December 15, 2014Uncategorized

Christopher S Walsh

Editorial

Published Online: December 15, 2014
Full Text: HTML, PDF

Editorial

Volume 6, Issue 4 celebrates 6 years since we first launched Digital Culture & Education (DCE), an output of a successful Australian Research Council (ARC) grant entitled ‘Literacy in the Digital World of the Twenty First Century: Learning from computer games’  (Beavis, C., Bradford, C., O’Mara J. and Walsh, C. S.).  It has been an amazing journey and we are undoubtedly continuing to grow with 2014 being the first year we have published four issues.  As a completely dedicated open-access educational journal, we are not only dependent upon our cadre of talented editorial boards members, but indebted to them for their on going pro bono work, support and dedication.

DCE’s success to date has been achieved through trust, collaboration and shared endeavours, particularly through special guest edited themed issues.  This year in collaboration with Tama Leaver and Michael Kent, we published ‘Facebook in Education: Lessons Learnt’   This special issue takes the tenth anniversary of Facebook as an opportunity to critically reflect on role of that platform in higher education, whilst simultaneously engaging with some of the larger questions about the place of education online, questions which pre-date the emergence of MOOCs by a significant number of years. Then working with the U.S. Agency for International Development (USAID) and co-supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), amfAR, the Foundation for AIDS Research, and the National Institutes of Mental Health (NIMH), DCE published ‘Innovative programmatic approaches to HIV prevention and care services for gay men, other men who have sex with men (MSM) and transgender persons using information and communication technology (ICT)’.  This special issue, edited by Darrin Adams, Kent Klindera, Christopher S. Walsh and R. Cameron Wolf, celebrates and shares the timely and crucial work of frontline workers, activists, researchers and educators working in the field of HIV prevention, testing, treatment and care. It is also the follow-up to an earlier special issue from 2012, ‘Prevention as a solution: Building the HIVe’.  Taken together, both guest edited issues offer relevant and applicable examples of digital technologies being leveraged, positioned and practiced towards community-based and led HIV prevention and care services in a digital era.

Thinking about the future trajectory of DCE, we are not only committed to remaining open access, but also equally committed to embracing an ethos of ‘slow citizenship’ over a trajectory of ‘fast citizenship’.  In this sense, DCE hopes to continue to publish work that explores how the tools of digital culture can be used to rethink not only how we live together with each other and machines, but also how we can leverage technology to create spaces for co-creation, co-production, debate and exchange that connect the local with the global.  Why slow citizenship to guide DCE? Because:

Slow citizenship would not seek to retreat from the discomforts and constraints of the physical world into the instant gratification of action in the virtual world, bit to address the lived problems and opportunities that being presented to communities by socio-technical change. Slow citizenship would seek to create space to explore and live with the new (and old) forms of diverse identity that our new socio-technical tools might offer. Slow citizenship would create a space for old and young to talk together, share expertise and insight across generations and build common response to shared problems. Slow citizenship would create conversation about the socio-technical structures we are building, and out responsibilities with in them and to each other. Slow citizenship would seek to reconnect the digital and the physical, to build bridges between the city street and the virtual world, and how these can enhance each other (p.100)

DCE embraces the vision of slow citizenship put forth by Facer at a time more defined by checking in and ‘sharing’ photos, than engaging in conversations and sharing aspirations for a more inclusive and democratic future. As our world wrestles with the depletion of resources, expanding wealthier and more demanding populations, economic globalisation, shifting socio-political values as fundamentalist belief comes into conflict with Western capitalism, and the reality that science and technology is transforming what is inherent to human existence (Craft, 2013), a trajectory of “fast citizenship in which digital technologies are used to ensure that everyone has a their say” (Facer, 2011, p. 99), does not challenge humans’ persistent confidence in an acquisitive, marketised, global culture despite increasing indicators of its destabilisation (Craft, 2013).

DCE continues to be interested in work that problematises digital cultural spaces in ways that reconnect the digital to the physical and offer new opportunities for children, young people and adults to engage in ‘possibility thinking’ and experimentation that is not dependent on commercial imperatives (Craft, 2013; Facer 2011). DCE hopes to publish more work that explores educational futures that challenge ‘what is’ in order to imagine ‘what might be’, “where ‘what is’ is a marketized, individualised narrative for childhood, youth, society and therefore education” (Craft, 2013, p. 132). We remain committed to keeping digital culture open to scrutiny and will continue to publish ideas, work and research that builds the capabilities and conditions for slow citizenship.  This is because this intentional stance tips the market balance in favour of more wise ‘possibility thinking’ because it has the potential to problematise the texts and narratives of fast capitalism—education, technology, money and science—that blur the reality they describe (Agger, 1989).  By unveiling these narratives in fast capitalism, through embracing slow citizenship, DCE hopes to publish work that reminds us individually, collectively and communally of our ability to imagine a preferable future where we live together and care for one another with the goal of designing a better world, built on trusting relationships.

In this issue

This issue begins with ‘Facilitating dialog in the game-based learning classroom: Teacher challenges reconstructing professional identity’ by Yam Sam Chee, Swati Mehorta and Jing Chuan Ong.  Their article explores the challenges teachers face when enacting authentic game-based learning predicated on dialogic pedagogy in the classroom. Rowan Tulloch then challenges the debate around gamification, conceptualising the concept not as a simple set of techniques and mechanics, but as a pedagogic heritage and an alternative framework for training and shaping participant behaviour that has at its core the concepts of entertainment and engagement in ‘Reconceptualising gamification: Play and pedagogy’. In ‘Digital ontologies of self: Two African American adolescents co-construct and negotiate identities through The Sims 2’, Tisha Lewis Ellison describes how two African American adolescent male cousins become co-constructors and negotiators of identity while playing The Sims 2.  Her work challenges educators to acknowledge how students participate with digital tools in communal spaces that shape how their literacy and identities are constructed, and it adds to the limited representation and investigation of African American family meaning-making and identity via digital tools. In, ‘Digital Culture and neuroscience: A conversation with learning and curriculum’, Kathryn Grushka, Debra Donnelly and Neville Clement outline the challenges faced by teachers as they engage in curriculum work that seeks to integrate the capabilities of our new digital culture in the design of learning experiences. It also highlights insights into human capacities for learning offered by neuroscience regarding the interplay of experience, memory, cognition, emotion and reflection in learning. Finally Robert Nelson and Phillip Dawson discuss their invention of a conversation simulator (or conversation sim) which illustrates how conversation and reading can be integrated in any Learning Management System (LMS). Their conversation sim for virtual learning demonstrates how automated educational technologies can positively contribute to the ongoing reinvention of reading and conversation through thoughtful absorption in a text and verbal interactivity over a topic. Daria Gladysheva, Jessica Verboom and Payal Arora present study investigates the phenomenon of museum communication through online video hostings, either by using YouTube or a customized platform in ‘YouTube as the art commons? Strategies, perceptions and outcomes of museums’ online video portals’.  Interestingly, they argues that as art becomes a cultural product to be consumed online, popular video portals such as YouTube serve as an important platform to facilitate this democratizing effect, with varied implications for the art world.

Into 2015

When Digital Culture & Education was conceived in 2006, open access publishing was not receiving the attention it does today. Our motivation for publishing DCE as an open access journal was simple.  We wanted to make all articles available to education practitioners—especially classroom teachers and front line workers—who might not have access to an academic library, and to scholars from institutions who are unable to fund that access. Open access was, for us, a way of disrupting the hegemony of academic publishing to intentionally reach a wider audience, particularly anyone who might find the work published in DCE useful. 2015 will see DCE continue to grow, with exciting changes.  We will be recruiting a new a co-editor, updating our website and publishing our first book under a first creative commons (CC) license.

We remain committed to publishing print and digital work that takes a critical approach to the issues raised by the increasing importance of new technology in all facets of society; in particular, research that examines the uneven uptake of technology, and perspectives on new media that emphasize its materiality, production, or environmental impact.  DCE has an open call for proposals for the development of guest-edited special themed issues and cover art. Guest editors and artists should send a short proposal or image to editor@digitalcultureandeducation.com for more information.

References

Agger, B. (1989). Fast capitalism: A critical theory of significance. Urbana, IL: University of Illinois Press.

Craft, A. (2013). Childhood, possibility thinking and wise, humanising educational futures.  International Journal of Educational Research, 61, 126–134.

Facer, K. (2011). Learning futures: Education, technology and social change. London and New York: Routledge.

Daria Gladysheva, Jessica Verboom & Payal Arora,

Published Online: December 15, 2014

Full Text: HTML, PDF

Abstract: The current study investigates the phenomenon of museum communication through online video hostings, either by using YouTube or a customized platform. The videos uploaded by museums present a combination of educational and entertaining content depending on their objectives, attracting users to watch art content online. While the literature on uses and gratification is highly represented in media studies, few studies exist about the specific user motivations and gratifications of new media platforms in a museum context. Three types of users were identified in this study. The first type – art-oriented users – display extrinsic motivation towards art exploration and seek for videos with educational content. The second type and the most widespread on these spaces – entertainment-oriented users – are intrinsically motivated and concentrate on the entertaining content of museum videos. Users of the last type are averse to exploring art content online, unless they are defined as non-art related. Overall, this paper argues that as art becomes a cultural product to be consumed online, popular video portals such as YouTube serve as an important platform to facilitate this democratizing effect, with varied implications for the art world.  

Keywords: YouTube, art, edutainment, gratifications, museums, online videos, user motivations, Web 2.0

Introduction

Since the beginning of the 80s, museums started to converge with a booming leisure industry and constitute an important part within the entertainment field (Burton & Scott, 2003). Art museums are commonly regarded as the most conservative and distant from this industry, although art and popular culture largely share a tradition in visual culture and storytelling. Since online video portals started to take off in 2005 with the launch of YouTube, videos are increasingly seen as an important tool for art museums to reach out to their audiences and fulfill their educational mission, at the same time offering a space for entertainment online.

This has raised important questions for museum managers, mainly focused on how to optimally attract users to their website through art video content online. How can museums’ video portals engage users and what target groups should they cater to? In other words, how do museums engage users and what are the different motivations for consuming online art video spaces? This requires a review of strategies museums currently use in their online activity, followed by an inquiry into the nature of users’ motivations to engage with these online spaces and their perceptions and gratifications from this activity. The current study applies a qualitative content analysis of three different video portals of museums with differing objectives and conducts interviews with online visitors of these spaces. Three different types of users are identified, which could further develop museums’ online strategies and tactics in engaging audiences.

Overall, engagement can be a powerful tool to enable the digital sphere to be a new kind of ‘art commons’ where the public can consume art as a community. Online video sites such as YouTube serve as a fresh means to redefine what constitutes as effective communication strategies in the art world. This moves away from the long perceived image of museums being exclusive-oriented to one that is more open to public involvement. This paper focuses on the typology of user engagement with art based video portals, arguing that user gratification is closely aligned with community belonging, in spite of the overarching elitism in the art world. And while YouTube can stimulate a more democratic space within a much gated community of art enthusiasts, the quality of participation is challenging to administer. This situates museums in a dilemma as the current economic climate compels them to expand participation and yet, their persistent role as society’s cultural gatekeepers compels them to exercise their expertise on what counts as quality art experience.

Review of Literature

Shifting Museum Landscape: From Custodial to Audience-oriented

Over the past three decades, the primary focus of museums has shifted towards the public, placing communication in a more central role. This has been a consequence of political, economic and socio-cultural changes in the museum field, such as the growing competition with other leisure activities, reductions in state funding and the advent of the Internet. Currently, museums have adopted a new social function as their mission in society, defined by the International Council Of Museums in 2007 (ICOM; affiliated to UNESCO) as follows: “A museum is a non-profit, permanent institution in the service of society and its development, open to the public, which acquires, conserves, researches, communicates and exhibits the tangible and intangible heritage of humanity and its environment for the purposes of education, study and enjoyment.” [1]

Museums have thus moved from a custodial, collection-centered approach to a marketing, audience-centered approach, a move which can be divided in three development periods: a foundation period (1975-1983), a professionalization period (1988-1993) and the current entrepreneurial period (1994-now) (Gilmore & Rentschler, 2002). Whereas the foundation period of museum marketing started to stimulate visitor studies and educational research, the professionalization period marked a real cultural change with the addition of marketing departments and the distribution of power to external stakeholders. Currently, museums’ accountability to society is evident in their primal function as educators of cultural heritage. Museums are expected to deliver three essential and interrelated services namely, education, accessibility and communication. Education, as the core element of museums, is focused on educating the public on the nature and range of its collection, while communication includes the nature and scope of the interaction with visitors. Accessibility is the proximity to the core product and the availabilty of museum services.

The Internet constitutes an important extension of the service industry which has changed the way of marketing and communication and increased the level of internationalization. Museums are compelled to go online, as these new platforms are seen to provide the public with added ‘digital value’ to their visitor experience. In addition, the museum can fundamentally benefit from an online presence as it is able to cater directly to their loyal visitors, reach a large potential public, and create new and surprising digital experiments to engage the audience with the upcoming exhibits (Lagrosen, 2003). In this latter area, American museums are at the forefront, mainly due to the long commercial tradition of its non-profit sector (Toepler & Dewees, 2005). New ICTs have inclined museums to be where their public is, and social media is becoming a preferred platform for new kinds of interactions.

For museum managers, it is not only important to educate and inform visitors, but also to stimulate discussions in order to receive feedback and ideas from the community (Arends et al., 2009). The interactive and open nature of social media applications is especially suitable for this purpose. The signficant increase of social networking sites (SNS) have ignited the need for more understanding of online user behavior and motivations (Russo et al., 2008). Besides this strategic opportunity for museums to create dialogue with their online visitors, there is also an opportunity for them to promote the museum online and generate revenues (e.g. web shops). However, against these benefits, museum management also needs to consider the potential loss of control over information and notions of quality within the democratic Web 2.0 arena of amateur knowledge (Arora & Vermeylen, 2013).

Museum’s Digital Communication Strategies

Despite today’s omnnipresence of the Internet in the museum sector, specific research on its adoption and reflection remain partial and limited. However, in recent years some explorative studies on the importance of online value creation have surfaced. Hausmann (2012), for example, argues that “[i]n times of a general information overflow, declining credibility of traditional communication tools and a continued shortage of resources in the cultural sector, the fact that these web-based applications can facilitate viral marketing and stimulate word-of-mouth is of special interest to arts institutions” (p. 174). This is strengthened by the fact that cultural institutions like museums usually offer an experience good whose quality can only be determined after consumption. Online word-of-mouth facilitated by social networking sites thus is an important marketing tool in creating a ‘buzz’ around exhibitions. However, this does require a good online communication strategy, which is usually limited by a general shortage of time and personnel within the arts sector (Hausmann, 2012).

Previous research on online strategies by Lagrosen (2003) distinguished three general strategies employed by museums: avoidance, content, and technological. The first one was an overall strategy of ‘being there,’ but at an absolute minimal level of effort, whereas the content strategy implied higher efforts in uploading content using simple technology. The last communication strategy is meant to gain a leadership position by uploading quality content on a technologically sophisticated platform. Interestingly, a study by Padilla-Melendez & del Áquila-Obra (2013) found similar strategies employed today, namely defender, analyser, and prospector strategies. The defender sees the online space merely as a complement and informational brochure. The analyser gladly uses the interactivity of such media as an expansion strategy, but does not take in an online leadership position like the prospector, who makes high efforts in creating high online value for visitors. Chung, Marcketti and Fiore (2014) take this art marketing literature a step further and developed three strategies for relationship marketing using SNS. The first strategy, awareness, includes placing content on as many platforms as possible in order to initiate relationships and raise awareness of exhibitions and activities among the public. The aim of the second strategy, comprehension, is to enhance visitors’ knowledge of the museum mission and to strenghten existing bonds by using only a few platforms and integrating them. Finally, the third strategy, engagement, aims to create and sustain an online community by continuous conversations between visitors and museum staff. This entails a good understanding among personnel of the features of SNS.

Particularly, the popularity of YouTube (which since its start in 2005 currently takes third place on Internet traffic rankings [2]), has lured many museums. In 2006, New York’s Museum of Modern Art solicited the public to weigh in via YouTube on the choice of finalists for their exhibition. This was seen as a new trend by museums to harness the popularity of online communities and cater to the new generation of art fans. In an interview with the Wall Street Journal, curator Barbara London of MoMa claimed this to be iconic: “It’s like Andy Warhol and his can of Campbell’s soup, almost. (…) It’s a brand. It’s very much now. It’s alive” (Lavallee, 13 October 2006). According to Yehuda (2008), the nature of video hosting allows organizations to personalize their approach towards consumers and to create a level of intimacy unbeknownst before.

This last remark is close to the argument of Burgess and Green(2013) on YouTube’s participatory culture. They argue that online videos on YouTube should be understood in the context of everyday media practice. Users can now easily upload content and make sense of the world around them by narrating and communicating their (cultural) experiences. In this, uploading content on YouTube can be understood as a meaning-making process, and not merly as an attempt to work around the mighty media industry. This hits, what the writers call, the ‘YouTube-ness of YouTube’, or its shared culture. The authors further argue that it is not helpful to draw a sharp line between professional and amateur videos, or commercial and community practices: this industrial logic does not apply in a cultural system with its coherent cultural logic. According to Goldberg (2011), these two logics are inescapably intertwined with each other due to the economization of online participation. Whereas most new media scholars celebrate the liberating and empowering nature of Web 2.0 applications, scholars like Beer (2009) and Goldberg (2011) call for more critique of this assertions, stating that online participation places users in a network of power relations. Digital players like YouTube earn a lot of money over the backs of their users, while promoting themselves through such liberating claims as ‘Broadcast Yourself’. Hence, within this new digital commons, empowerment can be deeply corportized and monetized.

Greenfield (2008) argues that museums need to address a range of issues before starting any social networking project like video hosting. These issues include security, placing software management in-house or outsourcing it, monitoring protocols for user-generated content and the assessment of the tool’s success. New media professionals are furthermore faced with identifying and stating the project’s mission and main objectives (Marty, 2007). When executed properly, these social media platforms can more fully engage users, promote the museum and create an online community (Kidd, 2010). In addition to functioning as an educational tool, entertainment is also recognized among scholars to be an important constituent of the online visitor experience.

The decision to open up an online video channel on platforms like YouTube is mainly based on its people-friendliness, cost-effectiveness and minimal technical demand (Greenfield, 2008). In addition, it includes a loss of control over content, which provides museums some leverage for experiment. Examples can be found where museums have passed down control to users by requesting for video contributions and limiting their role to mainly curating these videos, as for instance with the exhibition of the The Resident art group at the Museum of Modern Art in 2006. On the other hand, there is also the strategy of customizing online video portals, such as that of the Indianapolis Museum of Art. Their self-developed video portal ArtBabble is considered as a best practice within the field. Museum staff named several reasons for keeping control over their online video content (and those of partner institutions), which involved among others the creation of a cost-effective space for high definition videos with no advertising disturbing the view (as opposed to the highly commercial YouTube), the ability to design their own governance protocols and to build an online brand (cooperatively), and last but not least, providing a specific and unique platform for a niche community of art lovers (Stein et al., 2010).

Users of online museum videos

In the past, visitors were seen as ‘zombies’ mindlessly taking in what the museum host told them, but todays’ online marketing by museums reflect a changing mind-set (Hooper-Greenhill, 2013). Web 2.0 platforms such as video hostings allow users to participate more fully in cultural issues, control the information they receive from these media and enable them to provide feedback. Besides being a “powerful educational  and motivational tool” (Duffy, 2008: 124), online video platforms are also a significant discovery tool, where users encounter novel content.

Kidd (2010) argues that if users of museum websites and related social media find these spaces attractive, the level of users’ awareness and loyalty towards museums rises. In addition, Arends et al. (2009) emphasizes the participatory attitude of users online: as online visitors are able to create art online, which can be viewed and commented on by others, these spaces can add value to the visitor experience. While these studies are helpful, there is insufficient literature in this area, particularly on the range of motivations and behaviors of users in museum studies. Hence, we adopt the enjoyment or gratifications framing of new media use to look into the user’s motivations in choosing certain media, as the type of pleasure gained from media shapes individual’s evaluation and perception of the larger context at hand, in this case, the museums (Ruggiero, 2000).

Gratifications are highly dependent on the needs or motivations consumers have to fulfill in their media usage and vice versa. The study by Lin et al. (2010) for example builds upon the premise that informal learning on museum websites is influenced by the emotional experience and enjoyment of these spaces. We identify three prime motivations here that lead users to discover museums’ online video spaces, inspired by the model of pleasures presented by Bosshart and Macconi (1998, in Vorderer, 2001): entertainment, education and socialization.

Even though entertainment appears to be the strongest motivation behind media use, people also seek pleasures from gaining knowledge (Bryant & Vorderer, 2013). These users show a strong preference towards learning that is especially apparent within the museum context. Mediated learning is especially deemed effective when it brings enjoyment which highlights the importance of the socio-technical archicture of the media space, as argued by Lin et al. (2010). In their study of museum websites, they find that important design characteristics for encouraging informal learning are novelty, harmonization of the space, and proper facilitations.

Finally, users also seek relations with others through the mediated space, which has been facilitated by the interactive web. These new Web 2.0 communities allow users to share preferences and pleasantries, to discuss and argue, and to participate in the intellectual discourse and exchange knowledge (Jankowski, 2006). Three motives for media usage, entertainment, learning and feeling connected to a community, are interrelated to each other, as users can have different motivations at the same time. Concepts as ‘edutainment’ and ‘infotainment’ for example show that the user’s experience with media is often multidimensional. After all, many scholars argue that entertainment is an important prerequisite for the processing of information (e.g. Duffy, 2008; Lin et al., 2010). However, the literature does make a distinction between extrinsic and intrinsic motivations. According to Ruggiero (2000), “individuals either intentionally seek out information or ritualistically use specific communication media channels or messages” (p. 9). When people are extrinsically motivated, they show goal-directed behavior in their activity where they purposively seek out certain benefits and want to meet specific expectations. Their online activity is cognitive and the entertaining aspects of the content have a less emotional impact on them (Novak et al., 2003). On the other hand, intrinsically motivated users are more experimental and affective in their behavior, and they prefer a bottom-up approach in their ‘online journey’. As Bilgram et al. (2008) articulate, “intrinstic motivation results from the activity itself conveying a feeling of enjoyment, exploration and creativity to the users and enabling them to make full use of their potential” (p.441).

To conclude, museums have recently become more commited to their visitors, and in the production of their online spaces they take account of their user’s preferences and desired outcomes. Museums therefore pay much attention to the way they set up their video portals while keeping an eye on their educational function. On the other hand, in the consumption of these spaces the context of online video platforms matters. Users gain satisfaction or certain gratifications out of watching online museum videos; they are engaged in the activity, feel a positive affect in its consumption or fulfill certain needs. Usually, they are motivated by a need to be entertained, to learn something and/or to socialize with persons with the same interests, emotions or morals, and are either extrinsically or intrinsically motivated to engage with this activity. Within the design of their online video spaces, museums must take this literature on uses and grafications of both old and new media into consideration. However, museum research is still scarce in this area, especially in the area of online video platforms, while many initiatives are currently taken up by museums. Therefore, this study aims to discern the peculiar motivations and perceptions of users of online museum video hostings.

Methodology

To investigate the communication strategies employed by museums on online video portals, a qualitative content analysis of three museums’ video spaces was conducted. This includes an analysis of the museums’ activity online, their level of control over the uploaded content, the way they react to users’ feedback, and the features of their video space, and among others their use of Web 2.0 features. These case-studies were chosen because of their distinct usage of the portal, either by simply using a YouTube channel (Metmuseum [3] of the Metropolitan Museum of Art in New York), by collaborating with YouTube (YouTube Play [4] of the Solomon R. Guggenheim Museum in New York), or by making a custom video platform out of private means (ARTtube [5], initiated by the Museum Boijmans Van Beuningen in Rotterdam, the Netherlands). The different operational models of these portals allow for a comparative study between museums, while the incorporation of one Dutch museum portal enables a cross-cultural comparison with the two American museums, both situated in New York. Note that ARTtube, launched on 9 October 2009, is the Dutch equivalent of the larger and more popular ArtBabble [6], a collaborative project initiated by the Indianapolis Museum of Art, U.S.A. which launched on 7 April 2009 with six partner institutions, whose experiment was set as the example for ARTtube. As of autumn 2011, Museum Boijmans Van Beuningen also cooperates with four other Dutch and Flemish museums. However, at the time this research was conducted, the museum was the sole operator of the video platform, which allows a comparison between three individual museum portals.

Moving over to the consumption-side of these video portals, the motivation of users and their perceptions of these spaces, a two-fold method was used. First, a qualitative content analysis of users’ activity and perceptions of these video spaces through their comments, appraisals, and ratings was conducted. This concerns comments on 12 videos for each portal, chosing 6 top-rated and 6 top-viewed museum videos on YouTube and the 12 most commented videos on ARTtube, creating a data set of 36 videos in total. Thus, a selection was made among the most popular content, rather than a random sample. These comments were then scrutinized for patterns and compared to categories taken from the literature, most notably looking for expressions of video’s entertainment,  education and socialization value.

Second, semi-structured interviews were conducted with ten users of our case-studies, who were interviewed over Skype. These ten online visitors were selected by sending out online surveys over the selected portals and their respective social media, and were randomly sampled out of the pool of respondents. The online survey was only administred for two weeks and collected data from 100 respondents. Because the survey data was too small, no significant findings could be made, though a general picture did emerge. Therefore, this data served to shape questions for the semi-structured interviews, allowing for more focused enquiries. This does not take away from the fact that the sample of ten interviewees is still too small to take definite lessons from, but the interviews did shine a light on more complex questions regarding users’ attitudes, perceptions and experiences with art museums and their virtual video spaces. Interviewees were asked what features of online art videos attracted them, which videos they prefer and what they took away from watching these videos, at the same time leaving room for their personal interpretations and reflections on the subject.

Results and discussion

First, the strategies employed by museums on their online video portals are investigated by analyzing video and social activity, and the characteristics of these three portals. This leads to a general understanding of uses of video platforms from the perspective of museums and museum communication. In the second section, the gratification users get out of viewing art videos online are further investigated through interviews with users. Lastly, we try to grasp the motivations behind user’s behavior as they explore the Web for videos of their interest; we conclude by arriving at three types of users on these spaces. This classification will be especially useful for museums that want to get (more) visibility on the Internet for their art videos.

Museum strategies for online video platforms

Both the Metropolitan Museum of Art (popularly called the Met) and the Solomon R. Guggenheim Museum build their online web presence on the popular video hosting site YouTube. The main difference between the two museums lies in their web strategy. Whereas the Met simply took an account on a video channel on YouTube, the Guggenheim set up a joint video project in collaboration with YouTube, HP and Intel, their main purpose being to organize a biennial of creative (amateur) videos. Out of more than 23,000 videos submitted to the YouTube Play channel, 25 videos were selected by a jury and were highlighted in the museum and on the channel. In this undertaking, the Guggenheim played out a collaboration strategy with commercial parties as opposed to the broadcasting strategy of the Met. This is similar to Museum Boijmans Van Beuningen’s strategy of adopting a more experimental approach by designing a custom online video space, ARTtube. The objective behind ARTtube is to provide videos about art and design, the museum and its collection which are made by professional filmmakers. Dutch museums like Museum Boijmans Van Beuningen are for a large part funded by the government, either local or national (or both). However, for the ARTtube project, the museum received a generous contribution from the VSBfund, which is a donation fund.

In their YouTube Play project, the Guggenheim focused on the desire of users to create and share their content with others, with YouTube being a popular platform for such endeavors. Bernstein (2008) explains this notion by describing a similar museum project: “(…) the more we thought about YouTube, the more we came to believe that content created by the museum might not be as engaging as content created by others. Asking for visitor-created content seemed to be more in sync with the YouTube community.” In the case of YouTube Play this indeed turned out to be a success, with over twenty-thousand creative videos from amateurs being sent to the channel. However, the number of total views lag behind the number of channel views, indicating that the project was more popular for its creativity and experiment than its actual content consumption.

While the Guggenheim only produced some videos concerning their project and the organization of the biennial, the Met was more concerned with producing videos about their art collection for educational purposes, which is in line with their mission statement: “The mission of The Metropolitan Museum of Art is to collect, preserve, study, exhibit, and stimulate appreciation for and advance knowledge of works of art that collectively represent the broadest spectrum of human achievement at the highest level of quality, all in the service of the public and in accordance with the highest professional standards” [7]. The museum thus adheres to its image of an authoritative and expert institution, while also wanting to expand their audience reach through the popular and entertaining video platform of YouTube. And indeed, the number of views indicates that a considerable number of online users are reached.

ARTtube takes in a different position here, not only because its art videos are both in English and Dutch, with mostly English subtitling when Dutch is spoken. First of all, the navigation of the site is somewhat dissimilar to YouTube: although there is an overview of the latest videos and different playlists just like on YouTube, ARTtube also features news specific to the platform and allows for jumping to the next scenes in the video as pre-given by the producers. In a sense, the platform allows the museum to display professional videos in a fine-tuned socio-technical context for optimal information transfer. To this end, there is one specific feature that clearly distinguishes the platform from YouTube, namely its option to download videos from the site. In the Web 2.0 era, this is regarded among digital literati as a basic requirement that YouTube does not meet (Ito, 2006). On the other hand, ARTtube misses social statistics as likes (although videos can be shared).

With regard to content, the videos uploaded on YouTube Play are primarily for entertainment reasons, the Met almost exclusively presents educational content (e.g. with ‘talking heads’ of experts), while ARTtube shows a mix of educational and informational content and  entertaining audio-visual effects, i.e. displays videos for ‘edutainment’. This has some clear consequences in terms of interactivity and participation, although it is deemed common to have few comments on these museum video spaces (Mancini & Carreras, 2010). As expected, online traffic is more considerable when their participation is directly requested, as in the case of YouTube Play. This namely answers to the five main features of today’s participatory culture: 1) low entry barriers, 2) support for creativity, 3) informal mentorship, 4) evaluation of users’ activity, and 5) community building (Jenkins, 2006). The desire to create user-generated content (UGC) mainly lies in “connecting with peers, achieving certain level of fame, notoriety or prestige, and self-expression” (OECD, 2007: 4).

However, just as the other two platforms in our sample, little dialogue could be found within the comment sections. Users do provide feedback, but museums do not actively engage in responsive dialogue on video platforms, limiting receiver control (McMillan, 2006). One exception is a special series on ARTtube, the ‘Peanut-Butter Post’. This highly interactive section was initiated for the duration of an exhibition of the ‘Peanutbutterfloor’ (just as the name says) by Wim T. Schippers. Visitors could sit down for a webcam and ask any question concerning the art work which would later be answered by the artist. In this case, specific efforts were made to stimulate mutual discourse on the video space, and also quite succesfully (during the exhibition, which lasted from March 5, 2011 to May 29, 2011, 675 questions were posed, and about 90% were answered at the time of the content analysis).

To sum up, the Guggenheim engaged in a commercial enterprise with YouTube Play, using a bottom-up approach while highlighting its authoritative position by composing a jury for its biennial. In contrast, the Metropolitan Museum of Art uses YouTube in a top-down strategy, taking control over the production of its videos. Museum Boijmans Van Beuningen does the same with ARTtube, although its custom design allows for a more attractive and audience-centric context.

User engagment on museums’ online video portals

From the interviews, some main features of museums’ video hostings to attract visitors to these spaces could be extracted, namely the ease of access, entertaining and educative content, and the social platform it offers to users. These features can be connected to Bosshart and Macconi’s model of pleasures (see Figure 1). Interviewees for example indicated that online museum videos induced them to pay a real visit to the museum, enjoying the “use of physical abilities” and eliciting a “pleasure of the senses” (Vorderer, 2001: 251). This is supported by several studies, such as in the explorative study by Bakshi and Throsby (2010).

arora1

Figure 1. User gratifications from watching online museum videos

The interviewees most notably showed a desire to be entertained by museum videos, which is surprising considering the strong association of museums with learning. These important entertaining features of art videos connect well to Bosshart and Macconi’s notion of the pleasure of (ego-)emotions and is characterized by Green et al. (2004) as an immersion into a narrative world. When looking at the motives given in the interviews, five types of entertaining motives can be distinguished. First, users derive aesthetic pleasure from viewing museum videos, indicating for example that videos are beautiful, stylish, well-designed and have amazing visual effects. One interviewee responded on the YouTube Play channel from the Guggenheim museum in the following way: “I’ve got a visual pleasure through watching some fo the users’ videos, they were produced in a very creative way.” Visual characteristics of online museum videos thus have an important influence on users’ affective perception of these spaces.

Secondly, there is the immersive component; people indicated that they lost their sense of time while watching museum videos, i.e. felt immersed into the activity. As one respondent formulated it: “What I mean by being entertained by the video… is when I am fully absorbed in it.” A third motive was the empathy component; Users at times identified with the author or the main character of the video, for example in having the same ideas as him/her, or because of feeling connected with the author: “I watched that one-hour-video only because of Pogo, I was so excited and nervous about him” (about a participant of the YouTube Play Biennial). Fourthly, all interviewees indicated that they watched videos for the sake of escaping reality, for example boredom, seeking distraction from everyday activities, or to “explore something different from my life”. Lastly, interviewees also mentioned a desire to manage their mood (cfr. Zillmann, 1988), to feel better or just to feel serene. One respondent even advised that: “(…) even serious videos, such as museum videos, should involve some humor (…) Humor makes it easy to watch, and it also raises your mood”.

Although feeling mainly attracted to the entertaining content of museums’ online videos, interviewees also recognized the educational function of these videos. They felt a desire to learn something new or to find more depth: “Of course I’m not watching these videos only because they are entertaining. I am interested in art and I want to know more about my favorite periods of art or special artists (…) I also feel self-confident when I know more about the art issues I am interested in.” This provides them with a pleasure of personal wit and knowledge as found in other studies on cultural consumption online (Bryant & Vorderer, 2013). Moreover, some of the interviewees argued that they were more involved in the activity of watching museum videos online and remembered more information when videos were interesting and well-produced. Education thus works better when museum videos also have entertaining characteristics, or as Schweibenz (1998) argues, museum audiences seek both content and context and therefore museums should provide their visitors with ‘edutainment’ or opportunities for ‘playful learning’ (Resnick, 2004) in order to attract and engage them to a higher degree.

Basically, a key motivational factor for users is enhancing their socio-emotional state, i.e. the pleasure that users get from feeling affiliated to a community. Many studies have shown that visiting a museum is a largely social and group-based activity, which is engaged in collaboration with different subjects, such as family or friends. Spending leisure time on the Internet is no different, although it appears as a highly individual activity: relations are based here on virtual connections. Several motivations behind joining a virtual community can be mentioned, such as a desire to share information, to get social recognition for exchanging this information and to belong to a certain group. Interviewees in our sample for example indicated that they want to be viewed as an authority figure, and that they will only “write comments (…) when I’m sure somebody will read it. Otherwise there is no sense in it.” Respondents describe this feeling of belonging to a community as a desire to communicate with people who share the same interests: “I also follow this art channel and participate in discussions, because I like most of the other participants there. Sometimes I share my point of view and it seems like other users care about what I am saying”. Users thus seem to look for and place comments on those online museum platforms whose users will most likely share their interest in art. This opens up future avenues for research regarding the nuanced relationship between cultural capital, community and art consumption online.

User motivations for online art exploration

Having looked into the type of gratifications users seek when they engage with online museum videos and having distinguished the main characteristics of three museum video hostings with distinct strategies, we can progress by comparing both these consumption and production features in order to arrive at the peculiar motivations of users to visit and seek for content on these platforms.

Regarding the comments section, in YouTube Play, users mainly communicate their personal opinion about the video, the producer or its context, with few comments relating to art or museum issues. Many comments concern users’ delight with the way the video is produced or the soundtrack is chosen and the modern visual effects that are used. In effect, users act as jury members on this platform, although their comments are mainly limited to providing positive feedback and wondering how the video was made and what is the story behind it. A significant difference was found in comparing the six top-viewed and six top-rated videos on this channel, as comments on top-viewed videos showed a lot of spam and ‘trolling’ and top-rated videos mainly provoked appreciative comments. This can be explained by the fact that top-viewed videos are displayed on the main page of the video site, hence are watched and commented by everybody who conciously or unconciously encounters the channel on YouTube. On the contrary, top-rated videos are placed ‘deeper’ into the site, and are thus found by those people that are interested in its content.

Due to the popular and highly commercial strategy of YouTube Play, which was clearly advertised on the YouTube main page, the channel pulled in a lot of online traffic which far exceeds that of the other two platforms and thus contains more comments. However, both the Met and ARTtube attracted a considerable (niche) community onto their video channels. The accessible YouTube channel of the Met provides a free and open space for discussions about art, which happens to a far higher degree than on the YouTube Play channel. Remarkably though, no spam was found on the channel of the Met, which may either indicate a high level of ‘radical trust’ in the online community (Russo et al., 2008), or strict moderation from museum staff. Furthermore, top-viewed videos on the Met channel showed more comments expressing personal opinions, whereas top-rated videos were more topical, specific, and served more as an exchange of information. Comments on the ARTtube channel are scarce, which may be explained by the fact that (at the time) the site requires registration for placing comments. This may have refrained users from spamming, but also from commenting. The videos that received the most comments predominantly show positive opinions about the video content and enthusiasm for its entertaining and educational content.

The differing nature of users’ comments on the three video portals shows that different users seek different gratifications and are thus highly selective in their online viewing activity. Especially on YouTube Play many users weren’t expecting to see art videos; comments show that they were annoyed and irritated by this discovery. Upon reading these comments, different types of users can be distinguished, which are either pleased or appalled by the educational content of museum video spaces, or are mainly attracted by its entertaining content (see Table 1).

Art-oriented users. These users are mainly interested in exploring art and their online activity is directed towards this end. They are usually looking for art videos on museum video portals and are mostly interested in its learning content, although they are also attracted by its entertaining features. In this sense, these users are highly extrinsically motivated because their activities are “instrumental to achieving a valued outcome” (Hoffman & Novak, 1996: 61), i.e. aimed at discovering new or in-depth information about art. Their involvement is highly cognitive and their online attitude is mainly positive. Art-oriented users can be found on all platforms, although their participation on YouTube Play is less obvious than on the other two portals.

Types of users

Discovery

Attitude

Interest in

Presence on

YouTube Play

Met museum

ARTtube

Art-oriented Goal-directed Positive Interesting, educational content that contains knowledge

+

+

+

Entertainment-oriented Navigation-al choice Entertaining content, interactivity

+

-

+

Art-averse Negative Non art-related content

+

-

-

Table 1. Types of users on museums’ video portals

Entertainment-oriented users. This type of user pays a lot of attention to the entertaining features of museum videos, and are rarely looking for art-related videos directly. They are most likely to be overrepresented on museum video portals and mainly look for attractive visuals, opportunities to escape reality and to immerse themselves into the narrative of these videos. Because they accidentally come across art videos that they deem entertaining, the educational value is of less importance to them. They are intrinsically motivated, i.e. their viewing activity is performed for the sake of the experience of the activity, not for any apparent aim. These users browse the web for hedonic values such as enjoyment and their online behavior is highly experimental. If they like what they see, they will be more likely to come back. This may have positive outcomes for museums who want to increase their visitor numbers, also because this type of user is highly sensitive to commercial and bottom-up projects such as YouTube Play.

Art-averse users. This final type of users is mainly found on platforms such as the YouTube Play channel, leaving comments expressing their annoyance and dissatisfaction upon discovering art-related content during their online browsing activity (“Why YouTube decided I wanna know it??”). Just like entertainment-oriented users, they are highly intrinsically motivated with the difference that they like to be in control over the information they receive. They avoid spaces such as the Met channel and ARTtube altogether because they dislike their formal top-down approach. Although they are averse to art content, when videos are presented as displaying creativity they don’t mind watching them. However, they are also highly critical of these videos and do not refrain from providing negative feedback. In this sense, they put on their YouTube glasses and approach these videos as typical of this site: “YouTube formula #1. Take a DULL boring video… introduce “rapid cut” editing and cheap animation…and end up with… a BORING video with RAPID CUT EDITING and CHEAP animation” (one commenter on a video on YouTube Play).

Conclusion

In this day and age of Web 2.0, museums have a high stake in attracting and engaging their audiences online and thereby, museum management would benefit from more knowledge about the perceptions of users and outcomes of this type of digital commons. Considering the growing popularity of online video portals such as YouTube, this paper addresses the question of how museums can engage their users through online art video content. These digital spaces are seen as promising grounds for opening up the much gated art world and birthing new forms of public engagement. It is found that while art consumers online have individual differences in their gratifications and motivations, they do seek membership to virtual art communities and their consumption is affected by this collective participation. Even though these users consume art online, it is seen that they are first and foremost media users. Users bring with them well-schooled media practices, expectations and perceptions of digital spaces to these museum video domains. While contemporary museum video portals such as ArtTube, the Met Channel and YouTube Play are architected for democratic participation, the nuanced differences in their customized features give rise to diverse relations between these museum and their audiences. Other factors that influence user engagements within these novel art spheres are institutional funding and management strategies, commercial collaborations and institutional worldview on their role as experts and gatekeepers in this new media age.

Furthermore, this paper reveals three types of users with differing gratifications and motivations, namely, art-oriented, entertainment-oriented and art-averse users. So which type of users should museums attract on their online video platforms? Although entertainment-oriented users are by far the largest group encountered on these portals, museum management should make a choice between privilaging entertainment to meet the desires of this large group of users and their formal mission to serve art-oriented users who are looking for more in-depth knowledge of art. Platforms like ARTtube demonstrate that it can do both, provide ‘edutainment’ without being tainted by the commercial nature of YouTube and be recognized as a legitimate platform by a loyal art community. The balance between these two realms is an ongoing challenge as entertainment and education come with a long history of conflict in how we learn and engage as communities. Future research should explore the trade-offs that ensue in quality and expertise as popularization serves as an easier path to art markting in this difficult financial climate. 

Notes

  1. http://icom.museum/the-vision/museum-definition/
  2. http://www.alexa.com/topsites/global
  3. http://www.youtube.com/user/metmuseum
  4. http://www.youtube.com/user/playbiennial
  5. http://arttube.boijmans.nl/en/
  6. http://artbabble.com/
  7. http://www.metmuseum.org/about-the-museum/mission-statement

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Biographical statements:

Daria Gladysheva MA received a Master of Arts in media studies from Erasmus University Rotterdam, The Netherlands. She is currently a Communications officer at DSM in Delft, the Netherlands.

E-mail: daria.gladysheva@gmail.com

Jessica Verboom MA received a Master of Arts in media studies from Erasmus University Rotterdam, The Netherlands. She is currently working at the Marketing, Communication and Commercial Department of Het Nieuwe Instituut, institute for architecture, design, e-culture in Rotterdam, the Netherlands.

E-mail: verboom@eshscc.eur.nl

Website: http://jessicaverboom.wordpress.com/

Payal Arora PhD is an Assistant Professor in the Department of Media and Communication at the Erasmus School of History, Culture and Communication, Erasmus University Rotterdam, The Netherlands. She is the author of ‘Dot Com Mantra: Social Computing in the Central Himalayas’ (Ashgate, 2010) on internet practices in rural India. Her second book, ‘The Leisure Commons: A Spatial History of Web 2.0’ won the EUR Fellowship Award in 2011 and her paper on digitization of healthcare information won the 2010 Best Paper in Social Informatics Award by the American Society for Information Science and Technology (ASIS&T).

Email: arora@eshcc.eur.nl

Website: www.payalarora.com


Yam Sam Chee, Swati Mehorta & Jing Chuan Ong

Published Online: December 15, 2014

Full Text: HTML, PDF

Abstract

Despite widespread interest in the use of digital games to engage students and enhance the quality of student learning, the teacher’s perspective has been less extensively studied.  The challenges that teachers face when enacting authentic game-based learning predicated on dialogic pedagogy in the classroom offer powerful opportunities for professional learning despite potentially engendering stressful experiences. In this paper, we draw on the conceptual frame of dilemmatic spaces to theorise and document challenges teachers encounter when learning to enact dialogic facilitation in a game-based learning curriculum. Based on coded interview data drawn from nine teachers, our findings suggest that teachers wrestle with tensions engendered by habituated modes of classroom teaching and the need to redefine power relations with students. They experience a gap between their existing professional practice when they embark on the curriculum—their being—and striving to perform the role of an effective dialogic teacher—their becoming. The (re)construction of teacher identity that emerges is contingent on how teachers respond to continuing professional development as well as how they deal with challenges they face in the classroom.

Keywords: dialog, dilemma, game-based learning, performance, identity, becoming

I Must Not Prepare!

Relax. Breathe. Be yourself.

This time I went unprepared. Or so I managed to convince myself. I didn’t go through any readings this time, didn’t run through how the discussion should go in my head but merely decided on an anchor for the discussion.

These were some points raised during the discussion; “Money can buy everything”, “the teacher betrayed us”, “everyone started to attack us”, “we need to build up resources”, “we need to be prepared”. Each time a point was raised, my mind went into overdrive thinking of ways to bring the discussion “back on track”. Turned out, it was a rather weak attempt to “yank” the discussion back to where I’d wanted it to go. The discussion became disjointed and in my opinion, had failed rather miserably again. Instead of being a point of reference, the anchor became the yoke.

(Teacher’s blog entry, reflecting on a game-based learning lesson)

Introduction

The teacher’s blog entry conveys a palpable sense of heart-wrenching angst. It was authored by a schoolteacher, in the context of teacher professional development, while learning to support game-based learning in a Singapore classroom. Torn between the habituated practice of executing teacher-directed lessons and facilitating student-generated dialog on social studies issues fostered by game play, the teacher ruminated over a real dilemma: get her students to converse about issues that comprised her lesson agenda or allow her students to talk about what was meaningful to them based on their experience of game play?

This paper addresses the challenges teachers face when learning to master the pedagogy of dialogic teaching in conjunction with the use of authentic digital games. Teacher education programs in Singapore (at the time of writing) do not address dialogic pedagogy in any significant way. Dialogism is grounded in values different from conventional instructional objectives that revolve around teaching “content and skills.” Consequently, transitioning to this new practice does not come readily.

In earlier lesson reflection sessions with the teacher, research team members had suggested that the teacher prepare for the lesson rather than construct a predetermined lesson plan for subsequent classroom execution. She could do so by reviewing the most recent in-game events and considering their significance for issues related to the social studies curriculum. Titling her blog entry “I Must Not Prepare!” illuminates the slippery terrain of negotiating change in the teacher’s practice. She wrote about not preparing—“This time I went unprepared”—when we actually encouraged her not to plan the lesson (in the customary rigid manner). Furthermore, the teacher kept referring to the classroom activity as a “discussion” in spite of our efforts to contrast the concept of discussion, which connotes a convergent conversation whose trajectory tends to summative closure, with that of dialog, which connotes an expansive conversation that encourages and accommodates multiple voices and viewpoints (Bakhtin, 1981). As the teacher reviewed the topical ideas that arose during the class session, she reflected on feeling challenged knowing how to respond to students’ ideas as they spontaneously emerged, causing her mind to go into “overdrive.” The tension between fulfilling her classroom discussion agenda and that of genuinely facilitating dialog surfaced issues of lesson control, manifested in the reference to yanking the discussion to where she wanted it to go. Unfortunately, the teacher’s metaphorical “anchor”, an intended stabilising device, morphed into a burdensome “yoke” accompanied by a sense of failure.

The cited example makes evident the serious dislocation that teachers may experience when attempting to harness the power of authentic digital games for learning in the classroom. Unlike “serious games” (Abt, 1970) that tend to focus on the mastery of content and simple skills, “games-to-learn” (Chee, in press) challenge teachers’ conventional instructional practices and invite reconstruction of their professional identity. In this paper, we identify and explicate challenges that teachers experience when learning to enact authentic game-based learning in the classroom.

In the next section of the paper, we identify relevant literature and key concepts to situate our research problem. We then establish our research context and specific research goals. The next section articulates the research methodology. It is followed by our data analysis and findings. We discuss the implications of our work before concluding the paper.

Situating the research problem

Research on game-based learning adheres to different ideologies. We can identify two distinct orientations. In the first orientation, members of the research community accept dominant schooling practices “as is” while looking to games to strengthen student motivation in learning (Miller, Chang, Wang, Beier, & Klisch, 2011; Papastergiou, 2009). Members of this community appear not to see or feel the need to interrogate why students are increasingly disengaged and unmotivated in the classroom. Instead, they remain preoccupied with the discourse of technology integration. In the second orientation, members of the alternate community express increasing alarm over how schools are failing to prepare our children and youth for the realities of the 21st century and suggest ways to frame and address the challenge (Craft, 2013; Facer, 2011). Friedman (2013), in particular, argues that K–12 and college tracks are not consistently adding the value and teaching the skills that matter most in the marketplace and preparing students to be innovation ready.

For members of the alternate research community, authentic digital games of the kind studied by Gee (2007) offer the potential to transform educational practices in ways that respond to the demands for 21st century learning and educational reform. Gee (2012) argues that good games are a model of 21st century learning because they are about doing, making decisions, solving problems, and interacting, rather than being about content. Content in a game facilitates and serves acting, deciding, problem solving, and interaction. Game worlds, Halverson (2012) notes, are the referential totalities of tools, practices, traditions, and routines in which actors make meaning of actions and interactions. Consequently, games are excellent tools for driving inquiry and meaning making processes. Good games develop situational know-how: the capacity to act in contextually appropriate and informed ways. The value of such learning far exceeds the “possession” of knowledge or its mere profession (Chee, 2011b). What can be learned with good games is “performance excellence” (Friedman, 2013).

