Digital Technology in Public Health

From Alexa Morse, MPH (alum, 2017): 

When you think of technology startups, public health probably isn’t the first thing that comes to mind. However, due to the need for innovation, digital technology has become a larger focus in the public health realm over the past couple years.

The intersection of public health and digital technology is one of the most exciting places to be right now. Technology enables public health programs to reach more consumers, therefore impact health outcomes on a broader scale, and with the rise of the digital age, programs such as these are able to meet patients where they are. 81% of Americans own a smartphone and are able to access information at their fingertips without having to leave the convenience of their own home. As healthcare spend in the US is rising (nearly $3.7B in 2018!), companies are trying to find creative ways to scale interventions, impact care, and improve health outcomes outside of the traditional healthcare office visit. 

Digital health, e-health and health IT (HIT), are some of the terms used to describe digital technology in the healthcare space. All relatively mean the same thing and their definitions are blending further together with the convergence of patient care and consumer wellness.

According to StartUp Health’s 2019 Q3 Report, $10.4 billion has been invested in digital health companies this year to date—with very important public health issues nearing the top of those investments. Public health startups include those focused on social determinants of health, access to care, cancer care, women’s health, and many other topics.

There are many examples of companies doing incredible things in public health, enabled by technology. Here are just a few:

Omada Health: Chronic disease therapeutics

Lyft: Transportation to doctor’s visits

Curatio Social Network for Health

Bodyport: Heart Disease prevention and management

HealthTap: Telemedicine

If you’re looking to start your own company in the public health space (or any space), I highly encourage you to focus on the following areas:

• Team: Make sure you have the right team working with you. Bring in experts that believe in your mission and have strengths that mitigate your weaknesses.
• Product: How is your product differentiated from existing products on the market? What makes it unique?
• Market: how big is the market? Is there a need for your product in the market?

If you have these three areas covered and are creating something you are passionate about, you will be on a good path forward.

Plugging into the ecosystem and understanding the available resources is also an important piece of building any company. These are good places to start getting connected:

• Global Center for Medical Innovation
• Atlanta Tech Village
• ATDC
• Innovate @ Emory
• Emory Innovation Hub

Alexa Morse is the Accelerator Portfolio Manager at the Global Center for Medical Innovation. She graduated from Rollins in 2017 with an MPH in Behavioral Sciences and Health Education. During her time at Rollins, she focused on the scalability of health programs, in addition to the intersection of technology and public health.

Professional Feedback

From Elizabeth Hannapel, MPH (Alum, 2012): 

Workplace feedback looks, sounds, and feels different from school feedback. Classroom feedback tends to come by way of test scores, comments on papers, and final grades. These methods of feedback revolve almost entirely around the accuracy and content of your work product. Workplace feedback can (and should!) include the content and quality of your work products, as well as your attributes as an employee. The latter is something that many young professionals struggle with. It can be uncomfortable and is often only reluctantly engaged with by employees and employers.  Providing candid feedback on soft skills is difficult; employers may not feel confident in their own soft skills and it is a challenge to provide soft skill feedback that is actionable.

“It was impossible not to feel hurt (“Why don’t they like me?”) and defensive (“I’m getting my work done; if they don’t like it that’s their problem.”)”

I still remember the first time I received feedback about my approach to work. I was used to tackling my job duties and offering to help others. While that approach was beneficial for group projects in school, a colleague pointed out that it was creating friction with a group of colleagues with very different work styles. It was impossible not to feel hurt (“Why don’t they like me?”) and defensive (“I’m getting my work done; if they don’t like it that’s their problem.”) Neither of those helped me navigate my workplace or become a better team member.

“Only one of my ultimate objectives depended on the skills that were graded in school.”

What did help me was to step back and think about the feedback as an opportunity for improvement (rather than a critique of my identity.) I thought about my ultimate objectives: complete my job duties, foster collaboration, maintain open communication with colleagues, and have that communication be pleasant whenever possible. Notably, only one of those depended on the skills that were graded in school. I was able to realign my actions with those goals in mind, develop friendly workplace relationships, and was better able to recruit those same folks for support in other endeavors.

