Posts Tagged Social
July 2017: Social Wellbeing and Social Security
Welcome to the July issue of TotalWellbeing! If you have been following TotalWellbeing you know that every month we focus on one of the 8 Dimensions of Wellbeing. This month we are looking at how you can mature your sense of connection and grow your social wellbeing. What great timing to think about this as we start summer and are able to be outside more! This month we also are looking at expanding your knowledge about your social security benefits and delving into how social security is a part of your social support system.
For a closer look at this month’s topic and helpful resources please check out The Path and The Connection below or check out our latest infographic on how Social Security Benefits work. Always feel free to print these resources and post them around if you feel they would be helpful.
And of course, just a gentle reminder that for more resources you can check out MINESblog. This is where we always strive to bring you, helpful, informative, and inspirational content around topics that are important to wellbeing and community. Last month we had an inspiring post about the little know National Upsy-Daisy Day and how it’s a reminder to always take time the time to enjoy the small things throughout your day. MINES was also the recipient of two Founder’s Awards from Peer Assistance Services and you can read about that here.
As always, for more information please check out the links to the left or hit the share button to send us a message. To be notified when we post more resources and articles make sure to subscribe to MINESblog. See you next month!
To your total wellbeing,
The MINES Team
The Path: Social Security Benefits and Social Wellbeing
When you think of Social Security, you may not automatically see the connection to your social wellness. However, Social Security is a social benefit by nature, meaning it is available to all, within its limitations, and it affects the community as a whole. It also affects your social support system as your family could receive Social Security benefits. Helping your support system understand your benefits can only help you feel more confident and prepared for the future which inevitably helps improve your social wellbeing.
Mankind is meant to be social. We are built to interact, connect, and support each other. Even if we are more introverted or prefer to be behind the scenes, we still look to our families and friends to be our support system and enjoy being around others to some extent. As you think what being social means to you, try to find a way this month to expand your social network either through social media or in your community or workplace. Take time to find an activity to do- go to a parade or concert- or take a road trip to discover something new about yourself and those around you.
Here are some great tips on how to be social even if you don’t feel like it or if you consider yourself to be an introvert.
|Tips for you:
Social Security Benefits include financial assistance for you and your family members through retirement, disability, and Medicare coverage. Take the time to talk to your family and let them know what you have decided to do and how you can be financially secured regardless if you and your family have access to Social Security benefits. You can never be too prepared.
Check out this month’s webinar to learn more about how Social Security Benefits work, so you can feel equipped when you have to make a financial decision about Social Security for you or a family member.
The Connection: Get Involved
Wellbeing does not simply start and stop at the individual. Our community is connected to each of our own individual wellbeing in a huge way. When we are well we can better function within our community. We can help our fellow humans thrive, and in turn, when our community is prospering, it helps each of us reach our goals as individuals. So why not help our community so we can all thrive together? Each month we will strive to bring you resources that can help you enhance the wellbeing of those around you or get involved with important causes.
|Community Wellbeing Resources:
There are a lot of people who struggle with understanding their social security benefits. If you have an expertise in this area, consider going to your local retirement community and asking if you can share your knowledge with those who might be using it. If you don’t have this expertise, take time today to step into your community (and workplace) and share whatever is your expertise with those around you. Interacting with your community is a great way to be a part of a communal support system and help develop your sense of belonging.
We’re happy to announce that PersonalAdvantage, an online benefit available through MINES, has been redesigned and is better than ever. It still has tons of the same great resources for all the dimensions of wellbeing that we discuss here, along with some articles and assistance for Estate Planning, and now has a new look, easier navigation, and works great on mobile too. If you haven’t checked it out yet, or want to see what resources they have for this month’s topic check out the link below. You’ll need your company login, so make sure to get that from your employer or email us and we’ll be happy to provide that to you.
|If you or a member of your household needs assistance or guidance on any of these wellbeing topics, please call MINES & Associates, your EAP, today for free, confidential, 24/7 assistance at 800.873.7138.|
|MINES does not warrant the materials (Audio, Video, Text, Applications, or any other form of media or links) included in this communication have any connection to MINES & Associates, nor does MINES seek to endorse any entity by including these materials in this communication. MINES accepts no liability for the consequences of any actions taken on the basis of the information provided herein, nor any additional content that may be made available through any third-party site. We found them helpful, and hope you do too!|
Community, eap, Employee Assistance Program, MINES & Associates, MINES and Associates; Employees; Culture; Company Culture; Psychology;, Social, Social Security, Social Wellbeing, Tips, TotalWellbeing
I know there are a TON of articles and posts that have surfaced in these 6 days since PokemonGO was released in the United States. The sheer volume of discussion around this just-short-of-a-phenomenon app is certainly surprising in many ways, though another very popular app that just recently was eclipsed in downloads, Tinder, also got a ton of press at the beginning – mostly for the questionable intentions of its users. In this case, you might be able to make a case for the questionable intent of the creators, but I’ll stay away from either of those as the crux of this post and use it as a jumping off point for what I see as valuable technology for the future of health intervention.
