Rebecca Weintraub, Aaron C. Beals, Sophie G. Beauvais, Marie Connelly, Julie Rosenberg Talbot, Aaron VanDerlip, and Keri Wachter in HBR Blog Network : “In response, our team at the Global Health Delivery Project at Harvard launched an online platform to generate and disseminate knowledge in health care delivery. With guidance from Paul English, chief technology officer of Kayak, we borrowed a common tool from business — professional virtual communities (PVCs) — and adapted it to leverage the wisdom of the crowds. In business, PVCs are used for knowledge management and exchange across multiple organizations, industries, and geographies. In health care, we thought, they could be a rapid, practical means for diverse professionals to share insights and tactics. As GHDonline’s rapid growth and success have demonstrated, they can indeed be a valuable tool for improving the efficiency, quality, and the ultimate value of health care delivery….
Creating a professional virtual network that would be high quality, participatory, and trusted required some trial and error both in terms of the content and technology. What features would make the site inviting, accessible, and useful? How could members establish trust? What would it take to involve professionals from differing time zones in different languages?
The team launched GHDonline in June 2008 with public communities in tuberculosis-infection control, drug-resistant tuberculosis, adherence and retention, and health information technology. Bowing to the reality of the sporadic electricity service and limited internet bandwidth available in many countries, we built a lightweight platform, meaning that the site minimized the use of images and only had features deemed essential….
Even with early successes in terms of membership growth and daily postings to communities, user feedback and analytics directed the team to simplify the user navigation and experience. Longer, more nuanced, in-depth conversations in the communities were turned into “discussion briefs” — two-page, moderator-reviewed summaries of the conversations. The GHDonline team integrated Google Translate to accommodate the growing number of non-native English speakers. New public communities were launched for nursing, surgery, and HIV and malaria treatment and prevention. You can view all of the features of GHDOnline here (PDF).”
The Science Behind Using Online Communities To Change Behavior
Sean D. Young in TechCrunch: “Although social media and online communities might have been developed for people to connect and share information, recent research shows that these technologies are really helpful in changing behaviors. My colleagues and I in the medical school, for instance, created online communities designed to improve health by getting people to do things, such as test for HIV, stop using methamphetamines, and just de-stress and relax. We don’t handpick people to join because we think they’ll love the technology; that’s not how science works. We invite them because the technology is relevant to them — they’re engaging in drugs, sex and other behaviors that might put themselves and others at risk. It’s our job to create the communities in a way that engages them enough to want to stay and participate. Yes, we do offer to pay them $30 to complete an hour-long survey, but then they are free to collect their money and never talk to us again. But for some reason, they stay in the group and decide to be actively engaged with strangers.
So how do we create online communities that keep people engaged and change their behaviors? Our starting point is to understand and address their psychological needs….
Throughout our research, we find that newly created online communities can change people’s behaviors by addressing the following psychological needs:
The Need to Trust. Sharing our thoughts, experiences, and difficulties with others makes us feel closer to others and increases our trust. When we trust people, we’re more open-minded, more willing to learn, and more willing to change our behavior. In our studies, we found that sharing personal information (even something as small as describing what you did today) can help increase trust and change behavior.
The Need to Fit In. Most of us inherently strive to fit in. Social norms, or other people’s attitudes and behaviors, heavily influence our own attitudes and behaviors. Each time a new online community or group forms, it creates its own set of social norms and expectations for how people should behave. Most people are willing to change their attitudes and/or behavior to fit these group norms and fit in with the community.
The Need for Self-Worth. When people feel good about themselves, they are more open to change and feel empowered to be able to change their behavior. When an online community is designed to have people support and care for each other, they can help to increase self-esteem.
The Need to Be Rewarded for Good Behavior. Anyone who has trained a puppy knows that you can get him to keep sitting as long as you keep the treats flowing to reward him, but if you want to wean him off the treats and really train him then you’ll need to begin spacing out the treats to make them less predictable. Well, people aren’t that different from animals in that way and can be trained with reinforcements too. For example, “liking” people’s communications when they immediately join a network, and then progressively spacing out the time that their posts are liked (psychologists call this variable reinforcement) can be incorporated onto social network platforms to encourage them to keep posting content. Eventually, these behaviors become habits.
