Brian J. Biroscak

Elder Abuse in Long-Term Care: Types, Patterns, and Risk Factors

The authors investigated types and patterns of elder abuse by paid caregivers in long-term care and assessed the role of several risk factors for different abuses and for multiple abuse types. The results are based on a 2005 random-digit-dial survey of relatives of persons in long-term care. We computed occurrence rates and conditional occurrence rates for each of six abuse types: physical, caretaking, verbal, emotional, neglect, and material. Among older adults who have experienced at least one type of abuse, more than half (51.4%) have experienced another type of abuse. Physical functioning problems, activities of daily living limitations, and behavioral problems are significant risk factors for at least three types of abuse and are significant for multiple abuse types. The findings have implications for those monitoring the well-being of older adults in long-term care as well as those responsible for developing public health interventions.

Use of Ultrasound Guidance Improves Central Venous Catheter Insertion Success Rates Among Junior Residents

The purpose of this study was to determine whether junior residents had higher rates of first cannulation and overall success at central venous catheter insertions with the use of ultrasound (US) guidance compared to the landmark technique.

Community-Based Prevention Marketing for Policy Development A New Planning Framework for Coalitions

Community-based prevention marketing (CBPM) is a community-driven framework for program planning, which applies social marketing concepts and techniques to the development of health behavior interventions. Whereas community members who comprise an action committee or coalition set the goals and make programmatic decisions, social marketing provides the planning framework to guide program design, implementation, and evaluation. CBPM has guided successful initiatives to promote physical activity in both youth and adults, to increase safety eyewear use in agricultural settings, and to delay alcohol and tobacco initiation among youth. However, the emergence of evidence-based policy has fostered renewed interest in “upstream” approaches to health behavior change that, in the United States, have included community partnerships as an important tool for policy development. Unfortunately, these community partnerships have had variable success because of the lack of a systematic framework for identifying, selecting, tailoring, and promoting evidence-based policies. We describe the adaptation and application of CBPM to improve community capacity for identifying and promoting evidence-based policies. The resulting framework, CBPM for Policy Development, is comprised of the following eight steps: (1) build a strong foundation for success; (2) review evidence-based policy options; (3) select a policy to promote; (4) identify priority audiences among beneficiaries, stakeholders, and policy makers; (5) conduct formative research with priority audiences; (6) develop a marketing plan for promoting the policy; (7) develop a plan for monitoring implementation and evaluating impact; and (8) advocate for policy change. We provide a description of each step and an examination of the experiences and lessons learned in applying it to youth obesity prevention.

Applying Systems Science to Evaluate a Community-Based Social Marketing Innovation A Case Study

In the United States, community coalitions are an important part of the public health milieu, and thus, subject to many of the same external pressures as other organizations—including changes in required strategic orientation. Many funding agencies have shifted their funding agenda from program development to policy change. Thus, the Florida Prevention Research Center created the Community-Based Prevention Marketing (CBPM) for Policy Development framework to teach community coalitions how to apply social marketing to policy change. The research reported here was designed to explicate the framework’s theory of change. We describe and demonstrate a hybrid evaluation approach: utilization-focused developmental evaluation. The research question was “What are the linkages and connections among CBPM inputs, activities, immediate outcomes, intermediate outcomes, and ultimate impacts?” We implemented a case study design, with the case being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling. Community coalition leaders may expect CBPM to provide immediate gains in coalition performance. Results from causal diagramming show how gains in performance are delayed and follow an initial decline in performance. We discuss the practical implications for CBPM’s developers—for example, importance of managing coalition expectations—and other social marketers—for example, expansion of the evaluation toolkit.

The Prevalence and Characteristics of Emergency Medicine Patient Use of New Media

Background Little is known about “new media” use, defined as media content created or consumed on demand on an electronic device, by patients in emergency department (ED) settings. The application of this technology has the potential to enhance health care beyond the index visit. Objective The objectives are to determine the prevalence and characteristics of ED patients’ use of new media and to then define and identify the potential of new media to transcend health care barriers and improve the public’s health. Methods Face-to-face, cross-sectional surveys in Spanish and English were given to 5,994 patients who were sequentially enrolled from July 12 to August 30, 2012. Data were collected from across a Southern Connecticut health care system’s 3 high-volume EDs for 24 hours a day, 7 days a week for 6 weeks. The EDs were part of an urban academic teaching hospital, an urban community hospital, and an academic affiliate hospital. Results A total of 5,994 (89% response rate) ED patients reported identical ownership of cell phones (85%, P<.001) and smartphones (51%, P<.001) that were used for calling (99%, P<.001). The older the patient, however, the less likely it was that the patient used the phone for texting (96% vs 16%, P<.001). Income was positively associated with smartphone ownership (P<.001) and the use of health apps (P>.05) and personal health records (P<.001). Ownership of iPhones compared to Android phones were similar (44% vs 45%, P<.05). Race and ethnicity played a significant role in texting and smartphone ownership, with Hispanics reporting the highest rates of 79% and 56%, respectively, followed by black non-Hispanics at 77% and 54%, respectively, and white non-Hispanics at 65% and 42%, respectively (P<.05). Conclusions There is a critical mass of ED patients who use new media. Older persons are less comfortable texting and using smartphone apps. Income status has a positive relationship with smartphone ownership and use of smartphone apps. Regardless of income, however, texting and ownership of smartphones was highest for Latinos and black non-Latinos. These findings have implications for expanding health care beyond the ED visit through the use of cell phones, smartphones, texting, the Internet, and health care apps to improve the health of the public.