The construct of performance is central to the work of the authors (Chee, 2011a, 2013). It is predicated on three key characteristics: (1) patterned behavior, the doing and redoing of meaningful repertoires of behavior (including acting and speaking), (2) reflexivity, an evoked self-consciousness of the doing and redoing on the part of the performer, and (3) double consciousness, a critical self-assessment of actual performance against an ideal or standard that provides the basis for further improving one’s performance (Carlson, 2004). Based on the first author’s theoretical construction, performance constitutes the lived manifestation of personal identity. Identity, in turn, is constituted by a person’s knowing–doing–being–valuing manifested through engagement in situated action and participation in discursive practices (see Figure 1). It is helpful to think of knowing–doing–being as a three-colored, tightly interwoven braid wrapped around a central axial cable that represents valuing. The theoretical framing asserts the inseparability of knowing, doing, and being because they are co-constitutive. Furthermore, knowing, doing, and being are necessarily embedded within a larger sociocultural context of axiology because they are inherently value-laden activities (Ferré, 1996, 1998). Consequently, valuational dispositions ground personal biases, preferences, and choices (Dewey, 1938/2008). A performance-centric theorisation of human learning frames learning as a process of becoming (Semetsky, 2006) that progresses from a current state of being. It applies not only to students in schools and universities but also to schoolteachers, in relation to their ongoing development of professional practice to become better teachers. This theoretical framing helps us to better understand the challenges teachers face when enacting authentic game-based learning in the classroom.

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Figure 1. The constituents of identity manifested through performance

There is limited published work on the professional challenges teachers face when attempting to enact pedagogical innovation with authentic digital games. There are two main reasons. First, published work in the tradition of classroom use of “serious games” largely conforms to the model of games to teach content and limited skills. This approach aligns with Prensky’s (2001) definition of digital game-based learning as the combination of computer and video games with educational content to achieve as good or better results compared with traditional learning methods. It reduces educational games to an ICT resource directed toward conventional schooling and its associated goals. Innovative research on games and virtual worlds, such as Quest Atlantis (Barab et al., 2009) and River City (Ketelhut, 2006), focus on science education of a constrained, school-based kind. Such environments over-structure and over-simplify science education at the expense of the kind of inquiry advanced by Dewey (1938/1991).

Second, institutional and parental resistance has largely kept innovative use of games for learning out of the classroom. Consequently, most innovative work has taken place in situational contexts where teachers have less direct involvement, often participating in only a peripheral way. In the United States, for example, it is often the researchers who play a central role in non-formal, out-of-classroom learning settings (for example, Kafai, Peppler, & Chapman, 2009).

A notable exception is the research of Hanghøj that seeks to directly examine how teachers perceive, approach, and use COTS-like games in Danish and Belgian classrooms. This line of work is based almost exclusively on the Global Conflicts series of games. Hanghøj, however, consistently uses the terms “teaching with games” (Hanghøj & Brund, 2010) and “game-based teaching” (Bourgonjon & Hanghøj, 2011), lending a teacher-centric, instructional connotation to his writing. He also prefers to passively observe what teachers do with games in the classroom as part of naturalistic observation. Consequently, no professional development or active form of support is offered to the observed teachers.

While games have the potential to offer an inquiry-based, constructivist approach that allows learners to engage with material in an authentic yet safe environment (Becker, 2007), the pertinent question that arises is who will scaffold the teachers to teach differently so as to achieve this potential? Given the limited research on this topic, it appears that there is a real need to support teachers, via professional development, so that they may realise the power of authentic game-based learning.

As a construct, the term “dilemmas” was introduced into the educational literature by Cuban (1992) when he drew attention to messy situations in professional life that grant no simple “right” answer because they embed deep value conflicts. Denicolo (1996) argues that dilemmas are unavoidable given “the relativism of knowledge, different notions of what constitutes the ‘truth’ for the teachers themselves, for their pupils, and for those who set and examine the curriculum” (p. 60). Consequently, the commitments of mutual parties are not always in harmony. Because there are no inherently “right” answers to dilemmas, they tend to leave “a residue of guilt” or a “remainder of regret” whatever the course of action taken.

Similarly, Honig (1996) holds that dilemmas pose the question of difference and the ineradicability of conflict in specific and ordinarily familiar settings. Difference, she asserts, “is what identity perpetually seeks (and fails) to expunge, fix, or hold in place” (p. 258). Honig proposes the theoretical construct of dilemmatic spaces: the conceptual space within which moral subjects are positioned on multiple, conflictual axes of identity such that the subject’s agency is constituted and enabled by dilemmatic choices and negotiations. Thus conceived, socialised human beings, as moral beings, inhabit dilemmatic spaces as a matter of course. From this there is no escape.

Fransson and Grannäs (2013) extend Honig’s construct of dilemmatic space by inflecting space as a relational category associated with the concept of dilemma. Consequently, dilemmas are not conceptual entities but social constructions resulting from structural conditions and relational aspects in everyday practices, enacted through the execution of positioning and negotiation maneuvers based on personal values. Thus, a dilemmatic space also establishes a relation between human subjects and the negotiation, construction, and deconstruction of professional and personal identities. This theoretical framing of dilemmatic spaces furnishes us with a powerful conceptual tool with which to understand the challenges that teachers face when enacting game-based learning as a pedagogical innovation in the classroom. Much is at stake for teachers who engage in bona fide game-based learning in the classroom because a teacher’s professional practice is firmly and inextricably located within an intricate web of epistemological, ideological, professional, social, and power relations in the workplace.

Research context and goals

Our research takes place in the context of fostering teacher capacity to enact authentic game-based learning in the classroom using the Statecraft X curriculum. This curriculum, designed for social studies taken by 15-year-olds, is based on the Statecraft X mobile game. It is played on Apple iPhones (see Figure 2). The Statecraft X curriculum addresses the topic “principles of governance,” representing one of four key topics in the social studies curriculum for students in Secondary 3. In our school-based research, each student is loaned an iPhone with a supporting data plan for the duration of the curriculum. Details of this curriculum can be found in Chee, Gwee, and Tan (2011) and Chee, Mehrotra, and Liu (2013). Both papers reported on the efficacy of the curriculum for student learning in relation to citizenship and governance.

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Figure 2. The town map of the Statecraft X mobile game

Our earlier work revealed that teachers found the process of learning to facilitate student dialog (Roth, 2009) in the game-based learning classroom difficult. In the present project, teachers had the benefit of professional and moral support from their school leaders in addition to an initial two-day professional development workshop that oriented them conceptually to ideas associated with game-based learning supported by dialogic learning. Like learning to swim, enacting an unfamiliar pedagogical role in the classroom constitutes a performance of teaching. The challenge is not about knowing what to do but being actually able to do it (as suggested by the blog piece that opened this paper). Thus, learning some subject domain, Y, is not equivalent to learning about Y (just as learning swimming is not equivalent to learning about swimming). Consequently, no amount of lecturing, questioning, discussion, or self-study can adequately prepare a teacher for enacting game-based dialogic facilitation in front of, and with, students. A teacher’s capacity develops with practice over time. Representational modes of learning, based predominantly on language, lead to passive and inert outcomes. They cannot deliver what teachers need: the capacity for enactive performance.

In the research reported here, we worked with teachers to foster their capacity for dialogic facilitation in conjunction with the use of Statecraft X. The game-based learning curriculum is predicated on the pedagogy of performance, play, and dialog (Chee, 2011a). With respect to student learning, we seek to foster their dispositions and capacities to become active and responsible citizens—a performance capacity—because it makes little sense for students to merely learn about citizenship and excel in written tests. Consequently, with Statecraft X, students play the game in their own time, outside of classroom hours. Game play can take place anywhere—in school, in the shopping mall, at home, etc.—given the provision of wireless network connectivity. Scheduled social studies lessons are used by teachers to engage students in dialog directed toward making meaning of events and processes experienced during game play. Teachers interrogate the actions taken by students in the game and surface the values underlying students’ actions. They also encourage students to reflect on the consequences of their in-game actions as governors of virtual towns in the game and to evaluate their own actions to foster the disposition of reflexivity. We refer to these classroom conversations as dialogic sessions. Given a typical class size of 40 students, we divide each class into two independent game instances of 20 students each. Consequently, two teachers participate in each research intervention, with each teacher engaging in dialogic facilitation with approximately 20 students. Given that the pedagogy is oriented toward dialogic inquiry and sense making rather than to teaching content, it is imperative for teachers to be able to elicit and build on student contributions in a manner productive for deep interrogation and reflection.

The next section of the paper articulates our research methodology.

Research methodology

Our research is based on a collective case study (Patton, 2002). Our data is drawn from nine individual case studies, representing the nine teachers with whom we collaborated. Our empirical work in schools took place between January 2012 and February 2013. Each cycle of the Statecraft X curriculum intervention lasted three weeks.

Participants

Our research participants were nine government secondary school teachers, of whom six were female and three were male. They taught social studies to 15-year-old students in Secondary 3. The teachers were recruited via a talk for school leaders and teachers organised by the local Academy of Singapore Teachers. Five teachers were “beginning teachers” who had less than three years of teaching experience. Two were experienced teachers with more than three years of teaching experience. The remaining two teachers were “mid-career switch” teachers. They entered the teaching profession as a second career. One teacher had taught for less than three years while the other had taught for over three years. The nine teachers came from five separate schools. Five teachers enacted the Statecraft X curriculum twice with different classes. The remaining four teachers enacted the curriculum once. As part of the requirement for ethics clearance, the teachers were given a detailed briefing on the objectives of the project and what was expected of them as participants. We secured written agreement for their participation. The teachers consented to having their classes observed and being interviewed after each class except the first.

Materials

The teachers were familiar with the Statecraft X mobile game. They were introduced to the game as part of the professional development workshop held before they commenced participation in the research project. This introduction required them to play the game, as a student would, for a period of about five consecutive days. The five-day duration represents a compressed version of game play, as the typical duration of game play by students lasts approximately 16 days. As part of in-class teaching activity, the teachers periodically used the game’s web-based “Teacher Administration Tool” to share two graphs with their students: the Economic Wealth graph and the Citizen Happiness graph. These graphs furnish feedback to students on how the in-game faction (analogous to a political party) they belonged to was performing vis-à-vis other factions. Teachers were familiar with these graphs and how to interpret them in relation to emerging patterns of game play. The tool also provided teachers with detailed information about each faction (e.g. amount of gold, wood, ore; population size of various towns; inter-racial harmony; etc.).

Procedure

Each curriculum intervention cycle ran over three consecutive weeks. There were six social studies lessons in each cycle, given that schools typically scheduled two social studies lessons per week. The duration of each lesson varied between schools. The range was between 45 and 60 minutes. Teachers were interviewed prior to commencement of the in-class research. They were further interviewed after each of sessions 2 to 6. Session 1 was exceptional in that class time was used to introduce the curriculum and game to the students. The researchers presented this session. The iPhones, funded by the research project, were also loaned to the students at the end of this session.

Post-lesson interviews with teachers were positioned as lesson debriefs and professional development conversations. They were conducted informally and directed toward engaging teachers in reflection on their just-concluded lesson and to address any difficulties encountered. The interview sessions usually lasted between 30 and 60 minutes. These sessions were audio recorded.

Data analysis

We collected approximately 40 hours of teacher interview data. Two coders carefully transcribed these interviews. One coder was a research assistant with a degree in sociology. The other coder was a schoolteacher seconded to the research project from the Ministry of Education. The transcripts were crosschecked in instances of ambiguity. The text transcripts were systematically organised and labeled to facilitate ready identification of teacher and interview session.

We employed a form of coding akin to grounded theory (Birks & Mills, 2011) in order to distill, categorise, and establish themes that appropriately and fairly reflect the teachers’ articulations of challenges they faced while enacting their classroom lessons. We stress that it was not our intention to perform a grounded theory study in the full sense that may be implied by this term. As Corbin and Strauss (2008) point out, “[i]f the researcher is building upon a program of research or wants to develop middle-range theory, a previously identified theoretical framework can provide insight, direction, and a useful list of initial concepts” (p. 40). Our work is not oriented toward developing a complete bottom-up grounded theory from the data collected. Rather, it is located in the context of fostering teacher capacity to enact game-based dialogic facilitation with a view to encouraging the take-up of such teaching practice. Consequently, our analysis of data is oriented toward addressing this goal. Our findings may be colored because we embarked on the research process with an “appropriation model of innovation uptake” derived from a review of the relevant literature and used as a basis for securing research funding.

We used NVivo as the computer-based tool to assist in data management and manipulation, the coding process, and the subsequent distillation of code descriptors. This process was highly iterative, and it involved all research team members in dialog directed toward making emergent sense of the data and stabilising a collective interpretation that felt grounded and defensible. The coding work was the primary responsibility of the third author.

Findings

In this section, we present our findings of classroom challenges that teachers faced when enacting the Statecraft X curriculum. In the excerpts cited below, our collaborating teachers are not equally represented for two reasons. First, some teachers conveyed keener insights into their circumstance than others. Second, some teachers were more reflexive than their peers. We seek to share the voices of teachers as faithfully as possible. The cited instances convey how teachers wrestle with the process of change in professional practice. It is hoped that readers will not only read the excerpts but also feel the emotions that underlie them.

Classroom challenges that arise from reconstructing teaching practice

Facilitating game-based dialogic learning in the classroom constitutes a performance enacted by a teacher (and by her students as well). It entails more than simply having a requisite set of “knowledge and skills.” Akin to learning how to swim, the first attempt is always the most difficult. In this subsection, we exemplify the quandaries of teachers as they attempt a new pedagogical practice. The challenges articulated here are not merely professional “problems” (see Section 2) that would find natural resolution with extended opportunities to practice dialogic facilitation. Dilemmas arise when teachers feel they are “letting their students down” because they are unable to rise quickly to the standard of professional performance needed, as exemplified in the opening teacher’s blog entry. The moral dilemma is always: “what do I do now, in the present situation?”

Learning to think and act “on one’s feet.” Adele (all teachers names are pseudonyms) expressed her professional learning challenge in the following terms:

I totally forgot about the refugee arrival! . . . And that was actually what I had planned, as in like in my head, thinking of the refugee arrival and to link it to migration. . . .  That was what I had in mind before I step into the lesson. . . . But during the lesson, as it was going on, yeah, then I sort of got lost in the things that they were saying.

Adele had made due lesson preparation prior to her class. Based on her understanding of the game and how game play was evolving, she was aware that the in-game event of refugees arriving in the towns governed by her students provided the perfect springboard for conversing about issues related to migration and immigration policies. However, Adele felt overwhelmed by what students had to say in class, leading her to “get lost” in the things that they were saying. Brenda expressed this idea succinctly when she said, “to me as a Statecraft X teacher, you really need to think on your feet at all times.” As a teacher with less than three years of teaching experience and accustomed to teaching within the safe confines of a predetermined lesson plan, Adele had not needed to “think on her feet” very much before. Consequently, she found doing so challenging and felt disappointed being unable to keep track of multiple conversational threads effectively despite the availability of a whiteboard.

Pauline expressed the difficulty she experienced in terms of the need to be adept at multitasking. She said:

. . . most of the time when we go to the classroom it is just the screen and the board. But now I have the screen, the board, and then I got . . .  I’m like thinking I’ve got to show the results but then I want to refer to my notes. The unfortunate thing is that our printers are not working well, so most of the time we would have printed out all these things as reference . . .

The “results” that Pauline referred to were the Web-based graphs of the game’s economic wealth and citizen happiness scores. These representations allow teachers to convey to their students how various player factions are performing relative to one another. While teachers are used to working with just the projector screen and the whiteboard in a linear fashion, they can feel overwhelmed when they also need to pull up Web-based graphs and refer to their personal notes in a more contingent way. In this regard, Pauline added that knowing the members of the class very well would be a big help “[b]ecause having . . . you know your brain like . . . having to do so many things – you’ve got to think and then you got to know who’s that and then . . . It . . . it does tax you a little bit.”

Overcoming old teaching habits. When asked about the challenges she faced enacting the Statecraft X curriculum, Adele spoke of the difficulty “of really being a facilitator rather than the traditional ‘imparting of knowledge’” that she was accustomed to. She added, “I think I am still used to the habit of talking and talking and talking and talking. Yeah.”

In a more reflective moment, Pauline also shared:

And in fact sometimes because you are so used to doing things a certain way, and then you are very comfortable yet you are confident in that . . . it is what you are good at but because of that, it hinders you and then you have certain blind spots.

Later, Pauline added:

Yeah we are always prepared with PowerPoint slides and we are . . . And even if there is a discussion we know where to always go back to. And I think being used to that. That is a hindrance that I need to get rid of.

Pauline appeared conscious that her ingrained habits that made her feel “comfortable” and “confident” in her traditional mode of teaching and which she had become “good at” could lead to blind spots and hinder the take up of a new pedagogical practice. She also began to view the practice of instructing with PowerPoint slides, which facilitates returning to a point of departure following an unplanned digression, as a “hindrance” to the development of dialogic practice.

Maintaining flow and coherence in dialog. Teachers often struggled with the challenge of maintaining a natural conversation flow becoming of a dialogic classroom. Fiona spoke of this as “about being seamless – about just going into the virtual world and then back to S~ uh . . . you know, to Singapore, and then the real world.” (The tilde character is used to denote interrupted speech.) As part of dialogic pedagogy, teachers were encouraged to draw connections between events and processes in the game world (referred to here by the teacher as the “virtual world”), in Singapore, and in the real world beyond Singapore. This art of expansive and relational conversation was initially challenging for most teachers until they got the “hang” of it. In a later interview, Fiona added:

. . . it’s also pressurising because things may not go well.  . . . Things may not flow well, you know and then there are moments where some . . . I guess in the beginning with 3R1, sometimes when I felt like “okay, oh no we are stuck. What should we do now?”

The excerpt above was uttered during the teacher’s second intervention cycle. 3R1 refers to the class taught during her first intervention cycle. The sense of feeling pressured and of “being stuck” is palpable: what should we do now?

Teachers also wrestled with maintaining the coherence of conversational flow in the classroom. During her first intervention cycle, Pauline said:

But the low point was that I couldn’t pick up y’know enough on these things and I felt like the session didn’t . . .  I felt like there wasn’t a flow. I just felt like it was here and there.

In the subsequent interview, Pauline also referred to the ideas as being “disconnected.” Fiona expressed her difficulty as: “I felt that there was a bit of a jump.” These utterances illustrate the challenge teachers experience in orchestrating and managing the smooth flow of dialog so that the classroom conversation does not feel patchy and like being “here and there.”

Dropping points and missing opportunities to interrogate ideas. When asked to identify a low point after one of her classes, Pauline said:

Lowest point, the first one would be the dropping of points. Because, yeah, I think as a teacher you always look out for teachable moments. It could be the teaching of values, I mean, um, so I thought you know when the students said “I don’t really care about the people” you know, I thought  . . . yeap that was one – why do you not care, that is so obvious that people would be one of the most crucial, because without people then you will not have the town, you know.

Pauline regretted failing to seize the opportunity to foreground a pertinent point about a government’s attitude—not caring—toward its people. Consequently, a “teachable moment” was lost, and a “point was dropped,” much to her distress. Fiona shared a similar sentiment:

. . . one of the difficulties would be as you said, really thinking on the spot and trying to link IMMEDIATELY whatever the students say to a concept or to a learning point. And . . . yeah. That I still find difficult. And I think that it takes quite a lot of time to get the hang of it.  [Word in uppercase denotes speech emphasis.]

The excerpts above illustrate teacher frustration with letting slip some powerful opportunities for learning that their students’ utterances offered as they wrestled with the challenges of a new teaching practice.

Teachers also experienced uncertainty over what they should or should not say. For example, Pauline shared:

. . . when I was in intervention 1, we were carrying that out, I was afraid to share my thoughts because I didn’t know whether I would give the game away or give anything away. So I wasn’t quite sure of the balance.

In this instance, we had sensitised teachers to avoid “teaching content as content.” In the process of making meaning of this statement, teachers sometimes interpreted the statement to mean that they should not share their own thinking with the students. Fortunately, as part of the interview sessions, we were able to clarify that facilitating student dialog did not imply that they were precluded from sharing their own thinking with their students.

Classroom culture and the need to redefine relations with students

It is difficult to develop a dialogic classroom culture if teachers are accustomed to an authority position with respect to subject matter. Several teachers expressed the importance of developing rapport with students for dialogic facilitation to be effective. Noreen, for example, said that “rapport must be built very strongly such that uh the students are feel comfortable enough to really talk and verbalise their opinion.” Stephen further illuminated this issue:

. . . yeah I’ll just be very painfully honest. Okay. I mean after communicating with my students today, I think I really got to understand them on a deeper level. . . . Okay. These sessions like that do help. But then I realized that many of them actually really have a fear of speaking up. A deep-seated fear of speaking up and a fear of being judged.

Stephen was referring to the 22 students (half the intervention class) whose dialogic sessions he was facilitating and for whom he was their regular social studies teacher. Things had not been going well during his first intervention cycle. His students were unresponsive to his attempts to open up conversations. The students were top academic scorers and belonged to the best class in their cohort. They were known amongst schoolteachers as “high performers.” It was an epiphanic moment for Stephen when he shared “in painful honesty” that these students, based on conventional classroom culture, had a “deep-seated fear of speaking up and a fear of being judged.”

Brenda, who was from a different school, had a different experience:

I did fairly well in the sense that um, I guess that I have an added advantage because I taught quite a number of them last year. So I already had a rapport with a few of them, so I get their respect and the kind of cordial relationship. So the students are very open mmm with me, I don’t think anybody was reserved in asking questions.

As researchers, we sensed a deeper factor at work. While Stephen and Brenda appeared satisfied and comfortable framing the issue as one of student rapport, Brenda, we believe, got closer to the crux of the matter when she said:

I am more to the side where uh I prefer to be closer to students. A bit more pally, rather than the other end of the continuum, because I believe that um if I have a good relationship with the students and things like that, the respect that they give me could be easily earned and uh . . . support from them is very um easily garnered. I don’t have to be authoritative or authoritarian to earn their respect. But I earn respect by . . . by showing an example myself that when one person speaks I listen.

In an interview toward the end of her second intervention cycle, she added:

. . . initially as I you know, started as a fresh beginning teacher, it’s really like okay, a teacher um doing the teaching. And um . . . it’s more of top down because I’m the one having all the subject knowledge content. I have all the information and I know that . . . I clearly know that my students do not have access to all these. So I feel that I have an advantage over my students. . . . So I feel I have the upper hand. But you know as I do this um Statecraft X project, I find that it is . . . Okay, I [laughingly with emphasis:] descend to be of the same level as the student whereby I find myself learning a lot from the students and they are definitely in the capacity to teach me. And in fact, some of them they might even know more than me. And from a teacher, I become a facilitator. And at the same time, I am also a learner. So I’m of the same level as the students . . .

Brenda manifested an ability to reduce the culturally enforced power relation between teachers and students in Singapore schools and a genuine willingness to bring herself down to the level of her students. She expressly shied away from being “authoritative or authoritarian,” preferring to be “pally” with her students. She acknowledged feeling that she had “the upper hand” over her students because she had content knowledge that they did not possess. But, most importantly, she declared that her involvement in the Statecraft X project led her to “descend to be of the same level” as her students “so I’m of the same level” as them. She also found herself “learning a lot from the students and they are definitely in the capacity to teach me.” This attitude represents a significant shift in the relation typical between teachers and students in Singapore. It is also a significant marker of Teacher B’s personal growth and of the development of her professional identity.

As Brenda professed, she is a mid-career switch teacher with limited teaching experience. Perhaps the years spent working outside the school sector contributed to the seeming ease with which she changed her attitude toward her students. Being relatively new to the teaching profession, she appears not to have been much influenced by deeply rooted classroom norms that sway teachers toward imposing and maintaining a power distance between themselves and their students.

From the foregoing, it becomes evident that established cultural norms can strongly influence how readily dialogic learning is assimilated into classroom practice. While conventional cognitivistic analyses of student learning processes and outcomes exclude consideration of power relations in the classroom, a sociocultural analysis necessitates it. Opening up analysis to the consideration of power relations suggests that it is important for teachers to be able to redefine their relationship with students. Reducing the power gap encourages students to articulate their ideas and make their voices heard so that productive learning can take place. Teachers who feel that their professional identity demands the maintenance of high power distance, especially in Asian cultures, wrestle with the dilemma of striking a practical balance between school norms and pedagogical requirements.

Discussion

Our findings suggest that the challenges associated with shifting teaching practice gives rise to dilemmas in the professional life of teachers. From the perspective of theory, Fransson and Grannäs’s construction of dilemmatic spaces, extended from Honig’s original idea, possesses considerable theoretical merit. Unlike Honig and Denicolo who suggest that dilemmas are characterised by having no “right” answer, we propose that there may be situations where a “right” or inherently “preferred” answer may exist. However, the situation may still constitute a dilemma because the “right” answer remains out of reach to a teacher who has neither the means nor the power to attain that “right” answer. Consequently, a “remainder of regret” may be left as a situational residue. Teachers continually find themselves inhabiting a dilemmatic space when lessons do not go the way intended due to their still-developing dialogic facilitation skills. They may then either abort attempting to enhance their pedagogical practice (and feel a twinge of guilt about that) or try to master the practice and feel poorly about not succeeding. Either way, the outcome leaves some “residue of guilt.”

As suggested by Denicolo, however, dilemmas can trigger deep reflection and lead to emancipatory outcomes through transformative professional growth. Brenda, for example, felt more confident that she could facilitate her students’ development of 21st century competencies after she enacted two cycles of the Statecraft X curriculum. As she reflected on her learning journey, Pauline said, “you know I’ve really see how um, it has changed me.” During her second intervention cycle, she shared that she was already adopting a dialogic approach in her teaching of another subject with a different class. She spoke of how the professional support offered “help[ed] me change the way I see my kids” (referring to her students) and of a newly found “openness to really hear and accept what the kids are saying.” She also spoke of “my identity as a teacher, as well as a Statecraft X teacher, is that um the way I teach is different.” She further emphasised, “I definitely take greater ownership toward the curriculum.” These utterances are reflective of deep professional change. They illuminate the impact that enacting the game-based curriculum had on the teacher. When Pauline’s colleagues suggested that taking up Statecraft X “seems like a lot of work,” she responded, “I said ‘sounds like it, but actually . . . I don’t prepare!’” (cf. opening blog excerpt). Pauline’s identity shifted significantly, and her professional growth was evident for all to see. With reference to Figure 1, Pauline’s engagement in situated action, both in and out of the classroom, and her manner of participation in discursive practice helped her reconstruct her identity, as encapsulated by the knowing–doing–being–valuing of her reconstructed practice. Through learning as becoming, Pauline’s identity evolved. She likened her journey of transformation to how a pearl is formed. Beginning with a small piece of dirt that gets into an oyster and irritates its very being, the process of dealing with that triggering event, albeit painful and difficult, ultimately yields an outcome of great value.

From the perspective of teacher professional development, our findings point to a crucial need to approach teacher professional development as intensive person-oriented work. One-off teaching practice seminars and two-day professional workshops cannot yield the kind of deep change needed to transform teachers’ knowing–doing–being–valuing (Chee & Mehrotra, 2012; Flint, Zisook, & Fisher, 2011). The provision of continuing professional development is vital for teachers to build the capacities required for 21st century education and for them to be active agents of school improvement. For teacher identity to be impacted and for there to be sustainable professional growth, teachers must also begin to value learning outcomes vastly different from those that adequately met the needs of the 20th century and respond to the needs of a changing world. Change intervention and change management processes need to be instituted by policy makers to provide for greater teacher agency, participation, and voice in teachers’ professional lives so that teachers feel empowered to create their professional future and contribute their expertise and talent.

Institutional systems, such as that of school, entrench structures and processes for self-perpetuation. If teachers feel compelled to comply with the system’s bidding because their own work appraisal is tied to that of their students scoring high marks on tests and examinations, they are caught in a double bind. Such an environment leads to teachers resisting innovation, teaching to the test, and being unwilling to deviate from “proven success formulas.” The ensuing institutional culture is one of risk aversion. To counter this culture, education leaders need to develop an environment that teachers perceive to be safe and an institutional culture that welcomes and rewards pedagogical innovation. Teachers need considerable support, in terms of resources and moral support, to step outside of their comfort zone and take carefully considered professional risks. Deep change to practice moves in tandem with development of teacher identity. Apart from time and space needed to experiment with new pedagogies, teachers also require ample opportunity to practice new ways of teaching because it is practice that makes practice (Britzman, 2003).

Working with nine teachers on this research project, we observed a spread of teacher responses to the challenges they encountered when enacting the Statecraft X curriculum. While some teachers learned quickly, others were more challenged due to a host of complex interdependent factors. Apart from institutional and situational factors, teacher identity also influenced the outcome of teachers’ professional learning. We witnessed momentous transformational growth and emancipation on the part of teachers who adapted well to the demands of a new classroom practice. But we also witnessed teachers who experienced difficulty because they had limited control over system constraints that were, for them, fixed and non-negotiable. Consequently, entrenched systems, with their mandated rules, cultural norms, and assessment procedures, can stubbornly resist teachers’ best attempts to enhance practice.

Conclusion

In this paper, we addressed the issue of challenges teachers face when learning to facilitate dialog to support authentic game-based learning. Grounded in our work on helping teachers enact the Statecraft X curriculum in social studies, our findings suggest that the key challenges teachers face are not technology centric but practice centric. At its core, the overriding issue rests on competing visions of why students should go to school today. Entrenched schooling practices carried over from the industrial era of mass production work against pedagogical innovation needed to move 21st century learning forward. Caught in the vortex of currents that pull backward to maintain the status quo and currents that pull forward to reform practice, teachers inhabit a dilemmatic space that requires them to respond to situations where the “right” course of action either does not exist or is unattainable to them when situated in the dilemma. Our data suggest that such dilemmas engender stress in the professional lives of teachers. Depending on how teachers respond, these situations may contain the seeds of transformational professional growth or they may hinder teachers from strengthening their professional practice. Challenges engendered by the need to change classroom practice and to redefine relationships with students create obstacles to building capacity for dialogic facilitation. For authentic game-based learning to find traction in classroom teaching and learning, questions concerning the assumptions and purposes of schooling need to be revisited by policy makers and education stakeholders. Will the crust of institutional and social convention continue to engender resistance to change or will insight concerning challenges to teachers’ professional growth surfaced in this paper contribute to foresight for social good? Only time will tell.

Acknowledgements

This work was funded by the Office of Education Research, National Institute of Education, Singapore, under grant OER 02/11 CYS. Views expressed are strictly those of the authors only.

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Biographical statements

Yam San Chee is an Associate Professor in learning sciences and technologies at the National Institute of Education, Singapore. His research interests are in educational philosophy and game-based learning. He is an Associate Editor of the International Journal of Gaming and Computer Mediated Simulations.

Email: yamsan.chee@nie.edu.sg

Website: http://cheeyamsan.info

Swati Mehrotra was a Research Fellow in the Learning Sciences Lab, National Institute of Education, Singapore. She obtained her Ph.D. from the Homi Bhabha Centre for Science Education, India. Her research interests are in teacher professional development, socio-cultural perspectives of learning, and game-based learning.

Jing Chuan Ong worked as a Research Assistant at the National Institute of Education, having graduated from the National University of Singapore with a Bachelor of Social Sciences, specializing in sociology. Her interests relate to youth and education.

Kathryn Grushka, Debra Donnelly & Neville Clement

Published Online: December 15, 2014

Full Text: HTML, PDF

Abstract: Multimedia digital technologies mirror neural processes and capacities and their proliferation introduce new possibilities for learning. Not only does the new digital media have the capacity to instantly record and communicate lifeworld experiences unimpeded by the distance or size of the targeted audience, but offers the means to construct virtual reality environments which were previously beyond human experience. This finds the teacher confronted with a new array of modes and an extended concept of literacy through which to engage the student in learning and meaning making. Digital culture and its multiliteracies now present challenges for the curriculum work of teachers, both in terms of the integration of appropriate technologies and the capitalization of the sensory and memory capacities of students. This article outlines the challenges faced by teachers as they engage in curriculum work that seeks to integrate the capabilities of our new digital culture in the design of learning experiences. It also highlights insights into human capacities for learning offered by neuroscience regarding the interplay of experience, memory, cognition, emotion and reflection in learning. By aligning these strands, teachers can develop curriculum that align with the capabilities of new digital technologies with the capacities of students.

Keywords digital culture and learning, multiliteracies; neuroscience, digital technologies, curriculum, experiential and affective learning

Introduction

New digital technologies, with their multimedia capabilities, are now our social reality. These multimodal devices now shape the ways in which contemporary society makes meaning and communicates. This poses challenges for our conventional understanding of “literacy” as we attempt to incorporate them into curriculum design and practice. In addition, neuroscience provides educators with new insights regarding the role of learning in the formation of brain structures and the role of the classroom experience (Szűcs and Goswami, 2007). Together, these challenges and new discoveries will require the re-examination of curriculum and pedagogical content knowledge.

Not only does new media have the capacity to instantly record and communicate lifeworld experiences unimpeded by the distance or size of the targeted audience, it offers the means to construct virtual reality environments which were previously beyond human experience. Communication, entertainment and availability of information, the emergence of techno-social objects or multi-media devices within communicative practice make possible the emergence of the ‘low-tech cyborg’ (Escobar et al., 1994). The cyborg is defined as ‘hybrid of machine and organism, a creature of social reality’ (Haraway, 1991, p. 141), and student cyborg learning is firmly located in the lived social reality of the learners’ life world and is increasingly gaining a presence in the classroom. The popularity of these multimedia devices has profound implications for our understanding of experience, learning and literacy because of the new possibilities presented by this digital culture. Any expansion in the repertoire of modes and their ‘affordances’ are active in representation practices and shape ‘knowledge’ (see Kress, 2009). This presents new challenges for curriculum design in a digital culture.

Concurrent with this burgeoning of digital culture is the enhanced understanding of the nature of human perception learning and memory provided by the availability neuro-scanning technology. This expanded knowledge of brain functioning provides a further resource on which educators can draw in designing curriculum (Clement & Lovat, 2012; Lovat & Smith, 2003). Of particular interest, in light of the ubiquity of new media with its multimodal capacities, is that human perception and memory are multimodal with memory being a composite “of the sensory and motor activities related to the interaction between the organism and the object during a certain period of time” (Damasio, 2012, p. 133). This reinforces the notion that curriculum work is more than just selecting content to be taught and learned, but entails the careful and intentional design of learning experiences (Lovat & Smith, 2013). Given the nature and reality of an expanding digital culture in learning, this paper explores challenges presented for teachers enacting curriculum as they grapple with the impacts and implication for digital literacy, the emergence of concepts such as edusemiotics (Danesi, 2010) and their impact on teaching and learning. Through an examination of associated literature, it challenges normative assumptions as to what now needs to be regarded as “literacy” in the wake of current technological innovations and capabilities.

Digital technologies and curriculum

The availability and widespread use of small digital devices like smart phones and computer tablets raises issues for teachers designing curriculum as this technology is a new sociocultural phenomenon, able “to combine the material, the social and the symbolic in an associative web” (Budka, 2011, p. 4). Digitization has meant that image, sound and text are now processed similarly by a computer chip. This is unlike the previous analogue systems where each different mode required different rendering processes as in the case of printed text and images (Cope & Kalantzis, 2004) or even other media types as in the case of sound. Jewitt (2008b) proposes that this altered relationship between production and dissemination disrupts the conventions of the relationship between audience and author, as different types of texts proliferate and multiple literacies or different semiotic systems come into play. Furthermore, Jewitt points out that the corollary of these multiliteracies is the multimodal nature of social communication (see Kress, 2013) and argues that communication and meaning making call on a diversity of modes including sound, movement and image, each with its own repertoire of semiotics.

Given the increasing presence and use of multimedia communication devices, literacy is presented as more than learning to read and write in the traditional sense, and now extends to the manipulation, mastery and use of multimedia technologies (Mills, 2010). In addition, these different modes of communication are shaping new sensory capabilities and operate as a personal meaning making apparatus (Buckingham, 2012). As a result, there is an urgent need for teachers to understand how the different perceptual modalities function in relation to learning and memory and how each modality is socially and culturally represented.

Concurrently, technological innovation has seen the development of sophisticated neuroimaging technologies that afford unprecedented knowledge of the architecture and functioning of the brain coinciding with the proliferation of multimedia devices. For example, Gross (2008) points to the coevolution of neuroimaging and the increasing need to draw on the semiotic language of images to create and communicate meaning. Digital imaging technologies now allow opportunities to examine and understand the role and functioning of the sensory modalities in relation to perception and the processing and storage of data at the neuronal level. Any new insights provided by neuroscience regarding the nature of learning, memory and recall have important repercussions for curriculum design in the new digital world. Thus, a trilogy of elements will need to be taken into account to achieve authentic curriculum design for the contemporary educational context, particularly in relation to literacy. The elements include: multimodal media; the expanded repertoire of semiotics potentiated in the use of multimedia; and insights into human perception, learning and memory made possible by neuroscience in dialogue with cognitive science. Using new media in curriculum practice is therefore more than replacing one set of technologies with another. It involves understanding the capacities of the new technologies and matching them to the learner.

New media and curriculum problematized

The evolution of digital literacy curriculum for the 21st century and the incorporation of new media and multiliteracies into curriculum design is a complex task and not just a process of substituting redundant technology with the more recent, for example the replacement of the typewriter with the keypad. Rather teachers’ curriculum planning needs to take account of a divergent range of possibilities introduced by the new technologies and the new knowledge provided by neuroscience. A further problematic presented for curriculum development is the little known influence of the experience of using mobile digital devices on the cognitive development of individual students (See Mann, 2006).

As Lovat and Smith (2003) propose, a curriculum comprises a particular selection of knowledge, activities and experiences chosen and blended by the teacher in order to advance the learning of students. Curriculum development necessarily involves teachers in “selecting, sequencing, organizing and structuring knowledge, resources and activities” (p. 26). According to Lovat and Smith, this process of choosing and combining knowledge, resources and activities in a meaningful way is curriculum work or action and is informed by curriculum theory. Curriculum theory serves as a “linchpin” between the foundational educational disciplines such as psychology, sociology and philosophy, and curriculum practice. Curriculum theory, then, is a synthesis of knowledge derived from the foundational educational disciplines and experience of curriculum in practice as applied in actual learning and teaching situations. Experiences encountered in the practical implementation of teaching may provoke reflection on the adequacy of curriculum theory, which in turn asks questions of the educational disciplines.

New digital technologies challenge the manner in which curriculum work has been done in the recent past. Several key challenges include:

  • The identity and agency of the learner, the explicit link to their cyborg identity (Boyd & Ellison, 2007) represented as individual interactive and communicative technological potential.
  • Digital devices and the media they display extend the resource base of curriculum work.
  • Multimodal learning, or the flexible mixing of verbal and visual text, animation and sound, afforded by contemporary technology impact in unprecedented ways on knowledge representation and a widening of semiotic practices.
  • Digital technologies present an artificial adjunct to memory and can function as a learning prosthesis given their capacity to record experiences in multimedia format in a like manner the human brain.

It was Vygotsky (1978) who observed that humans employ a range of tools to support and extend cognition and memory. Now the capacity of multimedia digital devices to extend human cognitive and memory capacities is beginning to be understood and potentiated. Mills (2010) argues that students generally learn to use multimedia devices in informal situations, but they can benefit from expert scaffolding in their mastery of the media that will extend their knowledge and understanding of “multimodal practice”. It may then be possible to consider how the long-term use of these technologies alters and adapts the mind as part of the very being of the user (Mann, 2006), or builds their preferences and skills in some semiotic systems over others, such as animation over writing.

The dissonance introduced into curriculum work for teachers by the new digital technologies is further informed by the rise of neuroeducation (the considered application of the findings of neuroscience to education, see Geake[2009] and Goswami [2008]). There are several ways in which the influence of neuroscience might be brought to bear on curriculum theory and practice (Clement & Lovat, 2012). One is that neuroscience contributes to the understanding in disciplines like developmental, social and cognitive psychology (e.g., Cacioppo, Berntson, & Decety, 2010; Hruby, 2011; Willingham & Lloyd, 2007) and thereby indirectly contributes to curriculum theory. Another consideration is that neuroscience can be used to inform and modify the cognitive models which are adapted in theories of learning, and so contribute to the interpretation of behavioural data (e.g., Bruer, 2008; De Smedt et al., 2011; De Smedt et al., 2010; Hruby, 2011). Szűcs and Goswami (2007) believe that “mental representations can best be understood by combining behavioural and mental measures” (p. 120). In turn, these cognitive models or mental representations inform curriculum theory and this leads to modified curriculum practice (Butterworth & Laurillard, 2010). This dynamic interdisciplinary interaction portrayed by Butterworth & Laurillard renders the process of delineating the individual contribution of each discipline to curriculum work difficult, if not impossible.

Moreover, the interaction between experience and the neuroplasticity of the brain is of particular interest for curriculum work. Neuroscience has demonstrated that the plasticity of the brain continues throughout the course of a person’s life and that all learning involves, and is made possible through changes in the brain’s neuronal structure (Blakemore & Frith, 2005; Doige, 2008). Willis (2010) describes plasticity as “the ability of neural networks to extend, prune, reorganize, correct or strengthen themselves based on acquiring new information, obtaining corrective feedback, and recognizing associations between new and prior knowledge” (p. 55). It is this adaptability of the brain that makes learning and teaching possible. Neuroeducationalist, John Geake (2009) comments: “Our brains did not evolve to go to school” (p. 12). Furthermore, Goswami (2008) points out that the ability to read is a constructed rather than an innate capacity. Therefore, learning is actuated because of the plasticity of the brain and this is “experience induced” (Diamond & Amso, 2008, p. 136). Neuroplasticity underlies both development (which is experience expectant, where certain experiences are endemic to typical development) and learning (which is experience dependant, Galván, 2010). Thus, memory formation is a function of neuroplasticity.

Having outlined the challenges for curriculum work to teachers presented by (a) the emergence of new multiliteracies, a phenomenon accompanying the proliferation of digital technologies, and (b) the insights into the functioning of the human brain provided by neuroscience, attention now shifts to consider ways by which these challenges are being met in teachers’ curriculum work. What follows is the argument for the need to re-evaluate the nature of teaching and learning given that new media learning experiences and how the student brain has now been significantly shaped by the use of digital devices, and their preferences for and engagement with particular kinds of multimodal learning. This discussion now considers three aspects related to the incorporation of multiliteracies into curriculum work: the evolution of multiliteracies in the current century with the attendant implications for semiotics and knowing; the foregrounding and limitations of attempts to embed technology in curriculum design; and the insights offered by neuroscience into the experiential nature of learning.

The evolution of digital literacy curriculum for the 21st century

Digital technologies and contemporary cultural behaviours have shifted the notion of literacy and expanded the concept beyond the printed text. Added to competency in reading and writing paper text is a set of technological and semiotic understandings and skills (Anstey & Bull, 2004; Cope & Kalantzis, 2009; Kalantzis & Cope, 2012; Knobel & Lankshear, 2007; Kress & Van Leeuween, 2001; Moore, 2011). The term “multiliteracies” conveys the notion that today’s literacy calls for functionality across multiple forms of knowledge and discernment to identify the appropriate social context. As individuals are now deluged with vast quantities of information, an understanding of the constructed nature of texts has become vital as a broad range of platforms need to be evaluated in terms of veracity and reliability (Cazden, Cope, Fairclough, & Gee, 1996). The multiliterate student is able to seamlessly navigate between paper, electronic and live texts and their semiotic systems (Anstey & Bull, 2006; Kress, 2003; Luke, 2003) and they decode, communicate and collaborate to create across platforms.

Print-based models of literacy have been adapted to models of multiliteracies that have merit in that they provide a framework for analysis. However, the approach is a traditional one that sees the learner as interpreting and analysing rather than creating new meanings through new media. A consideration of Four Resource Model (Anstey & Bull, 2006; Muspratt, Luke, & Freebody, 1997) is useful here to illustrate the process is one of decoding, critical and semiotic image analysis as opposed to encoding, or creating new meaning through text production. This model proposes a continuum of four interdependent skills – code breaker, meaning maker, text user and text analysis. Code breaking, is defined as the ability to identify and use the semiotic systems of the electronic, print and live texts and understand how they collaborate. The reader then brings the broad range of literary, cultural, social and technological experiences to interpret and understand the text. The meaning making skill is not the creation of new meaning, but understanding the possible levels of meaning. The text user is able to transfer these skills to real-life situations. By understanding the structure, intent and meaning of texts the text analyst can make judgements about the reliability of the text and come to an understanding of it. This model is a demonstration of the essential initial stage of multiteracies, that of understanding and evaluating text. However, as a model of multiliteracies it is caught in the “physical-industrial mindset” (Gibbons, 2012; Lankshear & Knobel, 2003, 2004), one that views the contemporary world as much the same as the past, except for the addition of technology. This view constructs learning as teacher-directed and “curricular,” that is the learning is pre-determined and officially sanctioned, and learner as consumer rather than producer. As observed by Carrington and Marsh (2005), digitextual practices are blurring these traditional distinctions between writer, reader, producer and consumer and require a complex and sophisticated range of skills, knowledge and understanding. Lankshear and Knobel (2004, p. 16) have defined this “new literacies” as skills of accessing and using technology on various platforms “using and constructing hyperlinks between documents and/or images, sounds, movies, semiotic languages…producing non-linear texts, navigating three-dimensional works online and so on.” New literacies, they argue, require “new learning,” and a “post-physical and post-industrial mindset,” which acknowledges that cyberspace operates on a basis of different assumptions and values from physical space. The student as cyborg employs external prosthetic devices or techno-social objects to communicate with other users on a network of information exchange centred on connectivity (Escobar et al., 1994).

Literacy, and what is to be literate has now become a dynamic concept in the 21st century. It challenges educational systems and teachers to remain relevant to their clients (Kalantzis & Cope, 2012; Leu, Kinzer, Coiro, & Cammack, 2004; Provenzo, Goodwin, & Lipsk, 2011). Kalantzis (2006) has extended the pedagogy of multiliteracies while calling for a reflective epistemology in which agency is re-balanced to empower the learner and teacher/student relationships. This learning is re-configured to construct learning as “a dialogue of difference” (Kalantzis, 2006, p. 31). A transformative approach, where learning is negotiated and co-constructed in a “bottom up” methodology, centred on an enquiry based learning model. Knowledge is understood to be contested, complex and negotiated and values the personalization of learning journey (Deakin Crick, 2009). It encourages critical and self-reflectively understandings achieved through historical, cultural and personal insights. Learners require interactive thinking skills, material experiences and performative practices. “Each meaning maker designs the world afresh…then leaves a representational trace to be found by others and transformed once again” (Kalantzis, 2006, p. 20).

New media and curriculum design

Incorporating new media into curriculum design and practice ushers in a changed paradigm as traditional written texts are now in battle for dominance with the possibilities afforded by new media. The conceptualization of curriculum and literacy as a top down or the reproduction model in western curriculum is no longer appropriate. The living reality is that we have an altered range of semiotic communicative practices and these practices are fluid, co-constructed, mobile, and transnational. They range across epistemological fields and herald the brink of initiating new creative futures where students can initiate authentic learning opportunities that can respond to this new extra-linguistic field of semiotics or edusemiotics (Danesi, 2010). This field includes sign signification, such as aesthetic products, visual communication, new media, advertising, narratives, material culture, film and gaming or other performance based acts such as dance, body movement or drama, anything that is underpinned by sign based activity.

Jewitt (2008a, 2008b) has identified that the representation of knowledge as well as the mode and media are integral to learning. The New Media Consortium (2005) has placed emphasis on the development of 21st century literacy as, “a set of abilities and skills where aural, visual and digital literacy overlap … the ability to understand the power of images and sounds, to recognise and use that power to manipulate and transform digital media, to distribute them pervasively and to easily adapt them to new forms” (p. 2). This will require the development of a much wider range of ways of thinking by teachers about: how students learn; how student brains have already been shaped by new media learning and the significance and power of their individual communication prostheses which equip every student with the capacity to represent meaning using multiple representational forms.

The power of personal mobile digital devices or learning prostheses corresponds to the call for learner-centred pedagogies that move beyond offering simply new technologies. It requires pedagogies that offer students greater levels of agency, social connectedness and autonomy driven by each student’s access and experience of digital technologies. Students as knowledge producers take their digital prostheses into the rich world of daily experience and have already developed knowledge of working in digital communities of inquiry well before formal school. It therefore flows they will reject the learning metaphor of acquisition, as they have already gained insight into the richness of learning through participation, collaboration and/or production (Lloyd, 2013). Curriculum design will need to be underpinned by a range of transformative pedagogies that draw across different disciplines, modes and media to harness the existing multimodal brain development of students. These pedagogies will need to see a focus on creative inquiry and performance; learner-designed learning; inductive and creative modes of reasoning and collaborative problem solving through the iterative stages of inquiry, analysis, production and presentation.