What is PokemonGO
Loosely based on “Ingress,” PokemonGO is a marriage between Google spin-off Niantic and Nintendo’s Pokemon company. Both companies have, on their own, somewhat of a cult following at this point. While the platform that enabled Pokemon to flourish, Nintendo, has wider reception, both at this point, are not particularly popular on their own. I was actually never a big fan of either. There may have been Pokemon Pogs when I was growing up, but aside from that, I’m not intimately familiar with either. But this combination of geolocation technology and fantasy are not new at all. In fact, if you check out ARGNet, you will find a number of times when games have moved beyond their stated fantasy world and brought them into the real world. Even Cards Against Humanity’s 12 Days of Holiday Bullshit involved very real things IRL (In Real Life) that helped to solve a massive puzzle by contributing members.
But why is it so dang popular!?!
Simply put: it’s fun to play. In Jane McGonigal’s book Reality is Broken and in her TED talk Gaming can make a better world, she covers why gaming can be so much fun and how it can be used for more than just checking out from reality. For those that don’t know what makes a game, there are 4 rules for game-making:
- It has to be fun
- There are rules
- There has to be feedback
- It has to be voluntary
And PokemonGO handles these splendidly. If you are able to suspend seriousness and simply play the game, you get the cute characters of Pokemon as if they are in your own world. And then you have to interact with them. There are rules and while you don’t necessarily know them as a newbie, you pick them up rather quickly because there is a lot of feedback as you fail. And voluntary? At over 50Mb to download, significant battery management, dedication of time to the task, and a VERY serious draw on device memory, you’re making a conscious decision to volunteer your time to the goal “gotta catch ’em all.”
How does it work?
Relying on Niantic’s successful incorporation of layering fantasy graphics on Google’s mapping technology, your movement within the real world is translated to the world of PokemonGO. With real world locations acting as stops, real world walking moving you toward Pokemon, and real world feedback as you navigate around obstacles to find these critters, the technology is immersive while being a bit of a “screen suck.” You swipe and click the screen throughout the game to engage different activities (preferably once you’ve stopped moving!) and try to level up through the game.
A word on design
Despite the fact that there are no real instructions on how to use the game, it is incredibly easy to use and intuit as to the next thing you need to do in the game. In the case that you get jammed up, you can always talk to a friend about what they have experienced. And that conversation results in extended conversations about what you’ve seen, done, and enjoyed; even sharing what your highs and lows have been.
Laying the fantasy world on top of the real world allows for the interaction between real and false worlds to transcend the experience of the individual. While it is not necessarily a new technology, it certainly hasn’t been used to this level across a population of people. Look no further than the people walking around parks to see how pervasive this game has become.
Besides the clear security issues that one might expect with an app that logs one’s location, we’ve seen articles that highlight a number of, sometimes false, security concerns that may or not may reveal private details about someone. For example, Instagram’s geotagging feature might reveal that the user is nowhere near home; meanwhile, there have been users that have been vandalized by their Uber driver because they were recently driven to the airport.
While there is only one clear security issue derived by the PokemonGO app, other than the iOS opening that created access to Niantic for the complete control of the users’ Google account (which was quickly remedied within the first five days of operation) PokemonGO does not have the hallmarks of issues, inherent to the app, that many others have had. The one condition to this that I would offer is the use of Lures at Pokestops, which allow for control over the fantasy world for other players as well. This is intended to allow you to attract Pokemon and potentially meet other people, but as you can imagine, that might cause a problem if someone wanted to maliciously use that tech to lure users more than Pokemon. You can’t see other users. You can’t lure those users (unless it’s discovered that incense works beyond the user – which, as of yet, it hasn’t). And until you can hack the database, which, as far as I, know never happened with Niantic, the users are relatively safe.
Health hazard or opportunity
So what are the real opportunities or hazards for this app. Truth is that we’ll likely see more and more stories about the extreme situations like a robbing in O’Fallon, IL that used the technology to target individuals (disproved in this case but could have been a Lure) and a young woman finding a dead body near a stream near her home. But truth is that this has created an engaged population, regardless of age, that is regularly walking through areas that they don’t regularly. And is that bad? We live in a country that is SO LARGE that we don’t inhabit more than 90% of the mass, and yet we have SO many opportunities for exploration for a nation of explorers.
Maybe it is. There are maybe some places that we don’t go and that’s okay. But for the large majority of people playing this game, it seems that it runs through the normal course of daily activity, or just slightly more.
What can it potentially do?