The Need to Feel Empowered. While increasing self-esteem makes people feel good about themselves, increasing empowerment helps them know they have the ability to change. Creating a sense of empowerment is one of the most powerful predictors of whether people will change their behavior. Belonging to a network of people who are changing their own behaviors, support our needs, and are confident in our changing our behavior empowers us and gives us the ability to change our behavior.”
Mobile phone data are a treasure-trove for development
Paul van der Boor and Amy Wesolowski in SciDevNet: “Each of us generates streams of digital information — a digital ‘exhaust trail’ that provides real-time information to guide decisions that affect our lives. For example, Google informs us about traffic by using both its ‘My Location’ feature on mobile phones and third-party databases to aggregate location data. BBVA, one of Spain’s largest banks, analyses transactions such as credit card payments as well as ATM withdrawals to find out when and where peak spending occurs.This type of data harvest is of great value. But, often, there is so much data that its owners lack the know-how to process it and fail to realise its potential value to policymakers.
Meanwhile, many countries, particularly in the developing world, have a dearth of information. In resource-poor nations, the public sector often lives in an analogue world where piles of paper impede operations and policymakers are hindered by uncertainty about their own strengths and capabilities.Nonetheless, mobile phones have quickly pervaded the lives of even the poorest: 75 per cent of the world’s 5.5 billion mobile subscriptions are in emerging markets. These people are also generating digital trails of anything from their movements to mobile phone top-up patterns. It may seem that putting this information to use would take vast analytical capacity. But using relatively simple methods, researchers can analyse existing mobile phone data, especially in poor countries, to improve decision-making.
Think of existing, available data as low-hanging fruit that we — two graduate students — could analyse in less than a month. This is not a test of data-scientist prowess, but more a way of saying that anyone could do it.
There are three areas that should be ‘low-hanging fruit’ in terms of their potential to dramatically improve decision-making in information-poor countries: coupling healthcare data with mobile phone data to predict disease outbreaks; using mobile phone money transactions and top-up data to assess economic growth; and predicting travel patterns after a natural disaster using historical movement patterns from mobile phone data to design robust response programmes.
Another possibility is using call-data records to analyse urban movement to identify traffic congestion points. Nationally, this can be used to prioritise infrastructure projects such as road expansion and bridge building.
The information that these analyses could provide would be lifesaving — not just informative or revenue-increasing, like much of this work currently performed in developed countries.
But some work of high social value is being done. For example, different teams of European and US researchers are trying to estimate the links between mobile phone use and regional economic development. They are using various techniques, such as merging night-time satellite imagery from NASA with mobile phone data to create behavioural fingerprints. They have found that this may be a cost-effective way to understand a country’s economic activity and, potentially, guide government spending.
Another example is given by researchers (including one of this article’s authors) who have analysed call-data records from subscribers in Kenya to understand malaria transmission within the country and design better strategies for its elimination. [1]
In this study, published in Science, the location data of the mobile phones of more than 14 million Kenyan subscribers was combined with national malaria prevalence data. After identifying the sources and sinks of malaria parasites and overlaying these with phone movements, analysis was used to identify likely transmission corridors. UK scientists later used similar methods to create different epidemic scenarios for the Côte d’Ivoire.”
Embracing Expertise
Biella Coleman in Concurring Opinions: “I often describe hacker politics as Weapons of the Geek, in contrast to Weapons of the Weak—the term anthropologist James Scott uses to capture the unique, clandestine nature of peasant politics. While Weapons of the Weak is a modality of politics among disenfranchised, economically marginalized populations who engage in small-scale illicit acts —such as foot dragging and minor acts of sabotage—that don’t appear on their surface to be political, Weapons of the Geek is a modality of politics exercised by a class of privileged actors who often lie at the center of economic life. Among geeks and hackers, political activities are rooted in concrete experiences of their craft—administering a server or editing videos—and portion of these hackers channel these skills toward political life. To put another way hackers don’t necessarily have class-consciousness, though some certainly do, but they all tend to have craft consciousness. But they have already shown they are willing to engage in prolific and distinct types of political acts from policy making to party politics, from writing free software to engaging in some of the most pronounced and personally risky acts of civil disobedience of the last decade as we saw with Snowden. Just because they are hackers does not mean they are only acting out their politics through technology even if their technological experiences usually inform their politics.