Modern technology tools are driving teaching and learning to an understanding that the generation of new knowledge is grounded in the development of the brain and its inherent plasticity, its cognitive tools and imaginative endeavours. These have added a significant re-emphasis on “trans-disciplinary creativity”. This rethinking of the relationship between technology and creativity (Mishra, 2012) shifts to a more intuitive engagement when learning. Mishra has identified a contradiction in thinking that creative problem solving occurs in-discipline. She argues that having the capacity to work creatively across varied domains implies multimodal learning and will require students to deal with contradictory knowledge and diverse semiotic systems and to develop the skill to break through these boundaries when learning.

With rapid advances and the uptake of the new digital technology the vision of curriculum has lagged (Mishra & Koehler, 2006). Buckingham (2012) argues that teaching and learning has remained relatively untouched by technology while the lives of young people have increasingly become filled with digital devices, asking us to consider a re-emphasis on the significance of situated cognition. In situated cognition, the learning context is perceived as meaningful to the learner and the inquiry is grounded in their lived experiences. Buckingham (2012) advocates for a learning-technology-by-design approach, where the emphasis is placed on becoming a technological practitioner through creating artefacts. This approach applies both to the teacher designer and to the student designer. Creating through design involves critical reflection, problem solving, dialogue, application of technological processes and iterative creative acts. Both teachers and students need to learn through creative use of the technology (Mishra & Yadav, 2013) rather than be just trained in the technologies. As multimodal practitioners, students wishing to work with visual technologies require a repertoire of visual language and related visual digital technologies in addition to the knowledge of how images and other modalities work together in contemporary communication. The complexity of this new learning space may benefit from neuroscience insights.

Experience, learning and multimodality

Neuroscience has extended insights into the processes by which human knowledge is distilled from sensory experience received via the different sensory modalities. Neuroscience has contributed to the understanding of the innate capacities of the learner, the role of reflection in learning, the understanding of memory and the role of emotion in learning. From birth, children have the ability to extract patterns from the environment in their learning of causation and language (Meltzoff, Kuhl, Movellan, & Sejnowski, 2009; also Goswami, 2008). Hence, learning is not simply the reproduction of what is perceived through the senses, but humans come with the capacity to extract concepts from the world they experience. Furthermore, constructive learning involves an alternating pattern between independent states of external focus where information is taken from the external environment, and “constructive internal reflection” where the personal significance of learning, or meaning making emerges (Immordino-Yang, Christodoulou, & Singh, 2012). The implication is that facilitation of learning by the teacher requires recognition of the need for students to alternate between engagement with the external world where the focus is on the information and the internal processes of reflection and meaning making. Curriculum needs to be designed to provide opportunities for critical and reflective thought when using digital technologies and so connect to the lifeworld of the learner.

As Squire and Stark (2008) comment, learning is a process by which neural systems are modified by experience: “Learning is the process by which new information is acquired about the world and memory is the process by which this information can persist across time.” (p. 242). Likewise Sah (2013) observes that:

All learning results from the observation, manipulation and storage of information, and the long-term impact of any learning clearly depends on the efficacy and accuracy of recall. (p. 113)

Additionally, Sah (2013) observes that memory formation is affected by the internal emotional state of an individual as well as the environment in which a person is located. Memory, like perception, is multimodal, rather than being amodal or unimodal (Arnold, 2013; Barsalou, Kyle Simmons, Barbey, & Wilson, 2003; Butler & James, 2011). Moreover, as important as cognition is for learning, it does not function in isolation from emotional and social supports:

Modern biology reveals humans to be fundamentally emotional and social creatures. And yet those of us in the field of education often fail to consider that the high-level cognitive skills taught in schools, including reasoning, decision making, and processes related to language, reading and mathematics do not function as rational, disembodied systems, somehow influenced by but detached from emotion and the body. (Immordino-Yang & Damasio, 2007, p. 3)

According to Arnold (2013) memory is exhibited in two types: affective memory, which is to do with appraisal of good or bad experiences, and modality specific memory such as visual, auditory, sensory and motor memory. Additionally, Arnold explains that conceptual memory, or semantic memory, has to do with meaning, origin, usage and naming of experiences and supplements the other types of memory. Concepts formation is dependent on the other types of memory and is not found in a separate location of the brain, apart from modality specific stored memory. Moreover, as Duncan and Barrett (2007) explain, the separation of affective and cognitive phenomena has no basis on ontological grounds because the psychological distinction between cognition and affect is not reflected in brain architecture. Cognition can regulate and instantiate affect, and in turn, affect participates in cognition. Sensory processes are modulated by “core affect” which “plays a crucial role in all levels of cognitive processing, determining what people are conscious of, how they use and understand language, and what content is encoded and retrieved in memory” (p. 1186). Additionally, it is argued that confidence in facts regarding “the validity of experience… is rooted in core affect” (p. 1023, see also Storbeck & Clore, 2007).

The findings of neuroscience provide insight into the underlying neural structures that support human perception, the way in which experience is coded and stored for future recall and the capacity to assimilate new experience and learning into memory. Furthermore, the work of researchers such as Immordino-Yang and Damasio (2007), Duncan and Barrett (2007) and Sah (2013) emphasise that cognition and memory are not phenomena that can be isolated from affect and the social context. Additionally, both perception and memory are multimodal (Arnold, 2013; Barsalou et al., 2003; Butler & James, 2011). Memory recall involves both content and context and therefore includes the accompanying sensory and motor experiences (Damasio, 2012). It follows that the particular modalities foregrounded by multimedia will shape learner experiences and learner preferences, such as film or the moving image over written text.

Multimodality, then, is part of the way that humans perceive, make meaning from and store and recall knowledge relating to their experience and action in the world. Multiliteracies present a corollary to these aspects of human nature by asking how formal learning might be advanced by incorporating into curriculum practice the presentation of information in a variety of modes (to use the distinction between mode [the form of presentation] and modality [the senses that receive the information]) as proposed by Moreno and Mayer (2007). Hence, there are two aspects of multiliteracies relevant to the discussion of their use in a new digitally focused education. One is the appropriate and effective use of multiliteracies, that is, the combining of two or more modes of experiences in order to advance student knowledge in curriculum work (Moreno & Mayer, 2007). The other is to do with encouraging student agency by advancing their understanding and competence in their ability to deconstruct their everyday encounters with multimedia, and, in turn, increase their understanding, proficiency and creativity in their use of multimedia (Albers & Harste, 2007).

Discussion

Issues raised by the ever increasing presence of digital culture and multimedia literacies in education invite questions around the role of experience in education and the representation of knowledge, and such questions are by no means new. In 1938, Dewey published Experience and Education in which he argued that the quality of the design of learning experiences by teachers has implications for the quality of learning on the part of students. Dewey’s argument was that high quality learning was most likely to occur when students intentionally interacted with their environment and were able to deconstruct, reconstruct and reflect upon what they encountered and observed (see also, Dewey, 1933).

High quality learning finds the active student engaging in experimenting with problem-solving strategies increasingly accessed via digital communication, rather than being a passive consumer of information. For Dewey, high-level cognitive engagement and motivation to learn could only arise from appropriately structured learning environments where the student was recognized as an active learner and meaning maker. Knowledge of the type that would underpin purposive action could not be gained though second-hand transmission. When Dewey spoke of experiential learning he had in mind a certain quality of learning experience, whether formal or informal, that becomes grist for learning. In other words, students are active learners and that learning is an active response to the digital culture with which they interact. As Mishra (2012) points out, technology must facilitate and not encumber the learning process.

Dewey’s insights were the product of his own observation and reflection of learning behaviour, and are remarkably perceptive especially in the light of recent advances in neuroscience that have observed the impact of the environment (both physical and social) on brain plasticity and development (Diamond, 2007, 2009; Diamond & Amso, 2008; Goswami, 2008). Work such as that of Diamond (2007, 2009; Diamond & Amso, 2008) emphasizes the reality of the gene-environment interaction in human development. The role of experience in learning and subsequently the multisensory nature of learning is reiterated by the neuroeducationalist Usha Goswami (2008). Szűcs and Goswami (2007) go so far as to suggest that: “education involves the shaping of individual brains via targeted experience in the classroom (‘teaching’)” (p.114). This insight accentuates the importance of teachers’ work in designing curriculum that will be the reality encountered by students in their formal education (see Lovat & Smith, 2003). In line with Lovat and Smith teachers/educators need to be cognizant of the increasingly digital culture of the classroom, the complex nature of curriculum work and the need to factor in the innate and developed capacities of their cyborg students.

This article has sought to identify and explore issues related to the increasing pervasiveness of digital culture and the virtual world manifested through the increasing availability of multimedia technologies in small digital devices. It attempts to advance the discussion of the implications of these technologies and the use of multimedia in teachers’ enactment of curriculum. Framing the curriculum implications is Lovat and Smith’s (2003) notion of curriculum work which typifies it as a series of decisions that teachers/educators make regarding the content, processes and resources to be coalesced to produce engaging learning experiences. This requires teachers to have a level of mastery of the technology (Mishra, 2012) and to have an awareness of student capacities, interests and capabilities (Lovat & Smith, 2003) to aid student learning rather than these being solely used for entertainment purposes.

Curriculum design is not about the foregrounding of digital technologies but the pedagogical decisions about the interaction between modes, instructional method and sensory modalities in relation to solving problems, building concepts and selecting representational forms with which to communicate. The above can only be effective in action if there is acknowledgment of the role of the affect in cognition and in deconstructing and reconstructing ideas and information. This becomes increasingly more challenging when working with the digitally active and virtually stimulated learner who responds with the speed and complexity afforded by the digital experience. In the past these decisions have come second to content and teacher selected technologies. Furthermore, creativity and technology must be taught together and not in isolation, because creativity cannot function apart from mastery of the medium through which creativity finds expression (Mishra, 2012; Mishra & Yadav, 2013). Mishra (2012), citing the work of Root-Bernstein (1996), points out that although creativity is manifested within the discipline areas, the thinking or cognitive skills that underlie creative thinking are similar across disciplines. According to Root-Bernstein (1996) creativity is at the basis of cross-discipline thinking, with imaginative thinkers being able to translate ideas from one discipline to another. Additionally, recent psychological and neurological research affirms the place of creativity in education and its essential role in the preservation of future generations. Creativity underpins the capacities of individuals to adapt and invent for survival and the enrichment of our cultures and society (Zeki, 2001). The new digital and multimedia technologies present challenges to conventional boundaries between the various discipline areas and point to the fact that knowledge is seamless and transcends artificial boundaries. Hence, the question is raised: What influences do these prosthetic devices have on cognitive development, memory systems and mind modification (Mann, 2006) as well as personal meaning making?

Coinciding with the challenge accompanying the emergence of contemporary multimedia technology is the exponential increase in the knowledge of and understanding of the functioning of the human brain. In particular, brain plasticity and its inherent ability to restructure itself in development and learning. This restructuring is in response to experience, the synergy between cognition and emotion, and the nature and functioning of memory. All of the above are of interest because they add to the understanding of the use of multiliteracies and multimedia as they are applied in curriculum.

Curriculum work needs to be cognizant of an array of factors in relation to the design of learning environments and experiences. Teachers need to design lessons being aware of the interaction of modes or media, the instructional method and multimodality (Moreno, 2006; Moreno & Mayer, 2007). Multimodal learning is not a recent phenomenon but is used by civilizations both ancient and modern; however the media or mode of presentation varies according to the technologies used (Spivey, 2005). Moreover, it is obvious from Spivey’s commentary that these multimodal presentations, regardless of the technology involved, engage multiple senses, perception, affect, memory, problem solving, communicative purpose and performative acts. The benefits of an expanding digital learning culture and multimodal learning is that it strengthens the neural fibres between the different areas of the brain and stimulus of a single modality activates stored information of multiple modalities, but further research is needed to establish whether this represents “stronger learning” (Goswami, 2008, p. 390). Nevertheless, the evidence Goswami cites indicates that multimodal learning does influence brain structure, strengthening connections between various areas of the brain. Further research will need to address the impact of the digital memory prosthesis on the brain development of the learner. Consequently, if multimodal learning stimulates brain plasticity in different ways, then, what are the implications for curriculum?

Motivation, engagement and learning are dependent on the interplay between affect and cognition. The fine line between real world digital practices, entertainment, engagement and active constructed learning is present in the decision making of all teachers. To reduce the function of multimedia in curriculum work to that of entertainment is to miss the observation of Dewey (1938/1963) that learning requires the active engagement of learners in problem solving. One question that teachers need to hold in mind in curriculum design is: How do we actively design problem creating and problem solving learning in a digitally driven curriculum? Research needs to be carried out into the epistemological outcomes of working across modalities. In addition, are there benefits for learners when they engage in problem-solving and production via their preferred modality?

Conclusion

Given the nature and reality of digital culture with new media pervading daily life, this paper has explored some of the challenges presented for teachers’ designing and enacting curriculum as they grapple with the impacts and implications for digital literacy and hence teaching and learning in contemporary educational settings. It has plotted the trilogy of elements that need to be taken into account in curriculum design. Learning in a digital culture with and through new multiliteracies requires: multimodal media; the expanded repertoire of semiotics that accompany the new digital devices; and insights into human perception, learning and memory afforded by cognitive science and neuroscience. Additionally, it has argued that curriculum design is not about the foregrounding of technologies but the pedagogical decisions about the interaction between modes, instructional method and sensory modalities in relation to solving problems, building concepts and selecting representational forms with which to communicate. This is affirmed by the research that clearly articulates that human perception is multisensory as is the encoding, storage and recall of this experience. In other words, human perception and memory are by their very nature multimodal and digital prostheses replicate human functioning.

Multimedia technologies continue to have uptake across all generations and proliferate society. They have become more intuitive, sophisticated and developed in ways that mirror the neural processes and capacities that constitute learning. Hence, the teacher is confronted with a new array of modes through which to engage the student in learning and meaning making. Learners require interactive thinking skills, material experiences and performative practices (Kalantzis, 2006; Kalantzis & Cope, 2012). This interactive thinking encourages critical and self-reflective understandings achieved through historical, cultural and personal insights. Creating through digital design is a student-centred learning by doing approach. Such an approach supports the constructivist ideas about learning and communicating knowledge over the traditional transmission model. It concludes that pedagogies that have the most chance of success are those that take into account the synergy between cognition and affect, and are aware of the strengths, limitations of the complex nature of memory. The research favours attention to the affective and collaborative aspects of learning, capacities scaffolded by digital devices. In the classroom this would see students orientating their inquiry from a personal perspective, sharing and collaborating with others in order to discover the relational aspects of the learning and selecting and building fluency in a range of semiotic systems. In the end, engaging students through multimodal learning comes back to the teacher’s depth of discipline knowledge, and their expertise, creativity and fluency in the use of media devices to represent knowledge and the ability to explicitly teach these skills and insights to their students. Furthermore, the teachers’ ability to utilize their adaptive capacity to shift their pedagogies for their learners and scaffold skill development in new technologies through observation of student skills and interests is important to successful learning.

Contemporary learning situations see teachers faced with the question of how to deal with the rapid shift to a digital learning culture and the creation and implementation of curriculum that harnesses and incorporates the potential of the new technologies. A conversation with neuroscience regarding the interplay of experience, memory, cognition, emotion and reflection in learning may support the development of curriculum that matches the capabilities of the new technologies with the capacities of students.

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Biographical Statements

Dr Kathryn Grushka is a nationally recognised Visual Arts & Design Educator, visual art education researcher, curriculum writer and artist. Kathryn is known especially for her work on the performative role of artmaking, imaginative becoming, reflective practice, adaptive knowledge and transformative learning. In teaching and learning Kathryn’s research is centred on ensuring the most explicit links between research insights into cognition, embodied visual knowing and subjectivity insights and has led to a growing interest in digital learning and visual cognition, critical and performative pedagogies, knowledge as visual representations. Kathryn currently sits on international and national editorial teams for art and teacher education journals.

Contact: kath.grushka@newcastle.edu.au

Dr Debra Donnelly is a history educator in the School of Education at the University of Newcastle, Australia, lecturing and co-ordinating undergraduate and postgraduate programs. Dr Donnelly’s research interests centre on the role of the visual and media in the development of historical and global consciousness in an age of ever-increasing access through modern technology. This has led to the current interest in the impact of digital culture on teaching and curriculum and the role of image making in the exploration, communication and disruption of knowledge.

Dr Neville Clement is a researcher working in the School of Education at the University of Newcastle, Australia. He is current research interests are in values in education, epistemic cognition and the implications of neuroscience for education. Articles he has co-authored have appeared in the Oxford Review of Education, the Cambridge, Journal of Education, the Australian Journal of Teacher Education, and Curriculum Inquiry. Also, he has co-edited International Research Handbook on Values Education and Student Wellbeing (Springer, 2010) and co-authored Values Pedagogy and Student Achievement (Springer, 2011).

Rowan Tulloch

Published Online: December 15, 2014

Full Text: HTML, PDF

Abstract: Gamification is a complex and controversial concept. It has been both embraced as a marketing and education revolution, and dismissed as practice of exploitation. Contested within the debate around gamification has been the very concept of what a game is, what the core mechanics of games are, and whether gamification truly mobilises these core mechanics. This paper will challenge the foundation of this debate through reconceptualising gamification not as a simple set of techniques and mechanics, but as a pedagogic heritage, an alternative framework for training and shaping participant behaviour that has at its core the concepts of entertainment and engagement.  In doing so it will recontextualise current practices of gamification into a longer and deeper history, and suggest potential pathways for more sophisticated gamification in the future.

Keywords: Gamification, exploitationware, play, pedagogy, game mechanics, engagement

Introduction

There is understandable unease amongst many games studies academics and game designers about the concept of gamification. This awkward neologism used to describe any range of processes whereby game mechanics are integrated into traditionally non-game tasks, has become a favoured buzzword of marketers, online strategists, start-up gurus, venture capitalists and digital consultants. Many within gaming circles have become rightly sceptical of the hype surrounding gamification. The frequent predictions of gamification’s ‘power to change the world’ have led many to outright dismiss this emerging practice, and others to be highly critical of underlying ethicality and effectiveness. For many game designers and game studies academics it seems that gamification is a temporary distraction, a passing fad, that adds little to the discussion of ‘proper’ gaming. Indeed for some gamification is a perversion and misunderstanding of the core principles of game design. In this paper I will suggest that whilst a healthy scepticism is necessary to balance the techno-evangelist fervour of many gamification advocates, a rigid rejection of all facets of gamification is reductionist and indeed reveals some highly problematic assumptions underpinning contemporary models of gaming. I challenge the reading of gamification as a misapplication of game design practices and demonstrate that many of the current critiques of gamification operate on a false binary between core game play mechanics and inessential feedback. I will show this division to be, not only flawed, but ultimately counterproductive not just for gamification but for game studies and game design more broadly.

In this paper I will offer a conceptualisation of gamification, not as set of techniques or technologies, but as an academic discipline and theoretical heritage. I will argue that gamification is not simply a recent marketing trend but rather a product of an overlooked history of pedagogic refinement, a history of training that is effective, but largely ignored: the process of games teaching players how to play. In particular gamification can be seen as an extension of the mechanisms and principles through which video games teach complex tasks that players are not innately familiar with; tasks players need to learn. By looking at the way in which games train players into certain practices of play this paper will attempt to resituate all gaming as a pedagogically constructed act and create a new discourse for understanding gamification. I will argue that video games are sophisticated pedagogic systems that train players into performing difficult tasks through innovative and highly developed means, and they do all this whilst maintaining player interest and engagement. Likewise gamification is always about pedagogy, whether it is designed to train profitable consumers, obedient and efficient workers, healthy citizen, or knowledgeable students, its goal is to produce and shape subjects and subjectivities. As such gamification should be understood, not as a radical new commercial or educational application of game design principles, but rather as continuation of a long ludic pedagogic heritage. Understanding gamification this way not only helps us recognize the real relationship between the current practices of gamification and more traditional forms of play, but it also suggests new and more sophisticated ways gamification can be enacted in the future.

A History of Gamification

To understand the problems with the existing framings of gamification one must first look at the history of the term, the popular definitions that have circulated, and crucially the controversies that have emerged. It is a complex history where debate occurs across, and between, a range of different disciplines all seeking to discursively construct gamification in their own ways, to legitimise their approach or to defend their conceptual territory. Rather than offer a comprehensive review of all gamification literature, this paper will focus on a small number of crucial pieces of work that have functioned to define (or critique) the concept of gamification. This is not a complete account of the definitions and debates, but is illustrative of the underlying issues and tensions that need resolving.

The term gamification is relatively recent one. It was first used by in 2002 by Nick Peeling (Marczewski, 2012: 3) a programmer and consultant who used it to describe his idea that electronics manufacturers could improve their products by building on the lessons learnt by the games industry. Its current meaning however is even more recent. In 2008 Bret Terril from Zynga games used the term to describe “taking game mechanics and applying them to other web properties to increase engagement.” (Terrill, 2008). Yet it wasn’t until 2010 that the term gained widespread usage. The precise definition of the term however is still highly debated, with the different overlapping disciplines surrounding gamification: game studies, marketing, human-computer interaction, game design, etc. all offering variants on the theme (cf. Fitz-Walter et al., 2011, Huotari  & Hamari, 2011, Nicholson 2012, Zichermann & Linder, 2010).

One of the most widely cited definition comes from Deterding et al. who state that “‘gamification’ is the use of game design elements in non-game contexts” (2012, 10). This definition, whilst simple, contains a number of key attributes that differentiate gamification from other similar pedagogic and ludic processes. Deterding et al. are precise in their choice of language in this definition.  They distinguish between games and play, arguing gamification is based on the former which is more structured and formal, not the latter, which is more loosely defined, freeform, and improvisational (Deterding et al, 2012: 11). Their use of the term ‘element’ reflects that gamification does not employ “fully-fledged games” for non-entertainment purposes (as opposed to serious gaming) but rather it mobilises small components of a game experience (Deterding et al, 2012: 11-12). They also seek to define what they mean by design (interface design patterns; game design patterns or game mechanics; design principles, heuristics or ‘lenses’; conceptual models of game design units and game design methods and design processes) and ‘non-game contexts’: any situation where the user has no cultural expectation of a game experience (Deterding et al, 2012: 12-13). This definition is representative of the standard frame through which much of gamification is understood.

The strength, and weakness, of the Deterding et al. definition is that it is abstracted from the specificities of gamification. This broad approach means they are not proposing an overly simplified account of the practice, but it also means they do not attempt to articulate or categorise the kinds of game design elements that are employed in gamification, nor the kinds of non-game contexts in which the elements are often employed. This approach functions well to produce a non-controversial definition, but is less useful as a means of understanding the details and realities of the processes of gamification, leading other gamification theorists to seek less abstract accounts.

One notable alternative definition that addresses the specificities of gamification practice comes from Gabe Zichermann (2011). Zichermann, a leading gamification proponent, seeks to go beyond generalities and highlight the actual practices and purposes of gamification. He argues that:

Gamification can be thought of as using some elements of game systems in the cause of a business objective. It’s easiest to identify the trend with experiences (frequent flyer programs, Nike Running/Nike+, or Foursquare) that feel immediately game-like. The presence of key game mechanics, such as points, badges, levels, challenges, leaderboards, rewards, and onboarding, are signals that a game is taking place. (Zichermann, 2011)

Where the definition offered by Deterding et al. lacks specifics, Zichermann’s articulation pinpoints precise game mechanics that are being used and the purpose behind the process. Whilst his assertion that gamification functions in the ‘cause of a business objective’ ignores non business uses of gamification such as in the educational and health spheres (so is far from a universal framing), his emphasis on mechanics such as points, badges, levels, challenges, leaderboards, rewards, and onboarding is reflective of, and corresponds to a significant portion of broader gamification literature. Indeed a strong emphasis has been placed on the integral nature of these mechanisms to the process of gamification by many theorists (for example: Fitz-Walter et al., 2011, Huotari & Hamari, 2012, Muntean, 2011, Nicholson, 2012, Paharia, 2011). Likewise a survey of leading gamification service and application such as Badgeville, Bigdoor Media, Bunchball, FourSquare, and MyTown also reveals that these mechanics are crucially important to the dominant conventions of gamification. However whilst Zichermann’s emphasis on points, badges, levels, challenges, leaderboards, rewards, and onboarding is far from unusual, it is not without debate.

Critiques of Gamification

Alongside, and in response to, the popular positioning of such features as points, badges and levels as central to gamification theory and practice, has been a growing resistance to what is seen as a simplistic conflation of these mechanics with the concept of gaming. The notion that mobilising these mechanics transforms something into a game has been significantly critiqued. Indeed Zichermann’s definition has been a focal point for critique.

One of the most important critiques of gamification generally, and Zichermann specifically, comes from media theorist and game designer Ian Bogost. Bogost’s ‘Pervasive Games: Exploitationware’ (2012) neatly encapsulates, and informs, the key debates occurring around gamification, and articulates some significant objections to the process. In particular Bogost takes issue with gamification’s uses of points, level, badge, and similar mechanisms, and the assumption that these things are what makes a game a game. This is part of Bogost’s broader critique of the depiction of gamification as being game-like. Bogost challenges the rhetorical framing of gamification, even critiquing the term itself, arguing that it should in fact be more properly termed ‘exploitationware’. Bogost argues that the term gamification mobilises a specific discursive construction to legitimate an exploitative use of minor game mechanisms to control and dictate ‘player’ behaviour. For Bogost the terms gamification and gamify function to normalise and hide the sinister nature of the process. The combination of the word game: with its ‘mysterious power’ to captivate and enthral, with the suffix ‘ify’: which implies an ease and straightforward application, suggest that to gamify something is a simple and unproblematic task (Bogost, 2012). Bogost fundamentally disagrees with this, he suggests that creating a game is anything but simple and in using the term gamification, and in the practices it embodies, gamification proponents have misunderstood the very basics of what a game is.

Bogost aligns himself with critics of gamification who argue that:

gamification mistakes games’ secondary properties for their primary ones. It insults and violates games. It confuses the magical magnetism of games for simplistic compulsion meted out toward extrinsic incentives. (Bogost, 2012)

Indeed he furthers this argument, positing that gamification takes only the most superficial and insignificant elements of games and assumes that it is all there is to gaming, through a detailed rejection of Zichermann (whom he refers to as “the gamification movement’s Dark Lord”) and his aforementioned conceptualisation of gamification where “key game mechanics, such as points, badges, levels, challenges, leaderboards, rewards, and onboarding” are used, Bogost argues:

Note how deftly Zichermann makes his readers believe that points, badges, levels, leader boards, and rewards are ‘key game mechanics.’ This is wrong, of course — key game mechanics are the operational parts of games that produce an experience of interest, enlightenment, terror, fascination, hope, or any number of other sensations. Points and levels and the like are mere gestures that provide structure and measure progress within such a system.

For Bogost there is the belief that the gamification movement has missed the important elements of games and chosen just to focus on the trivial, the veneer of the game rather than its core qualities, signifying systems, not the gameplay itself. For Bogost the use of the word ‘game’ in the term gamification is misleading as it the mechanics of gamification have little to do with the experience of playing games.

Bogost is not alone in his argument, gamification critic Alan Chroney (2012) offer a similar perspective when he claims:

Gamification entrepreneurs will say they are using “techniques that game designers [have] used for years to motivate behaviour – points, badges, levels, high score tables and virtual goods”  (Paharia, 2011).  The truth is that these techniques are not core characteristics of video games, nor are they exclusive to video game design.  In reality, gamification strips games of their essential characteristic: content, and replaces it with a brand. (Chorney, 2012: 3)

Chorney here is just as dismissive of gamification as Bogost, and like Bogost he sees it as an exploitative practice looking to target the unsuspecting with mechanisms designed to make a commercial endeavour look like an entertainment experience (Chorney, 2012: 3).

Likewise fellow critic Margaret Robertson argues that:

[The] problem being that gamification isn’t gamification at all. What we’re currently terming gamification is in fact the process of taking the thing that is least essential to games and representing it as the core of the experience. Points and badges have no closer a relationship to games than they do to websites and fitness apps and loyalty cards. They’re great tools for communicating progress and acknowledging effort, but neither points nor badges in any way constitute a game. (Robertson, 2010)

Whilst Robertson is somewhat less damning in her condemnation of gamification than Bogost or Chorney, she believes the essential idea is one with potential but that current examples of gamification that rely of giving points as a reward are misguided. She suggests that gamification designers are actually self-deluded, they don’t understand games enough to understand what they are doing:

Gamification is an inadvertent con. It tricks people into believing that there’s a simple way to imbue their thing (bank, gym, job, government, genital health outreach program, etc.) with the psychological, emotional and social power of a great game.

For Roberston, contemporary gamification would be better off termed ‘pointsification’ because it about points rather than gaming. She ends her argument by stating that “Games are good, points are good, but games ≠ points.” (Robertson, 2010).

What we can see then is two broad schools of thought when it comes to gamification. One which believes that mechanisms such as points, level, badges and achievements, can function to produce a game like experience in a non-game context. The other, which sees the mechanics as secondary to true gaming, and as such disputes the current framing of gamification and indeed the very validity of the terminology.

Reconceptualising Games

This debate highlights the problematic nature of the term gamification and the need to reconceptualise it in a more sophisticated way. However the solution is not as simple as re-terming gamification exploitationware, or even pointsification. The debate around defining gamification has ultimately been a debate about defining games and as such it is only by producing a more expansive understanding of games that we can better conceptualise what is occurring (and could occur) with gamification.

This debate is an argument over what the fundamental core features of games are, and what features are ancillary, inessential or insignificant. This kind of discussion is not new; well before the term gamification was coined the definition of the term game was being actively contested. Indeed much of the early scholarship in the game studies discipline was devoted to exploring this issue (cf. Aarseth, 2001, Eskelinen, 2001, Juul, 2005, Salen and Zimmerman, 2004), and before that it was a philosophical question explored by authors ranging from Caillois (1961), Huizinga (1955), Suits (1978), and Wittgenstein (1953). As with past debates around the characterisation of games (for example the ludology versus narratology debate that dominated game studies in the early 2000s, (Aarseth 2004, Murray, 2005)), the gamification debate demonstrates a need to move beyond rigid definitions and terminology to advance our conceptual understandings. This debates, as with those that have preceded it, emerges from different disciplinary framings, and different conceptual goals.

The model Zichermann, and his fellow likeminded gamification proponents are offering is a reductive reading of what a game is when they conflate gaming with points, levels, badges, etc. This is problematic as it ignores the potential sophistication and true complexity of the form. Yet for these gamification advocates the model has significant utility, it offers easy to understand concepts that can be applied to a wide range of contexts. As such it also functions to make gamification a concept that is easily explainable to those not versed in the nuance of gaming.

Likewise for critics of gamification their framing of the debate functions to affirm their own theoretical territory, i.e. they seek to narrow what is understood as a game and as such keep it part of the domain of traditional game designers and theorists. However, in doing so, the critics of gamification ultimately oversimplify their own object of study. The critiques offered by Bogost, Chorley and to lesser extent Robertson fall into a reductionist trap when conceptualising what a game is. As with any definition that seeks to identify and differentiate between primary and secondary game elements it inherently seeks to marginalise and discount the power of the so-called secondary elements. In marginalising mechanism like points and levels these theorists (just like those they are critiquing) miss the complexity of games, particularly in terms of pedagogy.

Bogost in particular has painted only a partial picture of the game experience to further his argument. What Bogost ignores when he dismisses such mechanics as points and levels is the ludic function of these elements and crucially it is in this ludic function that we see the core, not only of gamification, but of all gaming. Games function through pedagogy. Far from being “mere gestures that provide structure and measure progress” (Bogost, 2012) these elements are intrinsically important components of the play experience. Points and levels are reflective of the basic pedagogic structures in games that train players into ‘correct’ behaviour. They are not an afterthought for designers or players but part of the informational schema that shapes the act of play. The gamification movement, and its advocates like Zichermann may not fully acknowledge the complexity of the pedagogic systems modern games use, but they at least recognise the power of games to teach, Bogost does not acknowledge this in his critique of gamification.

Games and Pedagogy

Almost all play functions through teaching the player the rules. With most forms of traditional play, this is a straightforward task, rules are often listed in an instruction booklet, on the box, or taught verbally. The player learns these rules, so that they can successfully participate in the game. In video games this process can be somewhat more complex because the rules are often not made explicit. Yet video games ask players to engage in unfamiliar worlds, perform tasks and understand logics of which they have little or no prior skill (from being soldiers in warzones, to criminal outlaws, commanding vast army and empires, to piloting planes) these are not skills players simply have naturally, these are skills that need to be learned, and consequently that games need to teach. Games therefore have to train the player into the ‘correct’ practices of play, these are the strategies needed to participate in and succeed at the game (Friedman, 1999; Galloway, 2006; Tulloch, 2014). Video games do this because they need players to play in specific ways: in order to create a certain experience, tell a certain story, or even just to be manageable to the computer system and the limited design resources. For game designers it is essential for players to learn and perform the correct play practices and strategies, so that their game experience can align with designer intent, and so the player can progress through the world that has been created. Games thus rely on training player to perform the tasks in specific ways. They allow the player a certain degree of agency but this agency is within boundaries that the game system can handle. At the core of game design therefore is training and games mobilise sophisticated training techniques, both overt and subtle that shape player behaviours and standardise them.

Amid all the definitions of gaming that have been proposed few however emphasise the pedagogic aspect. One theorists who does, however, is game designer Raph Koster. In his 2003 Austin Games Conference keynote (the origin of his ideas in his acclaimed book A Theory of Fun for Game Design (2003a) Koster argues that:

“all games are edutainment. Some games teach spatial relationships. Some games teach you to explore. Some games teach you how to aim precisely.” (Koster, 2003b: 19 – 22)

Koster’s focus is both on the ways games teach the player to play and how they teach broader skills that are applicable beyond games. He argues that the enjoyment of games, the fun, comes from the process of learning and mastery, and that once the player has learnt all they can from a game, once it is mastered it stops being fun.  Koster’s Theory of Fun for Game Design is, however, as the name suggests an exploration of the concept of fun, not a thorough account of the mechanisms through which games teach their players and despite the influence of Koster’s work, those who have built on his ideas tend to focus on fun rather than the mechanics of learning. Frameworks like the popular ‘8 Kinds of Fun’ (Hunicke et al. 2004) have developed through and alongside Koster’s work, whilst the mechanisms of training has been far less explored. Beyond Koster the way in which games, particularly video games, train players, is largely ignored or overlooked. Whilst this is unfortunate in the broad context of contemporary debates around the video game medium, as it closes of a useful avenue for exploration, it is disastrous for discussion of gamification, as it denies a fundamental heritage and an opportunity to develop the practice. Indeed it is only because, theorists like Bogost ignore the training process in games that they can make the claim that points and levels are secondary game elements. Whilst Bogost is correct to question the simplistic conflation from many proponents of gamification of games with points systems, levels (games are a lot more than just these elements) these elements need to be understood as part of the process of training. Points and levels are (basic) examples of two of the most important training schemas in video games: ‘numerical signifiers’ and ‘progression’. Far from being secondary these elements allow games to offer the complex and unfamiliar experiences they do.

Numerical Signifiers

Bogost’s dismissal of points as simply a system that provides structure and measures progress (2012) underestimates the complex role points play in gaming. More precisely, in seeing the measurement of progress as an unimportant process Bogost is ignoring the feedback loop at the centre of the game/player relationship. In many games points do measure progress, but in doing so they are providing constant corrective feedback to player on their play strategies. Players know they have achieved well, i.e. played successfully within the privileged norms of the game, if they receive a large number of points or achieve a high score. Points are not just a record of achievement, as Bogost implies, but a signifier of correct play practice. Points in this context are far from a secondary property, they are absolutely primary to the construction of the play experience; without them players would have significantly fewer indicators of how they should approach the game.

Not all games use points of course, and this is perhaps the thinking underlying Bogost’s resistance to understanding them as a key gaming mechanic. However whilst many video games and genres thrive without the use of a points mechanic, nearly all use a comparable system for signalling correct play practices. One such example that is perhaps more prevalent than points is ‘health’ and ‘lives’. A vast number of video games rely on health as the key mechanism of player challenge (to succeed you have to learn to stay alive), but also the core mechanic of game training. A player knows they have done the wrong thing if they lose health or die. Injury to the player character is an unambiguous signifier of incorrect action in the game. Whilst the injury is in no way ‘real’ or physical this informational schema resonates on a powerful cultural and biological level; players know without being told that they want to avoid injury and death for their character. The scale of the injury that happens in the game also often functions to inform the player how incorrectly they have performed. It shows them the magnitude of ‘improvement’ to skills or tactics required: a small loss of health requires a minor refinement, whereas death of the main character may suggest a significant correction is needed. Game genres vary as to how they represent this numerical data, some do this through actual visible numerical systems like health as a percentage, and others use graphs and charts (fighting games for example nearly universally have player health a bar graph at the top of the screen). Regardless however of the means of representation the function is the same, it shapes player behaviour by punishing deviation or transgression through virtual violence and injury and as such is integral to the act of play.

Other examples of numerical systems used to signify correct (and incorrect) play include virtual money, experience points, time remaining and even the number of military units available. Numerical feedback is so popular because it functions effectively in this role as it is easy to interpret and understand, minor increases and decreases are easy to observe and quantify. Games designers employ these different numerical systems in different game settings to appear as natural and normal parts of the gameworld (most games try not to draw attention to their pedagogic mechanism, to avoid spoiling immersion or potentially fostering resistance and counterplay) but underpinning them all is the same function: numerical signifiers give players real-time feedback on how well they are doing in the game, and to help them refine their technique in order to succeed.

Points are one of the most basic examples of numerical signifiers. Indeed as games have got more complex designers have found it necessary to move beyond these simple mechanisms, points are far less common in current games than they once were. As prominent features of 70s, 80s and 90s gaming, they (along with levels, discussed below) are often seen as, or used to designate ‘retro’ in contemporary gaming. One of the problems with point is their lack of flexibility, they are unusual within signifying numerical systems because they (commonly) only increase; they cannot be lost or traded or used as currency. Alternatives signifiers to points like the aforementioned health, money, experience points, and units often require the player to sacrifice, or risk sacrificing, in order to progress. For example, in a first person shooter the player may need to assess the probable cost in health of a sprint through an enemy infested room, versus a methodical targeting of all enemies. Such evaluations force the player to reflect carefully both on their own abilities, and on the basic rules and logics of the game. Such systems thus have a double pedagogic value, where points just reward correct actions, other more complex numerical systems like health function not only as a signifier but also a catalyst for reflection and deeper engagement. In this way points are a far less sophisticated and often less power numerical signifier. They are however not secondary elements, when used they are key to the teaching of correct play practices.

Progression

Bogost is as dismissive of levels as he is of points, but like point, levels are an example of a crucial process to the game play experience. Indeed levels function in a near identical way to points, they operate as markers of progression, and progression is another key signifier of correct action in a game. In this case rather than success being depicted numerically it is depicted through spatial, narrative or achievement schemas. Players know they are playing correctly when they make it to the next level. Again this is simple but crucial pedagogic mechanism in video gaming. Progress is fundamental to all games, and in the vast majority is clearly marked. This is one key reason (apart from technical limitations) levels have been such a popular design trope in gaming, by splitting the game experience into discrete sections the player can clearly see their progress, they can self-monitor their performance, and reflect on which strategies have been successful and which have failed.

Progression again works clearly as an unambiguous signifier because it is culturally familiar, we expect an entertainment form to progress, to build to move on, be it book, film, TV show or video game we are accustomed to our entertainment developing and advancing. Our desire for new experience also pushes us through a game, seeking progress, willing to take on the required play practices in order to progress.

However much like points, levels are increasingly falling out of favour with game designers. There are many reasons for this including improved technological affordance making dividing game into discrete levels less necessary, but there are more complex reasons as well. One such reason is that levels force a degree of linearity on a game. If a player moves through the game level by level then the progression, whilst easy to understand, leaves the player little choice or agency. As many games embrace non-linear stories and worlds, level become a less useful marker of progression. Other markers of progression are thus employed in these circumstances such as levelling up character skills, unlocking items, attaining achievement badge and trophies, weapons, moves, or perhaps most commonly moving the narrative forward. These system allow for the variability in play styles and interest whilst still offering clear signification of progress. They are more compatible with a gaming system that gives the player a degree of autonomy and self-direction. As such, they are useful as pedagogic tools as they encourage the player to follow their interests whilst still training them to keep within the broader scope of correct practices.

However no matter what marker of progress is used be it levels or a more complex system, they all function to signify, reward and correct play practice. They are crucial pedagogic mechanisms. And whilst like points, levels, may be a simple examples they are representative of range of training mechanisms that are far from a secondary.

An Alternative Pedagogic Heritage

Once we understand that points and levels are not just ‘mere gestures’ but rather pedagogic mechanisms (however rudimentary) we can start to see new possibilities for gamification, and the missed opportunities in current gamification. Bogost, and other gamification critics, are not alone in overlooking the true pedagogic significance of gaming mechanics like points and levels, neither side of the gamification debate has adequately acknowledged the pedagogic core of video gaming. Gamification critics miss the pedagogic techniques intrinsic to video gaming and thus fail to see the connection to gamification. Conversely, by emphasising the ‘new contexts’ many gamification advocates miss an opportunity to conceptualise gamification within a much longer heritage, and as such overlook important work already done in the area. The difference between arguing that games can be used for pedagogic purposes, and the understanding of games as intrinsically pedagogical, may appear minor, but it is crucial. In positioning gamification as a new discovery, a departure from traditional gaming’s core principles, gamification advocates become pioneers of a new field and can handpick the theory from game studies and game design that fits their purpose. The complex debates around such things as the ethics of games, the cultural specificity of play, gender differences in play, what kind of stories and experiences can be usefully conveyed through games, and many other critical debates of the last 20 plus years, can be largely sidestepped.

If current conceptualisations of gamification, from both advocates and critics, are limited because they fail to understand the full scope of what is occurring, and both sides are failing to articulate the aforementioned pedagogic dimension, then a new framing of gamification is required. Rather than understand gamification as the use of game design elements in non-game contexts, it is more productive to see it as the deployment of an alternative pedagogic system developed for, and refined in, gaming, in non-game contexts. Put simply: gamification is a form of training built upon the techniques used in, and heritage of, games rather than traditional pedagogy. In this conceptualisation of gamification the key term is heritage. If we recognise gamification is not a new pedagogic use of game mechanics, but rather the continuation of a long running practice, then it allows us to situate gamification as part of an established tradition of theory and design. It allows us to understand gamification as a form of pedagogy that that is not defined by the traditions of western institutional education, e.g. schools and universities (this is not to say that traditional pedagogy has not informed the training mechanism of gaming, it certainly has had a great influence, however the different cultural, economic, structural and material contexts have produced a form of pedagogy that are not defined by these traditions). It presents us with a ‘new’ discourse and set of conceptualisations through which we can understand gamification. It shows gamification to be the result of over fifty years of refinement of pedagogic technique in video game design, and an even longer history in traditional play. Once we recognise the teaching processes inherent in games, then we can see them as an unusual but important pedagogic system.

The Power of the Gaming Pedagogic Heritage

What makes gamification so unusual is also what makes it so important, the power and uniqueness of gaming pedagogy, comes from its focus on engagement, and this is why gamification has proved so popular and productive. At the heart of gaming, and consequently its pedagogic tradition, is an emphasis on player (learner) enjoyment. Game designer and theorist Ernest Adams articulates the centrality of player enjoyment when he argues a “game’s primary function is to entertain the player, and it is the designer’s obligation to create a game that does so.” (Adams, 2009: 30). It is this emphasis on enjoyment and entertainment that distinguishes gaming pedagogy from many other pedagogic models. Whilst fun and entertainment are part of numerous pedagogical frameworks, the emphasis on learning through play in these systems is often at its strongest with early childhood, and steadily decreases as the child get older, with little emphasis for adult learners. The importance of play to early childhood education can be seen in academic literature (Fisher et. al., 2011), governmental frameworks (Department of Education, Employment and Workplace, 2009), and in the emphasis on play in a range of education models such as the Montessori system (Lillard, 2013). This same prominence of play cannot be seen in the literature, policies and practices surrounding secondary, tertiary and adult education. Video games are as such unusual amongst pedagogic systems that teach adults (one recent study showed 71% of America video game players are 18 or above (Electronic Software Association, 2014: 3)) in this emphasis on entertainment as a “primary function”. The techniques they mobilise, the traditions of the pedagogic heritage they draw on and inform, are ones designed to produce an entertaining experience, whilst simultaneously functioning to train the player. This is what makes gaming pedagogy distinctive and valuable, and why gamification must be understood as part of this heritage not just a recent invention.

The centrality of enjoyment and engagement in gaming pedagogy makes it uniquely effective in situations where other forms of pedagogy may struggle. Techniques of gamification have often proved most productive in circumstances when participation is voluntary, such as in marketing promotions (Huotari  & Hamari, 2011) and personal health campaigns (McCallum, 2012); and circumstances where engagement is perceived to have declined, or in need of improvement, such as many contemporary educational contexts (Fitz-Walter et al., 2011). If we understand gamification not just as a set of mechanics but as a heritage, and an academic discourse (based in game design and game studies paradigms), the reason for this becomes easily articulable. As a practice gamification does not assume engagement and interest, but instead seeks to generate it. The key reason for this is the voluntary nature of gaming. When French sociologist Roger Caillois sought to define the act of play the first characteristic he describe was that it is ‘free’ in that “playing is not obligatory; if it were, it would at once lose its attractive and joyous quality as diversion” (Caillois, 1961). As a basis for a pedagogic model then, gaming comes from a very different setting than most traditional pedagogy. In most countries around the world some formal education is mandated, often for a period of approximately 10 years; in some countries this is then coupled with social and economic pressures encouraging higher education. These are highly distinct contexts, within which pedagogic models become established, and it has inevitably led to different techniques and models being employed. For games maintaining engagement and enjoyment is critical, for traditional pedagogic institutions these factors are less important. We can see then why, for contemporary situations with voluntary participation or low engagement, gamification (and the heritage upon which it draws) provides a powerful tool set.

Gaming is an unusual pedagogy in its emphasis on entertainment. The power of this model however is not that the player learns despite the primacy of entertainment, but that the play learns because of the primacy of entertainment. Within a gaming heritage, entertainment and learning are not discrete processes, they are one and the same. Play is learning, learning is play. The challenge and pleasure of a well-designed game come is learning the games rules, logics and systems (Friedman, 1999: 136).  For gamification to be successful then designers must recognise this tight relationship between entertainment and learning. More than this however, for gamification to be successful designers must recognise that the tight relationship between entertainment and learning is neither inevitable nor coincidental, it is the product of a long process of development and fine-tuning. It is for this reason that the wholesale lifting and transposition of elements of gaming into non-game contexts is likely to be at best a partial success. Doing so is a decontextualisation of individual processes from the broader heritage; in short it is a process of ignoring the uniqueness and power of the gaming pedagogy. For gamification to be successful this pedagogic history must be acknowledged and gamification itself must be conceptualised as the engagement with this heritage.

Gamifying Difficulty

The value for designers and theorists of reconceptualising gamification as a pedagogic heritage, not just a set of techniques, is best seen through a brief analysis of a specific example. There are countless examples that could be discussed, but here I will focus on the question of ‘difficulty’, it is an example that simply and easily shows how reframing gamification in this way opens up new possibilities and understandings, both in terms of theory and practice.

Like in all forms of pedagogy one of the key challenges in game design is the question of difficulty: how easy or hard should the tasks be, how does one challenge without frustrating, how does one teach without alienating. Gamification is no different; whatever form the gamification takes designers want players engaged, challenged but not discouraged, yet an understanding of gamification as a series of mechanisms and techniques gives us little in the way of guidance or insight into the issue of difficulty. Indeed the question of how we could think about difficulty is outside the scope of traditional definitions and discussions of gamification that focuses on points, levels, badges, etc. However if we understand gamification as a form of training built upon the techniques used in, and heritage of, games rather than traditional pedagogy, then we find not only a framework that incorporates difficulty but a rich academic discourse for understanding its complexity. We can see that in fact many game design texts implicitly and explicitly theorise the question of difficulty in relation to that core focus of gaming: player engagement.

As one would expect given the voluntary nature of play, most game design theory tends to frame the question of difficulty as an issue of enjoyment. Adam’s claims that “[to] be enjoyable, a game must be balanced well—it must be neither too easy nor too hard” (2009: 324). Such a statement, whilst simple in itself, hints at how established complex theorisations of engagement, like Csikszentmihalyi’s (1990) concept of flow (an optimal state of immersion and focus), are in this field (see Chen, 2007 and Cowley et. al., 2008 for more examples of the impact of flow theory on video game design and analysis). Flow theory, however, has a wide reach across many disciplines and pedagogic contexts, the real utility of the game design heritage that I wish to highlight here, comes from more detailed analysis and modelling of challenge in gaming, such as that offered by Jimmy Marcus Larsen in his 2010 work on difficulty curves.  Larsen presents an analysis of the way in which different models of difficulty alters the player’s experience of the game. Larsen analyses six types of difficulty curve, which represent the challenge the player faces as he or she progresses through the game. From fixed linear (difficulty remains the same throughout game), to fix increasing linear (difficulty increases at a set rate) to more complex models like fixed logarithmic wave (difficulty increases in steps towards a maximum), and interval logarithmic widening wave (difficulty generally increases towards a maximum but is randomised within a set range to provide unpredictability), Larsen evaluates the positives and negatives of each model in terms of player engagement and interest. The key thing here is not Larsen’s specific concepts but the detail and richness of his work, and of the work of others like him (see, for example, Salen and Zimmerman’s discussion of dynamic difficulty (2004: 224) or Brycer’s (2011) analysis of the effectiveness ‘Darwinian difficulty’ i.e. extremely high difficulty levels). If gamification is understood as a form of pedagogy informed by this kind of work, this heritage, then what we get is a very different understanding of the processes of learning; one that has a notably different emphasis from many other pedagogic models where difficulty is governed by other concerns such as what is age appropriate or what is required to give set skills. The question of the shape, and therefore effect, of the difficulty curve is one that is crucial to gaming but seldom discussed in other pedagogic traditions. Most pedagogic traditions, especially institutional frameworks (school, universities, etc.) uncritically mobilise fairly linear models of difficulty, where, as we have seen, the gaming heritage provides a powerful and nuanced alternative.