Non-linear causal modelling in social marketing for wicked problems

Purpose The purpose of this paper is to show how non-linear causal modelling knowledge, already accumulated by other disciplines, is central to unravelling wicked problem scoping and definition in social marketing. Design/methodology/approach The paper is an illustrative case study approach, highlighting three real-world exemplars of causal modelling for wicked problem definition. Findings The findings show how the traditional linear research methods of social marketing are not sensitive enough to the dynamics and complexities of wicked problems. A shift to non-linear causal modelling techniques and methods, using interaction as the unit of analysis, provides insight and understanding into the chains of causal dependencies underlying social marketing problems. Research limitations/implications This research extends the application of systems thinking in social marketing through the illustration of three non-linear causal modelling techniques, namely, collective intelligence, fuzzy cognitive mapping and system dynamics modelling. Each technique has the capacity to visualise structural and behavioural properties of complex systems and identify the central interactions driving behaviour. Practical implications Non-linear causal modelling methods provide a robust platform for practical manifestations of collaborative-based strategic projects in social marketing, when used with participatory research, suitable for micro, meso, macro or systems wide interventions. Originality/value The paper identifies non-linear causality as central to wicked problem scoping identification, documentation and analysis in social marketing. This paper advances multi-causal knowledge in the social marketing paradigm by using fuzzy, collective and interpretative methods as a bridge between linear and non-linear causality in wicked problem research.

Social Marketing and Policy Making: Tools for Community-Based Policy Advocacy

The Florida Prevention Research Center (FPRC) at the University of South Florida has been funded by the U.S. Centers for Disease Control and Prevention (CDC) since 1998. In that time, its staff of researchers and practitioners have codeveloped with its community partners a wealth of tools for using social marketing to address local problems. Similar to the field of social marketing, the FPRC is evolving from exclusively developing ‘‘downstream’’ innovations to working farther ‘‘upstream,’’ which means we are frequently developing and testing new types of tools for those purposes. In this ‘‘Tools from the Field’’ paper, we share some tools and lessons learned for carrying out social marketing with community coalitions as well as preview forthcoming tools emanating from our latest CDC-funded research.

Applying Tools From Human-Centered Design to Social Marketing Planning

In this “Tools From the Field” paper, we report our experiences using human-centered design (HCD), a process for using innovation as a means of developing more effective marketing offerings. The context for our use of HCD tools was a partnership with a new community committee. We combined elements of our previous social marketing frameworks -Community-Based Prevention Marketing (CBPM) for Program Development; CBPM for Policy Development–into a version better suited to address complex, dynamic problems that require a whole-systems perspective. Our product development work for this next iteration of the CBPM framework incorporated several HCD tools adapted from the prolific design firm, IDEO. The HCD process consists of three phases: inspiration (e.g., learning from those that one is designing for), ideation (e.g., brainstorming and prototyping), and implementation (e.g., building partnerships and launching a business model). In this paper, we describe “tools” for the application of HCD within the context of rapidly prototyping and testing CBPM framework activities for use with our community committee partners; we provide practical advice for the use of these tools (“process points”); and we present a real-world application from development of our new CBPM framework (“tools in action”). Overall, the HCD tools from IDEO helped us see new opportunities for our framework, transform insights into actionable ideas, and increase the speed of producing a minimum viable product and gathering feedback on it from our customers. We believe that HCD tools are worth exploring when it comes to the social marketing planning process.

Policy, Systems, and Environmental Change: Reflections and Suggestions for Social Marketers

I would like to thank the Editors and Editorial Board of Social Marketing Quarterly (SMQ) for inviting me to serve as Guest Editor for this Special Contribution on “Social Marketing for Policy, Systems, and Environmental Change.” In particular, I would like to thank Sameer Deshpande, Editor, and Ryan Hollm, Managing Editor. This has been a terrific opportunity not only because SMQ is the field’s longest running journal but also because its Founding Editors—Carol Bryant and Jim Lindenberger— are two people I have come to admire, starting with our time together at the University of South Florida. For this Special Contribution, SMQ invited submissions investigating the use of social marketing to stimulate behavior change through improving policies, systems, and macro-environmental factors. Had it not been for Carol, Jim, and so many other wonderful people at the University of South Florida’s Florida Prevention Research Center, I doubt that I would have started down the path of studying participatory social marketing frameworks and the use of social marketing to influence behavior through policy, systems, and environmental change. In the past, social marketing was subjected to the following types of critiques:

Leximancer Software as a Research Tool for Social Marketers: Application to a Content Analysis

The amount of human effort required to do content analysis research “by hand” is often time-consuming, and unreliability is a common concern. Our aim was to conduct a content analysis that traces the history of Social Marketing Quarterly (SMQ) articles by using Leximancer (version 4.5)—a software tool designed for analyzing natural-language text data. We adhered to Krippendorff’s network of steps to address two research questions: (1) “What are the prevailing conceptualizations of the application of social marketing?” and (2) “How have those conceptualizations changed over time?” We identified all SMQ volumes/issues published between May 1994 (inaugural issue) and September 2015. Our sampling units consisted of all SMQ “Application” articles published during that time (n = 162). Leximancer output includes a conceptual map representing the main concepts within the text and how they are related (themes). Based on conceptual and relational analyses, one would surmise that social marketing applications (e.g., campaigns) predominantly address health-related problems through behavioral influence strategies, informed by audience research and designed to include the elements of the marketing mix (e.g., messaging). The predominant health topic addressed by social marketing applications has been tobacco use and smoking. Leximancer has a number of desirable features including an ability to quickly handle large amounts of text in various formats and languages. However, those features are no substitute for a content analysis design that makes the research reproducible and available for critical examination—a shortcoming of previous content analyses of the social marketing field.