Social marketing in contexts of uncertainty: An analysis of social capital and health social support in online health communities facing treatment uncertainty

For several medical treatments there is considerable scientific and medical uncertainty about the relative benefits and risks they imply. The literature indicates social support as an important factor in health uncertainty management. The concept of social support has gained considerable interest in the areas of behavioral medicine and health psychology research. Despite such interest, it is still not clear how it can be approached in social marketing interventions since there is a lack of conceptual and empirical literature discussing the concept from a social marketing perspective. The present thesis aims to explore how the social support concept can be better approached in social marketing interventions targeting contexts of treatment uncertainty. To attain this objective, first a scoping review of social marketing interventions in the health area operationalizing the concept of social support was undertaken. Results indicated that interventions have operationalized the concept in connection with all the key aspects of social marketing, including behavioral change, consumer research, segmentation and targeting, and exchange, as well as marketing mix and competition. However, the findings also indicated poor conceptualizations of social support and the underreporting of the theoretical rationale for the operationalization of the concept. Second, the study adopted a mixed-methods approach that involved netnography and social network analysis, to examine the nature of online social support, understood as a resource generated through social capital, using two distinct case studies: i) an online forum focused on health discussion about electronic cigarettes; ii) an online forum dedicated to menopausal hormone replacement therapy. Findings indicate that online health communities can be a place for extending the support networks of people facing treatment uncertainty as multiple typologies of peer-to-peer social support are remotely exchanged in the virtual communities. Both online health communities were found to have similar network structures characterized by small-world and scale free properties and reduced levels of reciprocity. Results also indicate that users mostly search for informational types of support in the online health communities and that they can be segmented based on the structural positions they occupy in the networks and patterns of support interaction. However, it was found that the information available in these forums can be subject to imprudent processes of selection by forum participants who try to conform online discussion to suit the forums’ shared and accepted narratives that highlight the benefits of these uncertain treatments, while minimizing the respective risks. From a theoretical perspective, this study has relevant implications for health uncertainty management literature by putting in evidence collective processes of information selection in the online health communities, that can hinder the main objective of these virtual spaces, that is to function as platforms for knowledge acquisition. Second it deepens understanding about the interconnected relations between the concepts of social capital and social support. The study also brings innovation in methods by combining social network analysis and netnography, two naturalistic and online-suited research methods to study online health communities. For practionaires, the results of the study provide significant insights that can be used to program social marketing interventions intended to increase and enhance the quality of social support available in these types of online health communities.Para vários tratamentos médicos existe considerável incerteza médica e científica sobre os benefícios e riscos relativos. A literatura indica o apoio social como um importante fator na gestão de incertezas na saúde. O conceito de apoio social despertou muito interesse nas áreas de medicina comportamental e psicologia. No entanto, não é clara a forma como o conceito pode ser abordado em intervenções de marketing social uma vez que existem poucos estudos conceptuais e empíricos focados neste tópico na literatura de marketing social. A presente tese investiga a forma como o conceito de apoio social pode ser aplicado a contextos caracterizados por incerteza nos tratamentos médicos. Para atingir este objetivo, em primeiro lugar procedeu-se a uma revisão da literatura focada em intervenções de marketing social na área da saúde que reportam a utilização do conceito de apoio social. Os resultados indicam que as intervenções de marketing social analisadas operacionalizaram o conceito de apoio social em conexão com as dimensões chave do marketing social, incluindo os princípios de mudança comportamental, investigação sobre o consumidor, segmentação e targeting, o princípio do intercâmbio, bem como o marketing mix e análise da competição. Contudo, também se concluiu que a generalidade das intervenções abordam o conceito de forma pouco rigorosa e que não reportam o racional teórico para a operacionalização do conceito. Em segundo lugar, o estudo adota uma abordagem mista envolvendo netnografia e análise de redes sociais, para examinar a natureza do apoio social virtual, entendido como um recurso gerado através de capital social, em comunidades de saúde virtuais sujeitas a incerteza nos tratamentos, usando dois casos de estudo: um fórum online dedicado à discussão de cigarros eletrónicos e um fórum online focado no tema do tratamento hormonal para mulheres em menopausa. Concluiu-se que estas comunidades online podem servir como um espaço de extensão às redes de suporte de indivíduos sujeitos a incerteza nos tratamentos uma vez que múltiplas tipologias de apoio social parceiro-a-parceiro são prestadas remotamente nas comunidades virtuais. Ambas as comunidades analisadas apresentam uma estrutura de rede semelhante, caracterizada por propriedades de “pequeno-mundo”, propriedades de “escala livre” e reduzidos índices de reciprocidade. Os resultados também indicam que a generalidade dos utilizadores procura apoio do tipo informacional nas comunidades e que estes podem ser segmentados tendo por base as posições estruturais que ocupam nas redes e os respetivos padrões de apoio social. No entanto, foi igualmente descoberto que a informação disponível nestes fóruns pode estar sujeita a processos imprudentes de seleção pelos participantes nos fóruns, que tentam conformar as discussões online por forma a servirem as narrativas aceites e amplamente difundidas que realçam os benefícios destes tratamentos incertos enquanto minimizam os respetivos riscos. Do ponto de vista teórico, este estudo apresenta implicações importantes para a literatura sobre gestão de incerteza ao colocar em evidência processos coletivos de seleção de informação nas comunidades online que podem prejudicar a função primordial destes espaços online, que é funcionarem como plataformas para a aquisição de conhecimento. Em segundo lugar, o estudo aprofunda o conhecimento sobre as relações interdependentes entre os conceitos de capital social e apoio social. O estudo também apresenta inovação em termos metodológicos ao combinar analise se redes sociais com netnografia, duas metodologias naturalistas e perfeitamente adaptadas ao ambiente online, para estudar comunidades de saúde online. Para a prática, os resultados deste estudo oferecem conhecimentos significativos que podem ser usados para a programação de ações de marketing social destinadas a melhorar a qualidade e quantidade do apoio social disponível neste tipo de comunidades online