Within the conceptualisation proposed in this article, the gamification of a task’s difficulty can be understood as a process whereby an existing model of conceptualising difficulty from game design/game studies is mobilised in a non-game context. This gamification of difficulty has very little to do with the definitions offered by Zichermann and likeminded theorists. It is not about simply using points, levels or leader boards, but rather it is about drawing on the work of theorists and game designers like Larsen and building upon their lessons. One does not have to rely on points etc. to make a task more gamelike, the application of an interval logarithmic widening wave difficulty curve (Larsen, 2010) for example, can be just as, or more, successful. The gamification of difficulty is about recognising difficulty as part of play’s pedagogic process and understanding the intellectual history behind it. Put simply, good gamification should not indiscriminately recontextualise gaming elements, it needs to understand and build upon the underpinning logics and philosophies. By reconceptualising gamification as a pedagogic history based in the academic disciplines of game design and game studies we can encourage this more sophisticated approach and emphasise and reinforce the links between game mechanics and techniques and the contexts, rationales and desired outcomes that produced them in the first place.

Whilst the issue of difficulty effectively demonstrates the power of gaming as an alternate pedagogic framework, it is just one example amongst many that could have been analysed here. Game design and game studies offer innumerable other important frameworks expansions and challenges to traditional pedagogic discourses, from new conceptualisations of the relationship between spatiality and agency (Nitsche, 2008; Rogers, 2009), to rethinking pedagogic temporality (Aarseth, 1999; Juul, 2004); from examining the relationship between narrative and interactivity (Jenkins, 2004, Murray, 2005), to recognising the complexity of gender performativity (Kennedy, 2002; Taylor, 2009); from understating the challenges of resource management (Costikyan, 2005) to allowing for different types of engagement and the different pleasures they produce (Bartle, 1996, de Peuter & Dyer-Witheford, 2005), to draw on just a few better known pieces. All of these ideas can provide much needed contributions to thinking about how we learn, why we learn, and what it means to learn. Whilst rarely explicitly about pedagogy these theories implicitly offer new and unique ways to understand, and shape, practices of learning and interacting and can be mobilised to produce the desired profitable consumers, obedient and efficient workers, healthy citizen, and knowledgeable students for which gamification strives. To reach its full potential, gamification must be understood as the drawing on the rich theoretical heritage game design and studies offers, and the recognition that in doing so one is accessing a developed and distinctive pedagogic paradigm.

Conclusion

Gamification as a practice has existed far longer than the term itself. The use of the pedagogic mechanisms of games to shape understandings and behaviours is far from new. What the terminology of gamification offer us is an opportunity to recognise and integrate a range of potentially disparate practices and techniques into a cohesive framework. It allows us to see the connections and overlaps between such things as character health, narrative progression, and difficulty curves, and recognise that these are all processes and mechanism of pedagogy; a pedagogy where entertainment is entrenched and engagement fostered.

The techniques commonly associated with contemporary gamification: points, levels and leaderboards, are but simple examples of a much richer heritage. A heritage designed to engage and train players who are voluntarily interacting with a complex system. As gamification develops we are likely to see more sophisticated mechanisms and techniques become popular. Gaming has a deep history of refinement and thought about how to appeal to players, through challenge and reward, through progression and feedback. All these mechanisms can be drawn on and applied in other circumstances in ways that go well beyond points, levels and leaderboards. Most video games offer complex numerical economies, patterns of progression, precise difficulty curves, involving scenarios and stories, carefully constructed spatial and temporal dynamics, etc. It is through embracing these possibilities that gamification can become a richer, more nuanced, and more effective practice. The power of gamification is in its ability to engage an audience, to do so with any longevity for complex tasks requires more complex techniques than simple points and linear progression. If gamification advocates and practitioners move beyond the rhetoric of education revolution and instead embraces gaming’s rich pedagogic heritage then we may witness the real potential of gamification be realised. Understanding gaming as a pedagogic process, helps us reconceptualise gamification as an extension and recontextualisation of it methods and philosophies. This not only offers us a rich lineage of examples to draw on, but helps us understand how and why gamification is successful (and how and why it may fail). It gives us a deeper academic framework through which to view contemporary gamification, and the foundations to build a more sophisticated and nuanced version.

It is easy to dismiss gamification as a fad or a gimmick, but to do so would be to miss an important opportunity to re-evaluate contemporary pedagogy. Video games are now one of the most popular entertainment forms; players of all ages are investing more and more time in these virtual worlds. But these are not virtual worlds that are innately familiar to their players, these are world with rules, goals and strategies that the player must learn. Video games train players into how to understand and engage with them, they use numerical feedback, progress and other techniques in order to shape the player’s play practices. The current version of gamification we are seeing offers a rudimentary use of these same mechanics, but it has been held back by a lack of recognition of the broader contexts within gaming, and a lack of realisation of the significance and scope of what is occurring. It is also hampered by models of gaming that assume pedagogy to be a secondary process, and theorists who are thus resisting gamification due to a belief that it is not game-like enough. Whilst there are valid ethical issues to think through (as there are with any pedagogic paradigm) dismissing gamification for its lack of gameness is reductionist, and counterproductive. Gamification practices are building on the unacknowledged heart of gaming, its training mechanics, and are mobilising these techniques outside traditional play. Further work needs to be done by gamifiers to incorporate the more sophisticated mechanisms from video gaming (and this is where game studies theorists can be of great worth) but even the basic gamification we see today offers a glimpse of an alternative way of thinking about education, marketing, health and other areas, tailor-made for the 21st century and a new generation of learners.

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Biographical Statement

Rowan Tulloch is a lecturer in digital media and video gaming at Macquarie University, Sydney, Australia. His research looks at the technological and cultural logics embodied within practices of interactivity. His work on video gaming explores the pedagogy of video games and the normalising forces used to teach, coerce, and compel players to engage in certain privileged ways in order to construct the intended play experience. His recent research project The Gamification of Higher Education Teaching Practices analysed the effectiveness of different models of gamification in the university classroom environment. From this research he has formulated new frameworks for conceptualising gamification, and is developing a software package to assist university staff to better engage their student through simple gamification techniques.

Contact: Rowan.Tulloch@mq.edu.au

Tisha Lewis Ellison

Published Online: December 15, 2014

Full Text: HTML, PDF

Abstract: This article describes how two African American adolescent male cousins become co-constructors and negotiators of identity while playing The Sims 2, an online life simulation computer game.i Utilising literacy as social practices and multimodal practices, this article produces a framework to establish how adolescents use digital tools to construct their identities, and how identity construction and interactions with these tools extend understandings of literacies, multimodality, and self. Data were collected using ethnographic and multimodal discourse methods and guided by questions: How did adolescents use an online computer game to construct their identities? How might these identity constructions and interactions with digital tools extend their understandings of literacies, multimodality, and self? Analyses demonstrated how the adolescents took on student-centered roles as co-constructors of knowledge and meaning that contribute to the ways they need to be researched and studied in this era. This work also challenges educators to acknowledge how students participate with digital tools in communal spaces that shape how their literacy and identities are constructed, and it adds to the limited representation and investigation of African American family meaning-making and identity via digital tools.

Keywords: family literacy, digital literacies, multimodalities, adolescent literacy, digital media, identities

Tisha:               So how does it feel when you both create your own identity…like, your own person?

Jake:                It feels FUN because you get to do what you want to do in the future.

Gerard:            Yeah!

Jake:                I can make an inventor like I’ve always wanted to be.

Introduction

In today’s digitally mediated society, adolescents participate in a variety of literacy practices using digital tools (i.e., blogging, texting, instant messaging, and video gaming) for a variety of reasons and purposes, including: (a) interacting on social networking sites; (b) forming affinity spaces around digital tools (Gee, 2003); and (c) gathering information for personal and school use. What is most significant is the ways in which adolescents rely on digital tools to help make sense of both their on- and offline worlds (Lewis, 2009, 2010, 2011, 2013, 2014; Gee, 2003; Gutierrez & Beavis, 2010). For instance, emotions, anxiety, and creative actions occur when adolescents read and respond to text messages and emails (Turkle, 1995). Adolescents also make meaning and express ideas through popular forms of remix practices, images, videos, anime fan art, etc. (Gainer & Lapp, 2010; Knobel & Lankshear, 2008); and they shift selves within role-playing games (Hammer, 2007). However, within each of these digital literacy practices, identities get entangled when adolescents experience or participate in computer/video games, a popular and privileged literacy practice among adolescents (Beavis, Apperley, Bradford, & O’Mara, 2009; Gee, 2003; Lenhart, Kahne, Middaugh, Macgill, Evans, & Vitak, 2008; Thomas, 2007; Wonica, 2013). The above excerpt features the voices of ten year-olds Gerard and Jake (pseudonyms), and me while discussing their engagement in creating a Sims 2 character. Their interactions shed light on the ways in which they process choices, identity, and navigate their roles of self (Foucault, 1988), while having fun creating during real-time video gaming. Their comments speak to the rising trend of how adolescents use video gaming for creativity and gaining “textual/literate experiences in online worlds” (Beavis et al, 2009, p. 163).

In this article, I examine the affordances and limitations of two African American adolescent boy cousins’ digital literacy practices, and their involvement with The Sims 2 computer game to answer the following questions: How do adolescents use an online computer game to construct their identities? How might these identity constructions and interactions with digital tools extend their understandings of literacies, multimodality, and self? This work documents Gerard and Jakes’ construction and negotiation techniques while online, the roles video games play in their lives, and how elements of choice, creation, meaning, and creativity all relate to issues of identity that shape their constructions of themselves and their navigation of familial relationships and practices.

Literacy as Social Practices & Multimodality

This work is situated around questions about adolescents’ digital literacy and multimodal practices via an online computer game, and beliefs about identity constructions and self. The theoretical frame is informed by sociocultural traditions of literacy as both social (Barton & Hamilton, 2000; New London Group, 1996; Street, 1995) and multimodal practices (Kress, 2000; Kress & Jewitt, 2003; Kress & van Leeuwen, 2001). Literacy as Social Practices is derived from the New Literacy Studies which acknowledges that what individuals do with everyday social practices do not extend from a model of solely reading and writing. However, literacy as social practices requires social communicative interactions that force us to examine how individuals use and make sense of texts, meaning, and multiple literacies in contexts through time and space in everyday social practices (Lankshear & Knobel, 2003; Pahl & Rowsell, 2006; Perry, 2012).

According to the New Literacy Studies’ concept of “literacy as a social practice,” individuals’ literacy practices are based on the social, cultural, and political contexts of literacy that are shaped by digital technologies/literacies (Kress, 2003; Lewis & Fabos, 2005). Social practices involve the ways people use literacy: where they do it, what they do and do not do with it, and how everyday events and practices shape how they make sense of and accomplish things through it (Barton & Hamilton, 1998; Gee, 1996). Since all texts are multimodal, meaning draws on multiple modes of representation. Multimodality is used to examine the ways in which individuals process literacy through such practices as reading, writing, viewing, understanding, producing, and interacting with digital texts/tools through the modes of sight, sound, gestures, and movements through and within texts. When used in video game playing, these modes present ways in which individuals incorporate communicative systems with social practices to simultaneously make meaning (Kress, 2000; Kress & van Leeuwen, 2001; Walsh, 2010). What follows is an exploration of relevant literature pertaining to adolescents and perspectives of identities, figured worlds, video gaming, and digital literacy learning.

Perspectives of Identities, Figured Worlds, and Adolescents

Many scholars suggest that identities shape the way people make sense of the world and influence how they engage in literacy practices (Arnseth & Silseth, 2013; Gee, 2003; Hall, 2002). Other studies documented the impact of social identities regarding students in schools and in learning (Gonzalez, Moll, & Amanti, 2005; Wortham, 2006). Today’s adolescents rely on digital learning, relationships, and self, and represent identities through on- and offline participation as ‘experts in the field’ (Gutierrez & Beavis, 2010). By identities, I refer to an individual’s perception and understanding of themselves, their behaviour, lifestyles, and their language—all of which are formed and developed by a tool, thing, or situation. In other words, it is the position in which one authorises authority in that space.

Holland, Lachicotte, Skinner, and Cain (1998) claim that “identities are a key means through which people care about and are for what is going on around them…which people create new activities, new worlds, and new ways of being” (p. 5). In addition, Urrieta (2007) defines identity as “how people come to understand themselves, how they come to ‘figure’ who they are, through the ‘worlds’ that they participate in and how they relate to others within and outside of these worlds” (p. 107). Within larger frameworks of identity and self, it is relevant to acknowledge ‘figured worlds’. Holland, et al (1998) introduced figured worlds as ‘‘socially produced, culturally constituted activities’’ in which identities are formed, conceptualised, and materially produced (pp. 40–41). Urrieta (2007) suggests figured worlds in this way: “people ‘figure’ who they are through the activities and in relation to the social types that populate these figured worlds and in social relationships with the people who perform these worlds. People develop new identities in figured worlds” (p. 108). Figured worlds are described through four components as: 1) cultural phenomena in which people enter and develop through the work of others; 2) “contexts of meaning” in which activities are meaningful and individual’s positions matter; 3) “socially organized and reproduced” spaces in which individuals are sorted and learn to function with each other in different ways and purposes; and 4) spaces that cause individuals to relate to these worlds through “familiar social types and host to individual senses of self” (Holland, Lachicotte, Skinner, & Cain, 1998; Urrieta, 2007, p. 108).

In this digital age, identities are constantly being built and developed in manners that suit us for the moment. For example, adolescents constantly change their photos, friends, and post messages on Facebook and Twitter. They even create new characters or Avatars that express their personal and social identities while playing video games (Lotherington and Jenson, 2011), and are divided into on- and offline and personal and social identities (Palfrey & Gasser, 2008). More specifically, studies documented the role that video games or digital tools play with adolescent identities. Abrams (2009) suggests that the:

identity of a gamer not only reveals what he/she does (i.e., playing, and perhaps mastering, video games), but also it provides insight into the language, knowledge, experiences, and perceptions that are formed in relation to or as a result of video gaming. Engaging in specific activities such as video gaming means interacting with ‘specific groups of people’ (Gee, 1996) who recognize, value, and adopt the same discourses; ‘being-doing’ a gamer situates the individual among others in the Discourse community (Abrams, 2009, p. 3, Adams, 2009; Hinchmann, Sheridan-Thomas, & Alvermann, 2008).

In Gee’s (2003) What Video Games Have to Teach us About Learning and Literacy, he argues that learning and literacy in video games are just as significant as learning and literacy in today’s classrooms. He suggests that when we play video games, we take on certain identities, just as when we are learning a new literacy. We can create the characters that we want in video games to fit our culture, appearance, and gender. Gee (2003) highlights 36 learning principles as effective tools that are “built into good video games,” and describes how identities are formed and work in learning in and outside of schools. He states: “Video games recruit identities and encourage identity work and reflection on identities in clear and powerful ways” (pp. 49, 51). This quote does not solicit everyone to start playing video games, but it does open up the argument that there is much to learn from the young people who play them.

When we play video games or interact in digital literacy practices, we rely on semiotic domains (study of signs) to help us understand how things take on meaning. These domains can refer to “images, sounds, gestures, movements, graphs, diagrams, equations, objects, even people like babies, midwives and mothers and not just words” (p. 17). According to Gee (2003), semiotic domains are identities that we create consciously and unconsciously in our embodied habitus (Bourdieu, 1990)—ones that can adjust, shift, and transform at any time. Examining semiotic domains as identities opens up the discussion of learning and literacy concerning video games as well as how identity changes within digital literacy practices at home. For example, we might explore how family members interact with video games that position them such that their identities, consciously or unconsciously, shift while playing the game or creating characters.

Gee’s (2003, 2009) work also highlights three forms of identities that are all constructed simultaneously: real, virtual, and projective. Real-world identity represents my real life identity as Tisha playing a computer game. In this identity, everything I am and embody is embedded into this role (an African American woman, wife, daughter, professor, digital literate composer/storyteller, photographer, visionary, etc.). Virtual identity acknowledges one’s identity as the virtual character that has been created by the player. For instance, Tisha/Super Mario is the virtual character I am playing; therefore every move, role, or appearance is generated by my choices. Projective identity takes on the role as both the player (real-world) and the character (virtual) within the game. Both identities (Tisha as Super Mario) exert feelings, strategic motives, and knowledge to fulfill the games’ end result—to win or accomplish the goal. These different kinds of identities that are constructed and produced in- and offline also carry with them a socialised effect on how video games are explored and the effect on the characters who play them.

Sophisticated video games, such as simulation games, bring with them more critical insight and strategic methods. Games like SimCity involve active, inactive, and critical learning principles with problem-solving techniques, role-playing domains of make-believe and imagined worlds/relationships that encourage youth to take on various identities in the hands of the player (Gee, 2003). To be an active learner one has to experience the world in new ways, create affinity groups with like-minded people, and use these elements to prepare for future learning. According to Gee, individuals in this space can “challenge players’ taken-for-granted perspectives on the world” (p. 140). The following sections examine relevant literature on this topic.

Adolescents, Video Games, Identities, and Digital Literacy Learning

Scholars have recognised that adolescents’ engagement in digital literacy practices strongly reflect and affect their affiliations and identities (Alvermann, 2001; Dezuanni, 2010; Gee, 2004; Merchant, 2010; Rogers & Winters, 2010). Chandler-Olcott & Mahar (2003) address adolescent girls’ use of digital technologies in their daily literacy practices, considering how the girls used these technologies for literate purposes in communities of practice, as well as the ways in which issues of identity and gender played a role in their practices and choices (Gee, 2004). They discovered that the social relationships developed online between school and home were more relevant to the girls’ increased proficiency when using the digital technologies. This study was significant in that it describes how Internet-based technologies motivated the girls to improve as designers, writers, and artists in their everyday lives.

In addition, Norton-Meier (2004) examined the ways in which adolescent girls created and negotiated rules for communicating and identifying themselves in innovative ways in chat room discussions about various aspects of popular culture; such as music, television, books, and games. As a result, the girls created a Female Technology User’s Bill of Rights which included “rights” such as: “I have the right to make meaning as I personally invent myself as a language user”; “I have the right to play with language, technology and what it means to be female”; and “I have the right to question gender issues, technology and the world around me” (pp. 606-608). These rights shed light on the ways in which these girls identified themselves as “females” and as “language user[s],” and questioned “gender issues” that related to them and their world as they interacted in these online communities. The girls created power, voice, choice, rules, and community to make meaning as females in a safe environment. In a 2005 article, Norton-Meier documented her own multiple roles in the home while playing video games with her husband and adolescent children. She stated that the mechanics of game playing with her family shifted the face of her family’s literacy, in which her roles shifted from being a video-game strategist to a designer and then a troubleshooter at various levels of game play.

Digital tools/literacies have an impact on individuals’ everyday lives, particularly in the ways in which they interact, play, communicate, and associate emotions. This discovery sparked my interest in exploring how identity, through the engagement with digital tools, sheds light on the ways in which individuals create meaning, develop, and make sense of themselves when involved in practices or activities of choice with digital texts and tools (Chandler-Olcott & Mahar, 2003; Gee, 2004).

Youth interpret meaning when playing computer/video games in multiple ways. They use choice to interpret movement, images, words, and symbols to suit their interests and goals. Several studies have shown the success of video game use in today’s classrooms for the purposes of tutoring struggling readers (Adams, 2009), for encouragement, and as a means to capitalise on students’ strengths (Simpson & Clem, 2008). Still other scholars have focused on individuals from particular communities and cultures’ gaming practices, identity formation (McGaughey-Summers & Summers, 2007; Pandey, Pandey, & Shreshtha, 2007), and the impact of video gamers’ literacy habits and development (Hawisher and Selfe, 2007). For instance, in Hawisher and Selfe’s (2007) longitudinal seven-year study of digital literacy practices, they examined over 350 adolescents and adult video gamers to understand how their “literacies acquired, practiced and valued within the digital environments of computer games” (p. 2).

Dezuanni’s (2010) case study illuminated connections between digital media and school curriculum through the Video Games Immersion Unit, which allowed teachers and media specialists to offer adolescents the experience to design and produce video games. Students not only played the games, but they reflected on ideological and critical influences and themes around games and gender, which in turn shifted their motivation for learning (Abrams, 2009), and explored how the use of learning and gaming made up part of adolescents’ cultural identities. Alvermann, Marshall, McLean, Huddleston, Joaquin, & Bishop (2012) dispute the notion that adolescents’ online literate identities are isolated at school by exploring five students’ use of various web resources (i.e., gaming, social networks, and remixing music) constructed their online identities. In fact, they found that none of the students’ online literate identities were isolated from their offline social networks; instead, it was through their use of multimodal tools that they were able to negotiate their online literate identities.

Methodology

As part of a larger ethnographic case study on an African American family’s digital literacy practices in an urban community, this research began at an after-school program where ten year-old Gerard attended my reading class. Gerard’s observations and questions about his digital literacy practices in and out of class verified his engagement with digital tools and his accessibility to those tools (Lewis, 2009). Based on those criteria, I gained approval from his mother to study the entire family with specific emphasis on Gerard and his mother’s individual and collective digital literacy practices in the home and how those practices were embedded within their literate lives. I theorised that an in-depth understanding of the digital literacies of one family would provide a unique and complex portrait of family literacy practices.

Data Sources

Data were collected for a year with more intense collection occurring between July and October 2007. Data collection involved three phases: descriptive, grounded, and participatory. In the descriptive phase, I described the activities in the home including thirty-minute interviews and weekly/semi-weekly observations with Gerard; through the qualitative ethnographic techniques of audio/video-recorded semi-structured, structured, and unstructured interviews, participant observations and field notes. Digital photos, a guided digital walk-through of their house, and documentation via texts and emails were also used to capture the family’s digital literacy practices over time. The grounded phase included more focused and grounded methods of ongoing analysis and included targeted interviews, dialogues with the family about the digital walks, and continued structured observations in the family setting. The participatory phase involved both the descriptive and grounded phases with more focused semi-structured and unstructured interviews, participant observations, and video- and audio recordings. These methods helped me to directly describe the activities in the home and communities that would generate more questions and reasons for further interviews and observations.

Reflexivity in Data Collection

During data collection, I took on an ongoing role in a researcher-informant relationship. Due to our rapport and my working relationship with participants as Gerard’s reading teacher, this relationship allowed for reciprocity between the researcher and researched (Lather, 1991) and granted me with greater access to yield rich data into their academic and personal lives, as well as become involved in the research process (Lewis, 2009, 2014). In addition, being an African American woman was a vital component to gaining access and it afforded me the opportunity to gather information and knowledge about the family. As Gerard’s mother shared she would not have allowed another researcher outside of her race to conduct the stories of their lives (Lewis, 2009).

Data Analysis

Data analysis involved multimodal discourse analysis (MMDA) (Kress & van Leeuwen, 2001; Scollon & Levine, 2004; van Leeuwen, 2008) to capture the multimodality of mediated actions and the multiple modes of spoken language that carry meaning (i.e., gestures, visuals, sounds, etc.) in the home and in the family’s interactions with one another. MMDA was used to capture how meaning was made, interpreted, distributed, and received through many representational and communicative modes (Kress & Jewitt, 2003). Analysis from data such as transcripts, field notes, codes, and audio and video recordings were categorised to locate themes and patterns to answer the research questions (Creswell, 1998; Merriam, 2001; Miles & Huberman, 1994).

I also used color-coding to reflect my research questions. Colors were assigned to each research question and inquiry, making it easy to identify and trace its relevancy to the study by underlining words or phrases closely related to the topic at hand from the original transcript. I color-coded instances in which these categories captured the interaction (Merriam, 2001). Using the color-coded categories alongside the transcripts, I looked for situations in which the family enacted digital literacies in the home. Coding assisted me in identifying notations to easily develop, assess, and modify as needed during the collection and analysis simultaneously (Merriam, 2001; Miles & Huberman, 1994). The following sections represent the findings.

Gerard and Jake: Designing, Negotiating, and Strategising a Sims 2 Character

Ten year-old Gerard is an avid digital literacy user. He would occasionally create digital comic strips, troubleshoot, and text and instant message with his mother. One activity he thoroughly enjoyed was playing The Sims 2, an online life simulation game. One day, while collecting data at Gerard’s house, I met his 10 year-old cousin, Jake. Together they leisurely engaged in the creation of The Sims 2 characters for several hours (Lewis, 2009). They created from scratch artificial life-forms, or A-life, with personalities, feelings, and emotions that developed over time. I refer to this process as dig-entities (or digital identities): individuals design identities that come to life when merged with on- and offline worlds. Through these characters, Gerard and Jake created fictitious worlds that imitated real life. Just as in real life, the Sims have several life stages of development. They can attend school, marry, engage in relationships, and even die. Gerard and Jake’s most commonly played life stage is the “adult” stage. Their purpose was to create an adult character’s lifestyle by obtaining employment, status, and building a home while maintaining friendships in the SimCity community.

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Figure 1. The Sims 2 characters

Sim characters are driven by their needs (i.e., sleep, social interaction, and hunger). Each Sim has a meter that appears on the screen that indicates its need for a specific thing by shifting from green (satisfied) to red (desperation, which requires immediate action). Often overlapping in dialogues, Gerard and Jake explained how they created and designed their fictitious character from scratch. Gerard explained that the game “starts out with nobody”: just diamond-shaped tops spinning in the middle of the screen that, through the actions of the player, transformed into a character.

Images

Verbal Interaction

Nonverbal Interaction

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1a. G: It starts out with nobody.

1b. G: It’s better when you create a story…. And then you can do this body morphing stuff.

1c. J: Okay gender.                    Click it again. Just click accept Sim.

1a. (Instrumental music plays throughout the interaction)

1a. (Blank screen is shown with a diamond-shaped top that spins and an animated white male figure appears)

1b. (Gerard and Jake keep their eyes on the television screen; both have remotes in their hands)

1b. (Animated white male figure appears on the screen, including a side profile of the figure)

1b. (Title options are shown on the left of the screen)

1c. (With remote in hand, Jake quickly clicks on the body morphing icons and chooses other icons to consider)

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2a. T: So how do you know what to do?

2b. G: Because Jake played this game before.

2c. T: So how do you know what kind of person he will be?

2d. J: You don’t. You make your own person…

2e. G: You just see how it looks.

2b. (Jake is quickly choosing various shirts and color of the animated male; holds the remote steadily in his hand; sits erect)

2c. (Jake goes through various items to change shirts; hits the shirt designs)

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3a. G: That looks kinda good just change the color.

3b. J: I’ll take that head in.

3c. G: Change the color.

3d. J: I’m going to change him. He needs to get some exercise.

3e. G: That looks…no that’s the knee. Go down. Go…now THOSE are the

muscles.

3f. J:  That’s better.

3g. G: No. All the way to there. All the way to there. Down…Down like that.

3a. (Gerard gets up and points to one of the icons showing Jake where to change the color. With the remote in his hand, Jake continues to change the image, the color and clothes of the animated figure)

3c. (Jake changes the color and does not like it so he changes it to another color)

3d. (Scans to the figure’s legs)

3e. (Jake scans to the upper part of the body. Jake scans to the lower part of the body)

3g. (Gerard gets up and points to the figure’s                                           legs on the screen)

(Gerard points his finger in a downward motion and sits down)

Figure 2. Gerard and Jake playing The Sims 2 video game

Gerard and Jake created a character named Jake, a white adult male who emerged onto the screen wearing a brown T-shirt, blue jeans, and a brunette rock star’s hairstyle. Jake’s lifestyle included real-life problems and relationships, and each took turns to collectively develop ideas, problem-solve, generate choices, and make changes to their character. Holding the remote control with his eyes focused on the screen, Gerard informed me of the “body morphing stuff” that players could use to create certain features for the character. They were excited about making sure their character had the appropriate style and look, which reflected clothing that the real-life Gerard and Jake would wear.

Both boys made strategic choices on which they agreed to create the characters. For instance, when I asked them how they knew what kind of character they would create, Jake mentioned, “You don’t [know]. You make your own person,” while Gerard shared, “You just see how it looks” (see Figure 2). Here, they made, created, and remade over again to construct and negotiate the identities they have in their minds. Unlike comic strips, in which the designer must create characters from scratch using a pencil to erase and restart again, creating online characters gave Gerard and Jake quicker and sharper choices and movements to choose from. They made quick overlapping verbal and nonverbal gestures and changes throughout this interaction, showing: (a) how comfortable they were with the remote control (i.e., shifting items to collaborate on the creation of characters); (b) how Jake made more visual changes (i.e., changing Jake’s clothes), while Gerard directed the designing with verbal commands (i.e., “All the way to there…. Down like that”); and (c) how both compromised and worked together to make those choices (i.e., one manipulating the remote control while the other provided instructions).

Indeed, Gerard and Jake took on mutual responsibilities while creating Jake. Jake made modally dense choices by quickly clicking the buttons or scanning the upper and lower parts of Jake’s body to choose his clothes, while Gerard watched. Gerard recognised how and where certain parts should be emphasised and sought to change the design by saying things like, “Change the color…Go down…All the way to there. Down….Down.” In this way, Gerard identified certain flaws in the character that, in his opinion, needed to be reshaped (lines 3d-3g). Instead of manipulating a character that was “ready to go,” Gerard and Jake created and produced their own character—one they had imagined together. This proactive way of playing and learning to make meaning through design was self-motivated, intrinsically compelling, and engaging for them that made transforming identities of their character Jake unique.

Gerard and Jake: Taking on and Transforming Identities

Gerard and Jake took on identities and transformed old ones to make their story unique and complex, but these identities also helped them make sense of their own lives. For instance, their design choices spoke to how their personal and fictitious character’s identities were constructed as they sat elbow to elbow while playing the video game (see Figure 2). Gerard and Jake taught me how they manipulated texts, images, and colors, and used these elements to create and understand meaning in their online exchanges.

Gerard and Jake’s conversations, social interactions, and cultural models (Gee, 2003) played a significant role in their construction of their identities and the development of characters. The more Gerard and Jake spoke about, positioned, and created their characters, the more the way they spoke to each another changed. For instance, they began to speak the language of gamers—more mechanical and critical, similar to the way individuals text while using cell phones (Drouin & Davis, 2009; Drouin, 2011)—in verbal and visual codes typically used by those who know the system of creating and playing video games (Driscoll, 2008; Ensslin, 2011; Lewis, 2009; 2011; 2013). What is important to note is how Gerard and Jake consciously produced these various modes in this exchange that changed their understandings of the game. Their movements, modes, and language were more intentional and positioned them to describe Jake and themselves in this practice.

As Gerard and Jake continued to create their character, Jake became deeply connected to the identity of Jake. He attempted to make Jake look similar to him, thus intersecting online and offline worlds.

Images

Verbal Interaction

Nonverbal Interaction

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1a. J: I’m blonde, so I’ll make him look like ME!

1b. T: You’re blonde? You want him to look just like you?

1c. J: Yeah, that’s what I’d like to do. I have to make him look like me.

1a. (Jakes quickly goes through multiple hair colors till he gets to the color blonde.)

1a. (Jake enlarges the screen showing the character in full length with the options on the left side.)

1a. (Jake shows the character from the waist down)

1c. (Jakes quickly goes through multiple hair colors till he gets to the color blonde. Gerard stands up and sits down throughout the interaction. He appears to be excited and anxious)

Figure 3. Jake changing Jake’s hair color

Jake’s comment, “I’m blonde so I’ll make him like ME!” (line 1a) is one example. Jake is a light skinned, African American boy with light brown hair, yet his comment suggested that he thought of and saw himself as a boy with blonde hair. At the same time, he moved away from his racial identity as an African American and chose to create and design the character using other perspectives and identities that made sense to him.

Interestingly, Jake made connections between his identity as an African American and Jake’s identity as a white blonde-haired man. His authority to customise Jake’s identity gave him the opportunity to explore the nuances of his own racial/ethnic construction. In fact, as I listened to Jake and Gerard and observed their interactions, I came to understand how video games with advanced programming and design have the propensity to complicate all racial and ethnic backgrounds and boundaries. As a result, video game playing may have an influence on children’s identity development (Brougere, 1999; Chen, Lien, Annetta, & Lu, 2010; Tynes, 2007). In fact, playing games such as The Sims and Avatars could allow African American children and adolescents to formulate images that strongly impact their personal and racial identities (Gee, 2003; Neville, Tynes, & Utsey, 2008). With this understanding, some children may not only question who they are, but who they hope to become (Tynes, 2007). This notion is especially true when negotiating identities vis-à-vis digital objects. While Gerard and Jake interacted with Jake to design and introduce their character to social relationships, Jake continued to shape and reshape his identity whenever he entered SimCity. Since Jake already had experiences living as an African American, perhaps it was necessary to move beyond the familiar to explore new identities and experience new ways of learning and looking at life; a phenomenon similar to Gee’s (2003) concept of critical learning wherein learners use “semiotic domains as design spaces” that manipulate us in certain ways and that we can manipulate in certain ways” (Gee, 2003, p. 43).

For example, when Gerard and Jake created and designed Jake, this activity allowed them to think, feel, act, and value learning in ways that recruited new identities, which emerged when the players took on the life of an artificial life-form. Formulating relationships with the character created tensions between the players through activities and practices similar to those that real-life individuals experience every day. The excerpt below, and highlighted in the beginning of this article, provides evidence of how constructing and recruiting identities were important to Gerard and Jake.

T:    So how does it feel when you both create your own identity…like, your own person?

J:          It’s feels FUN because you get to do what you want to do in the future

G:        Yeah!

J:          I can make an inventor like I’ve always wanted to be. (Sings Hallelujah)

In this excerpt along with the previous figures, Jake ‘talked himself into being.’ He saw this activity as an opportunity to choose to make Jake in the image that he desired. As Jake and Gerard collaborated during this practice, they demonstrated how they were able to collectively use the everyday knowledge of designing video game characters with peers to successfully play The Sims 2 together (Jewitt, 2003) and form projective identities (Gee, 2003).

Projective and Manipulated Identities

Making the character’s name one’s own (as Jake created Jake) is an example of what Gee (2003) calls, “projective identity,” or “projecting one’s values and desires onto the virtual character” (p. 55). For instance, Gerard and Jake created Jake, but Jake was the one who mastered the remote control during this interaction. The examples in Figures 2-3 and the excerpt both illustrate online relationships between the player and the character, where the player acted as or attempted to be the virtual character. Indeed, Jake took character design to another level by creating meaning and similar dig-entities (digital identities) between on- and offline worlds—between himself and Jake. Though both boys collaborated on the composition of Jake, both unconsciously and consciously, Jake created the kind of person he wanted to be—quite like an inventor (i.e., line 6).

While Jake actively maneuvered and managed the remote control, Gerard’s role as designer was not minimal; and, in fact, he acted as a reflector, co-creator, and co-constructor; actively identifying and making choices about the importance of the character’s features, and offering critiques of how he understood what and how Jake should be represented in the computer game. Together, Gerard and Jake relied on strategies such as teamwork, problem solving, and reflexivity to design Jake. Their design allowed them to emphasise the real and imagined relationships (as in figured worlds) between the player and the character to make meaning through verbal and nonverbal descriptions in a multimodal space.

During their observations, Gerard and Jake processed meanings made and remade by each other. They thought about which movements went first, what modes were used, as well as how to interact with one another and make use of the available resources. This pattern appeared when Gerard and Jake had to work across or translate between modes. For instance, their choice of movements were quick and purposeful shifting from gestures, linguistic interactions, and proximity to each other and the end result were displayed on the computer screen. Both boys relied on digital literacy practices that allowed them to construct complex digital spaces, maintain social networks, and experience personal achievement. In the process, they made sense of their on- and offline identities and became more digitally literate through their collaborative interactions. Gerard and Jake came into this practice one way and left with a creation of a character and traces of extended digital literacy practices that informed their literacy, learning, problem-solving skills, discourses, and fostered affiliations and identity roles in this digitally mediated space they created.

The main ideas in this study are situated in the ways Gerard and Jake became co-constructors of self. Jake, as a real-world identity vs. Jake, a virtual identity, took on projective meanings of learning, being, and making sense of themselves through the Sims 2 computer game. Jake practiced identity play in which he took on different identities and roles in different situations to construct himself as White by changing his hair to blonde, and in the ways he and Gerard situated themselves as designers. Gerard and Jake problem-solved ways to create their Sims character, manipulated the digital tools (i.e., remote controls), and produced and distributed information on-screen. Their communication skills were enhanced because they both found a communal affinity for creating and playing a Sims character. Through conversations and my observations with Gerard and Jake, I learned that their engagement with digital literacy practices via computer games mattered. I learned that these exchanges with this video game held meaning for their natural selves and greatly influenced the ways in which they created data as co-constructors to make meaning and collaborate through innovative discoveries in their local settings.

Discussion and Conclusions

This article sought to address how two African American male cousins co-created, negotiated, and co-constructed meaning when playing The Sims 2 computer video game at home. The following questions: (1) how did adolescents use an online computer game to construct their identities; and (2) how might these identity constructions and interactions extend their understandings of literacies, multimodality, and self acknowledged how their constructions of the Sims shed light on the ways in which literacies are fostered, multimodal meaning is explored, and how the boys see themselves as co-constructors of meaning.

Exploring digital literacy practices, video games, and identities in the digital age creates “participatory cultures” (Jenkins, 2006) for adolescents, in which they become active citizens in their online worlds. Sophisticated literacy practices and varying modes of meaning, choice, and identities flowed through Gerard and Jake’s creation of and enactment with their Sims 2 character Jake. However, through their engagement in their video game, they brought about interesting challenges to identity that teach us about video games, identity, and self.

Such an activity is extremely important. Not only did Gerard and Jake spend time communicating and creating new identities online, but they also allowed the digital tools of The Sims 2 video game to create affinity spaces within the context of family relations. They adopted various roles as gamer, designer, learner, and mentor that provided evidence of how digital literacy practices shaped their relational practices, and how those practices transformed the ways in which family members related to each other. Creating, designing, and playing videogames require creativity, knowledge, and multitasking skills, which Gerard and Jake both acquired. As children are natural creators, Craft (2001, 2010, 2013) states that children behave as creatively “possibility thinkers,” in which they generate “new realities, through asking ‘what if?’ and imagining ‘what if”” (Craft, 2013, p. 131). According to Craft (2013), adolescent children like Gerard and Jake become empowered through their engagement with digital media (i.e., video games) rather than seen as a risk. Craft draws on four key points of “changing childhood and youth inherent in the digital revolution” as “plurality of identities”, “possibility-awareness”, “playfulness of engagement”, and “participation” (p. 7). For this study, “playfulness of engagement” became a relevant feature in how Gerard and Jake use the online space that they inhabit to engage in make-believe spaces as if their engagements come from real life. According to Craft, individuals like Gerard and Jake become self-creators through gaming and generate content from their own learning.

Games are no longer constructed to be short and simple to play; rather, they are longer and challenge players in multiple ways (Gee, 2004). Gerard and Jake’s attitudes, skills, and practices vary significantly in the home and school settings. As such, digital technologies will continue to cultivate new practices and identities for children like Gerard and Jake to learn optimally as students learn to multitask and develop different skill sets for use in varying venues in this society.

Based on Gee’s (2003) 36 learning principles, I gravitated to and found principles, Identity #8, Multimodal #20, and Insider Principles #36, to be the most relevant throughout Gerard and Jake’s learning during the video game and of themselves. The Identity Principle positioned Gerard and Jake to constantly play with identities and make choices about how they created and manipulated artificial life from characters which told of objects that were meaningful and real to them, but also told how identity work and play were key mechanisms in how they engaged, co-constructed, and identified themselves. For instance, Gerard and Jake’s dig-entities (digital identities) of characters in The Sims 2 game revealed how producing and video gaming held meaning to their natural selves and personal influences. Understanding their literate identities in a digital environment meant understanding not just what they said or created but how they chained modes together in complex ways to design, negotiate, and identify.

In addition, the frameworks informed in this study focused on the Multimodal Principle that highlighted how meaning and knowledge were wrapped up in the modalities that were carried out in Gerard and Jake’s practice. Playing The Sims 2 gave Gerard and Jake the freedom to create a character using special effects, designs and colors. Their choices were made through a collaboration of sorts (e.g., Gerard telling and Jake doing). Jewitt (2006) reminds us that there is more to engaging in “multimodal computer applications” (p. 76) than written words and speech but that there are a range of resources that all work together. These modes communicate meaning to the reader. The nonverbal channels (e.g., gestures, proximity, and posture) carry meaning in social interactions (Norris, 2004) to create multilayered stories that provide us insight into their literate identities. These identities create an Insider Principle in which Gerard and Jake, became co-producers, co-constructors, negotiators, and problem solvers in this learning practice from the beginning to the end of the video game.

Considering “performance of identity in online spaces” (Thomas, 2007) is significant to acknowledge how, through Gerard and Jake’s multimodal co-construction of and with Jake, we are forced to unpack power, race, and digital ontologies of self when individuals choose to perform in online spaces and bring themselves and their characters into being.

Power. Issues of power dominate certain practices and relationships in the home and on local and global levels. Barton and Hamilton (2000) argue that “Literacy practices are patterned by social institutions and power relations, and some literacies are more dominant, visible and influential than others” (p. 8). Power is “produced and enacted in and through discourses, relationships, activities, spaces and times by people as they compete for access to control of resources, tools and identities” (Lewis, Enciso, & Moje, 2007, p. 17). Foucault (1984) describes power as “productive” when it is developed from interactions and relationships. However, as in most relationships, there is always one who is more dominant than the other—an imbalance of power that is maintained in various spaces. As power relationships develop and are embedded in everyday social practices, some are less visible and less supported. I chose to highlight how adolescents like Gerard and Jake want and need to provide power structures when co-constructing, negotiating, and creating in online spaces.

During their interactions, Gerard and Jake showed us discourses and participation with Jake, and the modes used revealed how their relationships have influenced digital literacies. We see how digital literacies have influenced and provided a new insight on today’s digitised families and their relationships, changing and challenging them over time. Jake appeared to enhance power structures when creating Jake by deciding to call their character’s name Jake when both of them were engaging in this activity. Saying, “I’m blonde so I’ll make him like ME!” also revealed that he took control of the identity of their character. Jake’s verbal and nonverbal control of commands via the remote control exemplified power through unspoken rules. However, Gerard guided and coached Jake through Jake’s transformation, which afforded apprenticeship models and negotiating skills, materialising new transformations and constructions of self. Issues of power are also linked to how individuals see themselves within fictitious online activities. Thomas (2007) states:

Children are learning skills of collaborative problem solving, technological literacy, and how to manage responsibilities of power. They are also learning to accept and understand themselves better as they experiment with elements of their own identities. Furthermore, they are learning to understand, tolerate, and live with a range of other people from diverse backgrounds: all desirable skills for their social futures” (p. 186).

Gerard’s and Jake’s narratives and actions serve as backdrops for how both boys acknowledged themselves as strong components in their roles of creating Jake, interpreting multimodal modes and codes; as well as in their roles and responsibilities of having and emphasising power. They reacted to their commands, were drawn to the character’s features, make up, and actions, and valued certain actions and outcomes over others, all while relating to one another in time and spatial contexts.

Race. This work also offers insight into how binaries are interpreted in digital literacy research that can create oppositions in how game creators and others view issues like race. Kirkland (2013) suggests, “it is important to understand race as an element of history not to be separated from the bound compartments of time to which is forever tied” (p. 117). However, there still lies a mask of how discussions of race are perceived via digital tools. In a popular video game blog, Good (n.d.) stated, “[I]n American games industry dominated, marketed to and consumed mostly by white males, discussions of race and class can quickly hit a wall, blocked by insistence that the subject is inappropriate for a pursuit that should be colorblind in basis.” The fact that the participants in this research are African Americans from urban communities is significant to how they construct meaning and process the digital in their worlds and others that look like them. It is also significant that the Internet, video games, and other digital tools work to “differentially screen users by race, ethnicity, and language use” (Nakamura, 2008, p. 33) even when African American youth ages 8-18 play 30 minutes more video games than Whites (Roberts, Foehr, & Rideout, 2005) and most of the characters feature young white males (Packwood, 2011). For instance, individuals have the choice to change and distort video game characters to different ethnicities and positions, yet very seldom do we have to explain such digital literacy practices when individuals are from the mainstream society. It is known that these digital literacy practices are mostly associated with these types of individuals rather than those of color. Therefore, what needs to be explored are the links between adolescents, identity formation, and gaming across contested spaces in the home, especially for adolescents of color.

Banks (2006) suggest that “we know almost nothing about the uses to which African Americans put digital technologies or the processes by which they develop the skills, abilities, and approaches that will enable them to use computers, the Internet, or any other related tool or process in culturally relevant, individually meaningful ways” (p. 68). Nakamura (2008) describes a lack of visual culture of computing among African Americans and Latinos. However, she adds that movies like The Matrix trilogies attempt to depict African American males as a driving force to computers and as sound members in cyberspace, reproducing white male privilege. Yet, she shares that in games such as Avatars, “black men are underrepresented as game designers” (p. 18).

Putting a label of color on families like Gerard’s and Jake’s makes their story significant, yet when I report on African American families’ digital literacy practices, it is difficult for some researchers and reviewers to understand that there still lies a post-discourse of the digital divide era of adolescents like Gerard and Jake, who have access to digital tools and are avid digital literacy users and strategists, but who are marginalised by their sophisticated digital literacy practices. Banks adds that Blacks who have agency online and have crossed the Digital Divide talk b(l)ack “to postmodern theories of race, to ideas about the role of technology in African American life, and to thoughts about how to address problems of systematically differentiated access” (p. 72). In addition, he notes that most individuals claim a Black identity—one overtly described in their usernames—on dating online services, chat rooms, or on African American-geared information/educational sites. Therefore, I identify how race is a necessary component to have when describing Gerard and Jakes’ participation with their Sims 2 character and themselves.

Digital Ontologies of Self. Throughout the themes in this study, an important meta-theme suggests the notion of ontology and what it means for adolescents “to be” their real and virtual selves. For Gerard and Jake, the ways they engaged online are the same as they are offline, as they describe who they are and how they understand their literacy practices and the choices they make. Through this, I argue for digital ontologies of self to highlight what it means “to be” when creating and engaging in digital literacy practices and our representations of ourselves. For instance, we all have notions of who and how we want to be when ideas, decisions, and images are formed in our minds. Having a digital ontology of self extends projective identities (Gee, 2003) in video games, but also adds to a fluidity that creates ways and practices that we then embody.

Gerard and Jake constructed themselves in ways that were comfortable for them and how they think. Their beings were involved in their co-construction and creation of Jake. As such, their gender, ethnicity, age, and multimodal choices all create their digital ontologies of self. For instance, when Jake emphatically describes himself in the beginning of this article and later follows with “Yeah, that’s what I like to do. I have to make him look like me,” suggests a dualistic immersion of himself in designing the character to look like him, as well as process through which he was becoming the character. Through this ontology, both of their identities were being shaped by and through the modes, choices, activities, and digital tools they co-constructed and produced. Turkle (1995) suggests “[Y]ou can be whoever you want to be. You can completely redefine yourself if you want…you can just be whoever you want” (p. 184). Her comments confirm how Gerard and Jake were able to co-construct their character but to play out their (Gerard and Jake) fantasies of Jake in each of their minds while negotiating the desires of what they each could be. In addition, Norton-Meier (2005) shares her own lessons learned from being a gamer:

The video game has a unique perspective in that the consumer (who is also the player and learner) becomes the producer of an ongoing story line much in the same way a reader does with a choose-your-own-adventure book. The video game has the potential to push an individual to learn and think cognitively, socially, and morally. Players actively create new virtual worlds; participate in complex decision making; and think reflectively about choices that were made, including the design of the game (p. 430).

Norton-Meier’s experience strongly relates to Gerard and Jake’s roles when creating, constructing, and negotiating the Sims character Jake. Interestingly, these concepts can also extend to classroom settings.