Without going too deep into what the values of using gamification are here (feel free to read more here), it is certainly becoming more commonplace to bring this theory into regular technology for deeper interaction with users. The reason that gamification can be such a powerful tool in the capture of behavior change is that it seemingly separates the activity’s goal from the activity’s work by creating an intervening level of excitement with the user. This is done by initiating what is known in psychology as Flow.
Flow is the state where the skill meets the difficulty that the user is presented with in a maximally optimal position to engage.
One of the best arguments for, and against, augmented reality that I’ve seen is nicely packaged in the form of this short film:
While there are many opportunities that augmented reality potentially brings to the table with regard to the mundane (paying your tab at a restaurant, preparing food, even exercising like PokemonGO has been credited with) there are also potential dangers to these augmentations. With regard to PokemonGO in its current version there’s certainly no actual human interface except through the handheld device. While it can influence behavior by incenting the user to do one thing or another, it cannot override human decision making. Yet.
But let’s set aside the potential for danger for a moment to consider how immersive PokemonGO has become for its users and how another user interface might have a significantly decreased reliance on the “phone” to play the game might actually allow for it to become more of a background activity, rather than what one is actively doing. In PokemonGO, the user is staring at a screen trying to find where the leaves are moving and that’s partly because of the limited amount of time most devices can actively “play” the game. But if, say with a device like Google Glass, you could be hunting Pokemon all day long? What if, rather than having to seek out Pokemon in a thirty minute “hunt,” you were hunting all day? Tracking steps all day to incubate eggs? Regularly checking into PokeStops and learning about those locations?
There are certainly risks, and those need to be mitigated. But there’s definitely a lot more opportunity too.
When you are strong enough to actually do battle at a gym, you pick one of three teams to join. These have their own internal meanings to the game and once you’ve joined a team, you can rely on those other team members for support in controlling gyms and help with training your Pokemon.
One thing that is currently lacking in this first version of the game is the ability to bring in one’s pre-existing social network. Because you must log into the game with your Gmail account or a Pokemon.com account, the audience is potentially limited when it comes to mining the available social network data that might be available with, say, a Facebook login. Then you could invite your friends to join your team in the search for Pokemon. You could actually provide each other with tactical and strategic support in quests as well as provide emotional and physical support in reaching goals. Our social networks are significant in our health decisions, and forcing users into only having the option of the three team options in the game – which are highly contrived and not very useful on their own, so far as I can tell – there are additional opportunities for increasing the effectiveness of the platform for health behavior generation.
One thing that is for sure: there are a lot of people I’ve watched over the past few days playing this game. Will it last? I’m not sure. But watching two people who are running around a park together while staring at their phone certainly acts as a pattern interrupt for me. I’ve watched as someone stared at their phone and walked around corners, and down streets, trying to engage the PokemonGO world largely oblivious to their surroundings except for what is represented on the screen. And when you see someone doing that, it definitely has a similar impact to the way that we all responded when Bluetooth headsets and wireless earphones became popular for holding mobile phone calls in the public.
Yes, it’s a pattern interrupt. And yes, it was extremely annoying when phone calls made it out into the general public, seemingly creating dialogue that only existed in the speaker’s head. But that has become so normalized now, I can’t imagine there won’t be a possibility of a similar normalization of that activity. And once normal, adoption will likely go up, not down.
Why is this important?
These are not the Pokemon you seek
While the PokemonGO craze has blown away the expectations of the game-makers, and frankly any Ingress user is probably also doing the, “I was geocaching before it was cool” thing right now, this does start a discussion about how we can better leverage the technology that is already available to us to change our behaviors in small, although ultimately significant, ways.
Just the beginning…
…but an important one. Critical events like this are rare in helping to shape how we want our world to look. Each of us has the capacity to impact the way that we want to engage with our communities and our technology. What do you want your world to look like? Or, more precisely, what do you want which of your worlds to look like?
To our health,
To stay ahead on topics related to this, follow me on Twitter @dz45tr
AUGMENTED REALITY, behavior, DESIGN, FLOW, gamification, GEOCACHING, GOOGLE, Health, Health inSite, HEALTHIT, INGRESS, MINES & Associates, Mobile, Network, NIANTIC, Pokemon, POKEMONGO, psychology, Social, SOCIAL NETWORK ANALYSIS, Technology, Trust, UBER, wellbeing
It’s no surprise that our family and friends have an impact on our own habits and preferences, but do we realize just how strong this influence can be and how much of what we do, eat, wear, say, and think may be a conglomerate of our social influences? Like it or not those close to us have a say in our lifestyle choices without us even being aware of it, and in turn, we influence our own family and friends even if we are incognizant of this power we possess. Now don’t worry, no one has mind control powers here, it’s just simple social influence, and habitual behavior developed over years of contact with those you spend time with. Now this influence can reach into all sorts of facets within your life, such as what TV shows you watch, what clothes you wear, and so on. This blog focuses on influence over our health habits and diet, and look at what sort of barriers to change certain social connections might pose.