I graduated from Rollins with a MPH in Epidemiology in 2012. I now work for the Georgia Department of Public Health, and I interact with current Rollins students and recent alumni. Rollins students are well equipped for local and state public health job duties through their coursework. What Rollins students, and young professionals in general, could benefit from is openness to and active engagement with feedback.

“Often it is a gift we may not want, but a gift nonetheless.”

It is fundamentally harder to hear feedback on soft skills than on hard skills. It is particularly hard to remember that feedback is a gift.  Often it is a gift we may not want, but a gift nonetheless. Soft skills are often heavily weighted in decisions on advancement.  An employee may be technically brilliant, but without the soft skills to help drive the organization forward, their career goals may be stymied. Being open to improving both hard and soft skills helps to build a solid path for continued advancement.

As a potential employer, I can work to establish and improve mechanisms for feedback. Often in academic and government settings there isn’t much emphasis on feedback for soft skills.

“If you find yourself in a workplace without a formal feedback process, ask for one!”

This is a disservice to both the employee and the company. On-the-job training, and the corresponding evaluation processes, should reflect not only job-specific tasks but also the interpersonal skills that enable staff to navigate complex professional environments. Our team does not have a formal process for providing feedback to current students, and I’m working with others to establish one.

If you find yourself in a workplace without a formal feedback process, as either a student volunteer or a full-time-employee, ask for one! Reach out to your supervisor and establish regularly scheduled meetings where you can review not only your quantifiable job performance but also your soft skills. Your employer may have performance reviews, but they may not include feedback for professional skills.

“Request feedback and be open to it.”

Ask your supervisor “How do you think I’m performing with respect to interpersonal relationships and office dynamics? What can I do to improve my listening and communication skills? What areas should I further develop, and do you know of any resources or trainings that might be helpful?”

Request feedback and be open to it. Although difficult, this is a crucial component of continued development and a competitive advantage. Rollins offers many opportunities to prepare for public health work; Use this time to increase your technical knowledge AND your interpersonal skills that will help you succeed as a professional.

Additional Resources:

Ladders: How to Handle Negative Feedback Without Taking it Personally

Purdue CCO Blog: Receiving Feedback

MBO Partners: How to Identify and Improve Soft Skills

WikiJob UK: Soft Skills

Training Industry: Expert Perspectives on Soft Skills

Elizabeth Hannapel graduated from Rollins in 2012 with a MPH in Epidemiology. While at Rollins, her interests included Infectious Diseases and Public Health Emergency Preparedness. Now, Liz serves as the state coordinator for legionellosis and shigellosis, and leads infectious disease outbreak investigations for the Georgia Department of Public Health. Follow Liz on Twitter @LizBitler.

Self-Advocacy

Advocating for yourself is a skill we rarely talk about or teach and yet you need to do just that when you negotiate a job contract, ask for a promotion, or get the appropriate placement in authorship for a paper or poster. 

Self-advocacy is a dance between being appropriately confident and respectful. It requires a thoughtful amount of introspection about the gifts you bring to the situation and what you do not have to offer (perhaps yet)  as well as a very clear sense of why you want what you are advocating for in each situation. While self-advocacy makes many of us cringe, there are some standard preparations that can ease the conversations.

Advocating for a promotion or new position demands that we are able to clearly and cogently champion our accomplishments while not being braggadocios. This can be particularly difficult for women. While not promoting stereotypical gender traits, research has consistently found that women do not self-promote well and that when they do, they are not seen as favorably as men who do.