Implications

As students are learning about and growing up in the digital world, their ways of learning is new and different, making them “digital natives”. For teachers and teacher educators, new approaches and paradigms for teaching and learning in the 21st century are needed to make learning real, relevant, and fun for today’s students (Prensky, 2010). Thinking back to this research on Gerard and Jake, two digital natives, their at-home digital literacy practices of gaming revealed numerous ways in how they learned individually and collectively that can be brought into the classroom. While research has suggested that there are dichotomies in how video games are separate from school literacy practices, Gee (2003) states the opposite. There are shared literacy practices that are hidden and visible, but all are similar in that adolescents use them to construct their identities and understand their literacies, multimodalities, and selves. Therefore, it is important to acknowledge the use of digital tools that adolescents bring from home into the classroom. While this work highlights two African American adolescents, Gerard and Jake, and their practices while engaging in a video game, the practical implication is not to suggest that teachers and teacher educators must allow video games into the classroom. Rather, my aim is to acknowledge the skill sets and learning principles that students develop from these practices, and to extend this topic to larger frameworks on literacy learning.

Videogame Literate Practices School Literate Practices

Identities

Agency

Critical Thinking

Communication Skills

Processing

Problem Solving

Reflexivity

Develop Ideas

Generate Choices

Introduce Strategies

Collaboration

Make Changes

Apprenticeships

Sequencing

Interpretations

Engagement

Affinity Spaces

Experience Academic and Personal Achievement

Figure 4. Videogame and School-based Literacy Practices

Figure 4 reveals similar practices for literate learners in schools and within the digital world. These skills suggest that there may be something missing in how we get students to learn in this era. If we consider teachers and teacher educators’ own literate histories, they need to remember that literacy practices come in all shapes and sizes, ethnicities, and behaviours. First, teachers and teacher educators should remember their schooled experiences and the difficulties of learning in their particular school environments and cultures. It is also relevant to remember the make-believe characters who informed their literate histories of who they were while growing as students, and who they were as conduits of learning across a generation of potential scholars. Within this vein, we should shift to thinking about the ways in which today’s adolescents navigate and attempt to understand the many fun, exciting, yet distracting elements of the digital world that relate to their literate selves. Think of the countless times today’s adolescent identities of who they are, how they relate, and how they are perceived and socialised on websites, texts, and artefacts shift their thinking and epistemologies.

Second, teachers should welcome parts of adolescents’ selves that make them who they are that inform and transform their practices in and out of schools. Assignments that build on and acknowledge their ethnicities and multimodal modes—assignments like multimodal literacy autobiographies and digital stories—allow them the space to be active creators of who they embody in their world, and can make for better and more effective learners and literate beings.

Third, teachers and teacher educators need to remember that artefacts carry modes that adolescents create, negotiate, and produce, and that they should allow students to maintain and keep an artefactual journal in which to write, type, or produce multimodal assignments to capture objects that they like and that relate to both the skill sets in the classroom and in their literate selves. It is a real concern if teachers and teacher educators do not know what to do with adolescents like Gerard and Jake in their classrooms. As described by Woodcock (2010),

“[W]hen teachers focus on how students think and feel what their purposes and values are, what rules might govern their literacy practices, and how those practices may be hindered by school, teachers close the negative gaps between students’ everyday literacies and their school literacies, whether we are talking about the body or any other element” (p. 379).

While Gerard and Jake played The Sims 2 all night in Gerard’s home, their special engagement and environment brought about a different kind of learning that is often missed in schools. Shifting the environment from the four walls of school learning to the world in which they live will create different learning structures that extend beyond their natural selves. Gerard and Jake became “digital connoisseurs” (Katz, 2005) who, through their relationships, created and produced a life art form or artifact through power structures, modal choices, and complex and different ontologies of self to learn about themselves and others and to gain cultural capital (Bourdieu, 1990).

Gerard and Jake’s digital literacy practices exemplify the ways most adolescents co-construct, negotiate, and create meaning through video games while formulating digital ontologies of self within their online spaces. Their experiences extend through the construction and production of texts while illuminating the ways in which power, race, and identifiable notions of self are developed in real and online virtualities. This research explored how Gerard and Jake infused their online fantasies with real life desires that are common with adolescents in today’s societies.

Games such as The Sims 2 allow Gerard and Jake to be active problem solvers, to create and re-create meaning while recruiting identities in a way that could be equally relevant in schools. As video games become more sophisticated and demand more attention, it is vital for schools to capitalise on these media to enhance learning. My findings suggest that Gerard and Jake made meaning of the text in visually compelling ways through verbal narratives and pictorial images that represent how designers like themselves create multilayered stories and multiple literate identities. In addition, my findings indicate how creating online Sims forced the boys to make sense of and reconstruct their online and offline identities in the home.

This work also reinforces and concludes how literacies and social practices are often embedded in multimodality, construed, and then redirected to include new ways of exploring literacy learning—and they do so with the most mundane objects, such as video games. I add to the “funds of knowledge” (Moll, Amanti, Neff, & Gonzalez, 1992) theory by suggesting that the ways teachers learn and understand those funds is to closely examine artifacts and the culturally constructed personal narratives that surround them. In this way, we challenge educators to consider the everyday, normal, fluid literacies, the variety of modes, and the artifacts that expand learning for all students. Educators need to implement a perspective that takes material culture from everyday life into today’s classroom to inform students’ teaching and learning in ways that apply meaning to their everyday lives.

In an effort to learn more about the at-home literacies that our students bring into the classroom, it would be relevant to translate and/or connect these literacy practices into academic settings. There are resources out there that acknowledge out of school digital literacy practices, in particular around students and families of color, as real, intentional, and sophisticated that can help build tangible bridges to generalise that knowledge to academic settings.

Notes

i Computer and video games will be used interchangeably.

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Biographical Statement

Tisha Lewis Ellison, PhD, is an Assistant Professor in Language and Literacy Education at Georgia State University. Her research explores the intersections among family literacy, digital literacies, and multimodalities. She takes a critical perspective on how agency, identity, and power among African American families are constructed as they use digital tools to make sense of their lives. She was the 2012 recipient of the NCTE Promising Researcher Award, a finalist of the 2011 IRA Outstanding Dissertation Award, and a former fellow of the NCTE Research Foundation’s Cultivating New Voices among Scholars of Color Program. Her work has appeared in the Reading Research Quarterly, Journal of Adolescent and Adult Literacy, Literacy Research Association Yearbook, and Journal of E-Learning and Digital Media.

Contact: lewis.phd@gmail.com

Robert Nelson & Phillip Dawson

Published Online: December 15, 2014
Full Text: HTML, PDF

Abstract: Conversation and reading are regarded as essential ingredients of any discursive discipline.  However, though clearly central to learning and integral to study, conversation and reading are anything but essential in the sense of absolute, unchanging and eternal.  Our article reveals how both conversation and reading mutate and develop historically, serving intuitions of the learner’s autonomy and interactivity, which also evolve.  This backdrop of change contextualizes speculations about the impact of digital technology upon conversation and reading.  Our own invention of a conversation simulator (or conversation sim) reveals that conversation and reading can be integrated in any Learning Management System (LMS).  Pointing to a new educational genre, this method for virtual learning demonstrates how automated educational technologies contribute to the ongoing reinvention of reading and conversation:  thoughtful absorption in a text and verbal interactivity over a topic.

Keywords: History of reading, history of conversation, LMS, learning management system, assessment as learning, history of ideas, automated assessment, quiz

Introduction

Reading and conversation sit in a reciprocal relationship:  reading is a one-way process which ideally immerses the reader in the thought of the writer, while conversation is a two-way affair in which the participation of one interlocutor conditions the intervention of the other.  But for all their differences, the beguiling quality of both is that they have some magical quality of one another.  The absorption sought in immersive reading has shades of a conversation, where the mind of the reader engages with the thought of the writer as if there were potential for conversation.  And meanwhile, a good conversation that is headed somewhere has an informational structure and is not merely a chaotic string of reactions but a kind of text jointly constructed by the conversationalists, a little bit like collaborative writing, where the two participants ‘read’ one another’s intentions.

That would be ideal; but history suggests that neither conversation nor reading has grown with the inflexion of one another’s virtue.  Quite the contrary:  they have grown separately, united only by being set against a somewhat tense backdrop of authority.  The reason we want to begin—though hardly complete—the historicizing of conversation and reading is that we have invented a way of bringing them together with a learning technology.  We call it a conversation simulator or conversation sim, by which elaborate content can be presented not as a simple reading but a participatory cycle of proposal and feedback which rather characterizes conversation.  In this article, therefore, we first outline the historical basis for believing that conversation and reading have not been the constants of culture that we might assume; second, we provide an outline of the scholarly approaches to reading and conversation in the context of the digital age; third, we introduce and explain the conversation sim, demonstrating some of its capacities for bringing reading and conversation together; and finally, we conclude with the hope that new technologies, annihilating neither conversation nor reading, might visit the genius of one with some vivacious inflexion of the other.

Historicizing reading

Reading has always been a fragile activity, cultivated best by people with much leisure in epochs of humanist privilege.  Reading has often been constructed around pleasure, which dominates our consciousness for good reasons, as in Alberto Manguel’s (1998) eccentric and grainy History of Reading.  As seductive as reading is for us, it sits somewhat precariously between authority and intimacy and, in earlier times, it was situated very much on the side of authority.  In the days when reading was largely confined to clerics and nobility, reading was positioned close to the tablets of the law.  It is almost synonymous with obedience, in the same way that the very word obedience is about listening, as revealed by its Latin etymology (ob+audire, to hear; cf. the same motif in Greek, υπακούω).

In the Old Testament, reading is often public and directly linked to obedience (Exodus 24.7, Deuteronomy, 31.10–12, Joshua, 8.34–35).  It respects the absolute observance of the statutes as a fearful form of ascetic practice:  ‘he shall read therein all the days of his life: that he may learn to fear the Lord his God, to keep all the words of this law and these statutes, to do them, neither to deviate left nor right’ (Deuteronomy, 17.18–20).  Reading is not only public but demonstrative:  there is repeated use of the phrase of ‘to read in their ears’, as if drumming the covenant into the head (2 Kings, 23.2, again 2 Chronicles, 32.18, 34.30, Jeremiah, 36.6, 10, 13, 15 and 21); and elsewhere the ears are attentive (Nehemiah 8.2–3, 8.8).  Reading is performed standing up and it takes a quarter of a day (Nehemiah 9.3).  The reading may be for skilled people but the listening is identical for people of all classes, from prince to the lowest (Baruch 1.3–4).  To be ‘priest and reader of the law of the Lord’ is an epithet given to those who ‘read in the broad court before the holy porch from morning unto midday, before both men and women; and the multitude gave heed unto the law’ (Esdras 8.41; cf. ibid. 8.8, 9, 19, 39, 42).

This discipline of reading equates with a dedication to God, because the immutable tablets belong to him; and we feel that some vestige of this holy trust remains in reading practice, where we expect the reading to put us in contact with the wisdom that we lack, often of a pre-emptive kind:  we can learn either for profit or to forestall what will otherwise harm us.  Reading as the study of fate is expressed by Shakespeare’s metaphoric language, where reading is already a kind of prophetic dream—sublime and impossible—as Hotspur articulates:  ‘therein should we read The very bottom and the soul of hope, The very list, the very utmost bound Of all our fortunes’, 1 Henry IV 4.1.49).

In Hebraic tradition, much jockeying and arguing would have occurred over claims to knowledge, which was rooted in book-learning.  Like today, people of learning transact their authority on a somewhat competitive basis, proving that others have either not read or have forgotten what they have read.  Jesus uses this line frequently:  ‘have ye not read in the law’? (Matthew 12.3–5, 21.16, 42, 22.31, Mark 2.25).  Reading is therefore not without anxiety; and a further cause to worry is that one might read but not understand, which is why one says:  ‘whoso readeth, let him understand’ (‘ο αναγινωσκων νοιετω, Matthew 24.15, Mark 13.14), echoed in Petrarch’s line suggesting that not every person who reads understands (ogni uom che legge non s’ intende, 105.46).

In ancient Greek, the verbs for understanding (or recognizing) and reading are cognate, only a preposition apart:  ‘Understandest thou (γινωσκεις) what thou readest?’ (αναγινωσκεις; Acts 8.28–30).  Paul also obtains strong emphasis from the near duplication of verbs: what you read (αναγινωσκετε) or what you acknowledge (επιγινωσκετε, 2 Corinthians 1.13).  It is almost like a contract, where an offer is chased by consideration.  Thus, through the same language, the text is assimilated within people themselves:  ‘Ye are our epistle written in our hearts, known and read of all men’ (γινωσκομενη και αναγινωσκομενη, 2 Corinthians 3.2).

This metaphorical suggestion that you can read someone’s heart furnished the early renaissance with the idea that inner emotion can be read on the outside, as in Petrarch’s sonnet declaring that you can read on the outside how much he flares up inside (di fuor si legge com’ io dentro avampi, 35.5–8).  Elsewhere, you can read the depths of the heart upon the face (del cor profondo ne la fronte legge, 147.6; cf. 222.12).  Not surprisingly, given that the soul itself reads as well as sees, hears, speaks, writes and thinks of so many different things (204.1–2).

By the end of the renaissance, reading acquires a subjectivity which allows it to become a metaphor; but even as a metaphor, ‘reading’ really only means detection, a motif that centres on honesty.  Luciana thinks that dissimulation is logical if you are going to be dishonest.  So if you sleep around and ‘truant with your bed’, your transgression should not show up in your face:  do not ‘let her read it in thy looks at board’ (Shakespeare, Comedy of errors 3.2.18).  What one reads in a face is likely to be suspicious, as Buckingham says: ‘I read in ’s looks matter against me, and his eye revil’d me as his abject object’ (Henry VIII 1.1.125).  Accordingly, you may want to conceal your feelings and not be read, as in Luciana’s line: ‘Let not my sister read it in your eye’ (Comedy of errors 3.2.9).

It is as if reading moves from the institutional to the metaphorical without an intervening moment of intimacy; there seems no place for what we love in reading, where the transaction with a remote voice seeps through the mind of the reading subject.  As readers, we agree to activate the voice in the text.  It is we who bring the voice to life, whereas even Shakespeare’s ambitious usage suggests rather a process of divination, a form of scrutiny that yields information, an analytical faculty, which is maintained to the present time, as when spectators claim to be able to read artworks.  In such examples, as in the baroque, reading is understood as an act of penetration by the reader:  the reader penetrates the text (or the person by analogy to the text).  It is the reverse of my sensation of the text penetrating me when I let the ideas enjoy their freedom in my imagination.  These meanings remain to be explored in the industrial period in which the contemporary practice of intimate reading evolved.  The history of this development would make another project; and it must suffice at this stage to conclude that reading, even in glamorously imaginative periods, did not entail the rhapsodic engagement that we nowadays associate with this key intellectual activity.

Conversation

Analogous observations can be made of conversation.  There are curious paradoxes in the respective histories of reading and conversation.  Given that spoken language antedates written language by an unthinkable interval, we might expect that conversation has a much longer history.  But it is by no means self-evident.  People talk in ancient texts, sure enough, but do not refer to their talking as conversation.  It does not arrive at consciousness by that name, which suggests that it may not have been practiced in the same way as it is today.

One often imagines that the Platonic dialogues are a form of conversation, which in one sense they clearly are; but they belong to a genre of philosophical inquiry and testing which is more of a discipline than a conversation.  As in Buddhist pedagogical cultures, the master puts the student through his or her paces.  It is a common mistake to imagine that the word dialogue refers to two people speaking (hence the term monologue or the neologism ‘polylogue’ to pluralize the polarity of dialogue, as in Wikipedia, sv., or the French page polylogue.org).  But dialogue derives from the preposition for through (δια -), which has nothing to do with two (δυο).  The concept does not involve numbers.  A dialogue can be held by one person, a bit as with the English word discourse or discussion.  Despite efforts to distinguish these concepts on the basis of their criticality (Brookfield, 1999, ch. 1) in many ways the conversational stands out because of its organicity.

Historically, however, it was not always so hospitable to flux and banter.  Like reading, conversation—once it is remarked upon as something other than talking (like the Greek ‘ομιλία)—is also somewhat institutional.  Conversation does not always or immediately mean the gorgeous interchange that we think of, akin to leisure and ideally centred over coffee.  In the renaissance, conversation also means something more like social intercourse, people frequenting one another’s ambience and making up their company.  The word can sometimes even be translated as company, consorting with or having contact or even dealings.  So in a letter introducing one of his stories, Bandello notes that Augustus Caesar was constrained to confine his daughter and neice within certain places and to ‘prohibit their contact (conversazion) with men’ (1.36).

In the next story, Bandello speaks of a sick person with an abominable and horrible contagious disease, contact with whom (la cui conversazione), the whole world abhors and flees (1.37).  This form of meeting is spurned for clinical reasons, not because the person is so boring that you would run a mile.  And in the story after that, a character says that in eight days he would have a clear opinion of the future ‘if I bring myself to mingle with them (conversar con loro) or spy on what they do and the regions that they pass through and the churches where they go’ (1.38).  In all of these cases, the word can still be satisfactorily translated by our ‘conversation’; but the meaning is not as intimate as in our epoch.

Throughout the renaissance, the idea of conversation might better be translated as socializing.  No one in the renaissance would ever say:  in our conversation, you said…  One does not say ‘in conversation’—as Nietzsche would say (im Gespräche, Jenseits 266 and 333)—as if conversation is a vessel with contents.  From the outset in the fourteenth century, conversation is a practice rather than a live text where things are said and remembered.  Conversation wants to be decent (conversar honesto, Petrarch 354.10) which is also a reflection on the calibre of the participants.  It can be very suave (Bandello 1.15) or mirthful and pleasurable (gioconda e piacevole. 1.24).  And just so, in a letter to signor Ettor Fregoso, conversation is described as yielding delightful and joyful recreation (lieto e gioioso diporto), with witty and pleasurable speaking (parlari piacevoli e faceti 2.48).  But even so, the meaning is often associated with the act of being in a certain company, and is sometimes coupled with ‘frequenting’, as in the comely garden of Girolamo Archinto in the Brera region where a fine company of gentle spirits had assembled for discussions (ragionamenti) and Bandello praises the conversation of  ‘a young man of excellent letters whose conversazione delights and is desired the more one frequents it (piú è frequentata, 1.54).

Of all writers, Bandello the priest was also in a good position to criticize certain holy men and their conversations with nuns:

speaking all day long and conversing with the nuns, they take on a domestic familiarity with them; and for this reason sometimes the conversation which ought to be totally spiritual becomes carnal and turns into the ‘resurrection of the flesh’.  3.61

By Bandello’s day, conversation had already been defined as a key element to be managed skillfully in courtly practice.  For example, Francesco Guicciardini declares that he does not want to exclude people from common discussion and from conversing together with charming and lovely domesticity (conversare insieme con grata e amorevole dimestichezza, Ricordi 184); and so too in Baldassar Castiglione, the themes of conversation and familiarity are linked (Cortegiano 1.3), though again, this urbane author insists on the efficacy and delightfulness of conversation (1.14 and 2.7) as a sine qua non of the courtier (2.17, 2.18), some of which has to do with speaking to people of unequal rank (2.25).  But true to the pattern noted, one talks about conversation rather than talking within a conversation (2.31).

Similar observations can be made through the writings of Montaigne (‘if his conversation importunes you’, Essais 3.3), where the French mirrors the Italian usage in a transactional or operational emphasis.  And so, for that matter, does Shakespeare’s English: ‘your converse and business’ (Othello 3.1.40).  Space does not allow us to scour the whole of baroque literature, much less what followed; but it seems that throughout the ancien régime there is nothing which describes that organic incubator of content which we think of today, and which may have been expressed by Nietzsche when he says of two interlocutors: one seeks the midwife for his thoughts (Geburtshelfer für seine Gedanken) and the other seeks someone whom he can help; thus a good conversation arises (136).

It is not surprising that somewhat patchy traces of conversation are to be found in pre-industrial literature, given that western culture has long been devoted to defining and clarifying; and conversation is organically mobile, inventively self-cued and  resists definition or clarity.  But like the richness of reading, the endless pregnancy of conversation can be contemplated through attempts to replicate or simulate it.

Reading as early technology of learning

The written word was one of the first educational technologies, and it is changing.  Reading, which has remained much the same activity for as long as there were books, has also evolved, not just in the volume of participation but the headspace that it supports.  Though existing for millennia, books became more accessible in the renaissance with the invention of printing; then reading was greatly cultivated with Protestantism, where it would no longer be confined to a humanist elite but seemed integral to a pious life.  Reading received further emphasis in the industrial period, where it was linked to key competencies, a tool essential for many occupations, especially with the rise of technology and tertiary industries.  Consequently, to be illiterate is a terrible problem, because essential intelligence cannot be transacted without reading and writing.

If we are to move toward a critical scholarship of educational technology, there is a need for an examination of the histories and contexts in which technologies are used (Selwyn, 2010), and reading as a learning activity should not be exempt from this analysis.  Although reading may be considered the most banal of educational technologies, in various disembodied forms, reading has also become a key to global youth culture on the Internet.  It is a paradox, because the viral growth of chat (instantaneous communication by reading and writing) arises with a suspected decline of immersive reading (Buzzetto-More et al., 2007; Piscioneri and Hlavac, 2012), which is the absorption of delicate narratives that form the basis of the humanities.  We must also accept that our students may experience or conceptualize reading differently to us (Weller, 2010), and may be strategic in their close reading choices which a clever LMS design might be able to influence (Adlington and Wright, 2012).

So with the simultaneous resistance to reading and its exponential spread into personal interaction, we are both charmed and alarmed.  Historically, reading and other forms of communication have neither been in a direct nor a reciprocal relation.  The growth of printed books did not discourage face-to-face education.  Few lecturers in any epoch had cause for concern that the availability of books—many of which might be more learned and succinct than a lecture—would have a corrosive effect on the classroom.  The very word lecturer means reader, whence the two words may be put together in a somewhat monitory or instructional sense (Shakespeare, ‘I have heard him read many lectures against it’, As you like it 3.2.365; ‘read no other lectures to her’, Taming of the shrew 1.2.148; ‘we read lectures to you’, Coriolanus 2.3.243; ‘To read a lecture of them?’ Richard II 4.1.232,); and shortly after Gutenberg, it might have appeared that the lecturer would become redundant, given that the contents of a lecture could often be absorbed more economically by means of print media.  But over the centuries, the lecture theatre has lost little of its prestige and has remained the key spatial motif of humanities education, even though as a mode of dissemination it seems to lag technological progress by a half millennium (albeit supplemented with slide-shows), requiring people to huddle in a place and time of the university’s choosing, at considerable personal and environmental inconvenience.

Lectures

Lectures have the allure of the performative.  The reason for their obdurate appeal against so much technology might have to do with the witty and enchanting way in which knowledge and thinking are activated and dramatized in real time by the lecturer.  You do not know, as you do with a text, that the next words have been adequately formulated.  Thoughts lie somewhat in the balance, and the audience enjoys a kind of thrill in apprehending the lecturer’s rapid ratiocination in delivering what may have been planned optimally but not yet scripted.  The audience thus witnesses the lecturer actively rehearsing thought, going through a tense but pleasurable cognitive process and hence demonstrating its energy and joy.  It might also be argued that vivacious lectures delivered by means of videos embedded in an LMS (learning management system) invite a similar performative engagement with the viewer.

Learning Management Systems

While the lectern is still tenanted by charismatic scholars, a revolution has occurred around them in the advent of the LMS. Lecture-content can now be deposited in one form or another, tutorial-content disseminated, readings given out, discussion-forums held, small work-groups convened and even certain types of test administered.  The uptake of these packages has been swift and few university courses are without their support.

With a pessimism towards educational technology recently justified by Selwyn (2011) we entered the Learning Management System as skeptics, believing that these systems could do little but dump a sclerotic version of performative and organic intellectual content, whose dead electronic hand would serve, at best, to highlight the vivacity of the live presentation.  The lecture that has already been given and is recorded in televisual lock-off is tedious, dead, like cold coffee, able to match neither the adrenaline surge of a lecture in real-time nor the crafty surprises engineered in the mis en scène of film and television.

With the ‘trojan mouse’  (Brown, Paewai  & Suddaby, 2010) of an institutional migration to a new LMS, we have been prompted to revise and reconceptualize pedagogy, because the LMS offers new insights into reading and conversation.  Our approach has concentrated on the overlap between reading and conversation and is structured around student-computer relations rather than student-teacher relations or student-student relations; because student-teacher and student-student forms of conversation are the least like reading.  Like other scholars who recognize that ‘texts produced in association with digital technologies are hybrid, fluid and multimodal’ (Lea & Jones, 2011, p. 380) we see the transformative potential of a new genre of writing and an experience of reading that paradoxically clinches the very elements of reading that are most vulnerable in the electronic age.  However, the virtues of the LMS would not have arisen in our imaginations had we not first been suitably pessimistic, à la Selwyn, about the greater potential for digital mortification.

The LMS presents an opportunity to build a community, for students to talk to one another and for us as lecturers to participate in discussions.  Although clearly good and Socratic, from the moment it became available, this facility also brought difficulties with it, some of which only exaggerate structural difficulties before the LMS.  Discussion forums are useful but, in structural terms, we are only using the computer as a kind of accelerated post-office.  For the individual academic, the arrangement augments the already overburdened inbox with prolific chatter that self-generates on a level that is difficult to influence.  Either you allow much dubious content to self-propagate or you constantly have to intervene, like a paranoiac constable, monitoring discussions that are either wide of the mark or out of hand or boring with florid platitudes, inducing a depressing effect on bright students who are alarmed at the communicative promiscuity of mediocre students (at least in their view).  Large enrolment courses frequently see thousands of discussion posts expressing a mess of confusion and repetition.

In a tutorial, a slower student who is about to bore the speedy students can be thanked, with the case summarized to its benefit, so that a high standard of conversation is maintained.  Feedback can be provided quickly, tactfully, and in a manner that directs learning toward the intended outcomes. Asynchronous discussion tools coupled with mountainous workloads diminish the ability to intervene as a person writes, and as a result this proactive diplomacy of the tutor is difficult to achieve.  The indisposition is like the problem of having either too little discussion (which makes any electronic lecturer anxious) or too much.  A good tutor in a classroom can handle either situation by means of encouragement and the creative use of pauses or much smiling, or alternatively—when everyone wants to speak at once—a loud voice that says:  ‘please, let’s hear what Jessica is saying’.  However, a counterpart to the live language of blandishments, appeals and calls to order is challenging, albeit not impossible in the electronic classroom (Salmon, 2006).

Electronic conversation has to be handled tactfully, because digital communication chaotically exaggerates signs of impatience or sarcasm, and indelicate phrases can rapidly escalate to rudeness (Lu, 2010; Bordia, 1997).  The result is a horrific burden—as Shakespeare would say, ‘of a most facinerious spirit’—the like of which has never descended on academics in the history of the university.

To escape from this threat, we wanted to create our own conversations, which in a sense we have always sought when we aspire to be an engaging writer, where we trust that our train of thought follows the spirit of a conversation, with one idea coming up behind another, a bit like the gentle rhythms of a conversation (‘the converse of breath’, as Shakespeare says, Loves labours lost 5.2.745).  A vivacious text always presents an inflected voice; so in a sense it already simulates aspects of the conversational.  But now—and this is our theory—we can do better in creating a form of text that simulates conversation.  The computer will allow the reader (let us say our students) to take part in the flow of ideas, not by adding material but by choosing from various options.  We think of this as a conversation sim.  It simulates some of the more decisive conditions of taking part in a conversation (Nelson & Dawson 2012).

Conversation simulation

Using the multiple choice quiz tool of any LMS, it is possible to construct a conversation that presents a sequence of statements. We might begin with an unanswered problem or a proclamation that represents some embarrassment, of which ethere are thousands of in cultural subjects, and which any tutor is likely to float at the beginning of a class.  The tutor waits for an answer; but frequently either none is forthcoming or an errant response is given; so the tutor then manipulates the group to get the desired elements of a good answer.  So in the conversation sim, the computer then proposes a rough answer to the question.  As in the tute room, it might be very shrewd or somewhat naive.  The next step is for the student to decide:  is it a good answer, a poor answer or perhaps a good answer and perhaps not.  Receiving the student’s verdict, the computer then returns feedback on whether the student’s decision seems prudent or otherwise and gives reasons.  Essentially, the conversation sim takes this structure:

Screen Shot 2014-12-14 at 01.37.41

See Figure 1 below for an example graphical representation, using an MCQ plugin on Wordpress; this is available live at http://conversationsim.org

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Figure 1. A conversation sim running on Wordpress.

There are four voices in the conversation.  An example is the following from a senior unit dealing with research ethics.  The title for the lesson is ‘Beyond ethics as drill’.  It begins by stating a problem in the voice of a somewhat confused and worried person, implicitly a researcher who has no time to read the university’s compendious Doctoral Handbook or refer to the Research Integrity Policy every time a decision has to be made about a candidature:

I’m a bit worried that research is a field in which we’re harangued by rule-keepers and process-police.  Not that I’m an anarchist, but can you point me to some principles, so that I don’t need to be indoctrinated and then monitored forevermore in an uneasy relationship with dogmatic regulations that I’m sure to forget?

The question is fair and somewhat necessary, and not necessarily overstated.  In spite of the wayward and slightly grumpy voice, it has a degree of credibility, suggesting that learning rules by rote is not sustainable and hence seeking broad principles instead that underlie the rules.  No response is required of the student at this stage, because another voice contributes a proposal.  In a patient and supportive conversational acknowledgement of the problem, it says:

That’s a very good question.  It would be better if we didn’t have to observe rules but rather possessed a sense of fairness which would obviate the grand regulatory preoccupations and make the several committees redundant.

At this point, the student has to decide if this response deserves a ‘yes’, a ‘no’ or a ‘maybe’ or alternatively ‘agree’, ‘disagree’ or ‘partly agree and partly disagree’.  As soon as one of these options has been selected, the computer returns feedback, carefully inflected according to the choice that the student made.  In all cases, it suggests that probably the prudent answer would be ‘maybe’.  It goes on:

In principle, perhaps; but the problem is that the sense of fairness that you invoke is somewhat open to disparate interpretations.  Sometimes, we don’t see that our behaviour is unfair.  And sometimes, ideas of fairness—however we scrutinize them—differ sharply among researchers, and not necessarily because of our respective private interests.  So we prefer to think of a common process to negotiate and socialize what is fair in each circumstance.

A quality of all good conversations in cultural subjects is that (a) they are open ended, (b) they invite plural perspectives and (c) they handle doubt.  As Nietzsche says, ‘in conversation, assigning right or wrong to either interlocutor is more a thing of familiarity (Angewöhnung):  the one like the other has sense’ (Jenseits von Gut und Böse 334).  So the computer repeats the initial problem and presents the student with another response, which is quite different to the first:

The core principle is that no one should get hurt by our research.  It’s not a lot to ask.  The rules, as you contemptuously describe the delicate network of consideration, are about protecting people from harm.

Once again, the student has to decide if this response deserves a ‘yes’, a ‘no’ or a ‘maybe’.  The feedback is also coy about agreeing with the student if he or she gives assent to the response.  Again, speaking in the first person, the computer argues for a ‘maybe’.

I guess at a pinch you could call it a core principle; but there’s a prior value, namely that our research should do good:  it should be to the advantage of humanity and other living creatures or valuable planetary systems.

It does not clarify everything.  A conversation seldom does.  It does not go on to explain that avoiding harm is only a small part of doing good, or that sometimes you can do a great deal of good while enduring a teensy bit of harm.  Conversations are organic and inventively cue themselves by the last thing that has been said.  They take up directions because something has just been uttered which triggers an imaginative response and calls for a further argument or a different theme to be introduced.  So in our example, the next encounter takes up where the last left off, as if remembering the point from the computer’s feedback.  So once again, the initial problem is rehearsed and another response is given again:

An equally strong principle is that the world should benefit by our research.  It comes to the fore especially when our work handles people with fewer privileges than we have.  Our research benefits us but it doesn’t necessarily benefit our subjects.  In one reading, this is mere exploitation and, even though undoubtedly legal, is unethical.

This time, the voice of feedback in the computer is positive, praising the student for clicking ‘yes’ and quizzing the student for equivocating and disapproving for saying ‘no’.  It elaborates the suggestion, declaring:

Yes.  Our research clearly benefits us—because we hold down good positions and get publications, grants and gain authority—and we have lots of incentives to do what we do.  But if nothing flows back to our subjects and their community, we researchers are a kind of carpetbagger.

The voice of the computer here is also the voice of the lecturer, which (in the case of questions of ethics in research) implicitly speaks for the university.  So it is quite a cheeky apparatus, with a degree of presumption folded into the advice.  Every tutor experiences this rush of trepidation in assuming the voice of the university when interrogated by students about processes, and there are always temptations to toy with the rules.  Perhaps the slightly wayward turn of phrase deconstructs the high institutionality of the utterance; after all, questions of ethics are seldom capable of a totalized answer, as if comprehending all perspectives from a wide range of stakeholders.  So, through the writing, the computer has to equip itself with a non-robotic sentiment.

Most importantly, the element of doubt is insisted upon throughout the process.  First, doubt is projected by the question expressing some aporia; second, doubt is directly acknowledged by the presence of a ‘maybe’ or ‘partly agree and partly disagree’, which gives credence to the idea that an answer may be neither right nor wrong (not just that we cannot decide); and finally, doubt is accommodated and celebrated by the proliferation of responses to the original dilemma.  In the structure of a conversation sim, there are always four points of riposte.  And so the final response to our issue of research ethics is the following:

Ethics should be constructed around ‘dos’, not ‘don’ts’.  Unfortunately, regulations are structurally negative; and, as with occupational health and safety provisions, they’re seen in terms of embarrassment-prevention, liability, consequences, audits and risk-management.  Alas, this wily anticipation of failure sometimes seems to lack good faith:  it equates with brand-protection and perverts the positive and enduring point of ethics.

The computer is happy if you agree to this assertion.

Yes.  Paradoxically, this negative inflexion is a risk in any university.  And that’s where we look to you to show research leadership.  The concept of ethical research yielding a benefit to the people or creatures or ecosystems that we deal with as subject matter needs all the good faith it can get.  It’s the larger and socially generous dimension of research leadership.

While all of this conversation has been occurring, the students have just been reading.  It is a form of reading quite different from following the dialogue of a play, for example, where multiple voices answer one another in a conversation on stage.  The playwright has orchestrated the dialogue to be vivacious and inflected with wit and drama, no doubt enjoying the morbidity of characters who have a predictable defect in their thought and projection.  But the structural difference between the play and the conversation sim is that the reader of the play, like the audience in the theatre, has no input beyond following the banter, beyond the subliminal gasps or groans or laughter.  In the conversation sim, however, the student becomes the third interlocutor (admittedly somewhat taciturn) in a chain that ends with the lecturer’s wisdom.

Understanding the quality of learning from a conversation sim is challenging; the medical education community finds with its own simulation approaches that designing and executing studies that measure the transfer of simulated skill to actual practice is difficult (McGaghie, et al. 2010), but there is some evidence for approaches that privilege the narrative (Bearman, Cesnik & Liddell, 2001).  If assessment’s ultimate goal is to develop students’ lifelong ability to make judgements within the assessed domain (Boud, 2000), then practice with a conversation sim may have merit: although the student has no real voice; their entire experience is one of passing judgement, which is itself assessed.

It is clear that the conversation sim is neither a proper conversation nor a reading in the sense of immersive reading.  It is, however, a useful hybrid which has some of the advantages of both reading and conversation, and it has a special application in the context of an LMS, where it can also be linked to student-student discussion.  First, we rehearse a kind of conversation where the participant is guaranteed to be on-topic.  There is no chance of an irrelevant response or a mediocre thought that depresses everyone in the virtual space.  The whole encounter is entirely within the lecturer’s control and nothing is left to the probability of having excellent students as opposed to bombastic or lazy ones; and the monitory attendance of the lecturer is unnecessary, as the class can be 5 or 500, with no greater effort, in the same way that books can be read by any number of people in a way which does not affect the quality of anyone’s experience of the text, which can be as rewarding for the millionth reader as the first.

Second, we conduct a kind of reading in which the reader is not entirely passive.  Admittedly, the text blocks are short and err to sound bytes in their construction.  It is not deep reading.  But that is not to say that it does not prompt deep thinking.  The only limitation is the writing skill of the author in proposing ideas in condensed poetic antitheses.  The genre encourages the invention of aphoristic counterpoint, as if an extension of the ancient genre of apophthegmata or the pensées of the renaissance and baroque.  So the nature of writing in a conversational vein also becomes a subject of interest throughout.

Conversational reading

As freely acknowledged, a conversation sim is not a real conversation, nor does it directly facilitate student-teacher or student-student interaction.  But how apologetic we need to be for the gap remains unclear.  Any form of reading is conversational only to the degree that it provides the illusion of a conversation, given that there is only one interlocutor in the room.  How often and under what circumstances are writing and reading a simulation of conversation, as in the dialogues of Plato but more conspicuously in the long tradition of plays, which are so frequently read rather than performed in the theatre?

Most writing is somewhat conversational, because we seem to have a kind of interchange between text and us.  The text tells us something and hopes to persuade us.  Meanwhile, we judge and assimilate, just like when someone talks, and look for our moment to formulate a response.  In reading, we know that there is no reciprocity beyond the intimacy of imaginary convergent thought, nor can there be any reinforcement from us:  the text is deaf and we are dumb.

But just as we should not underestimate how dynamic reading is, so we should not overestimate how organic conversation is.  Much conversation is a case of two people scrambling for a toehold on one another’s soliloquy, which was satirized memorably by La Rochefoucault:

One of the things that causes us to find so few people who appear reasonable and agreeable in converstion is that there’s hardly anyone who doesn’t think about what he or she wants to say rather than responding precisely to what has just been said to him or her.  The most adept and diplomatic adopt an attentive mein, while you see in their eyes and their spirit a distraction from what you’re saying to them and a keenness to precipitate a return to what they want to say.  (Maximes 139; see also La Bruyère, Des jugements 9 (VII))

But even when we strike a lovely conversationalist who asks lots of questions and supplements what we say and finishes our sentences out of sympathy for our views, a similar process occurs which we might recognize from reading.  The two processes have much in common, because in either case the mind is caused to follow and build a thought which otherwise might have no place there.

In either reading or conversing, we subject our minds to an external influence that causes us to think differently, even if momentarily, and to take on the voice and headspace of someone else, which is perhaps the underlying reason that the ability to handle contradiction has been suggested as the basis of readerly pleasure (Barthes, 1975).  The mind is normally autonomous and somewhat given to dictating its own thoughts beyond the stimuli that constantly attend through the senses; but language in either a fixed or organic form invites, to some extent, an alien organization of thought, someone else’s thought inside your own.  It is then up to us to determine suitable parameters for this intrusion, so to speak; a wider conspectus of doubt and riposte subtends the content and takes care of discrepancies between the mind’s prior inclination and the influence that it becomes host to.

Both reading and conversing are clearly rich processes which are healthy for all kinds of reasons, presenting cultures as well as individuals with a powerful motif of growth in consciousness.  But they are also (a) inscrutable processes and (b) remarkably recent in any sense that contemplates their overlap.  Having outlined how both reading and conversation have been traditionally circumscribed by archaic social institutions, we feel that we have usefully identified a stimulating nexus that could be further cultivated through digital technology.

Toward new forms of reading and conversation

We contend that our understanding of both reading and conversation is historically determined; consequently, our current epoch, which offers new opportunities to simulate conversational structures through technology, provides scope for development in these bastions of education and intellectual life.  It is likely that new kinds of reading and conversation will arise in the future; and with technological developments becoming so widespread, it seems reasonable to imagine that the educational computer might become the host to new conversational structures between teachers and learners.

Setting up a conversation sim is easy, once the academic has conceptualized his or her content in terms of searching questions.  We have exploited the multiple-choice format, because it accommodates longer slabs of prose and the options remain one-liners:  yes, no or maybe.  But other engines inside an LMS will afford other benefits.  Similar conversational reading also can be structured by perverting the ‘survey’ option or ‘feedback’ or ‘choice’, depending on the LMS.  They will all allow a sequence approximating our string

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though the reflexion may not be so easily adjustable according to the decision that the student made.  As in a real conversation, where the interlocutors need to work out how long they will occupy the other person’s time, there are choices of length to be made within the genre which determine the appropriate tool.  In essence, though, the computer offers the same structure, where the reading process has a response within it.  Historically, that is something new and points to a curious convergence with conversation that has much potential.

References

Adlington H and Wright G. (2012) Teaching close reading: A VLE-based approach. Arts and Humanities in Higher Education.

Barthes R. (1975) Le Plaisir du Texte, Paris: Éditions du Seuil.

Bearman M, Cesnik B and Liddell M. (2001) Random comparison of ‘virtual patient’ models in the context of teaching clinical communication skills. Medical Education 35: 824-832.

Bordia P. (1997) Face-to-face versus computer-mediated communication: A synthesis of the experimental Literature. Journal of Business Communication 34: 99–120.

Boud D. (2000) Sustainable Assessment: Rethinking assessment for the learning society. Studies in Continuing Education 22: 151-167.

Brookfield, S, Preskill, S. (1999) Discussion as a way of teaching: tools and techniques for democratic classrooms. San Francisco: Jossey-Bass Inc Pub

Buzzetto-More N, Sweat-Guy R and Elobaid M. (2007) Reading in A Digital Age: e-Books Are Students Ready For This Learning Object? Interdisciplinary Journal of Knowledge and Learning Objects 3: 239–250.

Lea R, Jones, S. (2011) Digital literacies in higher education: exploring textual and technological practice Studies in Higher Education, 36(4): 377–393

Lu S. (2010) A Tentative Study of the Impoliteness Phenomenon in Computer-mediated Communication. Cross-Cultural Communication 6: 92–107.

Manguel A. (1998) A History of Reading: Penguin Books.

McGaghie WC, Issenberg SB, Petrusa ER, et al. (2010) A critical review of simulation-based medical education research: 2003–2009. Medical Education 44: 50-63.

Nelson R and Dawson P. (2012) Conversation sim manual (draft-in-progress) at http://conversationsim.org under the tab ‘Manual’

Piscioneri M and Hlavac J. (2012) The minimalist reading model: Rethinking reading lists in arts and education subjects. Arts and Humanities in Higher Education.

Salmon G. (2006) 80:20 for e-moderators. In: Mac Labhrainn I, McDonald Legg C, Schneckenberg D, et al. (eds) The challenge of ecompetence in academic staff development. Galway, Republic of Ireland: CELT, NUI Galway, 145–154.

Selwyn N. (2010) Looking beyond learning: notes towards the critical study of educational technology. Journal of Computer Assisted Learning 26: 65–73.

Selwyn N. (2011) Editorial: In praise of pessimism—the need for negativity in educational technology. British Journal of Educational Technology 42: 713–718.

Weller S. (2010) Comparing Lecturer and Student Accounts of Reading in the Humanities. Arts and Humanities in Higher Education 9: 87–106.

Numbers to classical and biblical texts follow the standard reference system derived from the canonical editions used in lexicography.  Different editions and translations have disparate pagination, whereas the canonical numbering is consistent.  Similarly, the numbering used in renaissance and baroque texts follows the order of canto/stanza for epic poems, act/scene for plays or book/story for novelle or essays.

Biographical Statements

Robert Nelson is Associate Professor and Associate Director (Student Experience) at Monash University. The key theme of Robert’s research is how the aesthetic interacts with the moral and the educational. Email:

Contact: robert.nelson@monash.edu

Phillip Dawson is a Senior Lecturer in the Office of the Vice Provost (Learning and Teaching) at Monash University. Phillip’s research explores how academics make decisions.

Nada Chaiyajit

Published Online: November 15, 2014
Full Text: HTML, PDF

Abstract

Currently, access to sexual health information that serves the needs of transgender individuals is non-existent or severely limited.  With “Getting to Zero” as the official UNAIDS campaign to achieve zero new HIV infections, zero discrimination and zero AIDS-related deaths, this lack of access to information coupled with immense stigma and discrimination among transgender individuals will not allow UNAIDS nor the world to achieve such impressive goals.  This paper identifies gaps and challenges in HIV services for transgender individuals living in Thailand.  Among other recommendations, the paper recognises the need for the ‘de-coupling’ of transgender services from those serving men who have sex with men.  The paper describes an innovative communication technology project, the Thailadyboyz (TLBz) Sexperts! Program, a low-cost, transgender-led, community project offering accurate online transgender-specific sexual health information, social support and legal advice.  The paper describes how the TLBz Sexperts! Program exemplifies the power of online communities and social networking platforms in reaching transgender individuals, especially when transgender community members lead in the design, development and implementation of such resources.

Keywords: Transgender, HIV and AIDS, Getting to Zero, UNAIDS, Sexual Health Information, Thailand

Introduction

Throughout the world, there is a lack of transgender-specific sexual health information, even on the Internet where one would expect to find a lot of this information. Even more glaring, access to online transgender-specific sexual health information in native languages is particularly limited. In Thailand, a country recognised as a world-renowned medical hub for sex reassignment surgery (SRS), such information is almost non-existent (Aizura, 2010).

To date, most online resources dedicated to transgender individuals’ health and wellbeing are based in high income countries.  Examples of extemporary resources are the web site of the Center of Excellence for Transgender Health at the University of California, San Francisco; the Gender Health Resource Guide developed by The American Congress of Obstetricians and Gynaecologists; Transgender Women – Transgender Health Matters by the Terrence Higgins Trust in the UK; the Gender Centre Inc.’s online platform, which is supported by the New South Wales Department of Human Services in Australia; and TransHealth, a U.S.-based comprehensive web-based clearinghouse that has a list of organisations that provide information and resources on a variety of topics related to transgender health. All of these resources are English-language websites. Transh4ck, developed by Dr. Kortney Ziegler, is an innovative open source web-based approach to tackling the socio-economic obstacles experienced by the transgender community, including unemployment, relatively lower salaries, homelessness, and discrimination across multiple social services, including access to adequate healthcare services. Not only is the establishment of these online resources providing transgender individuals in these high income countries and other English-proficient individuals with easily accessible vital and potentially life-saving sexual health information, they also serve as a web-based platform designed to help bring the transgender and gay/MSM communities closer to achieving the UNAIDS goal of “getting to zero”, which calls for zero new HIV infections, zero AIDS-related deaths, and zero HIV-related discrimination worldwide.

Unfortunately, to date, Thailand remains on the sidelines in the promotion and implementation of technologically innovative sexual health resources for transgender people. This paper aims to highlight the stigma and discrimination faced by the transgender community in Thailand, efforts implemented by Thai-based transgender-focused community organisations to address these and other barriers to accessing healthcare, and recommendations to help Thailand not only be recognised as a medical hub for sex reassignment surgery, but also as an leader in ensuring access to quality transgender health information and championing the social, economic, and health rights of all transgender individuals.

Background

Currently there is only one location in Thailand (Pattaya) that provides comprehensive, transgender-led services for transgender people.  The services are unique in that they are tailored to meet the actual HIV prevention and care service needs of the transgender community. Sisters, an transgender led and staffed organisation, is able to accomplish their efforts by working closely with key public health officials in Pattaya and by actively promoting healthy sexual behaviours among transgender persons.  As for the rest of country, Thai community-based organisations (CBOs) have been tasked with conceptualising and implementing virtual or web-based general health support services for the transgender population.  Rainbow Sky Associate of Thailand (RSAT) in Bangkok, Mplus Foundation (Mplus) in Chiang Mai, Health and Opportunity Network (HON) in Pattaya, and Andaman Power in Phuket are four prominent CBOs that have taken on the challenge of addressing the online sexual health information needs of the transgender community.

Despite efforts made by CBOs in Thailand to offer information to transgender individuals via a stigma-free, non-discriminatory, and easily accessible online platform, most sexual health initiatives targeting the transgender community are a sub-component of programming intended to address sexual health and HIV needs of men who have sex with men (MSM). For example, The Silom Community Clinics in Bangkok and Chiang Mai offer general sexual health services to both the MSM and the transgender community. RSAT, Mplus, and Service Workers IN Group (SWING)–which provides services to sex workers in Bangkok, Pattaya, and Koh Samui–also strive to provide appropriate services to the transgender population.  The fact is the sexual health knowledge and HIV prevention needs and wants of a transgender individual differ vastly from the needs of MSM. Transgender women and men require a safe transgender-specific space to discuss the sexual practices and behaviors that are specific to their individual anatomies, and a safe place to discuss the fear and struggles that accompany preparation for, and the experiences following, sex reassignment surgery. Currently, the resources available at CBOs and clinics to offer this vital public health service to the transgender population are severely limited.

The term MSM has been employed to describe a broad range of individuals where male-to-male sex is not framed so much in terms of homosexuality versus heterosexuality, or gay versus straight, but along a spectrum of masculinities and gender variance that incorporate ideas of feminisation, gender orientation, penetrative masculinity, desire, and sexual orientation. Although the majority of male to female (MTF) transgender persons who have undergone sex reassignment surgery identify as women, they are still referred to as MSM by key public health professionals and organisations. This unequivocally exhibits a lack of sensitivity and respect towards an individual’s self-defined sex and gender identity (Walsh et al.).

Ami B. Kaplan, an accomplished psychotherapist and committee member of World Professional Association of Transgender Health (WPATH) explains that the difference between gay men, MSM, and transgender individuals is contingent on the narrow definition of one’s sexual orientation (who you are attracted to sexually) and one’s gender identity (who you know yourself to be). While transgender individuals are now often lumped in the same category as gay men under the lesbian, gay, bisexual, and transgender (LGBT) umbrella, there are specific differences between the groups that are vital to the identity and experience of the members of each group. Historically, transgender individuals have had to jump through many hoops in order to transition to their desired sex and gender. LGB individuals go through the process of “coming out”, but this does not require anatomical alteration. Transgender individuals also “come out”; however, the process is more complex. For example, many transgender individuals are required to address issues around body dysphoria as well as social acceptance. The transgender individual also employs more invasive medical processes such as hormone replacement therapy, voice alteration, facial hair removal, and other alterations (Kaplan, 2009).