The social influence of family on health and fitness affects all family members of all ages. It can be both for better and or worse in terms of the types of habits your social connections can have, even as adults. One study published in The American Journal of Health Promotion said that, “Data clearly indicate that social relationships have the potential for both health promoting and health damaging effects in older adults.” (Seeman 2000) Now this study may have been looking at adult influence but it extends to children as well. In fact the influence that parents have is much more persuasive, especially the younger a child is, so it is important to start training healthy, sustainable habits as early as possible.
Even with outside influences such as physical education in schools, how well children and teenagers adopt these programs depends largely on how the principles presented in the program are reinforced at home. One study looked at the efficacy of physical education programs in elementary school in relation to home support. The study took took two groups of elementary level students and gave them both the same physical education at school but only one group received the additional requirement that parents also conduct health and nutrition study at home. In the end, the students who had the at-home component scored significantly higher on physical education and nutrition testing, as well as more improved body fat composition and blood sugar levels than the students who had no at home participation. “The family component of the program provided a practical approach to improving physical activity and nutrition behaviors for elementary school teachers who teach many participants in a crowded curriculum” (Hoper, Munoz, Gruber, Nguyen, 2005).
Another way parents sway children’s health is by controlling access to certain healthy outlets. Until they are old enough and financially able to move out, children are, for the most part, at the mercy of the rules, standards, and family customs set by their parents. Parents are the gatekeepers. Make no mistake about it, kids may have preferences; however, their desires and what they are actually capable of are two different things. For example,12 year old Sally might really want to play soccer and get the outdoor exercise, but if her parents cannot or will not accommodate Sally’s desire to play soccer for whatever reason, such as being too lazy or busy to drive Sally to practice, access to this outlet is barred. “Parents’ reported physical activity was not associated with child activity or fitness. However, availability of transportation by parents to sport and fitness activities was significant…” (Sallis, Alcaraz, McKenzie, 1992). So all you soccer moms and dads can rejoice, for you are truly doing your children a favor and contributing to their future health habits. But encouragement sometimes isn’t going to be enough and that’s where engagement comes in.
Increasing the frequency that a person has in opportunity to engage in healthy activities with one another, increases the chances they will adopt the behavior in their life going forward, meaning that children, as well as adults, are much more likely to participate in an activity if they have a friend, family member, or spouse participating in the activity with them. This can be for various reasons that differ from individual to individual; whether it is a feeling of social obligation, a role model’s influence, or that it’s just more fun to do things with friends or family.
It’s not all about physical activity alone; diet plays an important factor as well. The food we eat and our likelihood of choosing the healthier option is weighted in the homestead as well. And it’s no joke just how much it matters that we are exposed to good balanced diets and nutrition information growing up. One study suggests, “Family and home environment factors explained more than 50% of the variance in students’ FV (fruit and vegetable) consumption.” (Gross, Pollock, Braun, 2010). Providing fruits and vegetables, teaching children about the importance of nutrition, and restricting processed and sugar-filled foods, are all important steps to contributing to a healthy lifestyle that will stick with children throughout their lives.
So with all this in mind we need to look at this from two directions; as influencers and as well as the influenced. As influencers, especially if you have children, you must be aware of the message you are sending whether it is by consciously or habitually setting an example, make sure it’s an example you want to set. Children learn by the do as I do rather as I say approach to parenting. As you take care of your own health by eating well, exercising, and showing that living well is a priority for you, friends, co-workers, children, and other connections in your life will be subtly swayed by your choices. As the influenced, it is all about awareness. By being aware of the influence that others may have, you can begin to choose what habits of others to adopt and which to ignore. Your friend that asks you to go hiking with them all the time, they might be making you a little more active; your friend that wants to go out drinking and eats nothing but junk food, maybe not so much. But don’t let this information keep you from hanging out with your favorite buddy just because they have some unhealthy habits or make a bad choice here and there, just be aware of their influence and maybe try and sway them to the side of wellbeing with a little social influence of your own.
To you wellbeing,
- Nic Mckane
Business Development Coordinator
MINES & Associates
Teresa E. Seeman (2000) Health Promoting Effects of Friends and Family on Health Outcomes in Older Adults. American Journal of Health Promotion: July/August 2000, Vol. 14, No. 6, pp. 362-370.
Susan M. Gross, PhD, MPH, RD Elizabeth Davenport Pollock, MS, LGMFT Bonnie Braun, PhD, CFCS. (2010) Family Influence: Key to Fruit and Vegetable Consumption among Fourth- and Fifth-grade Students. Journal of Nutrition Education and Behavior Volume 42, Issue 4, July–August 2010, Pages 235–241
James F. Sallis, PhD; John E. Alcaraz, PhD; Thomas L. McKenzie, PhD; Melbourne F. Hovell, PhD, MPH; Bohdan Kolody, PhD; Philip R. Nader, MD. Am J Dis Child. 1992;146(11):1383-1388. doi:10.1001/archpedi.1992.02160230141035.