It concerns and bothers me that most technologists are male and white but I am not concerned, in fact I am quite thrilled, these experts are taking political charge. I tend to agree with Michael Shudson’s reading of Walter Lippman that when it comes to democracy we need more experts not less: “The intellectual challenge is not to invent democracy without experts, but to seek a way to harness experts to a legitimately democratic function.”
Imagine if as many doctors and professors mobilized their moral authority and expertise as hackers have done, to rise up and intervene in the problems plaguing their vocational domains. Professors would be visibly denouncing the dismal and outrageous labor conditions of adjuncts whose pay is a pittance. Doctors would be involved in the fight for more affordable health care in the United States. Mobilizing expertise does not mean other stakeholders can’t and should not have a voice but there are many practical and moral reasons why we should embrace a politics of expertise, especially if configured to allow more generally contributions.
More than any other group of experts, hackers have shown how productive an expert based politics can be. And many domains of hacker and geek politics such as the Pirate Parties and Anonymous are interesting precisely for how they marry an open participatory element along with a more technical, expert-based one. Expertise can co-exist with participation if configured as such.
My sense is that hacker (re: technically informed) based politics will grow more important in years to come. Just last week I went to visit one hacker-activist, Jeremy Hammond who is in jail for his politically motivated acts of direct action. I asked him what he thought of Edward Snowden’s revelations about the NSA’s blanket surveillance of American citizens. Along with saying he was encouraged for someone dared to expose this wrongdoing (as many of us are), he captured the enormous power held by hackers and technologists when he followed with this statement: “there are all these nerds who don’t agree with what is politically happening and they have power.”
Hammond and others are exercising their technical power and I generally think this is a net gain for democracy. But it is why we must diligently work toward establishing more widespread digital and technical literacy. The low numbers of female technologists and other minorities in and out of hacker-dom are appalling and disturbing (and why I am involved with initiatives like those of NCWIT to rectify this problem). There are certainly barriers internal to the hacker world but the problems are so entrenched and so systematic unless those are solved, the numbers of women in voluntary and political domains will continue to be low.
So it is not that expertise is the problem. It is the barriers that prevent a large class of individuals from ever becoming experts that concerns me the most”.
It concerns and bothers me that most technologists are male and white but I am not concerned, in fact I am quite thrilled, these experts are taking political charge. I tend to agree with Michael Shudson’s reading of Walter Lippman that when it comes to democracy we need more experts not less: “The intellectual challenge is not to invent democracy without experts, but to seek a way to harness experts to a legitimately democratic function.”
Imagine if as many doctors and professors mobilized their moral authority and expertise as hackers have done, to rise up and intervene in the problems plaguing their vocational domains. Professors would be visibly denouncing the dismal and outrageous labor conditions of adjuncts whose pay is a pittance. Doctors would be involved in the fight for more affordable health care in the United States. Mobilizing expertise does not mean other stakeholders can’t and should not have a voice but there are many practical and moral reasons why we should embrace a politics of expertise, especially if configured to allow more generally contributions.
More than any other group of experts, hackers have shown how productive an expert based politics can be. And many domains of hacker and geek politics such as the Pirate Parties and Anonymous are interesting precisely for how they marry an open participatory element along with a more technical, expert-based one. Expertise can co-exist with participation if configured as such.
My sense is that hacker (re: technically informed) based politics will grow more important in years to come. Just last week I went to visit one hacker-activist, Jeremy Hammond who is in jail for his politically motivated acts of direct action. I asked him what he thought of Edward Snowden’s revelations about the NSA’s blanket surveillance of American citizens. Along with saying he was encouraged for someone dared to expose this wrongdoing (as many of us are), he captured the enormous power held by hackers and technologists when he followed with this statement: “there are all these nerds who don’t agree with what is politically happening and they have power.”