Actually, it turns out that most of us are often much better advocates for others. When I was in graduate school, I applied for a teaching scholarship and was competing against a good friend of mine. Our department chair asked us to write our own drafts for the letters of recommendation. Due to a family emergency, my friend was not able to write hers in time, so I offered to write it for her rather than have her not apply. After she was awarded the scholarship, my chair met with me and said her letter of support had sealed the deal. By giving him a substantially more explicit draft letter of why she was a great teacher, I had advocated for her in a way I did not advocate for myself. It was a tough lesson to learn and one that data supports. We are often better at “other-advocating” than self-advocating – in part because we often tend to over-value other people’s achievements. Supporting others is a fabulous, but we must also learn to negotiate and promote our own accomplishments and needs.

Much of the self-advocacy in job negotiations is about salary, and while that can feel awkward, research will help you find the range of salary opportunities and then you should advocate for where your list of accomplishments fit in that range (be sure to fight the gender gap!). I also urge my mentees to consider negotiating for conference attendance, authorship opportunities, and other non-salary forms of compensation. In my research group, we set up authorship guidelines in advance for every study and work within these guidelines. While academia has been legendary for younger colleagues doing the work and getting minimal or no credit, this is slowly becoming a thing of the past. Clear conversations in advance can ease hard conversations later.

There are a few keys that go a long way towards a successful conversation when you are advocating for a promotion, new position, authorship, raise, etc., as found in this article.

1. The first is being very reflective about why you think you should be given this opportunity. What do you want to contribute and what have you already done that makes you a good choice?  
2. Then, set up a meeting to speak directly with the person who can best assist you and be sure to make your reason for the meeting known. You are going to come to the meeting prepared and you want them to be as well.
3. Clearly express your ask and provide examples of your work that supports this ask. 
4. And then, here is the part most articles don’t dwell on, listen. Listen to the feedback you are being given.

Ultimately, the answer might be ‘no’ and more self-advocacy won’t change that. However, this is not necessarily an indication of failure. First, the reality of budgets, organizational structures, and professional conventions might not fall in your favor – and these might be simply out of your control. Secondly, the act of prioritizing your goals and asking for them directly (and appropriately!) will give you a lot of credibility with your superiors. The next time an opportunity presents itself, they’ll have your priorities in mind and they’ll understand that you’re motivated and ambitious. 

On the other hand, if you are told you have asked for the promotion too soon or do not have the qualifications for the open position, your next decision is a fork in the road. You can use this information as a platform to ask for mentorship and guidance, or you can assume they are making a mistake. Both will get you on their radar but the first is more likely to make them your champion. 

At the end of the day, the dance of self-advocacy is tricky, but when you have done good work, you should be willing to ask for the appropriate recognition.  

Setbacks (not Failures)

Students often ask me how I found my way to public health – and while there’s a long and winding story that involves a knee injury and cigarette butts – it all comes down to a desire to use my quantitative skills to make a difference in the world.

Although I could not envision a more perfect job for myself than the one that I have, the reality is that this work isn’t all sunshine and rainbows, all the time. Among the successes of training the newest members of the public health workforce, shedding light on the importance of studying stillbirth, and breaking ground on a new stillbirth surveillance system, there are plenty of setbacks that have happened (and will continue to happen!) along the way.

It’s rare to hear about these setbacks (some might call them failures – I don’t love that term, and I’ll come back to why shortly!). I don’t know whether it’s a matter of pride, or simply wanting to avoid scaring those early in their careers or coming across as negative. But here’s the deal – no matter what field or sector you’re in, or how many years you have under your belt, we all stumble from time to time. Nothing goes perfectly for anyone 100% of the time. 

In the last few months, I experienced two setbacks related to funding for my stillbirth research. I knew that the application pools were competitive, and although I prepared myself for either outcome, I took the news much harder than I thought I would. As I reflected on why I was so upset, I came to realize that although I was disappointed that we wouldn’t get to do the research that we had proposed, I couldn’t help but think about all of the families that we wouldn’t be able to help this time around. I felt as though I had let them down. It all came back to why I got into public health in the first place – I wanted to make a difference – and these setbacks had gotten in the way.

I don’t like to think of setbacks as failures – first, it’s just not good for my mental health; but more importantly, the word “failure” sounds so final and evokes imagery of a dead end, where there’s little hope to move forward. It helps me to think of these setbacks as speed bumps, rather than closed roads. Sure, they’ve slowed me down, but they have not, and will not, halt my progress.