Originally posted on xchangehealth:
There is a shift in healthcare related to our concept of privacy that is sorely needed – and it’s probably a little different than what you’ve heard from a lot of groups/people around the web.
We need to stop thinking about healthcare as a private thing.
As far as information about us, it’s simply no longer acceptable to consider our lives as private. Not in a time where we actually understand our social network to such a degree that we can accurately and effectively map our connections in the social network (not like Facebook but friends, family, co-workers, neighbors, and the ‘guy at the gym’) and understand how we consciously and unconsciously make decisions about how we behave. These behavioral changes manifest in health outcomes and as we move to a healthcare system (rather than a sickcare system) what you do is what you are – or more precisely what you are going to become. Now, I’m not saying you shouldn’t be protected from abuse or discrimination or anything like that, but functionally, your decisions every single day are going to have an impact on more than just you; you owe some accountability to your social network (and they to you) as to what your decisions are doing every day, because Community is the Key to Health.
You may not know it yet, but what you decided to eat for lunch today (if you ate lunch today – and for some of you that might not even be the case) was decided long before you actually ate your lunch. Here’s a non-exhaustive list of the ways in which this decision was made before you actually ate it:
Schedule: The structure of your day had an impact on what you ate for lunch. Did you have a co-occurring meeting and therefore ate a “bagged lunch?” Did you have a meal prepared ahead of time – and if not did you have to throw a lunch together this morning before leaving, or did it force you to “forage” for a lunch?
Environment: Consider how the environment surrounding your lunch impacts your lunch decision. Did you run out for lunch because you needed some fresh air or a break from the office? Do you have a place where you regularly eat lunch and therefore have a system for preparing for that meal each day – conversely, did that get interrupted for this particular lunch by environmental impacts like bad weather or the space itself was occupied in a way that prevented you from following that regular schedule?
Social Impact: For some, eating lunch is a social activity. Do you have a regularly scheduled lunch partner? Was that true today?
Resources: Money and time as resources have an impact on the structure of lunch. How do you use these resources in an intentional way related to your lunch habit? Do you spend money at a restaurant / court / vending machine each day or bring your lunch? Do you have the resources of time and money to prepare ahead or use those resources to forgo preparing ahead?
And let me tell ya’, this isn’t even the beginning of the ways that this could be further expanded. Think about all of the ways that a single meal is planned and replicate that process for each decision you make today. Exercise, nutrition, social activities, occupational activities, mindfulness activities, financial decisions, personal intellectual development, etc. etc. etc.
Now think about this: why did you make those decisions? Consciously or not, you may have made those decisions because of someone else. Did your partner pack your lunch and therefore help to make the decision of what you’re eating – or was shopping not prepared in a way to pack that lunch in the preferred way? How much of your diet is based on someone else’s decision? Maybe your doctor suggested a change in your diet? Maybe you or a family member has a dietary restriction that changes your diet on a daily basis. In the case of a family member’s restriction, maybe your lunch is the time when that restriction doesn’t apply to your personal diet?
Lastly consider this: Can you push yourself to make a given decision either by limiting or adding options? Can you change the options you have available at the point of decision-making with a little bit of foresight? Try to find one example of a way that you can “pre-decide” by removing the alternative option. Maybe one of the questions above can be flipped to help you make a “pre-decision” that will help you make a single, healthier decision this week – even if it’s only once. You might find it’s pretty easy to do and may be a powerful way to change your behavior in a positive way. And then consider the flip-side of this. How can you help someone else through a “pre-decision” that helps someone in your social network make a decision that is healthier for them?
Here’s what I’m saying, and to slightly alter a quote from Cloud Atlas:
Our health is not our own. We are bound to others, near and far, and by each decision and every sharing of those decisions, we birth our health.
It’s time for us to stop thinking that we are fully separate members of society that don’t have an impact on others and start being accountable to one another for how the decisions we make impact others – and vice versa. Yes, even in health.
