Interoperable Push-Based Mobile Multimedia for Health and Preparedness Outreach

Background: Health information is the most searched subject on the web.  However, the web loses effectiveness among demographics underserved by the digital divide (typically lacking Internet access but frequent users of cell phone messaging), and health alerts posted on web sites but not pushed to the attention of impacted individuals.  Text messaging can grab attention among vulnerable populations, but is limited to brief text.  Multimedia messaging supports rich media, forwarding and bi-directional communication between audiences and subject matter experts, but lacks interoperability among different mobile devices and service providers.

Program background: During the 2010-2011 winter season, CDC/OPHPR conducted a public preparedness campaign on severe winter weather to evaluate the feasibility and effectiveness of mobile video as a medium for outreach.  The campaign solved interoperability issues among cell phones by deploying a middleware that converts preparedness videos into multiple formats, and broadcasts to each cell phone only in a format compatible with the model, carrier, subscription plan of the device.  The middleware permitted owners of older cell phones without web browsers or data plans to participate in the campaign, and did not require the owners of newer smartphones to install any “apps.”

Evaluation Methods and Results: The campaign broadcast nine preparedness video over three weeks, each lasting sixty seconds and derived from content on the CDC Winter Preparedness Web site.  The broadcasts used push-based transmission protocols, permitting participants to view a video at any time on a phone, mobile device, or computer.  The campaign was promoted to the public on the CDC Winter Preparedness Web site and via email to subscribers of the GovDelivery severe winter weather category.  Participants enrolled via email or with a simple phone call to an automated attendant.  The middleware tracked how participants enrolled, what devices they used to view the video, when videos were viewed, and whether participants forwarded videos to other individuals.  On average, a mobile device user was more likely to view a video and remain enrolled throughout the campaign than a desktop/laptop user, and the time from broadcast to viewing by a mobile device user was half that of a desktop/laptop user.  Even though the method to promote the campaign favored computer users, the majority of videos were viewed on mobile devices and a significant number were viewed on cell phones without Internet access.

Conclusions: Outreach audiences seem to have already adopted mobile multimedia behaviors that support outreach, and this medium can reinforce existing outreach mechanisms.   The campaign demonstrates ways to adapt rich web content into multimedia that is interoperable with mobile devices including cell phones without Internet access.  Advanced cell phones worsen interoperability obstacles, but these are manageable with middleware without involving outreach participants.

Implications for research and/or practice: Stakeholders of public health outreach and science translation should consider mobile multimedia to expand their audience and access vulnerable populations impacted by the digital divide.  Stakeholders should also consider engaging and empowering audiences by allowing them to forward pushed mobile multimedia to friends and family, and reply with requests for more information.