Smarter Crowdsourcing for Zika

Instead of a handful of people meeting once at great expense in a conference room, this initiative uses information and communication technology (ICT) - the internet - to mobilise and curate diverse and distributed expertise - both credentialed know-how and experiential wisdom - to identify, design, and iterate upon implementable ideas that governments can use. The internet enables the convening of an array of diverse stakeholders to collaborate with government officials on refining new ideas and taking them from the realm of research into the realm of action. Participants in the online conferences (click here to request an invitation) read background materials (click here for an example) and then participate in the discussion to: lend their skills to tackle a public health emergency, speak directly to those interested in implementing new approaches, and deliberate with diverse innovators and professionals to refine good ideas into actionable projects.

The conferences are as follows:

1. Predictive Analytics, October 26 2016: What are the innovative options to analyse available data from new technologies to predict and therefore prevent outbreaks?
2. Long Term Care, October 19 2016: How do we provide affordable and ongoing support for families with members who are at risk or already suffering with chronic effects of Zika, such as microcephaly?
3. Information Collection/Data Governance, September 28 2016: How do we develop policies and practices for better epidemiological data collection and for sharing data with the appropriate authorities?
4. Trash and Standing Water, September 21 2016: What can be done to eliminate uncollected waste and standing water where Aedes Aegypti mosquitoes breed?
5. Communication and Behavior Change, September 7 2016: What are the most effective ways for getting the public to change behaviour to prevent mosquito breeding and mosquito bites and get proper access to healthcare?
6. Assessing Public Awareness, August 31 2016: What are the most effective ways to capture the public's understanding of mosquito borne diseases? How to use these findings to inform the design of campaigns to improve public awareness?

The remainder of this summary elaborates on the latter (the first) conference to illustrate some of the communication strategies that reflect not the initiative itself but, at another level, the strategies the participants themselves explore. Specifically, 24 experts from 10 countries joined 24 public officials from 4 Latin American countries in a conversation focused on identifying novel strategies that governments can use to understand what different groups within the population do and do not understand about Zika. In a dialogue that meandered from English to Spanish to Portuguese and back, the assembled professors, technologists, data scientists, and public health officials brainstormed and deliberated about how new technology, in particular, might be brought to bear to make ascertaining public understanding faster, easier, cheaper, and more accurate. "With limited resources for combatting Zika, governments the world over are eager for more evidence-based approaches. But quickly ascertaining levels of public awareness will depend on doing more than going door-to-door with clipboards."

First the participants asked questions of the governments of Argentina, the City of Rio de Janeiro, Columbia, and Panama about how they assess awareness currently. Participants learned that there are already novel approaches underway, such as Argentina's use of hotlines to collect and identify public "perceptions, definitions, fears" and to know how "rumors are circulating, myths, erroneous understandings about the particularities of these diseases" are proliferating. Then, governments asked questions of the innovators, probing them for ideas: Are there less expensive, faster ways to gauge awareness? How do we distinguish between what different populations groups do and do not know? What are the best ways to frame the questions to elicit more accurate responses? The conference resulted in several concrete proposals, especially for using social media to track public awareness. Fabro Stiebel said, "the monitoring of social media is easy to do, although it provides just a sample of the population". This discussion on using social media for "digital listening" included a robust conversation about how to use Facebook to surface information from aggregated posts to inform the messages governments and health organisations send.

Another approach discussed was to explore more granular uses of Twitter to gain a better understanding of who knows and understands what when it comes to mosquito-borne diseases (MBDs), identifying the sources of both information and misinformation in communities. Identifying sources of influence within communities can help with targeting messaging to improve understanding. Manuel García-Herranz from the United Nations Children's Fund (UNICEF) talked about the importance of tracking the networks through which information travels (people to people, media to media) so as to identify messages before they become people's beliefs, as it is more challenging to change what people believe than to modify opinion formation. UNICEF has undertaken some efforts on mapping "the highways of information", doing network analysis to identify trending topics which is emerging information that can be corrected before it becomes a belief. Rafael Obregon shared that UNICEF Brazil has been using a digital listening approach, in collaboration with Google, to identify trends in public awareness, rumours, information seeking, etc, which in turn informs their approach to engaging with the public on risk perception. The conversation went beyond digital listening using social media to address how to use SMS (text messaging) tools like UReport to understand what people know as well as more conventional approaches. Prof. John P. Elder reiterated "the importance of face to face communication in changing behavior". Gaya Gamhewage from the World Health Organization (WHO) talked about how the WHO is training responders to conduct and use simplified social science research in epidemics using a WHO knowledge, attitudes, and practice surveys toolkit (see Related Summaries, below).

Health, Risk Management

Commenting on the impetus for the problem statement that animated the first conference, organisers note that, especially in the context of an epidemic, public health officials do not have the capacity and time to conduct extensive public perception research using a range of different methods. They need rapid access to reliable data on public perceptions and issues that affect public trust, along with methods for analysing such data. Currently, governments primarily rely on: face-to-face surveys and polls using landlines and mobile phones; focus group discussions involving population samples representative of diverse genders, ages, and socio-economic groups; interviews using structured questionnaires and conducted through face-to-face household visits; community dialogues, where neighbours meet face-to-face to deliberate about a public health issue as a means to surface misperceptions. In Brazil for example, the most widely used method is that of face-to-face household surveys, where Community Health Agents (within the Family Health Program) interview inhabitants about what they know of MBD and what their prevention practices are. Beyond the traditional face-to-face household surveys, governments usually struggle to fund a diverse set of qualitative methods (as mentioned above) needed to capture local indicators of public perception and factors that affect public trust.