Innovative, interdisciplinary health communication research wins $3 million grant to combat isolation in young adults

By Claire Cusick

Even before U.S. Surgeon General Vivek Murthy issued a dire warning this spring about the loneliness epidemic in America, two UNC researchers had already teamed up to work on a solution.

Loneliness is the absence of social connection, and even before the separations brought about during the Covid-19 pandemic, one in two Americans reported experiencing loneliness.

Barbara Fredrickson, Kenan Distinguished Professor of Psychology & Neuroscience, studies the health benefits of positive emotions and positive connections for decades. In a new research project, she has paired up with the UNC Hussman School of Journalism and Media’s Associate Professor Allison Lazard, an expert in how visual design influences message perception, especially in a digital environment.

“For decades, we’ve been looking at the benefits of positive emotions and positive connections for individual and community health and well-being,” Fredrickson said. “The next turn that I want to make is to find better ways to cultivate the conducive conditions for people to experience these health-promoting states. Allison brings a wealth of communication science to the table. With her help, we’ll have more messages, better frequency, lots of novelty, a lot of visuals, testimonials, and stories. All of that is a world apart and better from what we’ve used in the past.”

Fredrickson and Lazard are principal investigators of a $3 million study, funded by the National Institute on Minority Health and Health Disparities (NIMHD). The study will test whether, how, where and for whom social media messages can reduce social isolation in young adults (aged 18-29).

“My part is to design health messages to be relevant for people,” Lazard said. “I’ve spent my career thinking about how we use the scientific process and communication science to be rigorous, in how we’re designing messages — not just what we’re saying, but how we’re saying it.”

Harnessing Lazard’s expertise to reach a new audience is another step forward in Fredrickson’s work encouraging people to maximize their social connections in order to promote well-being.

Lazard is part of a cadre UNC Hussman faculty scholars focused on health communication, a strategic priority area for the school and a flourishing field in industry. “UNC Hussman faculty are among the leading health communication researchers and practitioners in the nation,” said Raul Reis, dean of the school. “Allison Lazard’s innovative, interdisciplinary work with Barbara Fredrickson to improve health for vulnerable populations comes at a crucial time for our nation. It exemplifies the promise of collaboration and how research at UNC can have a meaningful impact in people’s lives.”

THE CHALLENGE: According to the Surgeon General’s recent report, loneliness and a lack of social connection have serious health consequences. “Loneliness and social isolation increase the risk for premature death by 26% and 29% respectively,” the report states. “More broadly, lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day. In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke. Furthermore, it is associated with increased risk for anxiety, depression, and dementia. Additionally, the lack of social connection may increase susceptibility to viruses and respiratory illness.”

People who have grown up never knowing life without a smartphone are especially at risk. The Surgeon General issued another advisory this spring cautioning that social media can “have a profound risk of harm to the mental health and well-being of children and adolescents.”

“We know this anecdotally and we know it from the scientific literature,” Lazard said. “There have been enough meta-analyses showing that young people need help. They are struggling.”

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 encourage young adults to get offline and experience social connectedness through in-person interactions. They have already hired Hussman graduate Tushar Varma ’23, to generate youth-focused images and text for the messages.

The study leverages the fact that 84-96% of young adults use smartphones and social media. Social media messages, with relevant visuals and text, can raise young adults’ intentions for recommended behavior changes to improve their health.

“We will reach young people where they are to encourage them to go out in their communities to have more meaningful in-person interactions,” Lazard said. “We will give them information and tips for positive in-person interaction, like greeting a neighbor.”

THE INNOVATION: In order to test these messages in a safe but scientifically rigorous way, the team adapted an open-science framework to create a closed, simulated social network. They named it clikbrite, and it means this study will be the first to examine the messages’ impact in a way that combines the internal validity of lab studies with the external validity of field studies.

“Experiments conducted on social media are often hampered by proprietary algorithms and display constraints, privacy and condition independence violations, and lack of reproducibility across research teams and over time,” Lazard said. “With clikbrite, we have the ability for large-scale, reproducible randomly controlled trials to study the delivery of digital health campaigns on social media for vulnerable populations. These methods allow us to explore causal relationships in ways not possible with live social media.”

It wouldn’t be ethical to conduct communication research on social media with vulnerable young adults, Lazard added. “There’s too much risk,” she said. Two risks are scientific: “We would be at risk of what the algorithms show or don’t show, and of other people knowing they’re part of a study or not part of a study,” she said. Beyond that, social media brings the risk of harmful content. “We can ensure that the harmful content is not there, so we can look at helpful messages in a realistic environment, but also an environment that doesn’t introduce harm.”

Because it’s a controlled system, clikbrite eliminates these risks. “Every participant who comes into our social media environment has a similar experience,” Lazard said. “This allows us to better understand what catches people’s attention or interest. So when participants are scrolling on a newsfeed, will they pause on this message or not? Will they click on the message and comment? That’s the type of data that’s hard to get. You can’t do that on real networks. We can also control the background data, so we make sure that harmful content is not surrounding it.”

The study prioritizes populations with higher disease burden — young adults who identify as Black/African American, Latino/Hispanic, or with less socioeconomic privilege. These groups merit special priority as researchers develop this knowledge base, because these at-risk populations can face unique challenges in social contexts, including those stemming from discrimination and economic inequality.

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

THE MESSAGES: The first phase of the research will be to curate images and test which ones are most effective. “We know that there are many types of images that may work with these messages,” Lazard said. “We will show a range of people – from those who are socially connected to peers who are also struggling with social isolation – and also potential community places for positive interactions.”

Everyone is looking for health advice, and young people are looking for it on visual-based social media, Fredrickson said. “We want to convey to them that everyday social connection – however small, however brief, no matter with whom – is important for well-being,” she said. “To lean into that a bit more, we encourage everyone to try to make connections and in places where they might normally rush along on their way, not thinking about connecting. We’d like to encourage young people to see even brief encounters with others as opportunities instead of obstacles. These are small shifts in behavior that really speak to our social nature as humans.”