Asset-based community development practices in international service-learning: a content analysis of short-term programs in Nicaragua

The purpose of the study is to explore how students on short-term international service-learning programs in Nicaragua interact with local communities by analyzing the structure of the programs as evidenced by course syllabi and website content. After extensive online research of international service-learning programs offered in Nicaragua, seven programs became the focus of the study. The four research questions included: 1) In what ways do the international service-learning programs support key components of service-learning, such as academic connections and reflection? 2) In what ways do the international service-learning program structure the time in the host country for service and tourism? 3) In what ways do the international service-learning programs show evidence of partnerships and reciprocity with the local communities? 4) In what ways do the international service-learning programs promote an asset-based community development approach, where local community members are driving initiatives to better themselves and their community? Through this study, it was expected that programs will have varying levels of interaction with local communities. By looking further at the four research questions, methods of increasing meaningful interaction with local communities will surface. Based on these findings, recommendations for future program leaders and students of international service-learning programs will be given to adopt in the planning and implementing of future service projects with local communities in less-developed countries

Factors That Influence Healthcare Professionals’ Online Interaction in a Virtual Community of Practice

Online technologies have facilitated the development of Virtual Communities of Practice (virtual CoPs) to support health professionals collaborate online to share knowledge, improve performance and support the spread of innovation and best practices. Research, however, shows that many virtual CoPs do not achieve their expected potential because online interaction among healthcare professionals is generally low. Focusing on health visitors, who are UK qualified midwives or nurses who have undertaken additional qualifications as specialist public health workers in the community, the paper examines the factors that influence online interaction among health visitors collaborating to share knowledge and experience in a virtual CoP. The paper makes suggestions for how to improve online interaction among health professionals in virtual CoPs by increasing the size of membership in order to take advantage of both posting and viewing contributions, facilitating moderation to improve networking among geographically dispersed members groups and improving the topic relevance in order to stimulate contributions

