

1. Providers need help to prescribe digital tools.
2. When prescribed, clients are 3 times more likely to use them.
3. Behavioral medicine professionals can lead digital public health communication.

The First Speak Up Internship

Pilot Question:  Can a new online ‘Speak Up’ Internship (1) build the ‘no-code’ platform, & (2) design, create, and pilot the ‘Speak Up for Sleep’ social media challenge in which service-learners anywhere compete to promote the Path to Better Sleep to have the most impact?

Worldwide, healthcare educators assign online training for learners who earn certificates of completion. These QI hands-on projects have saved millions of lives.

For this pilot, educators would offer credit for a service-learning online project to get hands-on interprofessional practice in ‘collective’ health promotion. Learners would compete to have the most impact – individually & for their teams (class, school, profession).

To earn a certificate of completion, learners acquire skills to promote Path to Better Sleep:

1. Post on social media
2. Stimulate their team (class, school, profession) and others to re-share their post
3. Use defined metrics to measure & post their impact

Interns would build the no-code platform to support & lead the Speak Up Challenge

1. Inform learners about insomnia, CBT-I, apnea, Path to Better Sleep, and social media strategies
2. Activate learners to promote Path to Better Sleep in the competition they design, develop, promote & lead
3. Spotlight the posts of top performers (learner, course & professor, school, profession)
4. Promote the internship to recruit the next cohort
5. Use the platform to conduct and present their community-engaged scholarship.

Call to Action

Future interns COULD digitally clone the first ‘Speak Up’ – for ANY Speak Up challenge – to create & curate an interconnected People’s Network for Health Promotion – a non-profit to improve:

Teaching:  Enable social media practice to ‘collectively prescribe & promote‘ what works
Research:  Test/Identify/Disseminate real-world best ‘collective social media‘ practices
Service:  Boost health consumer awareness & demand for what works.

The People’s Network would enable ANY educator to assign ANY service-learner
to collectively leverage social media
to continuously compete
to … Inform & Activate … Patients & Populations
to find what works for:

• PREVENTION   (vaccines, fluoride)
• CHRONIC ILLNESS   (obesity, pain)
• HEALTH & WELL-BEING   (stress management)
• ADVOCACY   (gun safety, reproductive care).

Educators:  We seek partners to pilot:  (1) Co-lead the Speak Up Internship, and/or (2) Assign learners to earn a certificate of completion for participating in the Speak Up Challenge.
Helpful SMEs … civic-engaged education & scholarship, public health, sleep, behavioral medicine, communication, social media, technology, civic entrepreneurship, social marketing, the Path to Better Sleep.  This platform can be ‘cloned’ for future ‘Speak Up’ challenges.

Meredith Cary, PsyD  has over 20 years educating (Medical Psychology, Sleep Medicine, & Psychiatry) & over 30 years practicing clinical health psychology. Disclosure: Donations to 501c3, the onAir Network – a no-code’People’s Network to inform and engage the public on important issues.
Contact:  drcary@mac.com