The mobile-health field, or “mHealth” to techies savvy in the discipline, is a burgeoning player within the nutrition conglomerate. To understand where the digital age fits into nutrition research and professions, the American Society for Nutrition (@NutritionOrg) Student Interest Group (SIG) brought together experts from all aspects of the field -- investigators, dieticians, bloggers, professors, and industry professionals -- to discuss current and future uses of technology in nutrition. The symposium, “Social Media and Mobile Technology for Education, Research and Practice” was held on Tuesday at Experimental Biology 2013 (@expbio) and was designed to address how to access and use technology to advance accurate and evidence based nutrition information in the digital age. Drs. Carol Bouschey (Purdue University), Lauri Wright (University of Southern Florida), Deborah Silverman (Eastern Michigan University), Ilene Smith (Porter and Novelli) and Michael McBurney (DSM Nutrition) were on the panel. After a lively discussion on where technology fits into the nutrition field, it appears that the initial burden of pioneering the digital world falls squarely on the shoulders of our educators. Perhaps the most pressing message to come out of the segment was that the current pool of undergraduates is very different from their mentors. Today’s students are truly the first generation of digital natives, having literally grown up alongside WiFi, smart phones, and social media. Unfortunately, according to Dr. Deborah Silverman, higher education is lagging behind, both technologically and pedagogically. Students have come to expect “convenience, service, quality, low prices and faculty who are technologically competent.” She stressed that we must “transform ourselves to educate learners for the world in which they live.” Gone are the days of white boards and PowerPoint handouts. Students want, and expect, digital interaction -- from webinars, to iClickers, to international Skype sessions. And, here Dr. Silverman emphasizes, is where tech savvy educators are most needed. Because while today’s students may live in a world of tweets and texts, these “Millenials” appear completely unable to disseminate the personal from the professional. Facebook posts bashing employers and mentors, unbecoming pictures, and 140 character chit-chat define these aspiring professionals. In order to progress professionally in the modern era, they need mentors to pave the road to success. “We need to identify strategies to teach students not only how to use social media, but how to be literate in the digital age.” And to do that she warns, “Don’t wait too long to adopt, your learners are already two or more steps ahead of you!”
It became clear throughout the session that the lag time issue is a problem that we in the research field must truly address. A scientist in the symposium perfectly captured the dilemma when she described a story of an erroneous nutrition article run in the New York Times several weeks ago. Outraged, approximately 20 researchers banded together to publicly debunk the fallacies in the article. Unfortunately, it has been weeks since the NYTimes publishing date and in an effort to be thorough and cautious, it may be that the window of public interest has past. In a world where news is made in 12 seconds, not 12 hours or 12 days, weeks might as well be years. And with an issue as personal and popular as food, journalists and bloggers have already eaten up the story and spit it back out. Dogma has been set. Celebrities are on the bandwagon...and tweeting. The world has decided. And our evidence based argument may be too late.
So, then, what do we do? Michael McBurney (@MIMcBurney) of DSM Nutrition (@DSMNutrition) says, “Get ahead of it! ...We all know that science is based on the bulk of the evidence, not the latest single study”, but that’s not how the modern world works. In order to preempt the onslaught of misinformation gleaned from studies with journalistic sex-appeal, McBurney and DSM Nutrition started their own professional blog: TalkingNutrition.dsm.com. Based on press releases and connections with researchers, journals, and industry professionals, TalkingNutrition presents hot new research articles and distills the main points and limitations. Then, in an effort to spotlight important conclusions, posts several other articles relevant to the same topic. Throughout the life of the blog, they have developed a solid network of nutrition colleagues that read and disseminate the information posted each day. Using Twitter, McBurney and his digital army blast the findings to the people. “It doesn’t do any good to tweet, you want to be retweeted, and you want to retweet others that you think are positive and constructive. We need to work together to move the message forward by being relevant, influential and impactful”.
Ilene Smith (@Ilene_Smith), digital wordsmith of Porter and Novelli, agrees that building a digital network is critical. “Use your networks and establish lines of communication with people that can get your message out there”. Smith has done this by developing relationships with researchers, dieticians and bloggers, helping to facilitate the accurate movement of information from the lab to the public. Of note is her partnership between The National Cattleman’s Beef Association (@BeefUSA) and Dr. Michael Roussell (@mikeroussell) of Penn State to promote findings from the BOLD (Beef in an Optimal Lean Diet) study. The triumvirate even created their own hashtag, #BeefChat, to be used as a rallying cry on Twitter. Smith emphasized that developing these relationships is even more critical for positive health oriented outcomes. As an example, she noted another partnership with Laughing Cow, in which the outcomes of a study examined fruit, vegetable, and cheese snacking in kids. However, this digital campaign was not as successful because the web-based community did not appear to be sufficiently engaged. Unlike the beef study, the “healthy food” message did not generate the digital traffic. Smith states that, “communicating positive news does not translate as quickly as ‘Red Meat Will Kill You’”, but notes this is not always the case with positive health findings. When a team of dieticians and bloggers was prepped to promote the findings of a separate almond study, the tweet-fest was very similar to the beef partnership. “It’s all about making appropriate connections and using them in a transparent and productive way.”
Dr. Carol Bouschey goes on to emphasize that using technology to promote research is only just the beginning. She states that “we need to start to use technology in our research to make it relevant and meaningful...and this doesn’t mean altering our approaches”. Instead, we should continue to use our current theoretical frameworks but, “...find a geek!”. One shining example of a study that is utilizing mHealth platforms is the Health eHeart study at the University of California, San Francisco. The Health eHeart study is the first large scale prospective study utilizing next generation technology (smartphones, social media and advanced monitoring devices) to collect data from more people than “any other research study has done before”. The team, led by Drs. Jeffrey Olgin, Mark Pletcher, and Gregory Marcus, is attempting to gather data across the country on one million people, truly creating an incredibly rich data set useful in real time.
In the clinical realm, technology is already a part of daily practice. Dr. Lauri Wright, spoke of the numerous ways that digital tools are making their way to the bedside. Dieticians, as well as physicians, are using Computerized Personal Records to facilitate the flow of information between clinicians. Apps determine BMR and BMI. New training apps are being developed as simulators for procedures such as feeding tube placement. But while technology has been exploding, Wright warns of our emerging dependence on digital tools. She states that, “by moving all of our dietary assessments to the digital realm, we are losing the art of physical assessment. Symptoms that must be seen with the eyes -- like an ascitic belly or jaundiced eyes -- are being missed because we don’t actually look at the patients, only read their digital file.” So, what can be done about this? Ironically, there appears to be an app for that with an avatar to simulate physical patient assessment. (Ah, technology.)
Taking precaution to lose ourselves and our established procedures is certainly a worry in this smartphone era. As information, both personal and professional, flies out of our hands and into the cloud at alarming rates, we must pause to consider the implications of our posts, tweets, texts, and emails. However, McBurney warns that if we “do not partake in professional dialogue online, we will lose our credibility and thus, followers.” There are time honored, and tested procedures that we follow in our field. Ensuring that we do not lose the ability to recognize acute illness, or respond to misinformation with thoughtful collaboration, is of the utmost importance. However, we may just need to learn to be a little quicker...a little more savvy. Because if we, as highly educated professionals in the field of nutrition, don’t put ourselves on the digital front, someone else will take our place...in 140 characters or less.