Collaborative Online Education: A Case Study of an Ed.D. Program

This dissertation discusses collaborative teaching and learning models of online courses. Four research questions guide the study: How do instructors design online courses to facilitate instruction using collaborative teaching and learning models? When instructors co-teach online, how do they utilize collaborative teaching and learning models? How do students build online learning communities from collaborative teaching and learning models? and How do instructors and students evaluate online collaborative teaching and learning models? We conducted a case study of an Ed.D. cohort of Chinese students in the College of Education of the University of Missouri-St. Louis (UMSL). We employed a qualitative approach to this study, using a sample of seven students and four instructors who participated in online courses that used collaborative approaches to learning and teaching. We collected data from three primary sources: interviews, questionnaires, and relevant documents. The data analysis and discussion focus on the perspectives of instructors and students on collaborative learning and teaching in online contexts and offer insights into improving the design and implementation of collaborative online education. Our findings revealed that collaborative approaches in online settings are relatively complex and can effectively support instructors and students in achieving teaching and learning goals. The findings provide support for the following arguments, that professional development for instructors, effective communication, varied strategies to increase classroom interaction, and clear roles and expectations are all factors that influence successful approaches to online teaching and learning. Finally, this study may be a valuable resource for instructors who intend to implement successful collaborative education in an online setting

Instant Online Communities for Improving Perceived Learning

The Internet is increasingly used as a medium for communication. On the Internet, communities are forming around shared ideas, in contrast to former, location-based communities. Transition towards these online communities has also affected learning communities that are formed around learners such as university students. In universities, online learning communities are used both for supporting traditional courses and to offer courses that students can complete online, without the need to physically go to the university campus. However, current solutions for online learning do not fully utilize the potential of online communities. In many courses, there is only a website that offers essential information. It is accessed by a large percent of the students, but the website has minimal or no support for interaction. Instant online communities offer a lightweight solution for establishing interaction support for a group of visitors of a website. This idea can be used to enable interaction support for online learning communities in a course website. The students become aware of the online learning community they belong to when they access the course website, and they can communicate with other members of the community. This fosters social presence among the students, and thus improves their perceived learning in the course. In this study, first the literature and research behind online communities and online learning was briefly reviewed. This included studying the concept of instant online communities, learning communities, and how online learning communities can support learning in university courses. Secondly, features of instant online communities were more thoughtfully examined. Based on these, an idea of instant online learning communities was described with the features it should support. Thirdly, a group of students was inquired in order to find out their attitudes and expectations on how the idea could support them in learning. Finally, a proposal for features and establishment of an instant online learning community was constructed. Central aspects of an instant online learning community were found to be awareness of other students and the instructor, and discussion as a form of interaction. Presence of the instructor was found to have an important role. Also a need for both synchronous and asynchronous discussion was clear. With several issues still left open, a need for further study is acknowledged. /Kir1

Nonprofits and Volunteers in North Dakota Communities

This study looks at non-profit organizations in North Dakota to see how they attract and keep volunteers, how volunteer hours can be used to draw funding to nonprofits, and the increasingly important role non-profit groups play in local economies by creating jobs, services, and acting as a voice for those who might not be heard otherwise. Results show how universities can support local communities by developing research data nonprofit groups can use to solve practical problems, by acting as a bridge between student volunteers and appropriate organizations, and by creating a journal or online site communities can use to connect with each other and as a resource for information. This paper examines the following questions: which kinds of volunteer work do the people in North Dakota consider beneficial? What do residents consider to be the main benefits of volunteer work in U.S. society? What do they consider to be the main problems and challenges associated with volunteer work in U.S. society? The research used qualitative methods. The study made use of focus group data and panel discussions analysis published in academic journals.  The research concluded that the main issues confronting volunteer organizers are limited resources, and the need for information and knowledge about volunteer efforts in North Dakota. In these circumstances community engagement centers serve as vital sources of news and information. They can also serve as a prospective mobilizing platform for volunteer organizations