After a family trip to my favorite ice cream shop, and sitting in my disappointment for a few days, the first question I asked myself was: what can we do better next time so that we could achieve a different outcome? As I read the reviewers’ comments, I realized that there were no concerns about the science. In fact, the reviewers were convinced that the proposed work was really important. The sticking point, though, was concern about whether the results could be used to secure future funding. Truth be told, funding for stillbirth research is hard to come by, and in light of these concerns, I spent the last few weeks strategizing about how to fund the work in innovative ways. During this time, I identified a few new leads, but I have also channeled some of my frustration into an op-ed with the goal of garnering some more attention for this important topic.   

As you work through your own setbacks, or speed bumps, I would encourage you to consider the strategies outlined in this article (replacing the word failure with setback!), along with the following additions:

• Remove the word failure from your vocabulary, and reframe those bumps in the road as setbacks – words carry weight, and how you think about these things matters

• Share those setbacks! If we normalize sharing the things that don’t go as planned, we can support one another, offer suggestions for the next steps, and realize that we are not alone in this experience.

• Don’t compare your “behind the scenes” to everyone else’s “highlight reel”. I don’t remember where I first heard this phrase, but it really resonates with me. Until we all get comfortable sharing our setbacks, we have to realize that we mostly only see the very best of what happens to those around us. Remember that you only have a sneak peek into someone else’s life, and you are likely unaware of many of the setbacks that they face.

• Celebrate the little things. If we only celebrate when a manuscript gets accepted, or a grant is funded, those moments of celebration may be few and far between. That op-ed I mentioned before? As of this writing, it hasn’t even been submitted – but having a complete draft is something to celebrate in and of itself. I sure hope it will be published, but this is an important milestone along the way.       

While our work may not be constantly filled with sunshine and rainbows – remember that the rainbows only come with the rain. I hope that the rain motivates you to keep pushing forward to find those rainbows – and that you keep at it. I am certain that you, too, got into this field because you wanted to make a difference – let’s not let those setbacks, however large or small, get in our way.

Get to ‘Yes’

A lot has been written about the importance of saying “no.” The idea is to protect one’s professional time to be sure that it is mostly spent on the work most important to one’s self. Although there is merit in this mindset, taking it to its limit would make for a pretty miserable existence. How would it feel to work in a setting where no one ever agreed to help anyone else?

This weeks’ PROspective article offers suggestions for how to improve the chances a coworker will say “yes” when you ask for help. The first two suggestions are probably most relevant, especially early in a career: ask in person, and offer something in return. These two principles rest on fundamentals of human interactions. People are more likely to agree to help when asked in person, not by text, email, or telephone. In addition, offering something in return shows respect for the other person’s time and effort.

If you click through to one of the article’s links, you will find that humans feel a universal tendency “to repay or reciprocate when given a gift whether it has come in the form of a material object, a kind deed, or an act of generosity.” Its especially true when this interaction takes place in person. Taking too much advantage of this tendency can lead to unwarranted manipulation, so also a pretty miserable existence. Getting right this “dance of reciprocal giving and receiving” is important for all highly successful relationships, including those in the workplace.

Public Speaking

Most of us will not give a State of the Union address, be in the position to give an acceptance speech for an Oscar, or appear live on CNN. But almost all of us will have to speak in front of a group of people even though fear of public speaking is one of the most common phobias adults report (fear of spiders, snakes, and heights are most common). The name for the fear of public speaking is glossophobia and a whopping 40% of adults report having it. Mark Twain said, “There are two kinds of speakers.  Those who get nervous and those who are liars.” There are also some very logical methods to get past this fear and become a skilled public speaker. This article in Inc. focuses on five methods for speaking with authority and confidence including my favorite, tell a story.

