Innovative, interdisciplinary health communication research to fight stigma among young adults wins $3 million grant


By Claire Cusick

Even before U.S. Surgeon General Vivek Murthy issued a dire warning this spring about America’s loneliness epidemic, two UNC researchers were teaming up to work on a solution.

Loneliness is the lack of social connection, and even before the isolation during the Covid-19 pandemic, one in two Americans reported experiencing loneliness.

Barbara FredericksonKeenan, a distinguished professor of psychology and neuroscience, has studied the health benefits of positive emotions and positive relationships for decades. She is teaming up with UNC’s Husman School of Journalism and Media on a new research project. Alison LazardE. Reese Felts Jr. Distinguished Associate Professor, expert on how visual design affects message understanding, especially in the digital environment.

“For decades, we’ve been looking at the benefits of positive emotions and positive relationships for individual and community health and well-being,” Fredrickson said. “What I want to do next is find better ways to develop the conditions for ordinary people to experience these health care states. Alison brings a lot of communication science to the table. With her help, we’ll have more messages, better frequency, more innovation, more perspectives, testimonials and stories. All of that.” It’s a different and better world than what we’ve been used to before.

Fredrickson and Lazard are the principal investigators of the $3 million funded study. National Institute on Minority Health and Health Disparities (NIMHD) The study examines how, where, and to whom social media messages can reduce social isolation among young adults (ages 18-29).

“My role is to design health messages that are relevant to people,” Lazard said. “I’ve spent my career thinking about how we use the scientific process and the science of communication more rigorously, in the way we design messages — not just what we say, but how we say it.”

Using Lazard’s expertise to reach a new audience is another step in Fredrickson’s work to help people improve their social connections to increase well-being.

Lazard is part of a cadre of UNC Hussman faculty scholars focused on health communication, a strategic priority area for the school and a thriving field in industry. “UNC’s Husman faculty are among the leading health communication researchers and practitioners in the country,” he said. Raul ReyesDean of the school. “Allison Lazard’s innovative, multidisciplinary work with Barbara Fredrickson to improve the health of vulnerable populations is at a critical time for our nation. It is an example of the promise of collaboration and how research at UNC can have a meaningful impact on people’s lives.

The exam: Loneliness and lack of social connection can have serious health consequences, according to a recent report by a surgeon general. “Loneliness and social isolation increase the risk of premature death by 26 percent and 29 percent, respectively,” the report said. “In general, lack of social contact increases the risk of premature death as much as smoking 15 cigarettes a day. In addition, poor or insufficient social contact is associated with disease, with a 29% increased risk of heart disease and a 32% increased risk of stroke. It also increases the risk of anxiety, depression and dementia.” Also, lack of social connections increases vulnerability to viruses and respiratory illnesses.

People who have never known life without a smartphone are especially at risk. A surgeon general issued another advisory this spring, warning that social media “can have serious consequences for the mental health and well-being of children and adolescents.”

“We know this by accident and we know it from the scientific literature,” Lazard said. “There are enough meta-analyses to show that young people need help. They are struggling,” he said.

The study: Over the next four and a half years, the research team led by Fredrickson and Lazard will create, design and deploy social media messages to help young people find offline and experience social connections in person. They have already hired Husman graduate Tushar Varma, 23, to come up with youth-oriented images and messages.

The survey found that 84-96 percent of young adults use smartphones and social media. Social media messages, relevant images and text, increase young adults’ interest in recommended behavior changes to improve their health.

“We get to where they need to be to encourage young people to get out into their communities,” Lazard said. “We provide information and tips for positive physical interactions with neighbors.”

The invention: To test these messages in a secure but scientifically rigorous way, the team developed an open science framework to create a closed and simulated social network. They named it Clibrit, which means that this study will be the first to combine the internal validity of laboratory studies and the external validity of field studies to examine the effects of messages.

“Experiments on social networks are often hampered by proprietary algorithms and display restrictions, violations of privacy and freedom, and the lack of reproducibility of research teams and over time,” said Lazard. “Through Clibrite, we have the ability to conduct large-scale, replicable randomized controlled trials to study the delivery of digital health campaigns on social media to vulnerable populations. These methods allow us to examine causal relationships in a way that direct social media cannot.

Conducting social media communication research with vulnerable adults would be unethical, Lazard added. “There is too much danger,” she said. Two risks are scientific: “We run the risk of knowing what algorithms do or don’t show, and whether other people are part of the study or not part of the study,” she says. Furthermore, social media poses a risk of harmful content. “We can verify that the harmful content isn’t there, so we can see helpful messages in a realistic environment, but we can see an environment that doesn’t promote harm.”

Because it is a controlled system, Clibrite avoids these risks. “Every participant who comes to our social media environment has the same experience,” Lazard said. “This allows us to better understand what attracts people’s attention or interest. So when participants scroll through a news feed, do they pause on this message or not? Do you click on the message and leave a comment? It’s the kind of data that’s hard to find. You can’t do it on real networks. We can monitor background information, so we can make sure there is no harmful content around.

The study prioritizes those with a higher burden of disease—young adults who are Black/African American, Latino/Hispanic, or of low socioeconomic status. These groups should be given special attention as researchers develop this knowledge base, as these vulnerable populations may face unique challenges in social contexts, including those resulting from discrimination and economic inequality.

“Young people from all backgrounds are suffering from social exclusion, but these young people have additional burdens,” Lazard said. “We want to help all people, but if we can help those who need help the most, everyone can benefit.”

The messages are: The first step of the study is to edit the images and test which ones are most effective. “We know there are many types of images that can work with these messages,” Lazard said. We show diverse people – those struggling with social isolation from their socially connected peers – and also show areas of positive community interaction.

Everyone is looking for health advice, and young people are looking for it on social media based on visibility, Fredrickson said. “We want to convey to them that daily social contact – no matter how small or short, no matter who it is with – is important for well-being,” she said. “To lean into that a little bit, we encourage everyone to try to connect and try to connect in places where they normally rush on their way. We like to encourage young people to see their brief interactions with others as opportunities rather than obstacles. These are small behavioral changes that speak to our social nature as humans.”


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