To our health,
Manager, Engagement & Development
Follow me on twitter: @dz45tr
Each week I take an hour to join with a few colleagues and thought-leaders around the world on twitter to discuss all kinds of interesting topics related to where healthcare is going, what to expect in the intersection between Health and Technology, and how we might play a role in that changing landscape. These TweetChats are an opportunity to learn, share, and ultimately understand how social media, technology, and the role of various players in the healthcare world might better work together. Often, we turn to the topic of patient engagement. This is focused on what tools, technology, and other needs might help to get patients more involved in their own health. This can come in the form of tracking various metrics (see the Quantified Self movement) to making sure that individuals on medication are staying on top of that treatment to ensure their continued health improvement. While in our last TweetChat, which emphasized Patient Engagement and Experience specifically. We discussed that it was important for us to focus on what the patient could do, yes, but also what the provider and the payer could do. This is a common picture of the players in the healthcare world. Someone needs the service (patient), someone provides the service (provider), and someone pays for the service (payer). It looks sort of like this:
But that’s not really the whole picture, now is it? The truth is that this is the model of a sick-care system. As I’ve mentioned in blog postings beforehand, in order to keep people as healthy as possible before they need to access the healthcare system, the system must account for one more “P” in this proverbial puzzle (or pie, if you’d like!); one’s Peers:
It’s the convergence of all four P’s (Provider, Payer, Patient, and that Patient’s Peers) that will allow for greater healthcare reach. When the Payer and the Provider are able to engage the Patient’s Peers, then true health generation is possible and the benefits of one’s social network can then be fully leveraged.
With that, I submit a new hashtag for the consideration of a community that continually strives to make the very complicated healthcare system a little simpler as we move towards greater total health and wellbeing of the individuals that have to access this system. #4PHealth represents the four core stakeholders in healthcare that ultimately are responsible for the health of the patient and responsible for keeping that patient out of the hospital, involved and engaged in their total health and wellbeing, and always striving to improve one’s total health picture. When the Patient, Provider, Payer, and Peers come together, total wellbeing is possible.
This doesn’t have to be limited to the TwitterSphere, though. Take a moment and think about the real-world applications of this for you in your life. What can you be doing to help those in your peer group become healthier? What opportunities are there for you to help generate greater health for yourself and for your friends, family, and coworkers? What can you ask of your peers to help you with to create better health for yourself? The 4P model may not be the easiest thing for us to accomplish in our current healthcare system given the disjointed nature of care models, but you still have the ability to start working on the fourth “P” today. What will your first step be?
To our health,
(illustrations assembled myself!)
A review of a year and a half of Health inSite research and how I think one group is probably more on target than some might think.
I’m going to start out by laying out a couple of concepts for review.
Placebos and psychology
A placebo is defined as “a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient.” This causes what is called the placebo effect. A patient is said to have experienced a placebo effect when the intended deception manifests experienced results. While the research indicates that there is a small range of people that are susceptible to the effect, that range hovers at around 30% of the population.
One might ask, “How is it possible that the effects of a non-drug could be experienced as having the results of an actual drug that has the intended, or actual, impact on a patient?” This is explained as the product of self-fulfilling prophesy, or a form of expectation bias. If you recall the previous posting on Thinking Fast and Slow, one of the difficulties we face as human beings is both our difficulty in matching up experience and memory, as well as overcoming biases that tint our understanding of rational data. In a word, we are not always rational beings and sometimes our understanding of an experience or idea is subject to our memory and cognitive constructs that allow us to think fast. We respond the way that our mind has told our body it expected to experience the event. The concept, “Where your mind goes, the energy goes,” has been mentioned extensively by my colleague Dr. Mines in his series on Psychology of Performance, beginning with his first posting.
Hysteria (or mass psychogenic illness)
If you happened to miss the events in Le Roy, NY, where 18 people experienced Tourette’s-like symptoms for an extended period of time, there were many that identified the cause of the experience of these individuals as mass psychogenic illness. Mass psychogenic illness has been largely attributed to situations in which individuals are experiencing similar physical effects (tics, for example) without any clear physical reasons (e.g., environmental toxins, viral or biological triggers, etc.). Historically, this has been referred to as mass hysteria. The complexity of the condition has led many to write it off, but the core assumptions of mass psychogenic illness are sound given what we know about social influence. Oftentimes in mass psychogenic illness, an index case is discovered in which someone’s conversion disorder acts as a catalyst to the development and spread of the illness through the network.
Assuming that this is the way in which mass psychogenic illness works, index cases could be used to induce behavior change in a network towards a positive outcome. In this way, it is not mass psychogenic illness, but mass psychogenic salutogenesis (widespread generation of health through the influence of the mind over the body within the social structure of a network).
CBT and treatment adherence
Critical to adherence to any health maintenance or treatment protocol plan is the ritualizing of new behavior. In the chemical dependency field, we’ve known this for a long time. By creating new routines that positively impact our behavior; we are able to more easily overcome the many triggers that previously caused our substance use.
Triggers are defined in the substance abuse field as events, emotions, or thoughts that trigger the addiction response. They are a major focus in many treatment protocols and are especially important for recognition in the cognitive behavioral therapy (CBT) model. The goal in CBT is to identify why it is that we respond to thoughts, emotions, and events and then to develop, for ourselves with the help of a therapist, ways to counter the effect of those triggers. In this way, it’s not the abolition or avoidance of triggers so much as a rational understanding of the trigger and building tools to overcome that trigger’s effect on the coached patient/client.