Hammond and others are exercising their technical power and I generally think this is a net gain for democracy. But it is why we must diligently work toward establishing more widespread digital and technical literacy. The low numbers of female technologists and other minorities in and out of hacker-dom are appalling and disturbing (and why I am involved with initiatives like those of NCWIT to rectify this problem). There are certainly barriers internal to the hacker world but the problems are so entrenched and so systematic unless those are solved, the numbers of women in voluntary and political domains will continue to be low.
So it is not that expertise is the problem. It is the barriers that prevent a large class of individuals from ever becoming experts that concerns me the most”.
Civics for a Digital Age
Jathan Sadowski in the Atlantic on “Eleven principles for relating to cities that are automated and smart: Over half of the world’s population lives in urban environments, and that number is rapidly growing according to the World Health Organization. Many of us interact with the physical environments of cities on a daily basis: the arteries that move traffic, the grids that energize our lives, the buildings that prevent and direct actions. For many tech companies, though, much of this urban infrastructure is ripe for a digital injection. Cities have been “dumb” for millennia. It’s about time they get “smart” — or so the story goes….
Before accepting the techno-hype as a fait accompli, we should consider the implications such widespread technological changes might have on society, politics, and life in general. Urban scholar and historian Lewis Mumford warned of “megamachines” where people become mere components — like gears and transistors — in a hierarchical, human machine. The proliferation of smart projects requires an updated way of thinking about their possibilities, complications, and effects.
A new book, Smart Cities: Big Data, Civic Hackers, and the Quest for a New Utopia, by Anthony Townsend, a research director at the Institute for the Future, provides some groundwork for understanding how these urban projects are occurring and what guiding principles we might use in directing their development. Townsend sets out to sketch a new understanding of “civics,” one that will account for new technologies.
The foundation for his theory speaks to common, worthwhile concerns: “Until now, smart-city visions have been controlling us. What we need is a new social code to bring meaning and to exert control over the technological code of urban operating systems.” It’s easy to feel like technologies — especially urban ones that are, at once, ubiquitous and often unseen to city-dwellers — have undue influence over our lives. Townsend’s civics, which is based on eleven principles, looks to address, prevent, and reverse that techno-power.”
Cyberpsychology and New Media
A thematic reader, edited by Andrew Power, Grainne Kirwan: “Cyberpsychology is the study of human interactions with the internet, mobile computing and telephony, games consoles, virtual reality, artificial intelligence, and other contemporary electronic technologies. The field has grown substantially over the past few years and this book surveys how researchers are tackling the impact of new technology on human behaviour and how people interact with this technology.
Examining topics as diverse as online dating, social networking, online communications, artificial intelligence, health-information seeking behaviour, education online, online therapies and cybercrime, Cyberpsychology and New Media book provides an in-depth overview of this burgeoning field, and allows those with little previous knowledge to gain an appreciation of the diversity of the research being undertaken in the area.”
(Appropriate) Big Data for Climate Resilience?
Amy Luers at the Stanford Social Innovation Review: “The answer to whether big data can help communities build resilience to climate change is yes—there are huge opportunities, but there are also risks.
Opportunities
- Feedback: Strong negative feedback is core to resilience. A simple example is our body’s response to heat stress—sweating, which is a natural feedback to cool down our body. In social systems, feedbacks are also critical for maintaining functions under stress. For example, communication by affected communities after a hurricane provides feedback for how and where organizations and individuals can provide help. While this kind of feedback used to rely completely on traditional communication channels, now crowdsourcing and data mining projects, such as Ushahidi and Twitter Earthquake detector, enable faster and more-targeted relief.
- Diversity: Big data is enhancing diversity in a number of ways. Consider public health systems. Health officials are increasingly relying on digital detection methods, such as Google Flu Trends or Flu Near You, to augment and diversify traditional disease surveillance.
- Self-Organization: A central characteristic of resilient communities is the ability to self-organize. This characteristic must exist within a community (see the National Research Council Resilience Report), not something you can impose on it. However, social media and related data-mining tools (InfoAmazonia, Healthmap) can enhance situational awareness and facilitate collective action by helping people identify others with common interests, communicate with them, and coordinate efforts.