While I am generally comfortable speaking to large groups, I have had a few memorable moments when I expected to be carried off a speaker’s podium, most notably when I was in graduate school speaking at a large conference in Vancouver. After becoming sweaty and shaky, I decided to take off my uncomfortably high heels behind the podium to feel more stable.  I made it through the talk and was then faced with trying to get my shoes back on during a question. My dissertation advisor was in the audience and commented, “You sure got shorter during the talk.” He may not have been the only one who noticed but I had remained standing, my primary goal.  Today, my first rule of public speaking is to be careful with my shoes.

In general, comfort in speaking to large groups is correlated with an obvious area of preparation; practice and more practice.  I like to script presentations, practice and then record it.  Then I listen to the recording specifically listening for places that do not sound like the way I talk so that I can change them.  Most people do not speak the way they write which is why listening is so helpful.  The other thing you hear if you listen to a recording is number of times you say “um.”  Learning to pause, without filler words, is actually a way to place emphasis on what you are saying. Listening helps you find those moments. The last thing I listen for is a way to simplify what I am saying.  I always cut out sentences and words that look great on paper but are not needed to make a point. This is an iterative process until I have a natural sounding, time-appropriate talk.

The last of the methods described in this article pertains to this Native American Proverb, “Tell me the facts and I’ll learn. Tell me the truth and I’ll believe. But tell me a story and it will live in my heart forever.” The best speakers are really storytellers even if they are talking about science or a mathematical model.  This is what connects to people and will help them remember what you have presented.

Lastly, as you approach the podium (in appropriate footwear!), remember that 40% of your audience fears public speaking, too. Your nervous energy is normal and the practice always pays off. 

Generational Differences

This week on PROspective, we’re talking about generational differences and how they play out in the workplace. If you recently started a REAL job, maybe this will help you understand your manager and their expectations. If you are an alum, this might help you coach your REAL student or recent hire. 

BUT – what you might not realize, is that this discussion isn’t just about their generation – it’s also about your own generation. 

“Nosce te ipsum” – Know Thyself

This maxim was popularized by the ancient Greek philosophers, who carved it into the Temple of Apollo at Delphi. An important, but often overlooked empathic exercise – pointed toward yourself instead of at others. 

This infographic from King University online breaks down the major differences between Millennials and GenX’s in the workplace – what they value, how they work, and what they expect. As you read through the graphic, take a beat to think about how this applies to you just as much as how it applies to others. Understanding your own motivations, expectations, and values – and how they may be perceived by others – might help you navigate a workplace with a collection of different worldviews. 

Also worth noting – generalizations about people of different age groups are just that – general, and almost certainly don’t represent every individual in a group. Keep in mind that these categories are loosely defined and individual characteristics will always vary.

Voicing Dissent

Most public health workplaces involve teamwork, and no team always reaches unanimous consensus on every topic. In fact, one of the strengths of teamwork is the integration of a variety of points of view. On occasion, you might be the only member of the team who sees things differently than the others.

This week’s PROspective offers guidance on whether and how you should speak up. I especially like that the article encourages you to think about whether the group is asking you to compromise your values. If so, speak up!

For example, if the group is taking a shortcut in an analysis that compromises the rigor of the work, and so also the integrity of your part in it, speak up!

But then how do you speak up in a way that maximizes the chances that your view will be influential? Start by showing empathy for the views you don’t hold – that actually opens the group to hearing your views.

Second, separate the topic from the people; your team members need to know you value them, even if you don’t agree with them about the topic.

I encourage you to click through to this short article, which provides strategies for when and how to be the voice of dissent, a valuable skill in the workplace.

Have you struggled to speak up in a professional setting when your opinion was unpopular? Share your stories and ideas in the comments!

Time Management

Have you ever joked about needing more hours in the day? Although I’d love to find a way to sneak in an extra hour or two, the hard truth is that we only have 24 hours to allocate across all of the demands on our time – both personal and professional. The article below has some good tips to consider for professional time management, although I’d add that it’s also important to think about how you allocate time to both your professional and personal selves. After all, none of us only exist in our work spaces!