In Thailand, male to female transgender individuals are legally identified as male.  Transgender people in Thailand cannot legally change their gender on their identification cards. This often results in difficulties in securing employment. Transgender individuals in Thailand report that potential employers have denied them employment due to misperceived complications with hiring transgender people. A “Thai phuying praphet song” (‘woman of a second kind’) carries a male ID card, and travels with a male passport, which she must use when she opens a bank account, applies for a job, and any number of other everyday activities (Winter, 2008). Current Thai law maintains that only the transgender person’s sex at birth can be reflected on the individuals’ passport. This practice creates confusion, forces the transgender person to “come out” in situations where he or she may not want to, and creates unnecessary scrutiny at border crossings and immigration checkpoints. Thailand also prohibits same sex marriage, meaning that when the partner of a heterosexual transgender person dies, the deceased’s family receives any and all assets, and the transgender individual is entitled to no inheritance (Armbrecht, 2008). As a result transgender individuals’ career opportunities are fettered by the discrimination they experience, often forcing them to accept stereotypical jobs such as waitress, hairdresser, make-up artist, and street vendor. This is true even if the transgender individual holds an advanced academic degree.   The alternative is often sex work.

Social, economic, and psychological discrimination experienced by the transgender community, as described above, places them at high risk for gender-based violence (GBV), HIV, and other sexually transmitted infections (STIs). Because transgender people are marginalised in Thai society, national healthcare providers and human rights groups have been slow to address acts of GBV against members of the transgender community. GBV is frequent in the transgender community and often results in devastating consequences for the victims, including physical, sexual, and mental harm and suffering (Thepsai & Walsh, 2008). This overt, and often unchallenged, abuse is not seen as a crime, but as a private family matter, leaving its victims feeling intimidated and fearful.

In an effort to address GBV experienced by the transgender community, the Health Policy Initiative, funded by the United States Agency for International Development (USAID), engaged CBOs and other health sector entities in a project aimed at screening transgender individuals for GBV in Pattaya, Thailand. The 2008 study found that 89% of transgender individuals surveyed had experienced some form of GBV (USAID, 2009). This degree of GBV combined with the transgender population fearfulness of reporting crimes to the police, their inadequate access to healthcare and HIV testing, and the economic pressures they face to simply survive in Thailand place this population at high risk, not only for repeat GBV, but also for HIV infection and the transmission of other STIs.

Effective Programming

Given the absence of opportunities and platforms to access information regarding the needs of the transgender community, transgender activists in Thailand established Thailadyboyz (TLBz.) in 2002. TLBz[1] is a 100% virtual community aiming to provide transgender individuals with an on-line community and a second home, where they can  safely communicate with each other about issues that specifically concern them. The online community is warmly referred to by members as the “Blue House” due to the website’s colour. Virtual services offered by TLBz include chat rooms for specific topics. The “Blue Sofa” chat room serves as a guest room for members who want to address general topics and welcome new members. The “Beauty Ladyboyz” chat room gives members the opportunity to share beauty secrets. The “Red Chair” chat room is a space where individuals can listen to and view audio-visual stories that are collected by the site administrator and site members. The “Beauty by Surgery” and “Taking Hormones” are the most popular chat rooms where people exchange information about their own experiences with hormone use and sex reassignment.

In 2011, amfAR supported the development and implementation of The TLBz Sexperts!, an online HIV/AIDS, human and legal rights counselling service run by transgender individuals for transgender individuals. The program continued under the oversight of Bridges Across Borders Southeast Asia Community Legal Education Initiative once funding for the program from amfAR ceased. The TLBz Sexperts! program was offered three hours a day, five days a week (Figure 1). The current adaptation of the program focuses on providing counselling services to male to female (MTF) transgender individuals across Thailand.

The implementation of The TLBz Sexperts! program did not come without its challenges. During the first month of services, only seven visitors utilised the services. However, TLBz Sexperts! have now provided counselling services to more than 1,300 transgender members through closed trans-groups on Facebook. TLBz Sexperts! offers online counselling via trained transgender counsellors.  The impact of social media and online networking influenced the way The TLBz Sexperts! program operated. The administrators realised that the majority of the transgender community were virtually connected, primarily via Facebook, so they adapted and began offering online counselling services exclusively through Facebook. The two Facebook groups created by TLBz Sexperts! are “Sao Praphet Song of Thailand” and “TLBz Sexperts!”.

TLBz Sexperts! aims to foster a safe, online community for the transgender community by employing the evidence-based popular opinion leader (POL) approach.

chaiyajit

Figure 1: TLBz Sexperts! Facebook website

By having strong, knowledgeable, and empathetic transgender leaders as readily available online counselors, TLBz Sexperts! offers members a unique opportunity to engage with individuals who understand them and are eager to share their experience. The POL’s primary responsibility is to ensure that members feel free to ask whatever questions they may have regarding their sex, gender, sexuality, sexual behaviours, and their basic human rights.

To gauge the effectiveness of offering TLBz Sexperts! services exclusively via Facebook, members were directly asked to comment on their experience. Most members stated that they felt no gap between themselves and the counsellors, even though the information disseminated by the counsellors is done virtually. Members stated that TLBz Sexperts! were instrumental in providing vital individual counselling services around issues commonly experienced by the transgender community and were effective in referring individuals to a healthcare provider to address an individual’s more clinical needs, such as screening for HIV/STIs. Below are a few comments shared by members regarding TLBz Sexperts!:

  • “I never thought that HIV would become a serious issue in my life before until I found out my HIV-positive status during an annual health check-up.  During that moment, I knew nothing about HIV/AIDS, and no one from the hospital provided me with adequate pre or post-test counselling services. I was completely lost. A friend of mine introduced me to TLBz Sexperts!, and I reached out, asking for more information about HIV/AIDS and a referral to a medical provider. TLBz Sexpert connected me to Silom Community Clinic, where I connected with other people living with HIV/AIDS like myself. I was linked to medical care, informed that the cost of my care would be covered by the social security healthcare plan in Thailand and placed on lifesaving HIV antiretroviral therapy.” – Malisa (TLBz Sexperts! member)
  • “Transgender people tend to want to communicate about their health needs with someone they know they can trust. TLBz Sexpert! is great in that I know I can communicate with a trusted leader and receive services anonymously. The fact that the TLBz Sexperts! staff remains connected to the community ensures the appropriate and timely dissemination of information. There is a need for the TLBz Sexperts! counsellors who are well versed in issues about the body and mind; individuals who are always sincere and honest in their approach. – Bombay (TLBz Sexperts! transman client)

In 2012, the TLBz Sexperts! program began recognising it was a “big thing that had a small beginning.” The TLBz Sexperts! staff pride themselves on this statement, because they aim to provide the best services available, even in an environment of no resources. An article describing the work of TLBz Sexperts! has been published under the title “Sexperts! Disrupting Injustice with Digital Community-led HIV Prevention and Legal Rights Education in Thailand” with Digital Culture & Education (DCE) and The HIVe (Chaiyajit and Walsh, 2012). Nada Chaiyajit, a TLBz Sexpert and program leader, was invited to record the podcast “Reaching the Transgender and MSM population through Social Media” by AIDStar-One, on behalf of USAID and the United States President’s Emergency Plan for AIDS Relief (PEPFAR). TLBz Sexperts! was also named an effective model for the transgender community by Avert in an article entitled “Transgender and HIV”.

TLBz Sexperts! is committed to the idea of “Sexpertise”. “Sexpertise” promotes transgender-grown initiatives that are specific to their community and that assist transgender individuals in better addressing the barriers that exist with being transgender, including anxiety brought on by social pressure to be and act a certain way and not being able to access or enjoy certain basic human rights, such as the right to one’s own identity—a right that transgender people are often legally denied in Thailand.

Recommendations

TLBz Sexperts! is actively engaging the transgender community by providing 100% pro-bono work within a volunteer system, which is one example of a resourceful approach to engaging the transgender community online; however, there is a need for funds for capacity building TLBz Sexperts! would be a more effective online peer outreach and prevention platform if all counselors possessed the skill set to seamlessly deliver information, not only about the HIV prevention and care needs of members, but also to speak knowledgeably about issues of self-esteem, body image, sexual pleasures and gender rights.  Several approaches that key funders can take to address the issues of HIV infection, AIDS-related deaths, and stigma and discrimination faced by the transgender community in Thailand  were developed by TLBz Sexperts! specifically for the transgender community in Thailand to expand the work that has been to date:

Best Sexual Life in Practice Workshop: This is a learner-centered workshop conducted in safe and friendly spaces that aim to invite pre- and post-operation transgender individuals and individuals who have no intention of surgery. The goal of this initiative is to bring together a diverse group of transgender individuals to share their sexual experiences and discuss best sexual practices in a safe environment. Brainstorming sessions would be conducted to address issues Thai transgender persons experience in accessing sexual health and information about HIV prevention and care, as well as institutional and non-institutional barriers to sexual health and transgender health. Participants would also discuss how Thai transgender persons embody transgenderism or transgress heteronormative gender norms to better understand what these mean and to design customised, holistic sexual-health resources that are specific to Thailand and are specifically aimed at building and strengthening Thai transgender people’s self-esteem. An emphasis would be placed on discussing concerns around HIV and AIDS, STIs, and voluntary confidential counseling and testing services to identify obstacles and myths that influence Thai transgender person’s sexual practices. This would allow researchers to better understand not only the biological pathways of HIV infection, but also the psycho-sexual and social determinants specific for the transgender community in Thailand. The design, implementation and evaluation of this initiative should be guided by an elected steering committee of Thai transgender individuals.  This would bring the virtual online community efforts to a physical environment with peer educators for skills building.

Continue and Expand Design of Online Resources through Sexperts! Brand & Website: The aim of this activity is to use data collected on specific transgender health issues via the current website to develop holistic information regarding sexual education, sexual practices, and other health resources. This new and improved online platform would address misunderstandings that arise from stigma and discrimination; address short-term and long-term complications from body augmentations, surgical procedures, or hormone and silicone use; assist Thai transgender people in better understanding their personal risk for HIV (in relation to pre/post/no intention operation); help Thai transgender people engage in safer-sex negotiations; and provide referrals to transgender-friendly sexual healthcare providers who are known to other transgender people to be adequately aware of transgender anatomy and issues (e.g., neo-vagina & STIs; ) to meet Thai transgender person’s diverse sexual health needs. It would also provide referrals to transgender friendly legal services.

Develop Transgender Holistic Sexual Pleasure, HIV Prevention and Care and Legal Rights Online Resources Center: The aim of this activity is to create capacity to post “Sexpertise” content online, including articles and links to informative videos that could be easily accessed by all registered online members.

Designa Video Series, Transgender Mama Talk: The aim of this activity is to employ nominated Thai Transgender Champions, who can also be POL, to produce a web TV episode series conceptualised, written by, and starring Thai transgender individuals titled, Mama Talk: Living a Happy, Healthy, and Sexually Pleasurable Transgender Life in Thailand. This online series would cover topics such as transgender health, transgender sexual pleasure, transgender HIV prevention, how to negotiate safe sex, accessing transgender sexual health, top transgender beauty tips, hormone use, sexual reassignment surgery, transgender legal rights in Thailand, and dealing with stigma and discrimination.

Conclusion

Everyone has a fundamental human right to enjoy the highest attainable standard of physical and mental health. Yet, it is evident that the key international organisations responsible for crafting and promoting health policy to help ensure everyone has access to this right need to do more to better highlight and promote the specific sexual health needs required by the international transgender community, so transgender individuals can lead the safest, most productive lives possible. ).

In order to truly get to zero HIV infections, zero AIDS-related deaths, and zero discrimination, international and national organisations must invest in transgender-specific research, interventions, and advocacy needs. Research topics should include the effects of ART on hormone use and sexual reassignment surgery and the sexual risks for individuals with neo-vaginas; finding more epidemiological and behavioral data on transgender populations (including transmen); and linkages between human rights violations and increased HIV vulnerabilities specific to the transgender community. More information is needed around HIV treatment and other essential health issues affecting the health and well-being of the transgender community.

A successful, web-based transgender community was developed for providing healthcare information and sharing experiences through online communities in web boards and other types of social networking in online support groups. The experiences from this collective were compiled into TLBz Sexperts! and reached out to 1,300 transwomen. Unfortunately, TLBz Sexperts program suffers from funding limitations and lack of staffing of experts on the issues concerning transwomen’s health. Recommendations for further development of the program are contingent on funding.

An expanded online platform where transgender individuals can safely exchange information with members and benefit from the counseling of comprehensively trained online popular opinion leaders is a necessary weapon in the fight to stem HIV and AIDS and decrease stigma and discrimination towards transgender persons in Thailand. Key international organisations like UNAIDS are in a unique and powerful position to promote and advocate for these initiatives as well as engage local community-based organisations, national governments, donors, and research institutions, and to encourage public-private partnerships to tackle the socio-economic and psychological struggles that unequivocally make transgender individuals a key population at high risk for HIV infection.

Acknowledgements

I would like to thank Kent Klindera, Elena Kelly, Cameron Wolf and Dr Christopher S Walsh for their support in assisting her in publishing this manuscript.

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AIDSTAR-One (2012). Improving HIV testing and counseling. Retrieved from: http://www.aidstarone.com/focus_areas/hiv_testing_and_counseling/resources/case_study_series/sisters_thailand

Aren Z. Aizura (2010). Feminine transformations: gender reassignment surgical tourism in Thailand. Medical Anthropology: Cross-Cultural Studies in Health and Illness, 29(4), 424-443, DOI: 10.1080/01459740.2010.501314.

Armbrecht, J.(2008, April 11) Transexuals and Thai law. Thailand Law Forum. Retrieved from http://www.thailawforum.com/Transsexuals-and-Thai-Law.html

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Betron, M. (2009). Screening for violence against MSM and transgenders: report on a pilot project in Mexico and Thailand. Washington, D.C.: Futures Group, USAID. Retrieved from http://www.healthpolicyinitiative.com/Publications/Documents/1100_1_GBV_MARP_Final_Project_Report_FINAL_4_27_10_acc.pdf

Centers for Disease Control and Prevention. Popular opinion leader (POL): A community AIDS/HIV risk reduction program for gay men. Retrieved from http://www.cdc.gov/hiv/prevention/research/rep/packages/pol.html

Chaiyajit, N. and Walsh, C. S. (2012). Sexperts! Disrupting injustice with digital community-led HIV prevention and legal rights education in Thailand. Digital Culture & Education, Vol 4, No. 1, pp. 145–165. ISSN:1836-8301.

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Kaplan, A.B.(2009, December 21). The difference between the Transgender and the Gay/Lesbian experience. Transgender Mental Health. Retrieved from http://tgmentalhealth.com/2009/12/21/the-differences-between-the-transgender-and-the-gaylesbian-experience/

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Silom Community Clinic. Retrieved from http://www.silomclinic.in.th/

The American Congress of Obstetricians and Gynecologists. Transgender Health Resource Guide. Retrieved from http://www.acog.org/About_ACOG/ACOG_Departments/Health_Care_for_Underserved_Women/Transgender_Health_Resource_Guide

Thepsai, P. & Walsh, C.S. (2008). Maintaining and expanding HIV prevention programmes at Mplus+. Producing animation to educate MSM to fashion safe sex practices and address low perception of personal risk. Australian Association of AIDS Organizations (AFAO) grant.

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Walsh, C.S., Laskey, B., Chaiyajit, N., Morrish, W. (2010). Producing Animations to Teach Victims of Sexual Violence how to Access Legal Rights. IADIS e-Democracy, Equity and Social Justice Conference 2010. Freiburg, Germany.

Walsh, C.S., and Chaiyajit, N. (2012). Sexperts! Disrupting injustice Through HIV prevention and legal rights education with Transgenders in Thailand. In J. Wright (Ed.) AARE-APERA 2012 Conference Proceedings, Sydney, Australia December 2-6, 2012. Winter. S (2008, January). Transpeople (Khon Kham Phet) in Thailand: acceptance or oppression.

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Biographical Statement

Nada Chaiyajit is transgender Sexperts! Consultant at Health and Opportunity Network (HON) and the project manager for TLBz Sexperts! Online Peer Outreach and Prevention program, where she is working to improve education and empowerment among transgender communities in Thailand.  She has worked as a transgender advocate since 2006 and has been with BABSEA CLE since 2009, during which time she has been a guest speaker at the 17th, 18th and 20th International AIDS Conferences.  She is also the Audience Council Secretary for LGBT and transgender rights for the Thai Public Broadcasting Service (Thai PBS).

Nada is a founding member of the ‘Thai Transgender Alliance’, a fellowship network that promotes understanding and equality for transgender people in Thai society. The Thai Transgender Alliance is using the Internet to compile a database of human and sexual rights violations against transgender people to prove to the authorities that this gender-based violence (GBV) is a violation of their human rights and a major public health issue.

Nada has lobbied individually and collectively to modernise the Thai criminal law on rape, advocating for a specific equality provision for both men and women. Drawing on funded research and her experiences as advocate for human rights, Nada has worked collaboratively with marginalised and stigmatised populations in initiatives to promote democracy, social justice and equity by strengthening their capabilities and promoting their involvement in online communities of practice.

Nada was the keynote speaker at the 2010 IADIS International Conference on E-democracy, equity and justice, and also presented her work at the AIDS 2010 Conference in Vienna. Her work also has included media advocacy and education pieces with productions.

Email: nada.chaiyajit@gmail.com


Diane Maria Zambrano Rodríguez

Published Online: November 15, 2014

Full Text: HTML, PDF

Abstract

In this article, I describe Asociación Silueta X and highlight three of it current virtual campaigns: BESOS LGBTI (Kisses LGBTI), Tiempo de Iqualdad (Time for Equality), and Campana Mi Genero en Mi Cedula (My Gender Identity in my ID Card). I specifically outline how Asociación Silueta X uses information, communication technologies ICTs to support advocacy for the lesbian, gay, bisexual, transgender, and intersex (LGBTI) communities in Ecuador. I also outline and describe how Asociación Silueta X engaged in research and advocacy to lobby the Ecuadorian Government to establish the country’s first LGBTI counseling and medical center in Guayaquil, Ecuador. This medical center was created not only to meet the needs of LGBTI individuals, but also to improve access to healthcare among Ecuadorian transgender individuals specifically, due to data showing that this population has particularly low levels of access to services.

Keywords: Transgender, LGBTI, Ecuador, social inclusion, transgender friendly medical center

Asociación Silueta X

I established Asociación Silueta X when I was 28 years old. It is a grassroots organisation that was created on May 12, 2008 and legally established on May 5, 2010 by Presidential Decree MIES # 9989 of Ecuador. It is a nonprofit association whose mission is to fight for lesbian, gay bisexual, transgender, and intersex (LGBTI) rights in Ecuador.  Asociación Silueta X specifically works to create accessible living conditions for LGBTI individuals with an emphasis on the transgender and intersex population. These conditions encompass health, education, employment, and social justice programs for sexual diversity.  After nearly four years of working for the LGBTI people of Ecuador, Asociación Silueta X has transformed from a small grassroots organisation reaching people through face-to-face interactions into a highly visible grassroots association with a virtual presence that has helped the LGBTI population experience unprecedented visibility and access to information important to its diverse communities. This critical step not only highlights Silueta X’s innovative methodological process to successfully execute our advocacy plans, projects, and campaigns and celebrate the impact achieved nationwide, but also reflects Silueta X’s innovative and successful use of information communication technologies (ICTs). Asociación Silueta X runs numerous campaigns that focuses on holistic health and sexual and reproductive rights for LGBTI individuals, including:

  • Capacitaciones a Voluntarios (Training Volunteers)
  • Capacitaciones a Instituciones Públicas  (Training for Public Institutions)
  • Salud Integral  (Integral Health)
  • Juventud GLBTI (LGBTI Youth)
  • Incidencia Política  (Political Advocacy)
  • Arte y Cultura  (Arts and Culture)
  • Derechos Humanos (Human Rights)
  • Comunicaciones (Communications)

Importantly, as an LGBTI organisation, we are able to use ICTs to communicate widely and effectively with all of our members across Ecuador.

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Figure 1: Facebook of Asociación Silueta X

From its founding until the present day, Silueta X has experienced a dramatic increase in coverage by the mass media coverage, which now covers more of its activities than those of  LGBTI organisations in Ecuador that were founded earlier. Silueta X leverages the power of social media via social networking sites and apps, especially Facebook (with more the 5,800 members), using it to provide  updates about its organisational and advocacy activities (Figure 1). Asociación Silueta X clearly understands the powerful role of social media and has created multiple  sites that cover specific activities.  In part, Silueta X measures its impact by the tremendous amount of mass media coverage that grows out of social media strategies.

To date, ICTs have allowed Silueta X (Figure 2) to reach a diverse population of LGBTI individuals, especially those who are targeted through distinct approaches, such as the trans or intersex populations. The use of technology has not only brought the trans and intersex populations closer to organisational activities, but has also allowed the organisation to save time.  Previously, as a grassroots organisation, we working primarily thorough field work, which of course is still carried out, but has been made easier thanks to ICTs.

Technology has also been involved in legal matters, such as the recognition of name changes on ID cards (Campana Mi Genero en Mi Cedula/My Gender Identity in My ID Card), collecting data for trans-focused studies, and addressing proposed laws that include sexual diversity. Primarily though using ICTs, Silueta X has created paradigm shifts regarding the safety of trans sex workers; has engaged and trained national police officers (Capacitaciones a Instituciones Públicas/Training for Public Institutions); and has created several promotional and preventative programs with emphasis on the trans population regarding STDs and HIV using videos on YouTube as part of the Tiempo de Iqualdad (Time for Equality) campaign, among other activities.

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Figure 2. Silueta X’s website

We also have the three virtual campaigns we are very proud of:

  • BESOS LGBTI (Kisses LGBTI);
  • Tiempo de Iqualdad (Time for Equality); and
  • Campana Mi Genero en Mi Cedula (My Gender Identity in My ID Card)

BESOS LGBTI (Kisses LGBTI)

Beso Gay Les Bi Trans is Asociación Silueta X’s campaign that confronts homophobia.  It uses Facebook and YouTube videos.  It promotes a public kiss between the participating LGBTI partners. Besos LGBTI has had three massive public “kiss ins” in Guayaquil,  Ecuador that have been replicated across Latin America.

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Figure 3. Asociación Silueta X’s BESOS LGBTI campaign

Tiempo de Iqualdad (Time for Equality)

Asociación Silueta X’s campaign Tiempo de Iqualdad (Time for Equality) is focused on the structural and paradigmatic changes for LGBTI populations that resulted from the conservative and fundamentalist mentality in Ecuador that often denies LGBTI individuals their human and sexual rights. The campaign has five poignant videos that address the following topics:

  1. Centros de Tortura/Torture Centers
  2. Acceso a Salud/Access to Health
  3. Acceso a Empleo/Access to Employment
  4. Acoso/Bullying
  5. Educación Laica/Secular Education

Silueta X is using these videos, which are posted on YouTube,  to promote structural changes through advocacy and agreements with various state institutions. By collaborating with a number of LGBTI organisations, the films explore various topics from issues of sexuality to fighting for justice and rights. This national campaign would not have been possible without the support of Silueta X’s sponsors, including Mama Cash, amfAR, and Hivos.

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Figure 4.  Tiempo de Iqualdad’s  (Time for Equality) video, ‘Discriminación a transexuales en centros de Salud’ (Discrimination of transsexuals in medical centers)

Campana Mi Genero en Mi Cedula (My Gender Identity in My ID Card)

On June 6, 2012, the Ecuadorian Confederation of Trans and Intersex Communities (CONFETRANS), which is part of Asociación Silueta X’s Transgender Project “Building Equality,” presented a draft amendment to the Civil Registration Act of Ecuador that would remove the gender/sex on the Ecuadorian citizenship identity card. The campaign My Gender Identity in My ID Card  accompanied the amendment and was presented to the Rule Governments and Decentralization Commission of the National Assembly of Ecuador on July 23, 2012.  The campaign includes a YouTube video (Figure 5.).

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Figure 5.  Asociación Silueta X’s Campana Mi Genero en Mi Cedula (My Gender Identity in My ID Card) YouTube video

Background

Social inclusion for lesbian, gay, bisexual, transgender, and intersex (LGBTI) persons regarding public health policies in Ecuador is still challenged, despite the fact that sexual orientation and gender identity are included in the constitution of the Republic of Ecuador (Constitution of the Republic of Ecuador, 2008).  In fact, this recognition of gender identity and/or expression is one the first trans-inclusive constitutional provisions in the world (Martínez Dalmau, 2008).  However, the enforcement of and/or adherence to this ‘said’ recognition is complex in a conservative and exclusionary culture, such as the one in Ecuador.

In addition, in 2012 Ecuador’s Secretary of Health, Carina Vance Mafla, was the first openly lesbian secretary to be appointed in Ecuador (Garcia, 2012).  The inclusion of a lesbian Secretary would make most people believe that Ecuador is progressing on social acceptance of LGBTI human rights, even with regards to gender identity in the public or government sphere.  Nevertheless, accessing the right to gender identity or expression in public services is still complicated.  To address this glaring issue, as part of its social responsibility, Asociación Silueta X has requested countless dialogues with the authorities in order to be able to come to an adequate agreement.

Using ICTs to support advocacy

Depathologization of Transsexuality

Starting in 2012, Silueta X successfully engaged in dialogue with academia and the Department of Health to incentivise those who would appear before the WHO to advocate for the Depathologization of trans sexuality in a forum entitled “Psychology and the Department of Health on the Depathologization of Transsexuality.” This advocacy resulted in success. Gabriela Rivadeneira from the Department of Health’s Division of Standardization and Silueta X drafted a statement and appeared at a hearing on the subject.  All of the planning and community mobilisation activities for this event were done through contact via ICTs, including Silueta X’s website, Facebook, and Twitter. This allowed Silueta X to elicit constant feedback from members that was used to develop the document that was presented to the Department of Health.  With this statement Secretary Rivadeneira was prepared to appear before the WHO in

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Figure 6. Silueta X’s social networking mobilisation activities for the Depathologization of Transsexuality

December and advocate for the depathologization of transsexuality publicly in March of 2013. An official Letter was sent to the WHO from the Department of Health on the depathologization of transsexuality thanks to Silueta X’s work engaging in dialogue with the Department of Health. This is not only important because of Silueta X’s commitment, but also because Silueta X’s activities successfully influenced the political sphere to support the transsexual population, in this case by advocating for depathologization. Moreover, it is vitally important to emphasise that the organisation’s success lies in the use of information technology to mobilise LGBTI individuals and the general public.

Silueta X lobbying to establish the first trans friendly medical office

Asociación Silueta X has also sought to work more effectively with the Secretary of Health and educate the entire ministry about transsexuals and hormone therapy. This led to Asociación Silueta X successfully hosting a formal meeting to inform the Secretary about  the difficulties that transsexual and intersex populations face regarding gender identity. Silueta X also asked for support to establish the first LGBTI counseling and medical center in Ecuador.  After the meeting, the Department of Health verbally agreed to take on this task. Division 7 from the Department of Health was present to support the the LGBTI medical center, along with state authorities such as the Secretary’s Advisor Patricio Aguirre and representatives from multilateral organisations such as UNAIDS, among other high ranking key players (Salazar, 2013).

This medical center was specifically created due to statistical data recognising the low level of access to healthcare services among Ecuadorian trans individuals (Figure 7). A bio-behavioral survey of the HIV epidemic carried out in 2012 by the Department of Health of Ecuador shows that the trans population has an HIV incidence of 31.9%, followed by 11% among men who have sex with men (MSM) (Pan American Health Organization, 2012).  These results truly show that the trans population is the most exposed to HIV.  To compliment this study, Silueta X conducted another study in 2012 (in partnership with the University of Guayaquil and financially supported by amfAR) that indicated that 55% of female trans have been discriminated against while seeking public healthcare services (Asociación Silutea X, 2012). Close to one hundred surveys from this study were collected online through Facebook.

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Figure 7. The inauguration of the first LGBTI health center (El Telegrafo, 2014)

Silueta X also used its online community to help recruit clients for a study called “Report on LGBTI Access to Justice and Human Rights 2010 to 2013.” In the study, Silueta X gathered concrete data proving that the trans population is exposed to violence on multiple levels. For example, data indicated of 20 murders where victims were from the LGBTI community, two were gay men, three lesbian women, and 15 trans individuals (Asociación Silueta X, 2013). The report also made recommendations for Ecuadorian public policies paying greater attention to the needs and rights of trans individuals, including a call for research to estimate the size of the trans population, a call for gender- affirming healthcare, and a call for programsaddressing simple quality of life issues that are free from stigma and discrimination based on gender identity and expression.  The key goal of the study was to obtain a realistic picture of the lived realities of trans individuals and inform policies to match those needs, thus having greater impact on the health and rights of this population.

This study added to data from a study conducted by the National Institute of Statistics and Censuses, which used a sample of almost 1000 trans individuals. This study also showed major deficits in social services—58% of trans participants did not have access to basic services including, social health insurance (INEC, 2013).

A private medical consult for trans individuals typically costs USD $35 to $50, without the cost of medication, which is often quite expensive.  Additionally, the hormone therapy needed by the trans and intersex populations is not often covered by social insurance and has exorbitant costs. In fact, Ecuador does not regularly stock specific varieties of masculine and feminine hormones.  With the new Comprehensive Organic Penal Code, access to a medical consult for hormone therapy is almost impossible to obtain, due to the fact that there is no protocol for such services in Ecuador, and the Department of Health is not aware of established international norms, such as the guidelines developed by the Center of Excellence for Transgender Health in San Francisco.

In additional to collecting this data and supporting these meetings held with the Department of Health, Silueta X has continued operating its own counseling and medical center , while dealing with countless difficulties—namely lack of financial resources. Silueta X also held the first meeting between several governmental and mainstream non-governmental sexual diversity organisations to offer greater support for and achieve a greater impact on the trans population by discussing the common needs felt by all of the groups of Ecuador. In other words, Silueta X wanted to stop creating methodological processes that intend to solve social issues without having the key effected populations present during the design. Thus, the first meeting was held during which sexual diversity groups talked about health, education, employment, and justice for the LGBTI population. It was entitled, “Four Oversights Will be Created for the LGBTI Community in Ecuador” (2013).

The group proposed establishing a department of health oversight and a pilot program focusing on the topic of health.  The results of the oversight only reaffirm the study done by Asociación Silueta X in 2012 (supported by amfAR) and the survey data from the Department of Health’s study done by the National Institute of Statistics and Censuses, which for the 4th time has reaffirmed the need for separate health processes for LGBTI populations.

Although Asociación Silueta X carried out this study as a relatively small community-based organisation, the impact of the study has had a very significant effect. Asociación Silueta X worked with the National Institute of Statistics and Census to incorporate their methodology to implement a national study.  Due simply to the complexity of the trans population, the study was based on the popular “snowball” sampling methodology, which seeks additional participants for the study through interviewees’ friends and acquaintances.

Silueta X’s “Descriptive Study of the Influential Factors of HIV Rates and Discrimination of Female Trans on the Coast of Ecuador in 2012” surveyed 767 transsexuals on the coast of Ecuador. In order to carry out the survey and administer the questionnaires, Asociación Silueta X hired Ramón Aranguren, a Spanish Neuropsychologist specialising in scientific research who traveled from his home country of Spain to make a commitment to work with the organisation. An agreement was also reached with the State University of Guayaquil department of Psychology and its scientific ethics committee to constantly monitor the development of the proposed methodology.

In order to collect both the physical and digital data for the study, a questionnaire was developed that included questions focuseing on lived realities, such as socio-economic status, legal issues regarding gender identification, and sexual and reproductive health issues specific to trans individuals.  The questionnaire was created by the research team and was reviewed and approved by the Scientific Ethics Committee of the Department of Psychology of the University of Guayaquil.  The questionnaire was distributed in person to a sample of 621 transsexuals and transgendered people.  An additional 146 trans people were reached online. Awealth of information was obtained regarding the transsexual community in Ecuador, because a trans-led organisation—Silueta X—was the implementer.

The study confirmed that trans individuals have needs and demands that are not met by the department of health, such as hormone therapy and the use of aesthetic surgeries without risk of silicone use, to name a few.  All in all, Silueta X recognises that a process that provides healthcare under a gender affirming doctor in order to achieve an adequate transition without much risk to one’s health is vital for transgender individuals.

The Asociación Silueta X study also revealed that 55% of the trans population does not have access to healthcare in Ecuador.  This is a very troubling figure if we review the needs of the trans population that have not been adequately met due to the lack of access to healthcare in the country.  Moreover, 47% reported to be engaging in risky sexual behaviours, such as not using a condom on one or two occasions over several encounters.  Condom use must be consistent, and this results in a greater risk of exposure to HIV for the transsexual population, according to the data reported by Silueta X’s study.

Another health issue is that there is high mortality among trans individuals improperly using silicone (Salazar, 2013).  Silueta X, troubled by this issue, worked to create a protocol for better “gender affirming” services to meet the needs of the transgender population, given that the Department of Health, in spite of these deaths, has not paid much enough attention to this issue (“Death: The price to pay for beauty,” 2011).

Another issue specific to HIV and trans individuals is the lack of care being taken with regards to condom use, based on certain prejudices and religious beliefs.  Rejection by medical personnel due to the anatomy of trans populations does not allow service providers to adequately serve different gender identities and offer them all the necessary information in order to use adequate prevention regarding condom care and use.  These factors therefore become complimentary factors to the lack of adequate health services.

The first LGBTI-specific counseling and medical center in Ecuador

Recognising these challenges, Silueta X developed a sexual health strategy thatincludes a medical center and a gender-affirming sexual health handbook.  “Incentive to Make Your Femininity a Reality” is now available at the first LGBTI Counseling/Medical Center in Ecuador that opened its doors in May of 2013 (Figure 8). In launching the medical center, Silueta X engaged numerous media outlets, announcing the launch using technology and social networks.

Supported by amfAR, Asociación Silueta X responded to the the trans population’s need for a place where they can have access to healthcare without being mistreated by healthcare personnel or even other patients.  These findings were based on the qualitative study mentioned above, in which 20 focus groups were held throughout the country.  Each discussion resoundingly suggested a specific healthcare space for the trans population was vital.

The medical center was launched as a clinic for all LGBTI individuals to be as inclusive as possible; however, the clinic primarily services trans individuals, simply due to the turnout of the organisation’s community members and social networks.

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Figure 8. Facebook page of the first LGBTI-specific counseling and medical center in Ecuador

Therefore, in spite of its name, the clinic specialises in trans health.  To date, the clinic has been successful in serving trans clients because of the focus on the health issues that matter to the population, including supporting positive body images for trans people and helping them claim their sexual lives.  By addressing structural issues, Silueta X is more likely to see greater enrollment in such health services.

It is undeniable that identifying these challenges and finding solutions for them has not been easy.  Nevertheless, Silueta X recognises the power of social networks and communication technology to increase the organisation’s reach and effectiveness.  In addition, Silueta X has been able to offer comprehensive services, including both physical and mental health, and to collect patients’ medical data.   HIV testing is required for individuals before they receive hormone therapy.  Thus, the number of community members seen at the clinic is growing due to the trans- specific healthcare that is provided.  Silueta X provides effective and healthy hormone therapy provided by specialised doctors, and promotes this service to draw clients in on both a fieldwork level and through technologies such as social networks, e-mails, and even phone apps like Whatsapp.  During hormone therapy, the staff speaks to patients about the importance of caring for their sexual health by using support from the Department of Public Health. At the same time and as part of the process (with their consent), Silueta X asks them to undergo HIV testing.

It is worth mentioning that coming up with this process has not been easy.  In 2013, Silueta X did empirical work in implementing proposals for hormone therapy follow-ups.  Afterwards, staff was offered financial resources to develop a formal protocol for appropriate use of hormone therapy as administered by a doctor.

It should be noted that the process of hormone therapy is important in identifying people who are living with HIV.  In fact, we have considered all necessary factors in order to protect the confidentiality of those who have been tested.  This has given the population confidence in us, and caused them to promote the services that we offer.

Of the nearly 271 female trans individuals who have a chart at our medical center, 135 have been tested.  Twenty-eight of these trans individuals have tested positive for HIV.  It should be pointed out that the center uses rapid tests and therefore these data should be verified atpublic medical centers that administer micro-ELISA and western blot tests.  In this aspect we are still working out an agreement with the Department of Health so that we can access data that we have sent regarding these 28 individuals who tested HIV positive.

The first signs of satisfaction have been seen in our very own members.  In spite of not having yet been formally documented, they have made their satisfaction publicly known.  Below is a local news piece on the care provided at our medical center and a statement by one of our trans members:

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Figure 9: Local news piece on the care provided at the LGBTI medical center at https://www.youtube.com/watch?v=YsQm8Mq0Wh4

The whole program has been based on the experience and goodwill of the doctor and psychologist currently working at our medical center.  Due to the fact that the classification and behaviour of the trans population does not vary for the most part, our model that is under development could be implemented in other places in Ecuador and across Central and South America

Conclusion

In our experience, we estimate that Silueta X’s innovative ‘gender affirming’ sexual healthcare and HIV prevention methodology, complimented by both advocacy and demand creation activities through the use of communication technology, has affected the trans population in positive ways.  Even with the lack of support received by the Department of Health, which has only passed legislation but not acted to implement it.  Based on several meetings, including one held at the university hospital during which we thoroughly discussed the issue of hormone therapy, we recognised that other centers could not meet the demand for hormone therapy at this time. Thus, we created our own center as a pilot project to entice the government to implement their legislation.  Additionally, through our program, Silueta X is able to collect and store medical outcomes of trans clients, which could benefit researchers, advocates, and government.  We even hope to increase the capacity of our services to expand on a national level since there are many trans individuals who want to have access to our services, but unfortunately are from other provinces where access is difficult. Our pilot project is becoming a comprehensive HIV care model for the trans population, and we have decided that it is useful to share our experience so that it can possibly be replicated in other contexts.

ICTs have been the cornerstone of our successful efforts to advocate for and serve trans individuals.  With our daily e-blasts, Silueta X is recognised as a regional leader on trans rights and GLBTI health.  We consistently are looking for new technologies that would further our cause.  Clearly, in this day and age, these technologies make it easier to help trans individuals and allies get involved in demanding their rights.

Our next challenge is signing a formal agreement with the Department of Health, so that we can link our medical database to the national one (especially in cases of HIV diagnosis).  Unfortunately, this issue is a major challenge due to the fact that the new Comprehensive Organic Penal Code penalises the divulging of medical data.  The Department of Health will not come to an agreement on the confidentiality of the data of people who have had a seropositive test result since there is a new penal law, and many public healthcare officials do not want to provide public information on statistical data regarding HIV prevalence unless they divulge it themselves whenever they see fit.  So the information becomes monopolised using the new law as justification when the statistical data do not have anything at all to do with the new law.

Of our 28 trans members living with HIV, close to 13 have come back to our offices and continued therapy with the psychologist.  Nevertheless, we have 12 that are not participating, and we can identify those who have quit.  Our goal is not only to identify HIV prevalence, but also to give follow-up to trans individuals living with HIV.  Above all, we understand that individuals living with HIV are still discriminated against in Ecuador, and it is necessary to consider that an HIV-positive trans individual is dually discriminated against.

We will continue researching how ICTs can help Silueta X attract and educate the LGBTI population, provide outreach, and pressure state institutions to take action.  While we have been taking full advantage of ICTs, we believe that perhaps there are means that we have not identified to improve the productivity of our outreach.

Acknowledgements

I want to thank the team of individuals who worked with me to write this manuscript, first in Spanish and then to translate it into English.

References

Asociación Silueta X (2012).  Estudio descriptivo de los factores influyentes, en la incidencia del vih y discriminación de las trans femeninas en la costa ecuatoriana, durante el 2012.  Retrieved from

https://siluetax.files.wordpress.com/2012/06/estudio-descriptivo-de-los-factores-influyentes-en-la-incidencia-del-vih-y-discriminacion-de-trans.pdf

Asociación Silueta X (2013). Libro del Informe de Acceso a la Justicia y Derechos

Humanos de los TILGB en el Ecuador 2010 al 2013. Retrieved from: http://siluetax.files.wordpress.com/2012/06/informe-del-acceso-a-la-justicia-y-derechos-humanos-de-los-tilgb-glbti-lgbti-orientacic3b3n-sexual-e-identidad-de-gc3a9nero-en-el-ecuador-2010-al-2013.pdf

Constitution of the Republic of Ecuador (Vol. 2, p. Articule 11). (2008).

El Telegrafo (2013). ‘Hoy se inaugura el primer centro de salud trans-lésbico’. 2013, May 8). Retrieved from: http://www.telegrafo.com.ec/sociedad/item/el-55-de-la-poblacion-glbti-sin-atencion-medica.html

Forum, Psychology and the Department of Health on the depathologization of transsexuality. (2012, October 15). Retrieved October 15, 2014.

Four oversights will be created for the GLBTI community in Ecuador. (2013, January 1). Retrieved October 15, 2014.

Garcia, M. (2012). Ecuador: Lesbian Activist Appointed to Presidential Cabinet.  The

Advocate, January 24, 2012. Retrieved from http://www.advocate.com/news/daily-news/2012/01/24/ecuador-lesbian-activist-appointed-presidential-cabinet

National Institute of Statistics and Censuses. (2013). Retrieved from: Programa Nacional de Estadística. Retrieved from: http://www.ecuadorencifras.gob.ec/documentos/web-inec/Normativas%20Estadisticas/Planificacion%20Estad%EDstica/Programa%20Nacional%20de%20Estadistica.pdf

Martínez Dalmau, Rubén. Ecuador: Los 444 artículos de Montecristi. Retrieved from http://www.rebelion.org/noticias/2008/7/70772.pdf

Pan American Health Organization  (2012). Respuesta Nacional a la Epidemia del VIH. Retrieved from: http://www.paho.org/ecu/index.php?option=com_docman&task=doc_download&gid=398&Itemid=.

Salazr, G, (201). ¡La muerte, el precio a pagar por la belleza! Extar.ec. (2011, August 11). Retrieved from: http://www.extra.ec/ediciones/2011/08/25/especial/la-muerte–el-precio-a-pagar-por-la-belleza/

Salazr, G, (2013). ¡Primer consultorio médico trans! Extar.ec. (2013, May 1). Retrieved from: http://www.extra.ec/ediciones/2013/05/09/especial/primer-consultorio-medico-trans/

Salazr, G, (2013). ¡“Cristina” murió por querer ser hermosa!. Extar.ec. (2013, May 3). Retrieved from: http://www.diario-extra.com/ediciones/2013/05/06/cronica/cristina-murio-por–querer-ser-hermosa/

Biographical Statement

Diane Marie Zambrano Rodríguez was born on March 16, 1982 in Guayaquil – Ecuador.  She is a male to female transgender activist working for human rights and LGBT issues. Diane is currently the president of Silueta X, a trans specific health and advocacy organisation as well as the representative of the “LGBTI Observatory of Ecuador”. In 2009 she successfully advocated for the Ecuadorian government to legally allow transgender people to change their names. During the elections of February 2013, Diane became the first openly transgender candidate to run for public office in Ecuador. Through Diane’s intense advocacy, she was able to obtain funding from multiple donors for a trans-specific health care center in Guayaquil that specialises in hormone replacement therapy.

Editorial

Darrin Adams
Kent Klindera
Christopher S. Walsh
R. Cameron Wold

Published Online: November 15, 2014
Full Text: HTMLPDF, FULL ISSUE

Abstract

This Special Issue of Digital Culture & Education (DCE) provides innovative programmatic approaches to HIV prevention and care services for gay men, other men that have sex with men (MSM) and transgender persons using information and communication technology (ICT) at a time when these same populations are experiencing an alarming upward trend of new HIV infections. During a successful participatory consultation in Washington D.C. in May 2013 hosted by the U.S. Agency for International Development (USAID) and co-supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), amfAR, the Foundation for AIDS Research, and the National Institutes of Mental Health (NIMH), representatives from Africa, Asia, the Caribbean, Latin America, Europe, Australia and the United States shared innovative uses of communication technology across HIV research, programs, outreach, advocacy and public-private partnerships.   Believing it crucial to share their innovations more widely—through open-access channels—led us to working in partnership with these frontline workers, activists, researchers and educators to further document and share their technological innovations in different global contexts.  Importantly, we prioritised working with frontline workers and activists by providing cyclical and targeted writing mentoring to assist them in writing about their successful digital interventions. Disseminating this timely work through open-access channels, like Digital Culture & Education (DCE) means that researchers in less resourced institutions, practitioners and activists in the field and the general public can better understand how ICT, particularly mobile technologies, provides unprecedented opportunities to more effectively reach and engage gay men, other MSM and transgender populations across the HIV prevention, testing, treatment and care cascade.

Keywords: HIV, gay men, men that have sex with men (MSM), transgender, Information and communication technology (ICT), HIV prevention, HIV treatment, Internet, communication, mHealth

Introduction

This Special Issue of Digital Culture & Education (DCE) celebrates and shares the timely and crucial work of frontline workers, activists, researchers and educators working in the field of HIV prevention, testing, treatment and care.  It builds on, and extends. the work included in an earlier collection of related open-access articles published in this journal entitled, ‘Building the HIVe’ (Singh and Walsh, 2012).  This Special Issue acknowledges that combination HIV prevention, that draws on “evidence-informed strategic, simultaneous use of complementary behavioural, biomedical and structural prevention strategies” (UNAIDS, 2010, p.5) can effectively and successfully work to address the contextual and diverse needs of gay, other MSM and transgender populations.  The articles presented in this Special Issue emerge from a successful technical consultation entitled ‘Innovative Use of Communication Technology for HIV Programming for MSM and TG Populations” held in Washington DC in May 2013. The consultation and the articles presented here recognise the strong synergy between biomedical and social science approaches to HIV that work by:

  • Understanding emerging trends in gay men, other MSM and TG populations’ use of ICT;
  • Identifying innovative programmatic approaches and lessons learned for reaching gay men, other MSM and TG populations using technology;
  • Informing strategies for future gay men, other MSM and TG populations’ programming and research; and
  • Working to engage the private sector and public health partners in the use of ICT to better reach gay men, other MSM and transgender populations with HIV prevention and care messages and linkage/referrals to social and health services.

As a result of the technical consultation, nine important recommendations[1] emerged from discussions among diverse frontline workers, activists, researchers and educators (Alexanderson, Chintalova-Dallas and Cornman, 2013):

  1. Develop targeted content that specifically addresses TG populations’ needs
  2. Foster intersectoral collaboration
  3. Understand the strengths and limitations of virtual and physical spaces and identify opportunities to incorporate both into HIV programs
  4. Present the human face of HIV
  5. Think of health providers as users too
  6. Improve monitoring and evaluation for ICT programs
  7. Know the audience
  8. Respect and protect
  9. The time to prioritise ICT is now

The articles presented in this Special Issue of DCE take up, exemplify, illustrate and provide timely guidance on current innovations and lessons learned across diverse cultural contexts. The Special Issue contributes, collectively, to make the above recommendations a reality in order to stem the tide of new HIV infections among gay men, other MSM and transgender populations.

Leveraging ICT to transform current HIV research, prevention, treatment, care, support services and programing

Transgender persons and men who have sex with men (MSM), including gay-identifying men, face an alarmingly high burden of HIV globally. This is confirmed by high HIV prevalence and where available, incidence rates (Beyrer et al., 2012; Sullivan et al., 2009; Baral et al., 2013). In available global HIV incidence rates among MSM, HIV infection is significantly higher for MSM than in the general population over a one-year period. For example, in Kenya, Malawi, and Thailand, HIV incidence over a one-year period among MSM is reported to be 5.8 percent, 7.1 percent, and 5.9 percent, respectively (Baral IAS 2013; Sanders et al., 2012; Van Griensven et al., 2013). HIV prevalence among MSM in high-income settings surprisingly mirrors their low- and middle-income country counterparts. Overall new infections are on the rise in the United States, particularly among young black MSM (Sullivan et al., 2009; CDC 2012; Maulsby et al., 2013; Sullivan et al., 2014). The UK, Western Europe, and Australia have also experienced recent increased HIV incidence increases among MSM (Phillips et al., 2013; Sullivan et al., 2009; Murray et al., 2011).

Insufficient data on HIV prevalence or incidence exists for transgender persons worldwide. A recent global systematic review (Baral et al., 2013) reports transgender women are nearly 50 times more likely to be living with HIV, than adults in the general population and their pooled HIV prevalence was reported at 19.1 % for the countries were data was available. These data indicate a high burden of HIV in transgender women worldwide.

Currently, HIV prevention, treatment, and care programs still remain largely unreachable and often unavailable for many gay men, other MSM and transgender persons. Online sampling of over 3700 MSM in 140 countries reports only 35% had access to HIV testing, 43% to treatment, 35% to condoms and less than 25% to condom-compatible lubricants (Ayala et al., 2013).  A global review reports that MSM are recipients of a small proportion of total HIV prevention interventions (Sullivan et al., 2012). Little is known on the use of and accessibility to HIV services among transgender persons globally, as scarce data exists evaluating evidence-based HIV interventions among this population (De Santis et al., 2010; Garofalo et al., 2012).