Risks
- Eroding trust: Trust is well established as a core feature of community resilience. Yet the NSA PRISM escapade made it clear that big data projects are raising privacy concerns and possibly eroding trust. And it is not just an issue in government. For example, Target analyzes shopping patterns and can fairly accurately guess if someone in your family is pregnant (which is awkward if they know your daughter is pregnant before you do). When our trust in government, business, and communities weakens, it can decrease a society’s resilience to climate stress.
- Mistaking correlation for causation: Data mining seeks meaning in patterns that are completely independent of theory (suggesting to some that theory is dead). This approach can lead to erroneous conclusions when correlation is mistakenly taken for causation. For example, one study demonstrated that data mining techniques could show a strong (however spurious) correlation between the changes in the S&P 500 stock index and butter production in Bangladesh. While interesting, a decision support system based on this correlation would likely prove misleading.
- Failing to see the big picture: One of the biggest challenges with big data mining for building climate resilience is its overemphasis on the hyper-local and hyper-now. While this hyper-local, hyper-now information may be critical for business decisions, without a broader understanding of the longer-term and more-systemic dynamism of social and biophysical systems, big data provides no ability to understand future trends or anticipate vulnerabilities. We must not let our obsession with the here and now divert us from slower-changing variables such as declining groundwater, loss of biodiversity, and melting ice caps—all of which may silently define our future. A related challenge is the fact that big data mining tends to overlook the most vulnerable populations. We must not let the lure of the big data microscope on the “well-to-do” populations of the world make us blind to the less well of populations within cities and communities that have more limited access to smart phones and the Internet.”
San Francisco To Test Online Participatory Budgeting
Crunch.gov: “Taxpayers are sometimes the best people to decide how their money gets spent — sounds obvious, but usually we don’t have a direct say beyond who we elect. That’s changing for San Francisco residents.
It intends to be the first major US city to allow citizens to directly vote on portions of budget via the web. While details are still coming together, its plan is for each city district to vote on $100,000 in expenditures. Citizens will get to choose how the money is spent from a list of options, similar to the way they already vote from a list of ballot propositions. Topical experts will help San Francisco residents deliberate online.
So-called “participatory budgeting” first began in the festival city of Porto Alegre, Brazil, in 1989, and has slowly been expanding throughout the world. While major cities, such as Chicago and New York, have piloted participatory budgeting, they have not incorporated the modern features of digital voting and deliberation that are currently utilized in Brazil.
According to participatory budgeting expert and former White House technology fellow, Hollie Russon Gilman, San Francisco’s experiment will mark a “frontier” in American direct democracy.
This is significant because the Internet engenders a different type of democracy: not one of mere expression, but one of ideas. The net is good at surfacing the best ideas hidden within the wisdom of the crowds. Modern political scientists refer to this as “Epistemic Democracy,” derived from the Greek word for knowledge, epistēmē. Epistemic Democracy values citizens most for their expertise and builds tools to make policy making more informed.
For example, participatory budgeting has been found to reduce infant mortality rates in Brazil. It turns out that the mothers in Brazil had a better knowledge of why children were dying than health experts. Through participatory budgeting, they “channeled a larger fraction of their total budget to key investments in sanitation and health services,” writes Sonia Goncalves of King’s College London. “I also found that this change in the composition of municipal expenditures is associated with a pronounced reduction in the infant mortality rates for municipalities which adopted participatory budgeting.” [PDF]”
Three ways to think of the future…
Geoff Mulgan’s blog: “Here I suggest three complementary ways of thinking about the future which provide partial protection against the pitfalls.
The shape of the future
First, create your own composite future by engaging with the trends. There are many methods available for mapping the future – from Foresight to scenarios to the Delphi method.
Behind all are implicit views about the shapes of change. Indeed any quantitative exploration of the future uses a common language of patterns (shown in this table above) which summarises the fact that some things will go up, some go down, some change suddenly and some not at all.
All of us have implicit or explicit assumptions about these. But it’s rare to interrogate them systematically and test whether our assumptions about what fits in which category are right.