After you read these tips, and review my thoughts below – I’d like you to consider taking on a 30 day planning challenge: adopt one or more of these strategies and stick to them (!!) for the next 30 days. At the end of that time, evaluate the effect that it had on your productivity and determine how you will approach the next 30 days. Let us know in the comments – which tips are you planning to adopt and how do you plan to institute them?

Each Sunday, I try to sit down and plan out the “must dos” to accomplish at work the following week. I plan around the meetings that are on my calendar, and block off time to complete these tasks. This is different than simply creating a to-do list. When I don’t dedicate time for specific tasks, I notice that my weeks aren’t as productive, and I have tasks that remain unfinished.

As part of my Sunday planning, I also keep track of the ~10,374 activities that our family might have in a given week. With 3 growing boys, you can safely assume that grocery shopping tops the list of family priorities! To avoid the weekend rush, we plan around my teaching schedule (I’m looking at you, EPI 740!), and shop on a weeknight when I can get home a little early. This semester, Mondays are for grocery shopping – this means that I know not to count on having extra time on Monday evenings to catch up on work. I am protective of my time both at work and at home – I try not to let one bleed into the other, but certainly there are times when I have to make exceptions.

Last – but certainly not least – I plan time to take care of myself. After much trial and error, I realized that there is much truth in the expression “you can’t pour from an empty cup.” Whether it is exercise, reading, cooking, being in nature, or spending time with friends – find things that are truly rejuvenating for you and engage in those routinely. Personally, I love to sew – you can see a sampling of some recent projects here!

We are in the business of prevention, and yet we often work ourselves into the ground without realizing that we could have intervened and had a different outcome (hello, counterfactual!). The time that you spend caring for yourself is a worthwhile investment, and will likely amount to less time than you would need to recover after overworking yourself.

8 crucial time management tips adapted from “Jump Start Productivity,” Healthcare Executive, September/October 2010

1. Learn how to say no. If you say yes to every meeting, e-mail request or project, you’ll quickly find yourself overcommitted – and overwhelmed. Take on what is essential, but try to avoid doing things outside your core job responsibilities. Say no diplomatically by offering reasonable alternatives to your participation. 
2. Schedule your time effectively. Your calendar can be used for more than just meetings. If you find it difficult to get uninterrupted work time, then block off time on your schedule for the most important projects. Treat that time as you would a meeting; don’t allow interruptions, and focus solely on that project. 
3. Knock out time wasters. Your phone, e-mail and social media can be fantastic tools – or vicious time wasters. When you really need to focus, it can help to turn those tools off for a little while. In addition, take advantage of “Do Not Disturb” and silence your notifications.
4. End Procrastination. Try to determine why you are procrastinating on a particular project. If the project seems too big, then break it into smaller tasks and work on each of those individually. If it’s a project you don’t want to do, then try working on it for just 15 minutes at a time. It’s easier to get started than to let it hang over your head.
5. Set realistic deadlines. When you are setting deadlines for a project completion, give yourself some flexibility by building in additional time. A good rule is to say that your project will be done in 1.5-2 times as long as you think it will actually take to complete. Then if you finish it when you originally though, you’ll actually be early. And if you run into delays, you’ll still be on time. 
6. Bring back the to-do list. The to-do list still has a place in the office. It can help you prioritize your tasks quickly. And checking each task off gives you a sense of accomplishment. Try using a task management app on your phone or calendar, or printing your tasks our on a brightly colored piece of paper. 
7. Remember to take breaks. Breaks are a great stress reliever, and they can actually make you more productive. Rather than spending the entire day overloaded with work, take the time for a quick stroll or snack between projects. And remember to schedule a vacation day from time to time as well. You’ll come back to the office refreshed and recharged. 
8. Delegate when you can. Good delegating is more than just dumping a project on someone else’s desk. Try to delegate tasks to staff who might enjoy or learn from the project. Make sure you are clear baou the project’s goals and requirements. And plan a way to thank staff members for their assistance when the project is complete.