Teaching Artists Research Project

There have been remarkable advances in arts education, both in and out of schools, over the last fifteen years, despite a difficult policy environment. Teaching artists, the hybrid professionals that link the arts to education and community life, are the creative resource behind much of this innovation. Their best efforts are redefining the roles the arts play in public education. Their work is central to arts organizations' strategies for civic engagement and diverse audiences. Excellent research has shown that arts education is instrumental to the social, emotional, and cognitive development of thousands of young people. But little is known about teaching artists. The Teaching Artists Research Project (TARP) deepens our understanding of world of teaching artists through studies in twelve communities, and it will inform policy designed to make their work sustainable, more effective, and more meaningful. A dozen study sites were selected where funding was available to support exploration of the local conditions and dynamics in arts education: Boston, Seattle, Providence, and eight California communities (San Francisco/Alameda County, Los Angeles, San Diego, Bakersfield, San Bernardino, Santa Cruz, Salinas, and Humboldt County). A thorough literature review was conducted, and NORC conducted stakeholder meetings and focus groups, identified key issues and began designing a multi-methods study that would include surveys for both artists and program managers as well as in-depth interviews of stakeholders -- teaching artists, program managers, school officials, classroom teachers and arts specialists, principals, funders, and arts educators in a wide variety of venues.There are no professional associations and no accreditation for teaching artists, so a great deal of time was spent building a sample of teaching artists and program managers in every study site. The survey instrument was developed and tested, and then fielded on-line in the study sites sequentially, beginning in Chicago, and ending with the southern California sites. To assure a reliable response rate, online surveys were supplemented by a telephone survey. Lists of potential key informants were accumulated for each site, and interviewers were recruited, hired, and trained in each site. Most of the interviewers were teaching artists themselves, and many had significant field knowledge and familiarity with the landscape of arts education in their community. The surveys collected data on some fundamental questions:Who are teaching artists?Where do they work? Under what terms and conditions?What sort of education have they had?How are they hired and what qualifications do employers look for?How much do they make?How much experience do they have?What drew them to the field? What pushes them out?What are their goals?Qualitative interviews with a subsample of survey respondents and key informants delved deeply into the dynamics and policies that drive arts education, the curricula and pedagogy teaching artists bring to the work, and personal histories of some artists. The interviews gathered more detailed information on the local character of teaching artist communities, in-depth descriptions and narratives of teaching artists' experiences, and followed up on items or issues that arose in preliminary analysis of the quantitative survey data. These conversations illuminated the work teaching artists believe is their best and identified the kinds of structural and organizational supports that enable work at the highest level. The interview process explored key areas with the artists, such as how to best develop their capacities, understand the dynamics between their artistic and educational practice, and how to keep them engaged in the field. Another critical topic explored during these conversations was how higher education can make a more meaningful and strategic contribution toward preparing young artists to work in the field. The TARP report includes serious reflection on the conditions and policies that have affected arts education in schools, particularly over the last thirty years, a period of intense school reform efforts and consistent erosion of arts education for students. The report includes new and important qualitative data about teaching artists, documenting their educational background, economic status, the conditions in which they work, and their goals as artists and educators. It also includes new insights about how learning in the arts is associated with learning in general, illuminating findings from other studies that have suggested a powerful connection between arts education and positive outcomes for students in a wide range of domains

Re-Imagining Journalism: Local News for a Networked World

Details strategies for realizing healthy local information ecologies through for-profit and nonprofit media; higher education and community institutions; emphasis on relevance, research, and revenues; and government support. Includes case summaries

Climate of Opportunity: Gender and Movement Building at the Intersection of Reproductive Justice and Environmental Justice

Women's reproductive health and rights are inextricably linked to environmental health and justice issues. Women's bodies and reproductive health are often the markers of environmental contamination through diminished fertility, fetal developmental disabilities and increased rates of cancers. Beginning in 2008, the Foundation brought together grant partners working in these two movements to form the Environmental Justice/Reproductive Justice (EJ/RJ) Collaborative. The Foundation has seen firsthand how joint advocacy generates more inclusive movements and stronger outcomes for communities. This report summarizes the EJ/RJ Collaborative as a reference for funders, policymakers, organizations and others interested in joint advocacy work