Let’s start with the J shaped curves. Many of the long-term trends around physical phenomena look J-curved: rising carbon emissions, water useage and energy consumption have been exponential in shape over the centuries. As we know, physical constraints mean that these simply can’t go on – the J curves have to become S shaped sooner or later, or else crash. That is the ecological challenge of the 21st century.
New revolutions
But there are other J curves, particularly the ones associated with digital technology. Moore’s Law and Metcalfe’s Law describe the dramatically expanding processing power of chips, and the growing connectedness of the world. Some hope that the sheer pace of technological progress will somehow solve the ecological challenges. That hope has more to do with culture than evidence. But these J curves are much faster than the physical ones – any factor that doubles every 18 months achieves stupendous rates of change over decades.
That’s why we can be pretty confident that digital technologies will continue to throw up new revolutions – whether around the Internet of Things, the quantified self, machine learning, robots, mass surveillance or new kinds of social movement. But what form these will take is much harder to predict, and most digital prediction has been unreliable – we have Youtube but not the Interactive TV many predicted (when did you last vote on how a drama should end?); relatively simple SMS and twitter spread much more than ISDN or fibre to the home. And plausible ideas like the long tail theory turned out to be largely wrong.
If the J curves are dramatic but unusual, much more of the world is shaped by straight line trends – like ageing or the rising price of disease that some predict will take costs of healthcare up towards 40 or 50% of GDP by late in the century, or incremental advances in fuel efficiency, or the likely relative growth of the Chinese economy.
Also important are the flat straight lines – the things that probably won’t change in the next decade or two: the continued existence of nation states not unlike those of the 19th century? Air travel making use of fifty year old technologies?
Great imponderables
If the Js are the most challenging trends, the most interesting ones are the ‘U’s’- the examples of trends bending: like crime which went up for a century and then started going down, or world population that has been going up but could start going down in the later part of this century, or divorce rates which seem to have plateaued, or Chinese labour supply which is forecast to turn down in the 2020s.
No one knows if the apparently remorseless upward trends of obesity and depression will turn downwards. No one knows if the next generation in the West will be poorer than their parents. And no one knows if democratic politics will reinvent itself and restore trust. In every case, much depends on what we do. None of these trends is a fact of nature or an act of God.
That’s one reason why it’s good to immerse yourself in these trends and interrogate what shape they really are. Out of that interrogation we can build a rough mental model and generate our own hypotheses – ones not based on the latest fashion or bestseller but hopefully on a sense of what the data shows and in particular what’s happening to the deltas – the current rates of change of different phenomena.”
Patients Take Control of Their Health Care Online
MIT Technology Review: “Patients are collaborating for better health — and, just maybe, radically reduced health-care costs….Not long ago, Sean Ahrens managed flare-ups of his Crohn’s disease—abdominal pain, vomiting, diarrhea—by calling his doctor and waiting a month for an appointment, only to face an inconclusive array of possible prescriptions. Today, he can call on 4,210 fellow patients in 66 countries who collaborate online to learn which treatments—drugs, diets, acupuncture, meditation, even do-it-yourself infusions of intestinal parasites —bring the most relief.
The online community Ahrens created and launched two years ago, Crohnology.com, is one of the most closely watched experiments in digital health. It lets patients with Crohn’s, colitis, and other inflammatory bowel conditions track symptoms, trade information on different diets and remedies, and generally care for themselves.
The site is at the vanguard of the growing “e-patient” movement that is letting patients take control over their health decisions—and behavior—in ways that could fundamentally change the economics of health care. Investors are particularly interested in the role “peer-to-peer” social networks could play in the $3 trillion U.S. health-care market.
“Patients sharing data about how they feel, the type of treatments they’re using, and how well they’re working is a new behavior,” says Malay Gandhi, chief strategy officer of Rock Health, a San Francisco incubator for health-care startups that invested in Crohnology.com. “If you can get consumers to engage in their health for 15 to 30 minutes a day, there’s the largest opportunity in digital health care.”
Experts say when patients learn from each other, they tend to get fewer tests, make fewer doctors’ visits, and also demand better treatment. “It can lead to better quality, which in many cases will be way more affordable,” says Bob Kocher, an oncologist and former adviser to the Obama administration on health policy.”