Health Education 2.0: Evans’ health promotion draws online followers and Royal Society of Canada recognition

If social media had a family physician, it would be Doctor Mike Evans. Based at St. Michael’s Hospital and an associate professor in the Department of Family & Community Medicine, Evans utilizes social media to educate the public about health issues. His Twitter account has more than 9,000 followers, while his YouTube channel has almost 42,000 subscribers. One of his video— 23 and 1/2 hours: What is the single best thing we can do for our health? — has been viewed more than 4.2-million times. Evans lab brings together clinicians with filmmakers, patients and social entrepreneurs to promote the best healthcare information. Recently named the Chair in Patient Engagement in Child Nutrition at the University of Toronto, Evans is the 2014 recipient of the McNeil Medal from the Royal Society of Canada, which is awarded for promoting the public awareness of science.

How does public education about health and wellness fit into our health care system?

Right now our system is mostly reactive and the education is on the fly from clinicians — what we call opportunistic advice. This advice tends to be downstream when medical problems start to arise. There is an incredible opportunity to create a much more powerful scalable experience, both upstream and downstream from illness that not only educates but nudges people towards positive change.  This could be preventive coaching, email clinic, or social networks to support disease management. To give you a specific example, I am now prescribing apps for common problems. The app customizes to you and gives you one of our educational whiteboards, gives you reminders in real-time, data visualizes your progress, compares you to benchmarks or others, and so on. I might see you three times a year; the app sees you every day. We are creatures of habit and it would be wonderful to micro-change these habits in the right direction for a better life. So…lots of challenges in re-wiring and improving our clinical relationships with these tools. First and foremost is acknowledging that we are all different; different ways of understanding, different levers for change, and different definitions of success.

The public has never had more access to health information than it does today. At the same time, there are fears 'Dr. Google' — turning to the internet to research symptoms and arriving at your own diagnosis — is undermining medical care. Is there such a thing as too much information?

Dr. Google is a double-edged sword. Overall I am a fan, but it can be dangerous both pre-diagnosis and selling non evidence-based products to the vulnerable. Having said that, I find the vast majority of people have a pretty good sense of quality on the web and it has been a total game-changer. I used to run a med school for the public at the University of Toronto. I would brag that instead of seeing 25 people a day, I could see 400 in a session. Our med school for the public on YouTube has been seen by over 10 million people. We tell evidence-based stories and imbed them in the relationships of care. In medicine, we think this is mostly clinician to patient, but we are wrong. It’s mostly friend to a friend or loved one to loved one. We try and make our media infectious, what I call a 'healthy virus.' As Adam Gopnik says, “Everything — faith, science, love — needs a story for people to find it plausible. No story, no sale."

Are physicians doing enough to educate patients about their medical conditions?

No, they are not. Having said that, docs are just one player in the emerging model of patient education. The doctors that are excelling typically see themselves as one part of a 'media lab' where patients, technologists, social media, and old-school education all come together. They usually start with curation, collecting together the most engaging high quality resources and putting it in one place, and then identify gaps and opportunities. This might be outreach to vulnerable communities and patients, or an info graphic that explains key learnings.

You were recently appointed Chair in Patient Engagement in Child Nutrition, which is part of the new Centre for Child Nutrition & Health at U of T. How will you utilize your skills as a health educator to improve childhood nutrition?

Yes. It’s great and I am lucky. We are starting with two strategies. One is to both play to my strengths and engage the brains at the Centre by building a series of three whiteboards looking at the science of nutrition. What is actually happening in childhood obesity? Is there a best diet or supplement? What does science say about the best way for families to eat? Understanding carbs, proteins, calories, sugars, fats, and so on. There really is an opportunity, like we did with exercise and 23 and 1/2 hours, to summarize the science of eating in an engaging and actionable way. My second interest is to focus on the bigger cascade. Better eating, sleep, thinking, social capital, and moving. When you sleep better, you make better food decisions the next day. This overlaps with the chronic diseases and prevention and quality of life. We tend to want the miracle food or the sleeping pill, when in fact the absolute best treatments lie within each of us. I am calling this 'The Better Life Project'… stay tuned.

What was your reaction when you learned you had won the McNeil Medal for the public awareness of science from the Royal Society of Canada?

I didn’t really realize what a big deal it is. I am very humbled. I like that it spans arts and sciences. This is reflected in past winners where people like David Suzuki bridge these fields. Also, it comes with a $1,500 award that I am putting towards a donation to the STOP Community Food Centre and a new carbon road bike. This will put me over the $1,500, but how much will remain a secret to both you and my wife.