It’s an all too common scene: A girl looks at a photo in a fashion magazine and compares the model’s thin, airbrushed figure to her own rounder shape. She tells her friend, “I am so fat. I hate my body.” But what if, instead of playing along as usual, the friend flips the script and compliments her on something other than her looks? Could changing the conversation be a first step toward improved self-esteem and healthier behavior?
Empowering students to speak up when they see their friends getting into unhealthy situations or behaving inappropriately is a common component of college antiviolence workshops. Now Rob Buelow, SM ’12, a former violence prevention educator and antisexism activist studying health communications at Harvard School of Public Health, wants to know whether this type of positive peer pressure can be tapped to interrupt disparaging conversations about body image and weight. It’s one of several tactics the high-energy master’s student is exploring in his quest to spread the positive message of public health.
“I have a passion for helping people and also for understanding what makes them tick,” Buelow says. “It’s exciting for me to try to understand who my audience is and how I can most effectively reach them.”
Working with colleagues from the HSPH Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED), Buelow is assisting in a pilot evaluation of the effectiveness of Fat Talk Free Week, a national social media campaign aimed at college women. After going through the intervention, were participants any more likely to stop a friend from engaging in fat talk? Analyzing survey data for his practicum, Buelow hopes to show that targeting the attitudes and behavior of bystanders can help change social norms.
Although it has been tried before, most famously in the “Friends don’t let friends drive drunk” television commercials, bystander-focused interventions are still relatively new territory in public health, says Buelow’s adviser, Vish Viswanath, associate professor in the Department of Society, Human Development, and Health. “More empirical evidence is needed to show that this approach is effective across a range of problems. If Rob can show that this approach works, and why it works, then it may be appropriate to apply more widely,” Viswanath says.
Teenage distracted driving is another problem ripe for a bystander-focused intervention. “There’s a big difference between saying to a teenager, ‘Don’t text while driving,’ versus a campaign that promotes a norm of friends who encourage other friends not to text while driving,” Buelow says. “When friends communicate this message to each other, it bypasses the teenage force field of invincibility that tunes out ‘This is your brain on drugs’–type scare tactics.”
But according to Buelow, public health practitioners need to do a better job at selling the benefits of healthy living. “A lot of the things we are up against in public health—eating junk food, smoking cigarettes, unsafe sex—appeal to people as fun, sexy, cool, or rewarding. To offset that, our messages must generate positive appeal for healthy behaviors. We need to sell public health the same way alcohol or tobacco companies sell their products.”
Buelow first learned the power of the right message at the right time as an undergraduate at Penn State University. Encouraged by a dating partner at the time, Buelow registered for a women’s studies class that turned out to be taught by a man.
“The world looked different to me after taking that class,” Buelow says. “The fact that the instructor was a guy got me to question a lot of stereotypes I was unaware of. He taught me about privilege: who has it, who doesn’t, and why it matters. He ripped the rose-colored glasses off my face and inspired me to do something about it.” Buelow got involved in men’s antisexist activism and after graduation took a job conducting sexual assault prevention trainings at the University of California at Irvine. He quickly learned to tailor his message to his audience.
“With fraternity men, I stressed that they were leaders on campus upholding a set of values,” Buelow says. “In women’s self-defense workshops, we would work on building confidence, self-esteem, and personal strength.”
Ideally, positive messages about healthy living should start in childhood, Buelow says. “Teenagers and adults have health needs that must be addressed. But you get the biggest return on investment by focusing on kids before they’ve had a chance to develop bad habits.”
After recently taking an intensive course in informal learning for children, Buelow is excited to pilot another outside-the-box idea: a health newsletter that will be posted where all kids must go eventually—the restroom. Buelow, HSPH’s vice president of student life, launched the Stall Stories newsletter at HSPH earlier this year. Its mix of student-oriented news with fun features proved popular with its captive audience, and that got him thinking about real-world applications for both child and adult audiences.
For Buelow, reaching people where they are is what public health is all about. “The pursuit of knowledge is really important, but what good is data and theory if they don’t have practical application? You’re not going to change the world if research stays in your lab and knowledge stays in your head.”
Amy Roeder is assistant editor of Harvard Public Health.
Photo: Kent Dayton/HSPH
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