HIV research, services and programs for gay men, other MSM and transgender persons are often lumped together under the umbrella term ‘MSM’, yet these populations’ sexual behaviours, practices and HIV risk behaviours differ considerably. Gender identity, gender expression, sexual behavior and sexual orientation are factors that need to be considered separately (Wolf et al, 2013). These categories and their local understanding shift—in scope and perspective—at the global, regional, country, and even municipal levels The ubiquity of ICT and new and emerging applications—including geo-social apps (Grindr, Jack’d, Hornet, MISTER, etc.)—provide unprecedented opportunities to complement, even transform, current  HIV research, prevention, treatment, care and support services and programing to fill the data and service provisions’ gaps for these key populations. Gay men, other MSM and transgender persons use apps on smartphones and websites to find romantic and sexual partners (Allman et al., 2012; Beck et al., 2012; Chaiyajit and Walsh, 2012; Dasgupta, 2012: Henry et al., 2012; Scheibe, Brown and Bekker, 2012; Singh and Walsh, 2012; Shenck and Singh, 2012; Allison et al, 2014). The articles in this Special Issue take a step forward in further addressing these issues and reporting on successful and innovative programmatic approaches.

Networking to build the HIVe

This Special Issue of Digital Culture & Education (DCE) showcases the diverse ways gay men, other men who have sex with men (MSM) and transgender persons engage and use ICT for HIV research, prevention, treatment, care, support services and programing.  The purpose of this Special Issue is to share and learn from non-governmental and community-based organisations’ innovative practices using digital technologies to scale up HIV-related services and support for sexual minority communities worldwide and to continue and improve the ‘Building the HIVe’ work begun in 2012 (Singh and Walsh, 2012).

Forty-four prominent HIV activists, scientists, researchers, entrepreneurs and public health leaders shared and debated how the internet, social media, and other forms of ICT are improving—or have the potential to improve—the impact of HIV programs for gay men, other MSM and transgender persons. Meeting participants included representatives from Africa, Latin America, the Caribbean, Asia, Europe, Australia and the US.  The goal of the meeting was to provide a forum for key stakeholders in HIV research, programming, implementation and evaluation to take stock of important developments in the field and develop key recommendations to enhance the use of ICT in the delivery of HIV prevention and care for gay men, other MSM and transgender persons (Allison et al., 2014). Following the consultation in Washington D.C. in May 2013, all participants were invited to submit manuscripts for the Special Issue. The call for manuscripts was broadened to include other community-based organisations and partnerships innovating by leveraging ICT productively in the fight against new HIV infections.

This Special Issue of DCE complements academic and biomedical publishing through introducing a dynamic writing mentorship process with academics, researchers and activists to assist frontline and community-based organisations publish their innovations, results and ‘lessons learned’. We drew on a cadre of experienced professionals who provided pro-bono writing mentorships for those individuals with less experiencing writing up their successful programmatic approaches into journal articles. We undertook multiple rounds of editing and peer reviewing and provided access to critical resources often unavailable to individuals working in community-based and led organisations. Recognising the diversity of authors across professional, academic, and English language proficiencies, this Special Issue highlights community-led efforts through this unique publishing opportunity. An important goal of this Special Issue is to publish successful interventions through open-access channels in their entirety, not just the abstracts.

This Special Issue showcases a rich and representative sample of innovative programming, findings and recommendations from different contexts.  Guest Editors and authors from the Special Issue attending the 2014 International AIDS Conference in Melbourne Australia highlighted their work at the 2014 MSM Global Forum Pre-Conference: ‘Setting the Pace: Gay Men, MSM, and Transgender People in the Global AIDS Response’.  All of the articles from this Special Issue will also be added to The HIVe, an open-access networked ecology of HIV activists, practitioners, researchers and scholars. Following this, an edited and expanded book will be published under a Creative Commons (CC) license, including articles from this and the previous Special Issue. This forthcoming edited book will be completely open-access and shared widely through our collective networks.

DCE continues the journey to build The HIVe by developing, exploring, and substantiating the creative and effective merging of HIV and ‘e’ around sexual-social practices and networks, which can shape and influence the future of interdisciplinary and interconnected public health, human rights and education programs and policies (Singh and Walsh, 2012). The HIVe is a constantly evolving alternative resource for frontline and community-based workers to access social science and biomedical research and prevention practices that are normally inaccessible because this research is not commonly published in open-access journals.

Diverse voices, unprecedented innovation

With ten contributions from diverse settings working across HIV research, prevention, treatment, care and support we have organised the Special Issue into four sections.  Section one presents formal research from Asia and the US with HIV positive MSM which has implications for scale up of HIV services for MSM and transgender persons. The next section highlights the successful work of international NGOs working in collaboration with community-based organisational partners in Central America, Ghana and China. The third section showcases four community-led interventions in Sweden, Thailand, Tanzania and Ecuador. Then section four provides a new perspective on the potential application of public-private partnerships in the use of ICT, particularly geo-social apps, in reaching gay men and other MSM with important HIV health related information in Australia and the US.

Scaling up HIV services for MSM and transgender communities

In their article “Achieving HIV risk reduction through HealthMpowerment.org (HMP) a user-driven eHealth intervention for young Black men who have sex with men and transgender women who have sex with men”, Kathryn E. Muessig, Nina B. Baltierra, Emily C. Pike, Sara LeGrand and Lisa B. Hightow-Weidman succinctly illustrate how young, Black men who have sex with men and transgender women who have sex with men (YBMSM/TW) who are disproportionately at risk for HIV and other sexually transmitted infections (HIV/STI) can be reached through an online mobile platform. HMP’s platform is an innovative mobile phone optimised online intervention that utilises behaviour change and gaming theories to reduce risky sexual behaviours and build community among HIV-positive and negative YBMSM/TW.

Benjamin Hanckel, Laurindo Garcia, Glenn-Milo Santos and Eric Julian Manalastas present work that confronts the sexual stigma, HIV-related stigma and isolation HIV-positive gay men and other men who have sex with men (MSM) experience when accessing information related to HIV.  Their study presents the human face of HIV by exploring the technology use of HIV-positive MSM. Their research was part of a formative assessment undertaken at the initial stage of the development an information and communications technology (ICT) resource and peer-support web-app for HIV-positive MSM in Southeast Asia.  Hanckel, et al.’s work tentatively illustrate how the capability deprivations experienced by HIV-positive men can be overcome by mobilising Amartya Sen’s capability approach to developing an ICT resource that addresses the deprivations and information deficiencies of HIV-positive MSM by enhancing peer support and increasing access to HIV-related information and resources.

Working in collaboration with community-based partners

In their article, “Hidden on the social media”: HIV Education on MSM through Cyber-educators in Central America”, Jorge Rivas, Jennifer Wheeler, Marcos Rodas and  Susan Lungo present how they worked with The Pan-American Social Marketing Organization (PASMO) to develop a combination prevention intervention in Central America that delivers HIV prevention behavior change communication (BCC) messages, products, services, and referrals to promote improved condom and condom-compatible lubricant use, HIV testing, violence reporting and the use of complementary services. This innovative online “cyber-educator” intervention for MSM provides virtual one-on-one BCC and HIV counseling and testing referrals launched.

Kimberley Green, Phillip Girault, Samuel Wambugu, Nana Fosua Clement and Bashiru Adams describe the ‘Strengthening HIV/AIDS Response Partnerships with Evidence-Based Results (SHARPER)’ intervention which reached 92% of the estimated number of MSM in Ghana with HIV prevention interventions.  Achieving this significant reach at scale was the result of changing their earlier approach using face-to-face traditional outreach activities which only reached and estimated half of MSM in Ghana.  By being innovative, resourceful and collaborative with MSM affiliated with CBOs, they began using social media to reach an additional 15,440 unique MSM in addition to the 12,804 MSM they reached through traditional outreach activities involving peer educators.

In China gay men and other MSM who use ICT to meet up are less likely to visit ‘traditional’ venues where they can receive interpersonal HIV prevention interventions. In their article, ‘Two internet-based approaches to promoting HIV counselling and testing for MSM in China’, Matt Avery, Gang Meng & Stephen Mills present how FHI 360 and Guangzhou Tongzhi (GZTZ) piloted separate, but complementary, approaches to using ICT to promote uptake of HIV counselling and testing (HCT) among gay men and other MSM in three Chinese provinces: Yunnan, Guangxi and Guangzhou.  Both interventions included dedicated websites featuring online risk assessment and appointment making, crowd-sourced service promotion messages and dissemination via participants’ microblog accounts and social media profiles.

Community-led interventions

Nicklas Dennermalm introduces how the Swedish Federation for Lesbian, Gay, Bisexual, Transgender and Queer Rights (RFSL Stockholm) designed the Röda Paraplyet webpage in collaboration with male sex workers and Rose Alliance, a leading sex worker organisation in Sweden. His article, ‘Resistance to the Swedish model through LGBTQ and sex work community collaboration and online intervention’ stresses the need for targeted community-based sexual health services in Sweden because sex workers are often viewed as ‘victims in denial’ by public health authorities.  Dennermalm critiques the ways Swedish sexual health interventions traditionally focus on women and utilise face-to-face interventions and exit strategies over interventions targeting male and/or transgender sex workers that utilise harm reduction approaches or low threshold on-line interventions.  His work with Röda Paraplyet illustrates how a broad coalition between organised and non-organised sex workers, LGBTQ organisations, academics and the health care system can creating a sustainable platform of multi-disciplinary knowledge to improve the sexual health and legal rights of sex workers in Sweden and globally.

In ‘TLBz Sexperts! Using Information Technology to Get to Zero HIV Infections among Thai Transgender People’, Nada Chaiyajit argues that because access to sexual health information that serves the needs of transgender individuals is non-existent or severely limited, “Getting to Zero”—the official UNAIDS campaign to achieve zero new HIV infections, zero discrimination and zero AIDS-related deaths—is impossible. Chaiyajit’s article identifies gaps and challenges in HIV services for transgender individuals living in Thailand.  By recognising the need for the ‘de-coupling’ of transgender services from those serving gay men and other MSM, she describes an innovative ICT project, the Thailadyboyz (TLBz) Sexperts! The program is a low-cost, transgender-led, community project offering accurate online transgender-specific sexual health information, social support and legal advice.

Collins M. Kahema, John Kashiha, David Kuria Mbote and Michael R. Mhando’s article describes how Tanzania Sisi Kwa Sisi Foundation (TSSF) used online HIV peer education and outreach methods, particularly with Facebook, to increase HIV prevention knowledge and encourage the use of health services, condoms and lubrication among MSM in Tanzania. Their article, “Bambucha Media: Using social media to build social capital and health seeking behaviour among key populations” describes how TSSF launched educational campaigns using various social media that pre-existing members reported using for social and sexual networking, or “hooking up”. As a community-based organisation with limited resources, TSSF’s Bambucha Media (in Swahili ‘bambucha’ means cool) is innovative in the way it has designed a non-traditional avenue to provide HIV and AIDS information and referral. In a country where sexuality remains a major taboo subject, providing health messaging and forum discussions to educate about HIV, alert users when safe sex supplies are in stock or not, facilitate online discussions and sharing and provide direct peer counselling via private messages when needed and requested not only allows them to open up communication lines with gay men, other MSM, transgender persons and sex workers in the first place, but also enables TSSF to provide needed follow-up on specific and targeted HIV services.

Diane Marie Zambrano Rodríguez’s article, ‘Silueta Z: Lobbying to establish a specialised LGBTI counseling and medical center in Ecuador’ presents Asociación Silueta X which is working to creating accessible living conditions for lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals with an emphasis on the transgender and intersex population In Ecuador.  Silueta X engages social media via social networking sites and apps—especially Facebook—to   provide its LGBTI members with updates about its organisational and advocacy activities.  Silueta X leverages the powerful role of social media and has created specific sites and accounts for different activities.

Forging public-private partnerships

Yves Calmette describes how ‘Ending HIV’, an interactive social marketing campaign based on peer-education principles that incorporates communication, campaign and community mobilistaion initiatives, is working to ‘end’ HIV in New South Wales Australia by 2020.  His article, ‘Ending HIV: an innovative community engagement platform for a new era of HIV prevention’, argues ending HIV is possible.  ACON’s Ending HIV campaign was launched at the start of the 35th annual Sydney Mardi Gras festival. This multiplatform campaign is targeted at gay men to educate them about the real possibility that HIV transmission in New South Wales (NSW) Australia could be virtually eliminated by 2020.

Carl Sandler, a gay social networking entrepreneur and the developer of the geo-social networking app for gay men, MISTER, discusses the enormous reach and untapped potential of private sector geo-social networking. He makes the case for better coordination and flexible funding between the public health sector and the private sector for nimble, timely responses to public health crises while building a sense of community among users of the MISTER app. He argues the public health sector can work effectively with app developers becasue apps can reach thousands of users a day.

Thinking differently about the future of HIV prevention and care with ICT

The editors anticipate this Special Issue will motivate implementing partners and other community-based actors to continue to be creative and innovative in their endeavors to further the use of ICT for HIV services. Individually—and collectively—the articles illustrate the potential impact of innovative programmatic approaches to HIV prevention and care services for gay men, other MSM and transgender persons using ICT at a time when these same populations are experiencing an alarming upward trend of new HIV infections. The articles in this Special Issue present creative, promising, emergent and evolving programmatic approaches to be shared widely through open-access channels.

With the urgent HIV public health crisis growing amongst gay men, other MSM and transgender people, these innovative programmatic approaches offer models to be further tested and shared for ‘scale-up’.  We hope funders can work collaboratively and creatively to fill the anticipated resource gap for HIV funding for 2015 (UNAIDS, 2013), so that populations disproportionately at risk of HIV can continue to benefit from programmatic approaches similar to those presented in this Special Issue. We also acknowledge, congratulate and celebrate the innovative work and dedication of frontline workers in community-based and led organisations, that despite forecasted shortfalls in funding, continue to be innovative programmatically through ICT.  We believe the profound changes brought about by ICT on sexual practices can increase the effectiveness of social and biomedical HIV and AIDS research, prevention and care. Lets us not forget, ‘the time is now’ to continue improving access to health and human rights for marginalised gay men, other MSM and transgender populations.

Acknowledgements

Digital Culture & Education (DCE) acknowledges the success, dedication and hard work of all the contributors to this Special Issue.  Importantly the editors also acknowledge the cadre of writing mentors, peer reviewers and advisors who provided essential pro-bono services to assist us in making the publication of this Special Issue possible. We also acknowledge and thank Jesse Ko for copy editing all of the articles and Andrew Chong Design for the Special Issue’s cover design.  Importantly, we acknowledge the organisations whose support and funding—of many of the innovations presented in this Special Issue—actually make this work possible, including The United States Agency for International Development (USAID), the USAID-funded Health Policy Project, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and amfAR, The Foundation for AIDS Research. We would like to acknolwedge and thank Diego Solares, David Kuria Mbote, Ben Clapham, Joanne Keatly, Tonia Poteat, Billy Pick, Tisha Wheeler, Tim Mah, Cameron Hartofelis, Suzanne Leclerc-Madlala, Ken Morrison, Ron MacInnis, and Javid Syed for their ongoing collaboration and support.

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Biographical Statements

Darrin Adams, MSPH has led research, programming, strategic information, advocacy, capacity development, and empowerment and engagement initiatives among key populations globally for nearly a decade. He is a Senior Technical Advisor for HIV at the Health Policy Project in Washington, D.C. where he oversees and manages a key populations portfolio. Some activities include development of an Asia Pacific Trans health blueprint, regional MSM policy and advocacy interventions in sub-Saharan Africa, development of global programming guidance for MSM programs, and supporting governance strengthening for African regional MSM and sex worker organizations. Previously as a consultant, Darrin advised a country on how to scale up key population services, enhanced capacity of governments and community-based MSM organizations to conduct HIV surveillance, and has published and presented articles and reports that demonstrate a need for integrated, responsible engagement of key populations in all aspects of HIV service design, delivery, and management. Darrin holds a Masters of Science in Public Health from the Johns Hopkins Bloomberg School of Public Health.

Contact: dadams@futuresgroup.com

Kent Klindera, MPH, has 25 years of experience working on health and human rights programming, with emphasis on HIV-related key affected populations, youth, gender, and behavior change communication.  Currently based in New York City, he serves as the Director of the GMT Initiative at amfAR, the Foundation for AIDS Research, managing a portfolio of implementation science grants for HIV service delivery among gay men, other men who have sex with men and transgender individuals (Collectively GMT).  The initiative also supports GMT community led advocacy and service delivery projects, as well as strategies for greater community engagement in research. Previous to amfAR, Kent served as Chief of Party on a USAID-funded male gender norms initiative in South Africa impacting the dual epidemics of gender-based violence and HIV.  He also had a ten-year tenure at Advocates for Youth, directing various initiatives focused on HIV among most at risk youth in the US, the Caribbean and Sub-Saharan Africa.  Kent holds a Masters in Public Health degree from the University of Minnesota and a Bachelor of Science in Political Science from the University of Iowa.

Contact: kent.klindera@amfar.org

Christopher S Walsh, EdD, is an Associate Professor of Education and the Director of Education Programs at Torrens University Australia.  He specialises in digital technologies, literacy, multimodality, international development and HIV education and prevention. Walsh was central researcher on number of highly competitive grants awarded by The Spencer Foundation, The American Foundation for AIDS Research (amfAR), the Australian Research Council (ARC) and the Australian Federation of AIDS Organisations (AFAO) and the European Commission. Currently, he also works as a Senior Research Analyst and Policy Advisor for the Bridges Across Borders South East Asia Community Legal Education Initiative (BABSEA CLE).  He is also the co-founder and co-facilitator of The HIVe.

Contact: christopher.walsh@tua.edu.au

R. Cameron Wolf, PhD, has worked in AIDS-related public health since 1988.  Cameron studied Sociology at the University of Maryland and holds a Master of Science degree from Harvard University and PhD from Johns Hopkins University.  He taught at the University of Maryland and also designed and ran an HIV prevention program for men who have sex with men with AIDS Action Baltimore.  Dr. Wolf began his government service at the HIV/AIDS Bureau in the Health Resources and Services Administration (HRSA) in 2001.  He began work at the USAID Office of HIV/AIDS in Washington, DC in 2003 as Senior Technical Advisor for M&E and later as Senior Regional HIV/AIDS Technical Advisor for USAID’s Regional Development Mission Asia (RDMA) based in Bangkok in 2007.  He served as Acting HIV Team Leader for RDMA from 2010 until his return to the USAID/DC Office of HIV/AIDS where he currently serves as Senior Key Populations Advisor. He has authored numerous publications, reports, journal articles and book chapters on HIV/AIDS.

Contact: cwolf@usaid.gov


[1] For more information see: Innovative Uses of Communication Technology for HIV Programming for MSM & TG Populations: May 2-3, 2013, Washington, DC. Meeting Report

Collins M. Kahema, John Kashiha, David Kuria Mbote & Michael R. Mhando

Published Online: September 25, 2014
Full Text: HTML, PDF

Abstract

Recent surveillance data by Tanzania AIDS Commission has shown HIV prevalence among Men who have Sex with Men (MSM), transgender persons (TG) and Sex workers (SWs) to be well above general population estimates. Vulnerability to HIV among the MSM, TG and SWs has been associated with lack of correct and comprehensive information, informed decision, social and internalized stigma, negative legal and policy environment and language barrier.  This paper will describe how Information Communication Technologies – ICTs, used by Tanzania Sisi Kwa Sisi Foundation – TSSF, has supported communication and access to the health services especially through outreach and referrals among the MSM, TG, and SWs in Tanzania.

Keywords: Outreach, Tanzania, TSSF, Social Media, HIV/AIDS, Referral & Advocacy

Background

Vulnerability to HIV infection among the MSM, TG and SWs is associated with lack of access to correct and comprehensive HIV prevention information and services. These populations face discrimination in every facet of life, including in healthcare settings and in access to essential services (Beyrer, 2014). In Tanzania these populations are at greater risk of acquiring HIV than the general population. Recent surveillance has consistently shown HIV prevalence among MSM, TG and SWs to be well above general population estimates. The Tanzania AIDS Commission reports show of the MSM tested 41% were HIV positive, 43.2% had not used any condom with their last casual sexual partner and only 49.1% used condoms with their regular sexual partners. (TACAIDS, 2013, p. 20). To further compound the issue, HIV and sexual health information in Swahili, the official and widely spoken language of Tanzania, is limited, let alone information and education materials for targeted materials for the MSM, TG and the SWs. Criminalization, stigma, and discrimination also play a part in putting barriers to HIV and health service access. Information communication technologies (ICTs) offer distinct advantages to conventional methods in delivering HIV prevention education and legal counsel. Tanzania Sisi Kwa Sisi Foundation (TSSF) uses social media to reach MSM, sex workers (SWs) and trans persons across Tanzania.

Introduction

The Tanzania Sisi Kwa Sisi Foundation is a registered youth voluntary, non-partisan, non-governmental organization (NGO) led by members of Tanzania’s lesbian, gay, bisexual, transgender (LGBT) community, men who have sex with men, and sex workers. It operates as a national organization, with projects that span the geographic scope of the Tanzania Mainland. TSSF’s goal is to promote the dignity, safety, human rights and fundamental freedom for all persons, without regard to gender, ideological, political and sexual orientations. The organization is guided by the mission to pioneer new standards of hope, equity and involvement of their beneficiary populations. The vision is to have a society free of discrimination, preventable diseases, and where all economic, social, civil and, political rights are enjoyed by everyone.

In order to realize this vision TSSF has the following objectives:

  • Create awareness on issues of human rights for young LGBT and their networks
  • Fight the spread of HIV/AIDS, malaria, tuberculosis, cancer and other chronic and deadly diseases through Information Education, and Communication (IEC).
  • Promote, lobby and advocate improving the status and conditions of the young LGBT persons in Tanzania.
  • To create, raise and promote community awareness on issues on human rights, good governance, stigma and discrimination and their causes and effects within the context of sexual orientation and gender diversity.

TSSF’s experience is validated by growing body of knowledge that identify benefits social media brings on board for HIV prevention, treatment and care for the MSM.

…the growing popularity, decreasing digital divide, and multi-functionality of social networking sites, such as Facebook, make this an ideal time to develop innovative ways to use online social networking sites to scale HIV prevention interventions among high-risk groups (Jaganath D. H., 2012).”

One study found that “Facebook could provide a simple, easy to implement and adopt approach to prevent condom use decline for the short-term and that clinics providing sexual health services to youth might benefit from having a presence on Facebook (Bull, 2012).” Yet while “social networking for HIV prevention is an exciting area that combines HIV prevention/public health, engineering/technology (Young, 2012)” only about 12% of the population have access to the Internet with slightly under a million registered Facebook users by the end of 2012 (Internet World Stats, 2012). In recent years however, Internet enabled mobile phones have been on a rapid increase in Africa, including in Tanzania. According to Ihub – a technology company in East Africa, 79.39% of those who had access to Internet in Tanzania, in 2012, did so through their mobile phones (Mutuku, 2012).

Recognizing the limits on face-to-face HIV and health outreach and awareness among MSM and transgender persons, TSSF undertook an Internet outreach program to reach those who may be unreachable due to stigma, discrimination, homophobia, and/or geography. Calling the program Bambucha Media, “Bambucha” in Swahili is similar to American English language slang for “cool”, TSSF launched educational campaigns using the various sites that pre-existing members reported using for social and sexual networking, or “hooking up”. As a community-based organization with limited resources, TSSF’s Bambucha Media includes health messaging and forum discussions to educate about HIV, alert users when lubrication stock replenished (or stocked out), facilitate online discussions and sharing (or to watch and learn passively), and provide direct peer counselling in private messages when needed and requested.

By providing networking opportunity for the MSM in Tanzania, TSSF has in the process created a non-traditional avenue to provide HIV/AIDS information and referral. In a country where sexuality remains a major taboo subject, TSSF uses social media tools, to communicate in general terms, about health services as opposed to writing directly about HIV services at the first instance. Yet once communication lines have been opened, follow-up on specific and targeted HIV services are then provided.

Road blocks to care

In the few places where LGBTI-friendly health services are available, criminalization and stigma and discrimination maintain low levels of service uptake. As the Tanzania Commission for AIDS in its 2013 strategy, titled  Tanzania Third National Multi-sectoral Strategic Framework For HIV and AIDS (2013/14 – 2017/18) notes:

Stigma and discrimination against MSM remains high, posing a significant challenge to outreach and delivery of [LGBT] friendly health services. Given the criminalization of consensual adult homosexual intercourse, the multi-sectoral national response requires significant cooperation from all key stakeholders to ensure that MSM are reached with HIV and AIDS services. (TACAIDS, 2013)

The Tanzanian penal code criminalizes “canal knowledge against the order of nature.” Indeed the Sexual offenses special provisions of 1998 (Tanzania: Act No. 4 of 1998, 1998), reviewed the penal code and added stiffer penalties for attempt and commission of these offenses. The penalties for these offenses now range from 10 years to life imprisonment

The presence of criminalization, fuels social stigma, and crimes against LGBT persons in Tanzania by creating a hostile environment that is characterised by verbal and physical violence, torture and rape, assault, arbitrary arrest, and extortion (Human Rights Watch, 2013). This environment discourages LGBT persons from self-identifying when they seek health services or even avoid seeking these services all together. By going underground, sexual and gender minorities are deprived of critical health and legal information and the Tanzanian health system is kept unaware of their specific health service needs. It is in this environment that TSSF have brought on innovative tools for outreach, such as those offered by ICT.

Bambucha Media

Social media offers a unique opportunity for HIV/AIDS organizations and other health institutions to disseminate health information and even legal counsel quickly, easily, and anonymously. Recognizing the advantages social media brings in reaching stigmatized individuals, TSSF’s approach is to integrate with social media and dating services popular with LGBT people in Tanzania such as Twitter, Whatsapp, Facebook, Instagram, Marafiki, Manjam, and adam4adam. For those who may lack the means and access for social media and the Internet, TSSF sends bulk messages to mobile phones with health information.

Membership

TSSF is acutely aware how the need to hide for fear of violence and criminalization not only drives the MSM underground where they cannot access services, but it also isolates them from meeting their peers. This not only limits their ability to form social capital, but denies them opportunity to know where to access services or even whether services targeting their sexual practice are available. The Social media strategy is focused on addressing this need for providing information on the available services as well as providing linkages to these services.

The outreach is however challenged by the need to navigate a social and political environment that may perceive growing organizational membership negatively as “recruiting people into homosexuality” rather than enabling personal freedom and protection from S&D. An opposition MP in the Tanzanian Parliament even feels that the existing laws need to be made more stringent so that they can punish those who “induce others to become gays or those who promote the behavior (Muga, 2014)” Under the circumstances, TSSF has to craftily use the social media networking tools judiciously both to provide the much needed information, but also to avoid the much feared characterisation as an organization that “recruits” people into homosexuality.

Confidentiality

To accommodate for different confidentiality needs, TSSF also displays its mobile phone numbers and email addresses on the social networking websites so that the MSM can send messages through the short message services (SMS) or emails. Through this channel, people who do not wish to participate openly on social media platforms can still receive information and make inquiries. This mixed approach has allowed TSSF to reach many different members using the form of communication that works for them (Table 1; Figure 1; Figure 2).

Table 1 – Social media tools and registered members reached

Social Media tool

Registered members

Means of Engagement and tracking participation

SMS

2000

SMS exchanges with a database of 2000 numbers

Facebook

500

Membership likes, comments and shares

Instagram

120

Likes and comments

Adam4Adam

80

Profile views and messages exchanged

Marafiki.com

50

Profile views and messages exchanged

Twitter

40

Re-tweets and favourites

Whatsapp

20

Message exchanges

kehma1

Figure 1: Screenshot of the total number of TSSF online outreach page unique ‘likes’ between October and December 2013

kehma2

Figure 2: Screenshot of total number of people who viewed group posts in the TSSF online outreach page from October 2013 to December 2013

Managing online content

TSSF has volunteer Information and Communications Officer who handles communications needs, including updating the various online and offline communications channels. TSSF’s Director and other staff members are also tasked with capturing new information or events that require immediate response; and in doing so, initiate and sometimes participate in online discussions.

Topic Generation

Discussion topics are determined by monitoring important changes in the political, legal and social environment or gauging popular interests through paying close attention to our member’s inquiries. Large-scale social events that concern the scope of TSSF’s work (e.g., World AIDS Day, International Day Against Homophobia and Transphobia (IDAHOT), Transgender Day of Remembrance, Human Rights Day) might also prompt a discussion. Other times, it is a unique encounter with public officials, health officials and religious or cultural leaders that will encourage us to engage with our online and offline members. This way of engagement accomplishes many objectives by informing our members of current events and information, getting their feedback, and creating a place where they can talk freely about the topic and with each other. Recurring topics of conversation posted by our members include LGBT health, human rights, sexual health and reproductive rights, referral services, employment opportunities, security alerts, and social events.

Effectiveness & Sustainability

Social Media tools have proved to be very effective in disseminating information on health services in Tanzania as the Internet increasingly becomes accessible through mobile devices (Pfeiffer, 2014). Targeted social media websites such as Marafiki, Manjam, and adam4adam bring people with similar interests such as sexual orientation or gender identity. This makes it possible to provide outreach and referral information to MSM, TG & SWs. TSSF’s experience has demonstrated that social media tools, serve to reach even the most isolated individuals, if they have access to the Internet because, people with similar interests tend to “flock” together (Jernigan, 2009).  TSSF also engages in weekly analysis of their reach, tracking the performance of their outreach messages, to find out why some messages outperform others in terms of views, feedback or onward sharing.

In a highly dynamic social media environment, sustainability for TSSF’s approach requires ability to constantly adjust health information to this changing environment. The growing fusion between Internet and mobile phone technology has significantly scaled back barriers associated with running social media advocacy strategies. To ensure sustainability of this social media project, TSSF allocates associated costs across all the other projects under implementation. The justification for this cost allocation is that all projects have a communications component, which is effected through online and offline media. TSSF has also been pursuing a “co-branding” strategy, in partnership with mainstream human rights and donor organizations keen on communicating directly with the MSM, TG and SWs in Tanzania. The co-branding approach provides some income that goes into the Social media communications kitty, with the clear desire to making it sustainable in the long run.

Challenges

Given the precarious state of LGBT rights in Tanzania, TSSF is often faced with scepticism about its ability to exist while maintaining its mission and objectives. It becomes important to answer such questions, typically asked by potential members, institutional partners, or government, comprehensively to preserve confidence in its work.

The second challenge has to do with resources; particularly as it relates to attracting and retaining staff members. Managing the numerous social media interactions especially when members increasingly require prompt responses required a fulltime staff member. This has not been possible due to limited resources to hire persons with relevant communication skills.

Another challenge has to do with the language barrier. Since most people understand Swahili, it becomes necessary to translate most of the documents and discussion topics to Kiswahili. Yet it is not always possible to translate scientific  and technical terms (e.g., anal warts, transgender) leading to some people who have yet to encounter these realities to be left out of the discussion forums or even at times to assume things not under discussion.

Another recent challenge has been the withdrawal of TSSF’s registration due to the organization’s presence in online and social media.  On the 4th of April 2014, TSSF’s registration was withdrawn by the government and the reason given was that their social media program was perceived as advocating for homosexuality (Mpekuzi, 2014). This follows a Facebook post that TSSF had posted online as follows:

“je wewe in mwanaume anayejihushisha katika mapenzi ya jinsia moja? TSSF inakualika katika semina fupi, itakayofanyika kesho Ijumaa ….maada zitakazoongelewa ni: Magonjwa ya ngono yanayowaathiri kuchu; Namna ya kujilinda na magonjwa hayo, kujiepusha na magonjwa hayo na tiba …(Are you an MSM? TSSF would like to invite you for a short seminar tomorrow on Friday, ….the agenda will be about Sexually transmitted diseases, and how you can prevent or treat them…)”

The ensuing National debate however proved quite productive for even greater reach for TSSF’s message. Because the news was broadcast over a prolonged period of time, through mainstream media, even those living deep into the country where the organization would never have had resources to provide outreach heard of TSSF’s work. As a result, many people have been writing to TSSF seeking linkages to HIV and other health services.

Examples of ICT use by TSSF

The following snapshots of online discussions, in Swahili with English translations, demonstrate how communications with the MSM can be initiated in a conservative cultural context. The first presents information on an MSM friendly health clinic. At this clinic the MSM are advised to seek services regardless of their sexual practice because the clinicians are competent and friendly enough to engage with them. Just like the other cases below it, HIV/AIDS conversations are not discussed directly since such upfront engagement would be considered culturally unacceptable. However, such information is progressively introduced in the comments sections or at the point of health service uptake. It is noteworthy that even this rather laid back approach to outreach has been criticised as being too upfront for the Tanzanian audience (Muga, 2014).

Discussion 1: Facebook Outreach for Health Services

CLINIC CLINIC CLINIC CLINIC CLINIC

Hivi Unatambua kwamba Clinic yako ya Afya Bora Inafunguliwa hadi Juma Mosi na pia haiangalii wewe ni Bottom, Top, Versetile au Bisexual na pia unatambua kwamba unaweza hata kuja na mwenza wako kwaajili ya uchunguzi wa Kiafya zaidi??

Bado hujachelewa fanya hima uje uonane na wataalamu mahiri ambao wataweza kujibu maswali yako yote yanayohusiana na Ujinsi na Ujinsia wako au Afya ya Mkunduni.Pia unaweza kuwasiliana moja kwa moja wa wataalamu wetu kwa njia ya simu ya mkononi.

[Contact phone numbers removed]

Waweza ongea nao na kupanga mikakati ya kukutana.

Tafadhali tambua Afya Bora ndio Msingi Bora penda maisha jali Afya yako.

Translation

CLINIC CLINIC CLINIC CLINIC CLINIC

Do you realize that clinic for your health and wellbeing is always opened even on Saturdays and it does not discriminate whether you are Bottom, Top, Versetile or bisexual? And also do you realize that you can come even come with your partner for screening in order to remain Healthy??
But you are not yet late; make effort to come and meet vibrant professionals who will answer all your questions about sex and sexuality related to your health.  You all contact us our experts through mobile phone numbers.
[Contact phone numbers removed]
you can talk to them and schedule when to meet with them.
Please note that good health is the good foundation [for life]; love life, care about your health.

Discussion 2: Facebook Discussion the Experience of LGBT High School Students (120 views)

KUCHU/GAYS: Jamani hili swala mashule kuwa na sheria ya kuwafukuza shule wale wanaogundulika kuwa ni gays limeota mizizi sasa.

Jana mtoto wa jirani yangu alirudishwa nyumbani kutoka boarding school kwa kuwa alihisiwa anavitendo vya kishoga. kwavile baba wa mtoto yupo safarini mama wa mtoto aliniomba nimsindikize mpaka shuleni tukasikilize hayo mashtaka. tulipofika tuliambia kuwa yule mtoto alikuwa akihisiwa anavitendo vya ushoga na kinyume ya taratibu za shule ile.

Tulipopata maelezo ya awali toka kwa mwalimu nilimhoji Mwalimu Mkuu na Patron wa wanafunzi kwa kumuuliza ya kwamba waliwezaje kutambua kuwa huyo mtoto ni shoga, Patron wa shule alijibu kwa kuanza kusema ya kwamba wanafunzi wenzake ndio waliomripoti kuwa ni shoga/Kuchu.

Nikawauliza tena “Je wao kama watoa maamuzi waliwahi kumkuta akifanya vitendo hivyo walivyo muadhibu navyo?” walinijibu Hapana ila waliegamia kwenye kauli za wanafunzi.

Swali la mwisho nikawauliza “Je walimpa Mtuhumiwa fursa ya kumsikiliza ama kumkanya?”….

Tafadhali unaweza kututumia kupitia email yetu ya Tanzania Sisi Kwa Sisi Foundation tanzaniasisikwasisi@yahoo.com

Translation

NI Kuchu / GAYS : Friends this question of expelling students found to be gay has taken root in our schools

Yesterday my neighbor’s son was sent home from boarding School after being suspected of homosexual acts. As the father of the child had been traveling the mother asked me escort the student back to school to be told of the charges. When we arrived we were told that the child had been suspected of homosexual acts and is contrary to the school rules.

Initial details from the head teacher I interviewed and the school patron of how they recognized the study was gay, the school Patron responded by starting to say that it was his fellow students who reported him of being gay/kuchu.

I asked them again, “since they are the decision makers had found the student doing the acts for which they were punishing him? ” No they said, but they were relying on information from the other students.

The last question I asked is “whether they had given the student an opportunity to defend himself or even admonish him? ” ….(read more)

Please send us your observations through our Tanzania Sisi Kwa Sisi Foundation email

tanzaniasisikwasisi@yahoo.com

Discussion 3: Questions & Answers (Q & A) session on Facebook peer education (503 views)

JE! UNA MASWALI YENYE UTATA KATIKA MAISHA YAKO YANAYOHUSU HALI YAKO YA KUWA GAY, LESBIAN, BISEXUAL, TRANSGENDER & INTERSEX??

Tafadhali tunaomba mtuandikie Maswali yanayowatatiza katika Maisha juu ya hali yako ya kuwa Gay, Transgender,Bisexual, Lesbian and Intersex tutakujibu na kukupa maelezo kwa Kina.

Translation

DO YOU HAVE ANY CONTENTIOUS QUESTIONS REGARDING YOUR BEING GAY, LESBIAN, BISEXUAL, OR TRANSGENDER AND INTERSEX??


Please we are requesting you to write to us any question that you may have regarding your being Gay, Transgender, Bisexual, Lesbian or intersex and we shall give you detailed responses.

Discussion 4: Call to Report Human Rights abuses & Outreach (629 views)

UDHALILISHAJI UDHALILISHAJI UDHALILISHAJI

Ndugu jamaa na marafiki na wapenzi wetu wote tukiwa kama wadau wa kusimamia haki za kila mwanadamu Tumehudhunishwa na Wimbo wa mpendwa wetu na Rafiki yetu MATONYA alioutoa hivi karibuni unaojulikana kwa jina la “Agwelina” unaopinga Usagaji .

Tunatambua kweli haya ni maisha ya ndani ya kila mtu ambayo kwa namna moja ama nyingine ndivyo anavyofurahia maisha. Tumesikitishwa na ujumbe kwenye wimbo huu kwani umezungumzia upande mmoja wa shilingi tu yaani mabaya ya wasagaji.Kwani hawa hawana mazuri yanayofaa kuimbwa??

Tafadhali ukiwa kama mdau, mshirika, rafiki ndugu pinga udhalilishaji huu kwa kuunga hii kapmeni na kutonunua wala kusikiliza nyimbo wala cd za matonya.

Na hii iwefundisho kwa watu wengine na wenye tabia za kuzungumza mabaya na kupotosha ukweli kuhusu homosexuality tunatambua kila mtu anahaki ya kuishi vile anavyotaka na anavyojisikia imefika mwisho sasa kudharaulika na kunyanyasika kwa vile tu ya jinsi na ujinsia wetu

Tafadhali tunaomba usambaze ujumbe huu kwa wadau wote na members wote na wa like the post.

Translation

ABUSE ABUSE ABUSE

Brothers, family and friends and all of our partners; As stakeholders in the Human rights fraternity, we have been sadenned by the song sung by our beloved friend Tonya known by the name of ” Agwelina ” which seeks to fight homosexuality.

We know that this is about the private life of an individual. We are saddened because this song only talks about one side of the coin – the bad about gays. Is it that gays have nothing good that can be sung about? ?


Please if you are a stakeholder, partner, friend, or brother protest this and join the campaign of not listening to this song or buying any music CDs by matonya.


Please help to spread this message and also ‘like’ the post.

Discussion 5: Peer Education through a Posting on Facebook (501 likes)

SHUHUDA USHUHUDA USHUHUDA USHUHUDA

Du jamani hivi vilainishi kumbe vinasaidia hata kuondoa mapele sehemu zangu za siri,tazama nilikuwa na rashezi katika sehemu ya mkundu nilijaribu kutumia dawa mbalimbali mara nilipoanza kutumia nimeshangaa vimeisha na ngozi ya mkunduni imekuwa nyororo hatari. Nadhani sasa tumepata mkombozi kwani sasa ufumbuzi umepatikana.

Jamani huo ulikuwa ushuhuda wa mdau wetu aliyekuwa Mkoani Morogoro aliyetumia Vilainishi na vikamsaidia.

Wewe unasubiri nini???? Kamata Kilainishi Twenzetu!!!

Translation

TESTIMONY TESTIMONY TESTIMONY TESTIMONY

Du! So lubricants can help to remove rashes in my private parts, I had rashes and  I tried using various medications I was surprised when I started using lubricants the rushes in the anus region are over and it has been very smooth. I think now we’ve found the solution for this.

That was the testimony from one of our member from the Morogoro region, for whom lubricants changed his life

Advocacy Tagline: What you waiting for???? Grab your lubricants my friends!!

Social media/capital

From the foregoing, there are a number of lessons TSSF have learnt over time and can share with our partners in the region. One is that social media is an effective social capital building tool and critical in addressing health service and human rights needs of the LGBT community in the region. Social capital here refers to the building of “networks with shared norms, values and understandings that facilitate co-operation within or among groups (World Bank, 2011).” Given the high social stigma, risk of violence and even rejection by family, most LGBT persons strive to reach out to each other anonymously. Increasingly, social media addresses this need, not just because people can join through the forums, using aliases or hidden identities, but also because of its ability to aggregate many more people together like them. This is especially important in increasing snowballing effect of health services linkages, increasing social capital among the MSM networks and increasing personal efficacy in their HIV prevention, treatment and care needs.

Furthermore, social media tools provide an opportunity to create a system of referrals to MSM-friendly and LGBT knowledgeable HIV service providers. The scarcity of such service providers is most notable in rural areas where essential services are geographically far, even for the general population. An online referral system is thus cost effective and an important way to ensure that LGBT persons who invest in traveling to these locations receive access to qualified services. To date social media has enabled TSSF to refer about 50 people from different parts of the country to HTC services, psycho-social support and supportive medical consultations.

The online forum provides people with space to be and affirm themselves. As one member described it, “It is our home.” As such, it becomes a space for individual and collective empowerment, where members do not have to pretend to be anyone other than themselves. Often, the online social forum becomes a stepping stone for LGBT members to gain the self-confidence and self-acceptance that then lead them to “come out” in real life.

Secondly, social media can proved a broader outreach opportunity for programs working with MSM. HIV and health programs that use “traditional” peer support programs could see a benefit in complementing with online peer outreach and support. Historically, peer support has included a person or persons meeting face-to-face in spaces where LGBT people meet and as referrals through LGBT social network gatekeepers. This method is still valid and should be used in addition to, and as a complement of, online outreach programs. The difference between the two methods, however, is timing.

The online program can respond and dispatch with instant information, collective and dynamic social support that responds to their particular needs, and references and referrals to where users can find in-stock HIV prevention supplies like condoms and lubricants. This instantaneous information exchange can happen anywhere the user normally access the Internet. Physical space peer support, as compared to the virtual/online space, requires planned meeting times or spaces, and appointments can be missed or spaces rendered unsafe.

Though the physical space peer educator can directly address the concerns and questions of a person they are with, the online space gives users the freedom to search for and ask questions and address concerns. This freedom of information has proven beneficial for TSSF member retention and maintaining levels of interest in the Bambucha Media program. Furthermore, the anonymity of social media enables a more accurate estimation of the magnitude a particular problem. It becomes possible to triangulate health problems that people typically keep secret and then reach out to them with information and even encouragement.

In the last few months Nigeria and Uganda have adopted extremely regressive anti-LGBTI rights legislations that further criminalize homosexual conduct and for the first time criminalizing promotion and the organizing of LGBTI rights groups. These regional policies are having an impact in Tanzania. There is a debate now in the Tanzanian parliament on further criminalizing “induce others to become gays or those who promote the behavior (Muga, 2014).”  Our response to this issue is still the same as when there is a hotly debated subject in public domain particularly the press.

TSSF experience has been that, pulling out from commenting on this or any other contentious issues generally lead to the debate dying down – in other words we do not “add fuel to the fire.” During situations such as these we would often pull out the social media campaigns, as well as boycott and urge our partners, friends and stakeholders in the Human rights fraternity to boycott News outlets that advance contentious issues – especially if they do so to increase hostility against the LGBT people.

Conclusion

TSSF’s experience shows that it is possible to engage a considerable number of target audiences through social media and other ICT tools. When working with criminalized and often socially stigmatized populations innovative outreach services can determine success or failure of a particular service or program. TSSF has been able to create, raise and promote community awareness on issues on HIV and other health services, human rights, good governance, stigma and discrimination, even in the context of a socially conservative culture.

Even when the social media engagement led to national debate and eventual withdrawal of TSSF’s registration certificate, their presence in social media still continued to serve its purpose of providing information and linkage to services. Indeed the very discussion online scaled up the reach of these tools since people who had not heard about TSSF and services, began to actively search for TSSF on the Internet.

Programs looking forward to working with the LGBT community under similar social context, particularly in many African countries can find in this approach an effect tool for outreach, peer education and community mobilization.

References

Beyrer, C. (2014). Strategies to manage the HIV epidemic in gay, bisexual, and other men who have sex with men. Current Opinion in Infectious Diseases, 27:1 – 8.

Bull, S. S. (2012). Social media–delivered sexual health intervention: a cluster randomized controlled trial. American Journal of Preventive Medicine, 3(5), 467-474.

Human Rights Watch. (2013). “Treat Us Like Human Beings” Discrimination against Sex Workers, Sexual and Gender Minorities, and People Who Use Drugs in Tanzania. New York: HRW.

Internet World Stats. (2012). Internet Usage Statistics for Africa. Retrieved March 27, 2014, from Internet World Stats: http://www.Internetworldstats.com/stats1.htm

Jaganath, D. G. (2012). Harnessing Online Peer Education (HOPE): integrating C-POL and social media to train peer leaders in HIV prevention. AIDS care, 24(5), 593-600.

Jernigan, C. &. (2009). Gaydar: Facebook friendships expose sexual orientation. First Mond@y, Vol 14, no. 10.

Leonardi, M. P. (2013). Enterprise Social Media: Definition, History, and Prospects for the Study of Social Technologies in Organizations. Journal of Computer-Mediated Communication, 1–19.

Mpekuzi. (2014, April 11). Shirika la Tanzania Sisi Kwa Sisi Foundation (TSSF) Lafutiwa Usajili kwa tuhuma ya kujihusisha na kuhamasisha ushoga Nchini. Retrieved from http://www.mpekuzihuru.com/2014/04/shirika-la-tanzania-sisi-kwa-sisi.html

Muga, E. (2014, March 29th). Dar plans to introduce tougher anti-gay Bill . Retrieved April 7, 2014, from http://www.theeastafrican.co.ke/news/Dar-plans-to-introduce-tougher-anti-gay-Bill–/-/2558/2262374/-/iq7xix/-/index.html

Mutuku, L. (2012, January 13). Mobile Technology in Tanzania. Retrieved March 27, 2014, from Mobile Technology in Tanzania: http://www.ihub.co.ke/blog/2012/01/mobile-technology-in-tanzania/

TACAIDS. (2013). Tanzania Third National Multi-sectoral Strategic Framework For HIV and AIDS (2013/14 – 2017/18). Dar es Salaam: Tanzania Commission For AIDS. Tanzania: Act No. 4 of 1998. (1998, July 1st). Sexual Offences Special Provisions Act, 1998. Retrieved April 1, 2014, from http://www.refworld.org/docid/3ae6b5098

World Bank. (2011). Social Capital. Retrieved from: http://go.worldbank.org/X17RX35L00

Young, S. D. (2012). Recommended guidelines on using social networking technologies for HIV prevention research. AIDS and Behavior, 1-3.

Biographical Statements

Collins M. Kahema is the Information and Communication officer at Tanzania Sisi Kwa Sisi Foundation. He is an actor and is in the main cast of DW Swahili’s radio series called Noa Bongo for the past three seasons. Collins dreams of better world of young lesbian, gay, bisexual, transgender, and sex workers are well informed and educated of various issues pertaining to their life through ICT.

John Kashiha is the Program Director of the Tanzania Sisi Kwa Sisi Foundation, a lesbian, gay, bisexual, transgender, intersex (LGBTI) and sex worker organization, based in Dar es Salaam. Kashiha is a young researcher, social worker, programmer, activist and human rights defender. His research and advocacy over the last six years has enabled him to gain experiences in LGBTI sexuality, human rights and health and HIV/AIDS programming. A graduate of Cooperative and Finance Management, Kashiha received a M.A. in Community Development in 2012.

David K. Mbote works with Futures Group; USAID funded Health Policy Project as policy and advocacy Advisor in Nairobi Kenya. He has over 10 years working in the field of HIV & Human rights advocacy in Africa. He holds an MBA from University of Nairobi and MSc in commerce (finance), from the KCA University.