Network theory, social comparison, and braggadocian behavior
If you’ve read all of the links to other blog postings in the Health inSite category, but missed the posting on braggadocian behavior, the concept is very simply that social media has enabled us to engage in bragging around the things that we are doing and that this activity can influence the way that others perceive us – and we do this to intentionally accomplish that change in perception. This gives us the ability to influence the way that others behave as they engage in responses which may include trying to match our behavior (wittingly or unwittingly) or rejection of our behavior as a method of coping with one’s own deficiency in the category of behavior being expressed. This has a powerful impact on the social network in which agents operate as they can directly and indirectly influence the behaviors of individuals that are proximally or distally connected to them.
In their book Connected, Christakis and Fowler explore the significant effects that our social network has on our health and health behaviors. Social networks, of course, are not just websites like Facebook or Twitter, but all forms of interaction that we have with various people in our lives, including our family, friends, co-workers, neighbors, and even the people at the grocery store. The power of individuals to have an effect across a network based on their location within the network is a clear and well-documented reality.
Suspension of disbelief
As I mentioned in an earlier blog posting on the fourth and fifth wall, suspension of disbelief is critical to the effectiveness of theater. Without the audience allowing suspension of disbelief, a presentation falls flat in its ability to engage the audience emotionally. Think back to a PowerPoint presentation that was particularly awful because the speaker failed to actively paint a picture that the audience could connect with. Similarly, engagement strategies are starting to use these concepts to create thick tapestries of story that immerse the audience in the story-line, and even sometimes ask them to co-create the story, as in the case of the Lizzie Bennet Diaries’ spin-off series, Welcome to Sanditon.
Recently, an IndieGoGo campaign was started for a new project that would create a placebo app. You might think to yourself, “How the heck could a placebo app affect someone’s health?” The app, which leverages the power of mirror neuron activity and the placebo effect by creating positive thought-feelings in the brain, could actually override the systems in the brain that cause us to act irrationally in terms of triggers and cognitive biases by leveraging suspension of disbelief. Further, the app allows individuals to interact with their social network around their use of the placebo app, creating a unique opportunity for mass psychogenic salutogenesis. Now all we need are some index cases to start the process toward a tipping point.
It will be interesting to see the resulting data from this project as we would expect that there is a real opportunity for this to be leveraged to significant effect, not only for those directly accessing the placebo app, but also those that end up interacting with those users. But the rest of the story is still to come.
Whew, that was quite a round-up of research, huh? Comment or send questions!
To stay ahead on topics related to this, follow me on Twitter @dz45tr
app, bias, Braggadocian Behavior, CBT, Cognitive, Cognitive Behavioral Therapy, comparison, conversion disorder, effect, fifth wall, fourth wall, Health, indiegogo, Influence, Kahneman, lizzie bennet diaries, mass psychogenic illness, mirror neuron, Network, placebo, Psychology of Performance, salutogenesis, self-fulfilling prophesy, Social, thinking fast and slow, Twitter, welcome to sanditon
One of the most compelling bodies of research for providing coverage for all comes from the mental health sector in the form of Employee Assistance Programs (EAP) that are offered by almost all of the largest employers in the country. EAP’s typically offer free counseling or psychotherapy sessions to anyone in the employee’s household. This reduces the barriers to access (such as co-pays, deductibles) and allows for earlier intervention. The medical cost offset literature is very clear that as co-pays go up, individuals with chronic illnesses and limited income such as those that may be enrolled in Medicaid programs defer purchasing medication even though not taking the medication eventually will result in serious medical complications. Having no insurance will increase the probability even further that “healthy” individuals will be even less likely to seek medical care than other populations when they need it because of the barriers to access, thus driving up costs in the public sector, or contributing to medical bankruptcies when treatable illnesses become complicated later in the course of the illness.
Beside early access and cost reduction, the future of our health as a country lies in proactive wellbeing interventions. As one of the most obese countries in the world due to our over-reliance on processed foods, high carbohydrate diets, and excess animal protein consumption, our medical costs are only going to continue to sky rocket unless we start applying what we know from the behavioral health research related to adherence and relapse on health behavior. Using wellness coaching to modify health beliefs, food choices, exercise adherence, and other healthy behaviors will not only save lives, it will improve the quality of life for all of those in the community. The Social Psychology of health research indicates that “your friends’ friends make you fat.” The converse is also true; they can also make you healthy.
If that’s not enough…
We also know from the literature that simply being healthy does not exist in a vacuum and that, in fact, just because one happens to be healthy now, does not preclude them from treatment planning. Healthy people need to exercise, they need to choose whole and nutritious foods, and they need skills development to help them affect cohorts in the workplace. The idea that has been put forward that suggests that healthy people don’t need insurance, or more precisely, don’t need to engage in the healthcare market, ignores the continuum of health. We don’t innately become or stay healthy, that comes from behavioral decisions, influenced or bolstered by our social networks. Therefore, every person we enroll in a healthcare plan leads to 2nd and 3rd link solutions for others within the network.
