Most adults with access to the Internet have used it to search for health information, and half of these queries are for friends or family of the searcher. Unfortunately, access to the Internet varies by socioeconomic status, hence the well quantified """"""""digital divide:"""""""" 65% of white adults in the United States searched online for health information in 2008 versus 51% of African Americans and 44% of Hispanics. An alternate mechanism with which to convey visual content (e.g., pictures, animations, and videos) is the ubiquitous cell phone, and demographics with less access to the Internet tend to be more frequent users of mobile multimedia: 54% of white adults use multimedia messaging on their phones, versus 56% of African Americans and 76% of Hispanics. Multimedia messaging between friends and family is the fastest growing data service on cell phones and the second most invoked (text messaging being the first), but it is not used as a communications medium on which to deliver health information due to technical barriers that include instructional design constraints and a lack of device and wireless carrier interoperability. The proposed STTR Phase I effort will investigate the feasibility of using mobile multimedia for health outreach, the appeal of multimedia messaging to health outreach users, and its effectiveness in facilitating the sharing of health outreach information among social groups. The effort focuses on differences between multimedia messaging and traditional web-based outreach, including the personal nature of mobile devices, user acceptance of pushed content, and the cost to a web-based outreach program of repurposing content and maintaining wireless opt-in enrollment. The effort will also investigate the potential of outreach recipients to disseminate health outreach through peer-to-peer forwarding of multimedia messages, and posting multimedia messages on social websites (e.g., Twitter and Facebook). The ability of a public health outreach program to send multimedia to any (opted-in) cell phone, and the ability of any user to post multimedia content on a social network web site from any cell phone, require technical solutions to the current lack of interoperability. In order to conduct field tests within the Phase I period of performance, the proposed effort builds upon two ongoing projects: the Community Outreach and Education Core (COEC) at the University of Medicine and Dentistry of New Jersey (UMDNJ) and Cell Podium's Just-In- Time Training for Emergency Incidents System (JITTEIS). COEC translates research information from the Center for Environmental Exposures and Disease (CEED), an NIEHS Environmental Health Sciences Core Center, into tools and resources for community stakeholders. The goals of COEC are to (1) develop partnerships with community stakeholders to translate and disseminate CEED research information;(2) enhance the dialogue on environmental health issues between community stakeholders and CEED researchers;(3) increase awareness and understanding of environmental health research;and (4) promote environmental health research as a career option. JITTEIS is a training technology being developed under the NIEHS Worker Education and Training Program that serves skilled support personnel (SSP, e.g., carpenters, ironworkers, sanitation workers) deployed to aid first responders in emergency incidents. SSP are often exposed to the same hazards as first responders, but lack formal instruction in hazard assessment and the use of personal protective equipment. When SSP are deployed to an incident, JITTEIS sends brief relevant multimedia lessons to their cell phones in the form of multimedia messages. JITTEIS works with the SSP's existing cell phone, carrier, and wireless subscription plan, and does not require the SSP to change any settings in the phone or account, install any software, or browse for content. The proposed effort adapts JITTEIS technology to community outreach and education at the COEC, and assesses this new outreach medium with COEC stakeholders. Mobile multimedia will complement COEC's current dissemination of CEED research by providing COEC's target audiences with timely and regular access to CEED research information well beyond the annual COEC events, even if the user has no computer experience. Any user will be able to opt in and select specific topics of interest. As COEC develops information on CEED research and community events, this technology will push it onto users'phones in the form of easily assimilated multimedia. At any time, the user can view the content, forward it to the mobile devices or email of friends and family, and post it on any social networking site, thereby leveraging communications among peers to increase the audience footprint of the outreach messages.
Demographics underserved by the digital divide tend to be more frequent users of cell phone functionality that can convey and propagate health information. However, public health outreach in the United States does not exploit this communications medium, and the country overall lags behind the rest of the world in the adoption of cell phones in mobile learning. The proposed effort is a public application of mobile learning that addresses the technical interoperability and instructional design barriers that have previously impeded such services: the public at large will have access to appealing health outreach multimedia regardless of their cell phone. Unlike a web-based experience, the proposed messaging pushes theme-specific multimedia outreach to the phone without requiring the user to browse for it, and is easily forwarded by the user to his/her friends, family, and social websites, potentially accelerating the dissemination and coverage of public health outreach.