The return on investment for the individual, the employer, and society is significant. For example, EAP’s have been shown to return $4.00 to $22.00 per employee per month. The difference between these two numbers is largely due to the panoply of programs available and the ways in which these proactive programs are promoted. The medical cost offset literature for treatment of co-morbid mental health diagnoses and medical conditions would more than pay for the cost of the premiums to the individual. The savings to the U.S. government (thus its citizens) of not having to bail out the insurance companies would be in the 100’s of billions.
There is precedent that even though we as U.S. citizens have our civil liberties (which have been seriously compromised in the last ten years) and freedom of choice, in some cases those choices are limited because of the negative impact on the community. For example, drug testing to ensure safer work places, lowered speed limits in school areas, and even paying into the Social Security system are all ways that we, as a community, have come together to make a decision for the benefit of all. Having a fully-insured population for this country falls into the same societal good ethics argument and this is what makes our country great!
Robert A. Mines, Ph.D.
CEO & Psychologist
Nature of the problem
There is interesting disparity in understanding regarding the health care reform act and the impact on requiring individual coverage. The assumption is that it violates individual freedom of choice and will be costly to that individual. But in actuality, the impact of the individual coverage tax penalty of the Act will affect only 2% of the population.
Some thoughts on the PPACA
Last week, the Supreme Court of the United States held 6.25 hours of discussion regarding three pieces of the PPACA: severability, the constitutionality of the individual mandate, and the effect of overturning the mandate. To listen to the various sessions that occurred, you can find those here:
In these many arguments, some interesting points stand out to us (please keep in mind that we’re not lawyers, we are behavioral health experts):
- Choosing to not purchase something is still a decision of commerce. Choosing to not purchase today may result in increased cost tomorrow and therefore deferring the decision is an increased risk to the overall economic fabric. Further, deciding to not engage in the economy is in its own right still engaging with the economy as choosing to not purchase something means that the demand/supply relationship is affected by not purchasing.
- It would seem that since Massachusetts already has an individual mandate within the state, and that there are no limitations to traveling across or emigrating to other states within the Union could mean that one could defer purchasing insurance until a critical or chronic condition occurred and move to Massachusetts and increase the liability and cost of the risk pool, thereby adversely affecting the Massachusetts healthcare burden and budget.
From a Social Psychology perspective, it is clear that choosing, or not choosing, to participate in a program that ultimately will be utilized by the greatest majority of citizens at some point in their lives, is a behavior of short-sighted self-interest and poor, long-term risk management.
If the Supreme Court overturns the tax penalty portion of this law, there are projected scenarios that include bankrupting insurance companies as the number of those with pre-existing conditions who have been limited in obtaining insurance will sign up. The healthy may not enroll, thus shrinking the pool that the risk can be distributed across. The U.S. government may then be faced with bailing out the insurance companies which it, in all likelihood, will not be able to do. The other hidden cost is that those who are “healthy” and uninsured are still at the same risk for mental health and substance use problems. The research in the behavioral health arena has documented consistent epidemiology data that those in the “healthy” group are no less vulnerable to addictions, depression, anxiety disorders, and other mental illnesses than other groups in the population. In addition, the costs to employers of these illnesses are significant. Individuals with co-morbid diagnoses have significantly higher medical costs when they experience cardiac events, cancer, chronic illnesses such as diabetes, and greater difficulty with losing weight if they are obese which causes further medical costs downstream. Allowing the “healthy” to remain uninsured creates unnecessary costs to themselves, their employers, and to society.
Robert A. Mines, Ph.D.
CEO & Psychologist
The latest issue of Harvard Business Review published the results of a large-sample-based article (Lynette Ryals and Iain Davies, authors) on successful and unsuccessful sales people. To the extent that empirical-based research exists on sales performance, this article is an important step forward. (http://hbr.org/web/extras/the-trouble-with-salespeople/1-slide). The top sales people were described as experts, closers and consultants. The bottom 2/3 of the sample were described as story tellers, focusers, narrators, aggressors and socializers. The value of this taxonomy is that it allows sales managers to focus on areas for coaching and training that need refinement or improvement for the sales staff. This allows the manager to do it systematically rather than situationally or case-by-case on each sale. A key recurring theme for the bottom two thirds is that the styles collectively share a common communication error of not doing a good job of qualifying a prospect and not assessing the prospects “pain” through good listening and questioning skills. They tend to communicate by the “show up and throw up,” “let me bully you,” or distraction techniques of talking about anything but the sales situation.
The social psychology of a sale is partially about a thorough assessment and application of persuasion and motivation research. If MINES can assist you and your staff to attain higher levels of performance, please contact us.