Michael R. Mhando is a Capacity Building Officer at Tanzania Sisi Kwa Sisi Foundation. He is a Teacher and Accountants. He has been working on the Key Population Issues over three years here in Tanzania, He is the one who Initiate the program called Create a space for Young LGBT where by the learn and overcome the stigma and Discrimination through their talents and He is also initiated the program called Peer to Peer Support Group through the Social Media space. He has earned his BAC in 2010 at Tanzania Institute of Accountancy and has been a Secondary School Teacher for 4 years.

Works Cited

World Bank. (2011). Social Capital. Retrieved from web.worldbank.org : http://go.worldbank.org/X17RX35L00

Young, S. D. (2012). Recommended guidelines on using social networking technologies for HIV prevention research. AIDS and Behavior , 1 – 3.

Bull, S. S. (2012). Social media–delivered sexual health intervention: a cluster randomized controlled trial. American journal of preventive medicine , 3(5), 467-474.

Beyrer, C. (2014). Strategies to manage the HIV epidemic in gay, bisexual, and other men who have sex with men. Current Oppinion in Infectious Diseases , 27:1 – 8.

Internet World Stats. (2012). Internet Usage Statistics for Africa. Retrieved March 27, 2014, from Internet World Stats: http://www.internetworldstats.com/stats1.htm

Human Rights Watch. (2013). “Treat Us Like Human Beings” Discrimination against Sex Workers, Sexual and Gender Minorities, and People Who Use Drugs in Tanzania. New York: HRW.

Jaganath, D. G. (2012). Harnessing Online Peer Education (HOPE): integrating C-POL and social media to train peer leaders in HIV prevention. AIDS care , 24(5), 593-600.

Jaganath, D. H. ( 2012). Harnessing Online Peer Education (HOPE): Integrating C-POL and Social Media to Train Peer Leaders in HIV Prevention. AIDS Care , 24(5): 593–600. .

Jernigan, C. &. (2009). Gaydar: Facebook friendships expose sexual orientation. First Mond@y, vol 14, no. 10 .

Leonardi, M. P. (2013). Enterprise Social Media: Definition, History, and Prospects for the Study of Social Technologies in Organizations. Journal of Computer-Mediated Communication , 1–19.

Muga, E. (2014, March 29th). Dar plans to introduce tougher anti-gay Bill . Retrieved April 7, 2014, from http://www.theeastafrican.co.ke: http://www.theeastafrican.co.ke/news/Dar-plans-to-introduce-tougher-anti-gay-Bill–/-/2558/2262374/-/iq7xix/-/index.html

Mutuku, L. (2012, January 13). Mobile Technology in Tanzania. Retrieved March 27, 2014, from Mobile Technology in Tanzania: http://www.ihub.co.ke/blog/2012/01/mobile-technology-in-tanzania/

Mpekuzi. (2014, April 11). Shirika la Tanzania Sisi Kwa Sisi Foundation (TSSF) Lafutiwa Usajili kwa tuhuma ya kujihusisha na kuhamasisha ushoga Nchini. Retrieved from http://www.mpekuzihuru.com/: http://www.mpekuzihuru.com/2014/04/shirika-la-tanzania-sisi-kwa-sisi.html

Pfeiffer, C. A. ( 2014). The use of social media among adolescents in Dar es Salaam and Mtwara, Tanzania. Reproductive Health Matters, Volume 22, Issue 43 , Pages 178-186.

TACAIDS. (2013). Tanzania Third NationalL Multi-sectoral Strategic Framework For HIV and AIDS (2013/14 – 2017/18). Dar es Salaam: Tanzania Commission For AIDS.

Tanzania: Act No. 4 of 1998. (1998, July 1st). Sexual Offences Special Provisions Act, 1998. Retrieved April 1, 2014, from http://www.refworld.org/docid/3ae6b5098.html: http://www.refworld.org/docid/3ae6b5098.html

Jorge Rivas, Jennifer Wheeler, Marcos Rodas & Susan Lungo

Published Online: September 25, 2014
Full Text: HTML, PDF

Abstract

Most countries in Central America have HIV epidemics concentrated among men who have sex with men (MSM) and transgender women (TW), with prevalence in these populations ranging from 8% in Nicaragua to 26% in El Salvador. High levels of stigma and discrimination coupled with this heavy HIV burden create a major challenge for efforts to reach these populations and combat the epidemic. The Pan-American Social Marketing Organization (PASMO) developed a combination prevention intervention in Central America that delivers HIV prevention behavior change communication (BCC) messages, products, services, and referrals to promote improved condom and condom-compatible lubricant use, HIV testing, violence reporting and the use of complementary services. As part of this program, an online “cyber-educator” intervention for MSM, consisting of virtual one-on-one BCC and HIV counseling and testing referrals, was launched through existing chat-rooms and websites.  Participants were tracked using a confidential unique identifier code (UIC). In 2013, 7,219 MSM UICs were recorded. Created as a response to social media evolution, this intervention successfully illustrates how innovative HIV prevention education can reach populations most-at-risk for HIV.

Key Words: MSM, social media, peer educators, HIV, Central America

Introduction: HIV in Central America

The Central American region includes Belize, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panamá. Approximately 380,000 people live with HIV in Central America, most of whom reside in El Salvador, Honduras, and Guatemala. Epidemiologic surveillance in the region suggests a concentrated epidemic in large urban areas, with prevalence among the general population ranging from 0.2% to 0.9%, with the exception of Belize, where HIV prevalence is 2.3% (UNAIDS, 2009). HIV prevalence is much higher among MSM (7.5% to 13% across the region) and TW 24% in Guatemala (Soto, R. et al, 2007) and 26% in El Salvador (Hernandez, F. Guardado, M. Paz-Bailey, G. 2010)— The only two countries that have collected prevalence data in this group.

Stigma and discrimination against sexual minorities is high in Central America. According to the public opinion study conducted by USAID/PASCA in El Salvador in 2011, 50% of the general population reported discriminatory attitudes towards high-risk groups, including MSM; 85.1% of respondents agreed that “people have the right to assault trans/transvestites for being who they are” and 72.4% disagreed that “transgender/transvestites have the right to have legal documents that identify them as women.” HIV/AIDS-related stigma is also high, and there is widespread belief that people who are infected deserved their illness because of a wrongdoing usually linked to sex or illegal or socially disapproved behaviors. The same USAID/PASCA study cited above found 38.1% of respondents believed “female sex workers with HIV or AIDS deserve it for their bad behavior.” Another study conducted in El Salvador about Internalized Homonegativity (IH) in 2012 reveals that higher levels of IH shown to be a factor for higher risk behaviors and postponement of health care treatment and adherence (Andrinopoulos K, Hembling J. 2014).

A recent study conducted with 3,748 MSM globally found that perceptions of homophobia within the respondent’s country functioned as a consistent barrier to accessing HIV products and services. Higher levels of homophobia were significantly associated with lower odds of access to condoms, lubricants, HIV testing, and HIV treatment. Similarly, MSM who reported that they would feel comfortable discussing HIV with a health provider were significantly more likely to report access and use of products and services (Ayala G. et al, 2013). Discrimination and stigma towards MSM by health care providers may also result in reluctance to access care, reluctance to disclose sexual behavior or clinical symptoms of STI, negligence or substandard care on the part of the provider, or even refusal of service. (Chakrapani V. et al, 2007)

Homophobia and HIV stigma in Central America result in challenges reaching MSM with HIV prevention, treatment, and care, particularly those who are most socially vulnerable and thus most at risk. HIV prevention, treatment and care programs in the region must confront two key challenges: reaching a population that does not want to be identified and the overly close identification of HIV with sexual minorities, which may trigger further stigmatization, as well as rejection by lesbian, gay, bisexual, transgender groups and communities who strive to downplay the role of HIV in sexual minority politics (Dibble, S. Roberts, S. Nussey, B. 2004). According to the UNAIDS 2013 Global report, the percentage of MSM reached by HIV prevention programs in Latin America remained unchanged, at 51%, between 2009 and 2012. The median condom use at last anal sex in 43 countries also remained unchanged at 57% over the same time period. This stagnation may be due in part to the social inequalities and traditional norms that reinforce stigma towards high-risk groups and in turn interfere with the effectiveness of HIV prevention programs (De Boni, R., Veloso, V., & Grinsztejn, B. 2014).

There is a need to identify better strategies to serve hard-to-reach MSM, including those who are isolated, who do not identify as gay, and who are married, with adequate, sensitive HIV prevention, treatment, and care programs. A new and promising mechanism for reaching these groups is offered by the Internet. This technology is both already used by men who seek sex with other men in many countries in the world, and is also already being adopted as a space where health-related information and referral services can be offered confidentially and securely (Caceres, C. Aggleton, P. & Galea J. 2008).

The PASMO program

The Pan-American Social Marketing Organization (PASMO), with regional headquarters in Guatemala, has the mission of improving the availability, access and use of information, products and key health services, through its social marketing techniques, aiming to significantly contribute to the development of an enabling environment that facilitates good health and a better quality of life for vulnerable people in Central America. PASMO, an affiliate of Population Services International (PSI), began operating in 1997 and has expanded its presence to all countries in Central America, with a local infrastructure in each of the seven countries. In 2010, PASMO and its partners began implementing the USAID-funded Combination Prevention for HIV in Central America and Mexico, with the objective of helping individuals make positive behavior changes and access HIV prevention products and health services by providing a minimum package consisting of behavior change communication (BCC) activities, biomedical interventions, and structural approaches.

The BCC activities are aimed to promote healthy behaviors and must involve a sequence based on the monitoring of prevention work. Traditionally these activities have included a series of methodologies that allow the target populations to interact with the educator and make the intervention more appealing and different. This component would not be complete if you do not have accessibility and availability of products to promote behavior in this case condoms and water based lubricants. All educators must verify the availability of these products on site and/or nearby places so as to ensure that people can find them when needed.

The core component of combination prevention, named the biomedical, comprises all those actions of a medical nature – supporting clinical prevention efforts on HIV, such as STI screening, treatment, testing, detection of viral load, etc.  This component must ensure that each share of combination prevention, people: a) constantly have access to sexual health checks (prophylaxis). B) In case of infections, carry out the treatment prescribed in doses and timing, following the doctor’s instructions. C)  When taking a voluntary HIV test, provide the pre and post counseling. All referrals for this component are made through numbered vouchers that allow the program to count these types of interventions.

The complementary or structural component are the services and/or products that complement the actions called “Combination Prevention”, this is a series of products and/or services based on the specific needs of each population, actions to be considered at this level are: a) referral to support groups (stigma and discrimination, legal support, violence, etc., self-acceptance, nutrition programs (PVS) virtual etc.) b) Reference to Care centers for decreasing behavior related to alcohol/drugs.

Closing the Combination Prevention Cycle

By PASMO’s definition, closing the combination prevention cycle includes ensuring that individuals are exposed to three BCC interventions, one services intervention (either HIV counseling and testing or STI screening and treatment) and one complimentary service referral.

A new intervention

Given the high levels of stigma, discrimination and violence in Central America, new technologies, such as computer-delivered interventions, could be an important means for reaching subgroups of MSM, such as those who are non-gay identified. or who may not feel safe through face-to-face interactions from gay or bisexual peers (Sullivan, P. et al. 2012). Some examples of interventions including educational websites and other more interactive theory-based interventions are shown by Rietmeijer & McFarlane 2009, which translate traditional behavioral interventions to an online format, such as computer-based counseling models or chat-room interventions. These recent advances in interactive and participatory Internet technologies (termed Web 2.0) have transformed the pattern of communication, including health-related communications (Eysenbach, G. 2008). Health communications programs have put forth efforts into identifying new opportunities for using social media to impact population health (Thackeray et al. 2008; CDC, 2014; Norman, McIntosh & Eysenbach, 2008; Vance, Howe, & Dellavalle, 2009). While the implementation benefits of these online interventions, including the ability to target multiple sites from a central operating location and the ability to use real-time data to target the busiest sites for improved reach are clear, (Caceres, C. Aggleton, P. & Galea J.) evidence about the effectiveness of these new interventions in achieving behavior change is emerging.  Some studies have shown that well-conceived, theory-based interventions can achieve short-term changes in proximal determinants of behavior change (such as knowledge, self-efficacy, and motivation) and also on some key sexual risk behaviors, such as condom use during anal sex (Bowen et al. 2008; Carpenter et al., 2010).

As shown by Jones & Fox 2009, the use of social media has grown significantly in Central America over the past decade. Participation in social networking sites more than quadrupled between 2005 & 2009. In order to reach MSM, particularly hidden or non-disclosed MSM, in 2011 PASMO launched and currently implements an online outreach “cyber-educator” initiative that adapts face-to-face outreach to online and social media channels as part of the USAID Combination Prevention Program. The intervention is specifically designed to target young MSM, bisexual men and MSM who do not self-identify as “gay” in all program countries—those who were not being served by other outreach activities that are traditionally implemented in high-risk zones and other physical spaces.

The intervention consists of peer cyber-educators using chat functions to engage MSM in conversations about HIV prevention and initiate BCC activities. Framed in the stages of change model (Figure 1), cyber-educators use information divulged during the conversation to identify where in the behavior change process a user could be with regards to a specific and desired HIV prevention behavior. The BCC engagement is intended to motivate the user to advance to a stage closer to the desired healthy behavior.

rivas1

Figure 1: The Stages of Change Continuum (DiClemente and Prochaska, 1998)

When MSM disclose HIV risk behavior, cyber-educators also provide online referral vouchers for HIV testing and counseling services in clinics where staff are trained and sensitized to provide services to the MSM/TW population. The online voucher system allows users to download vouchers that can be redeemed at partner institutions for biomedical services that are free of charge or provided at discounted prices. An emergent window also offers the user a list of all clinics available in each city. To download the voucher, a link prompts the user to enter data to create a unique identifier code (UIC) and print the online voucher. The UIC is used to track individuals throughout all the program’s intervention components and allows the program to identify individuals reached with each type of intervention (behavioral, biomedical or structural).

Peer outreach workers were recruited and trained as “cyber-educators” to deliver the intervention. The outreach workers were trained in the use and management of online tools and social media for the purposes of behavior change communication. In each country, local teams conducted a formative assessment to identify the most popular websites, chat rooms and social networking sites used by the target population and their patterns of use, including the times of day or night when they were most frequently online. In all countries, the most popular mechanism through which to conduct the online outreach is Facebook. Other country-specific sites like gayguatemala.com are also used.

Given the vast amount of information available on the Internet, cyber-educators must be well versed and prepared to discuss subject matter that is of educational importance and interest to MSM and TW. In addition to the online outreach activities, PASMO developed informational websites that are tailored to the program’s target groups and cover specific topics, such as stigma and discrimination, HIV information, and masculinity (Table 1). The online outreach activities and websites are integrated in that the websites serve as a resource for cyber-educators and as a place to refer users to further HIV prevention information. Constant communication between the cyber-educators and the Webmaster at the regional PASMO office keeps the material on the websites current and responsive to input from the online outreach activities.

Screen Shot 2014-09-27 at 09.44.05

Description of the websites created by PASMO

Monitoring activities is keen when tracking the success of the Combination Prevention Program. A series of procedures and tools are constantly implemented to track the reach of all activities across the region:

  1. a. SAM

SAM is the Activities Monitoring System, which allows the program to enter, store, analyze and generate reports related to all Combination Prevention components; Interpersonal Communication Activities (IPC), Biomedical and Structural. Each site in the region enters their activities, biomedical vouchers and trainings. Monthly, information is exported and sent to the Regional Office, where is consolidated into a central database. In addition, adjustments to overall system configuration, including settings in the various lists interface databases are established and managed from the Regional Office.

  1. b. The Cyber educators portal (www.cibereducadores.com)

Recently launched, this website was created as a complement to the monitoring system and a resource for the difficult labor of tracking online interventions. The website has three main functions: a) Serve as a data-entry source for cyber-educators. b) Transfer information of all online outreach activities to the MIS (SAM). c) Generate unique links to be sent to the users which allow to track the interaction of the user with the link sent and determine if the person opened the link, accessed the website, the frequency of access, and if they downloaded the biomedical voucher for the test or not.

Findings

The cyber-education intervention results

The online outreach activities are now implemented as a mechanism for delivery of BCC through the Combination Prevention Program in all of the Program countries. Using UIC, individuals were tracked through the program interventions and across the services offered by implementing partners. Based on the MIS records as shown in Table 2, during 2013, PASMO was able to reach 7,219 individuals through online peer education activities across Central America. The Program in Nicaragua not only reached, but also doubled its initial target of 1,300, providing online outreach interventions to 2,647 individuals. A total of 2,515 referrals for HIV testing services were provided in 2013 (both online and through face to face interventions) and 145 individuals reached with online activities were counseled and tested for HIV at partner clinics that were trained by PASMO to provide services to MSM.

Table 2: Regional PASMO Combination Prevention interventions January to December 2013

Screen Shot 2014-09-27 at 09.44.46

During the same calendar year, 836 individuals completed a minimum of one BCC intervention, one biomedical intervention and one complementary referral, and 126 (15%) of those 836 closing the cycle did so by participating in at least one online outreach.

The online format of the cyber-educator intervention facilitates the collection of monitoring data that includes: unique identifier code (UIC), type of message delivered, population; and can be used to provide rapid feedback to the program, making the program flexible and responsive. New monitoring data fields can be tracked to assess the implementation of activities. For example, in Costa Rica an increase in duration of online activities from 10 to 20 minutes (on average) demonstrates greater engagement and exposure to the BCC intervention.

The quality and consistency of implementation, however, is difficult to monitor and requires extensive support and supervision. PASMO uses three mechanisms for quality control: 1) reviewing past chat conversations to ensure quality of the intervention; 2) supervising the delivery of the intervention during implementation, and 3) reviewing activity reports provided by the cyber-educators.

The interactive nature of social media also allows users to provide instantaneous feedback and facilitates follow up, both on the cyber-educator and on the user side. Throughout the course of implementation, many users have returned to the webpages to share their HIV test results after having received a referral and to obtain follow-up and support. In Panama, in-person follow-up was provided by cyber-educators to users initially reached online. This follow up consisted of accompanying users to receive counseling and testing, facilitating the use of the referral voucher, and ensuring that they felt safe and confident during the HIV testing process.

No quantifiable information exists about the impact of the cyber-educators component in the change of HIV risky behaviors of the MSM in the region. As part of the evaluation of the Combination Prevention program, PASMO will conduct a quantitative study in 2015 to gather information from a representative sample of the target population. The data collected from this study will allow the program to measure health behaviors, and knowledge and use of health products in the target population over time. From this study programmers will be able to measure effectiveness of the different components of the program including the exposure to the cyber-educators component.

The websites interaction

Traffic on the program websites is high and the number of hits and likes for the webpages has grown significantly:

  • The ”Generación Cero” Facebook fan page (focused on reducing stigma and discrimination) grew from 530 fans (persons who liked the fan-page) in 2012 to 14,059 in 2013, an increase of 13,529 new fans during the last year.  By the end of 2013, the fan page had 177 twitter followers and 60 tweets.
  • The “Y ahora que?” webpage had a total of 7,570 visitors by September 2013—60% of whom were new visitors. This web site also has a fan page on Facebook, which earned a total of 3,457 likes in 2012 and 4,395 in 2013. In 2013 it had 938 new fans, 285 posts and 338 twitter followers.
  • “Mi zona H” webpage had a total of 7,626 visitors in 2013, 74% of whom were new visitors. The success of this web page on the Facebook fan page in the last year is tangible, increasing from 7,667 fans in 2012 to 30,720 in 2013, which indicates in the most recent year, the webpage earned 23,053 new fans—and increase of over 300 percent. Mi zona H had also 80 twitter followers and 172 posts.

Discussion

Reaching hidden populations with HIV programs has been challenging due to various social and political barriers in Central America. HIV programs in the region have worked hard to overcome these barriers. This article describes a pilot program that explored whether advances in social media could be used as an alternative or a complement to traditional health communication channels in Central America. PASMO has found that using virtual chat and web-based approaches for HIV BCC interventions successfully reached a different cohort of MSM population, mostly young MSM, as evidenced by UIC emerging from the online program that are not previously registered through other interventions (Table 3). Some of those reached online also went on to receive other program interventions, including counseling and testing services.

Table 3: Age ranges of MSM exposed to online activities in 2013, by country.

Age range

Country

Total

Guatemala

Costa Rica

El Salvador

Nicaragua

Panama

20 years old or younger

18.1%

14.4%

26.7%

21.7%

26.7%

20.9%

21 – 24

29.0%

26.0%

31.9%

28.4%

27.0%

28.2%

25 – 30

29.4%

26.1%

23.8%

33.0%

24.3%

29.2%

31 – 35

14.4%

13.2%

11.5%

9.9%

10.0%

11.7%

36 – 40

5.2%

9.6%

3.1%

4.0%

7.1%

5.4%

41 years old or older

4.0%

10.7%

2.9%

3.0%

4.9%

4.5%

From 2011 to 2013 more than 10,000 individual MSM were reached through online activities, which represents nearly one-third (31%) of the total population of MSM and TW reached by PASMO with prevention services in Central America. Using the Facebook interactive platform as a resource has made possible to have more than 30,000 persons aware of at least one of the resources available online, according to the fans reported. The use of online activities for the Combination Prevention Program is growing—in Nicaragua, PASMO is no longer implementing BCC activities directly, and now exclusively implements interventions through training and supervision of subcontracted NGOs, making the implementation of online approaches a key component of the overall intervention in that country.

Traffic on the various program websites has also grown significantly; in some cases even more than 10 times from one year to the next. Having thousands of new visitors and “fans” represents an important opportunity to continue delivering messages to a growing audience and maximizing the instant access to information that the internet provides. As an educational program, being present in the popular sites and resources, not only gives the program more exposure but also relevance and credibility, since most of internet users are constantly looking for trends and popularity.

Online interventions have the potential to greatly contribute to HIV prevention programs in the region because they can reach a different demographic within the target group, or serve as an entry point to other interventions, such as counseling and testing.  Several projects in Central America deliver HIV prevention activities through face-to-face approaches or interpersonal educational interventions. Online interventions are a new tool and, if expanded, properly implemented, and integrated into a program that allows for follow up support and services, can improve access, coverage and plausibly improve the effectiveness of combination prevention programs for HIV prevention, treatment and care. The online approaches used by the Combination Prevention Program in Central America are designed so that any organization inside or outside the region can use the materials and tools as references.

The cyber educators program has been able to reach a different cohort of MSM from those reached with face to face interventions; however it is important to understand that other populations in the region have high HIV prevalence. There is no substantial evidence that this program can be replicated with transgender women or female sex workers, and if that were necessary, it represents another series of limitations and challenges that need to be addressed.

Conclusion

As technology and social media continue to develop, new communication technologies represent an opportunity that cannot be ignored. PASMO’s experience with cyber-educators in Central America has been successful in targeting and reaching MSM with key HIV BCC and referral services. Although a new intervention, web-based communication now makes up a third of PASMO’s BCC interventions through the Combination Prevention program, with traffic on websites including more than 12,000 new visitors only in 2013.

Because the Internet is a global tool with increasing coverage, it ensures that this strategy can be replicated in almost any country where the Internet is accessible to a large segment of the population. Using this strategy also becomes important when target populations are difficult to reach through traditional methods, such as interpersonal communication programs. The use of online media provides the opportunity to instantly link the individuals to different sources of information which are not easily replicated in person.

After three years of implementation, some important lessons and limitations in the implementation of web-based communication programs are:

  • Some other populations with high HIV prevalence in the region, such as Female Sex Workers and Trangender women, represent a challenge for this approach. The cyber-education approach is primarily designed from the MSM perspective, which may be irrelevant to these groups.
  • Both FSW and TGW have lower SES and educational attainment than MSM, two factors that are significantly associated with internet access within the region, thus limiting the effectiveness of cyber-educators as a viable intervention.
  • Tracking the virtual vouchers is a challenge in some clinics, particularly when they have not been trained properly. In some clinics biomedical interventions were recorded with no differentiation between personal and virtual referrals because of lack of training.
  • There is no scientific evidence about the impact of this program on changing HIV risk behaviors, however, a new study will be conducted in 2015 aiming to respond to these premise.
  • Cyber-educators need to be trained intensively on the communication process and be mentored for a substantial period after that. Online conversations can be difficult to redirect and manage and the skills necessary to ensure proper implementation of the intervention are not easily learned. Refresher trainings are important to keep cyber-educators updated on health information and new approaches.
  • Continuously monitoring the program is crucial in order to keep content updated and relevant. Monitoring popular trends among the target group allows the program staff to make adjustments immediately, before losing users’ interest.
  • Online approaches have the potential to grow rapidly. It is challenging to adequately and continuously monitor the quality of the educational interventions and ensure rapid and efficient responses when required.
  • More evaluation activities are needed to determine the effectiveness of these approaches and their impact on motivating users to seek HIV counseling and testing and other services.

References

Andrinopoulos K, Hembling J., (2014). Internalized Homonegativity and Its Health-Related Consequences for MSM in San Salvador. 1st ed. El Salvador: MEASURE Evaluation.

Ayala, G., Makofane, K., Santos, G. M., Beck, J., Do, T. D., Hebert, P., … & Arreola, S., (2013). Access to basic HIV-related services and PrEP acceptability among men who have sex with men worldwide: barriers, facilitators, and implications for combination prevention. Journal of Sexually Transmitted Diseases.

Bowen, A. M., Williams, M. L., Daniel, C. M., & Clayton, S., (2008). Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy. Journal of behavioral medicine. 31 (6), pp.463-477.

Caceres, C. F., Aggleton, P., & Galea, J. T., (2008). Sexual diversity, social inclusion and HIV/AIDS. AIDS (London, England). 22 (2), pp.S45.

Carpenter, K. M., Stoner, S. A., Mikko, A. N., Dhanak, L. P., & Parsons, J. T. , (2010). Efficacy of a web-based intervention to reduce sexual risk in men who have sex with men. AIDS and Behavior. 14 (3), pp.549-557.

Centers for Disease Control and Prevention (2014). Social Media at CDC. [ONLINE] Available at: http://www.cdc.gov/socialmedia/. [Last Accessed June 10, 2014].

Chakrapani, V., Newman, P. A., Shunmugam, M., McLuckie, A., & Melwin, F., (2007). Structural violence against Kothi-identified men who have sex with men in Chennai, India: a qualitative investigation. AIDS Education & Prevention. 19 (4), pp.346-348

De Boni, R., Veloso, V. G., & Grinsztejn, B., (2014). Epidemiology of HIV in Latin America and the Caribbean. Current Opinion in HIV and AIDS. 9 (2), pp.192-198.

Dibble, S. L., Roberts, S. A., & Nussey, B., (2004). Comparing breast cancer risk between lesbians and their heterosexual sisters. Women’s Health Issues. 14 (2), pp.60-68

Eysenbach, G. , (2008). Medicine 2.0: social networking, collaboration, participation, apomediation, and openness. Journal of medical Internet research. 10 (3).

Hernández, F., Guardado M., & Paz-Bailey G., (2010). Behavioral Surveillance and HIV/STI Prevalence Survey in Vulnerable Populations, Transgender, Transexual and Transvestite Subpopulation. UVG/Tephinet Inc. Publication. 12 (), pp

Jones, S., & Fox, S. , (2009). Generations online in 2009. Pew Internet & American Life Project., pp.1-9.

Norman, C. D., McIntosh, S., Selby, P., & Eysenbach, G., (2008). Web-assisted tobacco interventions: empowering change in the global fight for the public’s (e) Health. . Journal of medical Internet research. 10 (5).

Prochaska, J.O. DiClemente, C.C., & Norcross, J.C. (1998).  Stages of Change:  Prescriptive Guidelines for Behavioral Medicine and Psychotherapy.  In G.P. Koocher, J.C. Norcross, & S.S. Hill III (Eds.), Psychologists’ Desk Reference.  New York, Oxford:  Oxford University Press.

Rietmeijer, C. A., & McFarlane, M., (2009). Web 2.0 and beyond: risks for sexually transmitted infections and opportunities for prevention. Current opinion in infectious diseases. 22 (1), pp.67-71

Soto, R. J., Ghee, A. E., Nunez, C. A., Mayorga, R., Tapia, K. A., Astete, S. G., … & Estudio Multicentrico Study Team, (2007). Sentinel surveillance of sexually transmitted infections/HIV and risk behaviors in vulnerable populations in 5 Central American countries. JAIDS Journal of Acquired Immune Deficiency Syndromes. 46 (1), pp.101-111.

Sullivan, P. S., Carballo-Diéguez, A., Coates, T., Goodreau, S. M., McGowan, I., Sanders, E. J., … & Sanchez, J., (2012). Successes and challenges of HIV prevention in men who have sex with men. The Lancet. 380 (9839), pp.388-399.

Thackeray, R., Neiger, B. L., Hanson, C. L., & McKenzie, J. F., (2008). Enhancing promotional strategies within social marketing programs: use of Web 2.0 social media. Health promotion practice. 9 (4), pp.338-343

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UNAIDS (2011). “Getting to zero” UNAIDS, 2011–2015 Strategy. [ONLINE] Available at: http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2010/20101221_JC2034E_UNAIDS-Strategy_en.pdf. [Last Accessed September 3rd, 2014].

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USAID/PASCA (2011). Estigma y Discriminación asociados al VIH – Encuesta de opinión pública, Informe regional, Centroamérica. [ONLINE] Available at: http://pdf.usaid.gov/pdf_docs/PA00J4VH.pdf. [Last Accessed February 3rd, 2014].

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Biographical Statements

Jorge Rivas: Senior Quantitative Researcher for the Pan American Social Marketing Organization. With a marketing degree, he provides technical support and builds research capacity in study design, analysis and interpretation of results for new strategies.

Jennifer Wheeler: PSI’s Regional Researcher for Latin America/Caribbean. She manages and provides technical assistance to the region’s research portfolio, including formative and evaluation studies in the areas of HIV/AIDS, FP, and gender violence. Dr. Wheeler has a PhD and MPH in International Health and Development from Tulane University.

Marcos Rodas: Social Media Specialist for the PASMO regional office. He is responsible for the Cyber-educators program, social networks and websites of the projects, developing communication strategies for behavior change communication and strategies to generate traffic on the websites.

Susana Lungo: PASMO deputy Director and COP of the USAID Combination Prevention Program. She has specialized expertise in brand management, new product positioning and communication, consumer research and evaluation.  Ms. Lungo has also extensive experience in Social Marketing, Behavior Change Communication and knowledge in HIV/ AIDS and STI prevention methods.


[1] Belize program was starting the online interventions program in 2013.

[2] Numbers reflect the quantity of individuals that received this type of intervention, based on the UIC.

Yves Calmette

Published Online: September 25, 2014
Full Text: HTML, PDF

Abstract

ACON is Australia’s largest LGBTI health organisation with a primary focus on the prevention of HIV and other sexually transmitted infections (STIs), as well as health promotion with gay men and other men who have sex with men (MSM). This is the group most affected by HIV in New South Wales (NSW), making up around 80% of all new infections annually (NSW Health, 2013). ACON is a community-based organisation, running a number of programs tailored to gay men’s sexual subcultures, practices, ethnicities and ages. In February 2013, ACON launched Ending HIV, the first large-scale campaign designed to meet the new targets set out in the NSW HIV Strategy 2012-15: A New Era (NSW Health, 2011). This strategy set the ambitious targets of reducing the transmission of HIV between gay and other homosexually active men in NSW by 60% by 2015, and 80% by 2020. Ending HIV was designed to mobilise the gay community to reach these targets. Ending HIV is an interactive social marketing campaign based on peer-education principles that incorporates communication, campaign and community mobilistaion initiatives to reach this goal. Ending HIV has been rolled out nationally and has received a high level of international attention, including winning the 2013 and 2014 Sydney Design Award, Australian Creative Best of the Best, Communication Arts Award of Excellence and the 2014 Graphis Annual Design Award. This article explores the genesis of ACON’s innovative engagement platform, which now drives all of ACON’s HIV and STI prevention work, and discusses the approach’s growing promise for prevention for diverse contexts.

Keywords: HIV, Ending HIV, Social Media

Ending HIV: Introduction and Background

2020: Ending the decade, ending HIV. Imagine that.

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In 2013, the NSW Health Minister Jillian Skinner, launched ACON’s innovative education initiative designed to help end the HIV epidemic by 2020. ACON’s Ending HIV campaign was launched at the start of the 35th annual Sydney Mardi Gras festival. This multiplatform campaign was targeted at gay men to educate them about the real possibility that HIV transmission in NSW could be virtually eliminated by 2020. This article outlines the steps that led to ACON’s ground-breaking initiative and its development through the first three phases of implementation to date. These phases included the launch (phase 1) to educate on the possibility of ending the epidemic by 2020. This was followed by a focus on the importance of maintaining the strong culture of safe sex in NSW (phase 2). Finally the campaign focused on testing (phase 3). The 4th phase honing on early treatment will be launched next year.

Ending HIV is possible

In 2011, Australia became a signatory to the United Nations Political Declaration on HIV/AIDS (UNAIDS, 2011). This significant international agreement was endorsed by all UN member states. Given Australia’s leadership role negotiating the Declaration and also Australia’s role as host of the International AIDS Society conference (AIDS2014), it was considered that there would be considerable international interest in Australia’s efforts and progress towards achieving the UN Political Declaration goals (Australian Federation of AIDS Organisations (AFAO), 2012).

The global targets set in the declaration include reducing sexual transmission of HIV by 50%, reducing HIV transmissions through injecting drug use by 50% and eliminating mother to child HIV transmissions by 2015. The Declaration also sets a target of having 15 million people living with HIV in low and middle-income countries on antiretroviral treatment (ARVs) by 2015. Promising emerging research findings (Matassa, M, 2011; Anderson, PL et al, 2013), together with the commitment encompassed in the Declaration, offer nothing less than the possibility of bringing the HIV epidemic to an end.

Australia, the NSW government endorsed this approach and the NSW HIV Strategy 2012-15: A New Era was launched on 1st December 2012. In line with this strategy ACON has committed to work towards reducing new HIV transmissions between gay and other homosexually active men by 80% by 2020.

New biomedical approaches such as Truvada used as post-exposure prophylaxis (PEP) and Pre-Exposure prophylaxis (PrEP) have been called a lot of different things by HIV experts. It has variously been called ‘Combination Prevention’, the ‘Prevention Revolution’, the ‘New Prevention Paradigm’, ‘Treatment as Prevention’ or even ‘Treatment for Prevention.’ Whatever it is that we choose to call it, it is about one thing – Ending HIV.

We are entering into the third and possibly final, phase in the history of HIV/AIDS in NSW. In the first phase in the 1980s, many gay men took up and promoted safe sex practices to protect themselves and their partners from the threat of the virus. Thing changed in the second phase in the 1990s, with the introduction of combination therapy, HIV stopped being a death sentence and became a manageable chronic condition. There was new hope for people living with HIV and HIV stopped being a death sentence. Understandably, condom use declined after this period as HIV became less of a visible threat to gay men. Now, for the first time, we know that treatments can be as effective (if not more so) than condoms. Everything has changed, as we enter into this 3rd phase of the epidemic. Finally we are able to look forward to a day where we can end HIV transmissions.

However, as for any revolutionary change, challenges, barriers and obstacles can potentially stop ACON and communities of gay men and other men who have sex with men from meeting the challenge of Ending HIV. This HIV-prevention approach is very ambitious and different from the simplicity of messages around condom-reinforcement. This complex set of messages differs from previous campaigns in several key ways:

-       It is not about a decrease in HIV notifications, but the elimination of HIV transmission for good.

-       It is not only about condoms, but about building community awareness of other risk reduction methods such as treatment as prevention, the effects of having an undetectable viral load (UDVL) and PEP and PrEP as prevention methods.

-       It is about mobilising key populations, educating them and encouraging them to embrace a vision of a world without HIV – then take steps to make this a reality.

-       It is about radically changing behaviours within a few years – creating a massive upscale in testing frequency and early treatment uptake while maintaining a strong safe sex culture.

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Image1: ‘by 2015, we will reduce the transmission of HIV among gay and other homosexually active men by 60% and by 80% by 2020.’ (NSW Health, 2013).

Ending HIV has a number of ambitious objectives, leading towards these goals.

-       to inform gay men about recent research findings, new prevention approaches and technologies that make ending HIV transmissions attainable.

-       to update gay men’s knowledge about significant advances in HIV treatment, resulting in simpler regimens, far fewer side effects and much greater health and prevention efficacy benefit.

-       to encourage all sexually active gay men to test for HIV more frequently.

-       to support and encourage gay men to sustain safe behaviours sufficient to ensure the goals are attained.

-       to ensure that gay men diagnosed with HIV are able to access treatment and care as soon as possible.

-       to achieve a dramatic decline in community viral load sufficient to attain the overall reduction in transmission goal.

-       to refresh and reposition the role of condoms as the safest and most assured means of preventing HIV transmission, among a ‘toolbox’ of prevention strategies.

-       to reinforce the importance of regular HIV/STI testing for all gay men.

-       to update knowledge and awareness about the prevention benefits from maintaining an UDVL, sustained over time.

ACON is well-positioned to meet these challenges. As a community based organisation it is run by members of the community most affected by HIV. This peer-led approach ensures that messaging can be tailored to subcultures within the broader population of gay men. By adapting campaign messaging to target these groups, messages become more personally meaningful and help to encourage behaviour change (Spina, 2013).

The populations of gay men we work with are diverse. Certain individuals may find these discussions uncomfortable, others will be sceptical and some will be already convinced. Research into attitudes towards these new approaches among HIV positive and negative gay men in Australia (Holt et al., 2013) revealed very high levels of disbelief about the prevention benefit of treatment.

‘HIV-negative men more strongly disagreed that HIV-positive people on treatments are unlikely to transmit HIV and that a person with an undetectable viral load cannot pass on HIV’ (page 6).

This indicates that education around these new approaches is needed to ensure that most gay men are aware of the effectiveness of these new approaches. The research must be translated so that these individuals know what they can do to help end the HIV epidemic.

Creative collaborations for designing the new prevention landscape

Ending HIV is a complex set of messages. There are key conditions that will need to be met to ‘end’ new HIV transmissions by 2020. It requires all stakeholders from non-governmental organisations (NGOs), government departments, clinicians to community members to work together in close partnership. The one-size-fits-all approach to HIV prevention, support and care will not work. Core messages had to be designed to speak to gay men collectively, convincing them of the possibility of ending HIV by 2020. This involved active participation by affected communities, both LGBTI and heterosexual.

In addition to the broader messaging of Ending HIV, customised messages were also disseminated to provide sub-culturally tailored information. This involved targeting the campaign in culturally appropriate ways to specific sub populations. The Ending HIV website contains different ‘entry portals’ directing a website visitor to tailored information that are designed to meet their needs. These portals are ‘Young’ (under 29), ‘Sexually Adventurous’, ‘HIV +’, ‘HIV –‘ and ‘In a Relationship.’ The messaging through these portals uses language aimed at engaging that specific population, as well as information specific to that group. Specific information that needs to be communicated differently includes recommended frequency of testing and treatment options.

Finally barriers to achieving the stated goals needed to be addressed. These are both structural and based on addressing the perceptions of gay men. Structural barriers continue to be addressed through strong partnerships with government, clinicians and regulatory bodies, with advances made in the ease of access to treatment as well as the scale up of rapid testing centres and the introduction of home testing. Looking to the future other barriers such as access to PrEP and the use of rectal microbicides are yet to be introduced. Other barriers including stigma and discrimination towards LGBTI people and especially those living with HIV, must also continue to be challenged through the campaigns being run.

ACON’s Ending HIV Strategic Approach

The Ending HIV approach required a radical rethinking of how we did HIV prevention work. This required major organisational change as well as challenging the beliefs of HIV ‘experts’ about what is effective HIV prevention. Both anecdotally and through qualitative research studies (Prestage, et al., 2010) on the perceptions of gay men and other men who have sex with men. ACON was receiving feedback that its campaigns were boring or that they did not relate to the condom-reinforcement messaging and that it did not speak to their sexual practices and needs. It is difficult to galvanise community mobilisation if the communities being served do notfeel sufficient ownership or engagement with campaign messages. The Pleasure and Sexual Health (PASH) study (Prestage G et al, 2009) showed that while most men were generally appreciative of HIV prevention messages and supported their continuation, there were also many criticisms. These criticisms ranged from feeling that the messages were not hard-hitting enough and failed to show HIV as a sufficient threat. Still others believed the messages were out of proportion to the real level of HIV threat and were designed to make gay men afraid of having sex. Even though HIV still matters to most gay men, they do not tend to personally engage with the details of HIV prevention messaging and campaigns. Also, they often don’t pay particular attention to those messages. The majority of respondents also suggested that there was little to distinguish campaigns from one another, that they all look much the same. Some respondents indicated they had simply switched off from HIV education messages as this quote from a 33 year old, HIV-negative, PASH study participant exemplifies:

All that talk about “condoms not being a nuisance” or even “being part of the fun” is simply a lie so don’t keep telling us this BS – no wonder no one reads it.’

Business-as-usual approaches, even if they are best practice, are no longer enough. To re-engage gay men HIV prevention, education and care organizations must use new approaches.

How to End HIV

HIV notifications have remained relatively stable in NSW over the past ten years (NSW Health, 2013) but Ending HIV is about eliminating new HIV transmissions, not accepting stability as the status quo. This dedication required ACON to innovate and move away from using the traditional social marketing framework. In order to position Ending HIV as an achievable goal ACON had to rethink the ways that it communicates and engages with gay men.

This required much more than a standard campaign. ACON developed an entire community engagement platform that sought to achieve a massive impact in reaching and engaging the majority of gay men in NSW. It was also designed so that it was not a static campaign, but rather had the flexibility to grow and evolve along with the community it engages. It has been released through various phases released over multiple years to keep the messages fresh and relevant. The social media presence allowed resources from partners and key stakeholders to be shared with our audience. Through being adaptable, innovative, interactive and responsive the campaign ensured an ongoing dialogue with community members could be maintained.

The five pillars of Ending HIV: Impact, Reach, relevance, Dialogue and Ownership.

Impact

ACON had to think ‘outside the box’ to demonstrate that everything had changed.

New messages needed to be communicated in terms of HIV testing frequency, the health benefits of new treatments, treatments impacts on transmission and other HIV risk reduction strategies. ACON’s creative development process was driven by:

-       Looking at creative inspirations from sources beyond the traditional gay imagery and the ‘sex sells’ formula commonly (over)used in the HIV sector.

-       Developing a holistic concept to perfectly fit all communications channels including; print, digital, video, social and ambient.

-       Designing a communication platform with the potential to be used as a brand for multiple years and multiple campaign iterations.

-       Leveraging the same guidelines for optimum activation around multiple sets of executions.

It all started as a provocative promise, which became our new HIV prevention brand. Ending HIV (by 2020) came to life with a very simple yet effective visual mnemonic:

[TEST MORE] + [TREAT EALY] + [STAY SAFE] = [ENDING HIV].

Ending HIV embodies a movement, a vision, a target and a new journey. ACON would like gay men to go on that journey with them. The campaign speaks to all gay men, whether HIV positive or negative. Ending HIV is an inclusive movement that everyone affected by HIV can be a part of.

While the ‘2020’ target isn’t part of the core message, it is referred to throughout the channels that support the campaign such as the web portals, videos and relevant print material. The equation visually explores the link between testing, early treatment, risk reduction and ending HIV.

While the messages are complex, the simple visual mnemonic ensures all gay men and other men who have sex with men understand the components that are needed to make this goal a reality.

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The Ending HIV design is a bold, simple black and white font-based approach. There is no need for colours, visuals or images of hot, half-naked men. ACON believes the message is strong enough to stand by itself without the addition of ‘cosmetic’ effects. It gives the campaign a very specific and unique edge to help it stand out against the thousands of messages people are exposed to daily. Colour was added during phase 3 of the rollout, to draw attention to the new messages. The ‘Stay Safe’ messaging of the condom reinforcement aspect of the campaign and the ‘Test More’ messaging to encourage people into rapid testing services. This gave each new phase an original, contemporary look while leveraging the strength of the original design.

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The different phases of the campaign examine the elements of the main equation. Communicating that it is possible to end HIV if we test more often, treat early and continue to play safe. The design allows for different levels of complexity in the messaging, adapted to the channels where the messages are run. This ranges from the equation alone for quick messaging, to in-depth information through media articles and websites. The website address (endinghiv.org.au) is very prominent and directs the viewer to further information.

Since its inception in February 2013, 5 different executions have been developed.

Phase 1 – Ending HIV and I’m IN executions, promoting community education and buy-in.

Phase 2 – Carry On series focusing on safe sex practices.

Phase 3 – Easy As and Know Now focusing on promoting HIV testing services.

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18 months after the initial launch campaign evaluations have shown that the Ending HIV brand and design earned a very strong currency with the gay community, with each phase building upon the last and strengthening recall, reach and engagement (Spina, 2013).

Reach

The campaign is asking gay men to radically change their behaviours. In order to cut through the noise it had to be big, loud and visible everywhere. It needed to leverage what works best to hit hard and engage as many gay men as possible, as quickly as possible.

The team at ACON knew that changes in the gay community meant that relying on the gay press, posters in sex on premises venues (SOPVs) and the traditional gay bars was no longer sufficient. Spina’s evaluation reports (2010a, 2010b) show that relatively low readership of the gay press and declining numbers of gay men going to gay venues means that a four week print-only campaign would likely miss up to half the target audience, with only a third of the target audience having multiple exposures to the campaign. ACON worked with Universal Media, one of the leading global media planning agencies, who offered to collaborate on a pro-bono basis. Their expertise combined with efficient media planning tools helped develop a solid mix of outdoor, online and mobile advertising formulated to optimally target the gay community.

Mainstream outdoor media was used to maximize impact and reach. Large format billboards on street furniture and bus shelters where gay men live, work and play were prime sites for campaign messages . The total reach was expected to be 50% of all men (gay and heterosexual) in Sydney aged 18 to 55 at a frequency of 4 to 5 exposures. These figures ended up being much higher for our target audience, as the gay population was over-represented in the selected areas.

Digital approaches were key to increasing reach and generating further engagement. This approach increased the frequency of messaging and added to the impact generated  by the outdoor advertising. High impact digital executions targeted to gay sites such as Samesame, Manhunt, Gaydar, Aussiemen were used alongside sophisticated targeting approaches including demand side platforms, smart targeting, YouTube advertising, Google Adwords, search engine optimization and mobile advertising. This was effective as gay men over-index against all mobile statements in terms of mobile usage compared with the rest of the population.

Social media was also central in the mix and included series of ads run through Facebook. This allowed the ads to be highly targeted and a comprehensive content plan with daily posts and updates for the main social media platforms. Given that gay newspapers and magazines are now among the less utilised media among gay men, campaign presence was kept to a minimum. It was limited to 2 gay publications. This helped the campaign to reach men in regional areas outside of our targeted outdoor advertising.

Relevance

‘What’s in it for me?’ If each gay man could find the answer to this question in the Ending HIV platform, it would go a long way towards optimising our chances of meeting our targets.

It was rapidly identified that an interactive website would play a significant role in delivering the key messages and help drive the cultural shift within the gay community. Convinced that this shift would need to be sustained for a few years, the opportunity was taken to develop a web portal dedicated to gay men’s sexual health. This aimed to develop a highly interactive platform where gay men could find generic and customised information, videos and tools delivering more information on how they can be a part of Ending HIV. It also hosted comprehensive content on sexual health, in particular other popular sites ACON developed in recent years.

An entire section of the portal was dedicated to a range of interactive tools and interfaces to allow gay men to find customized information to encourage them to test more often, consider treatment if positive and to  stay safe and minimize the risk of HIV transmission. The tools were distributed as follows:

Tools for Testing:

  • Where to Test – a geo-locational tool to search for the nearest location to get an HIV test or rapid HIV test
  • Remind Me – an email/SMS notification service for gay men to receive reminders for their next HIV test.
  • How Often to Test – a tool to determine how often guys should get tested for HIV, based on their HIV status and number of sexual partners
  • Won’t get Tested? – an interactive tool to educate gay men about HIV testing and demystify the concept of testing
  • Get a Check-up – a geo-locational tool to search for the nearest sexual health clinic, gay-friendly GP and/or bulk-billing GP

Tools for Treatment:

  • Recently Diagnosed? – A tool for recently diagnosed gay men to easily get access to services such as counseling and workshops
  • Won’t get Treated? – An interactive tool to educate gay men about the benefits of HIV treatment uptake
  • Get a Check-up – A geo-locational tool to search for the nearest sexual health clinic, gay-friendly GP and/or bulk-billing GP

Tools for Stay Safe

  • Where to find free condoms? – a geo-locational tool to search for the nearest location to get free condoms in NSW
  • Risk calculator – the tool developed for our previous campaign Know The Risk, which aims to educate gay men on non-condom based risk reduction strategies.

One year after the launch, new sections were added to give customized information and tailored calls to action to address specific needs of priority populations. This was especially aimed at sexually adventurous men who drive 35% of new infections (Prestage, 2006), guys in relationships who drive 25% of new infections and younger men who make up about a third of all new infections in NSW (NSW Health, 2014).  Negative men and positive men each got a dedicated section as well. This addition proved to be very successful at improving the time spent on the website.

Dialogue

Given the massive behaviour changes we are seeking from gay men and the need to develop, grow and sustain a huge level of mobilisation, we moved away from the traditional off-on education campaign model to a new framework. This allows ongoing dialogue and interactions with gay men. This dialogue builds on a new ‘contract’ between ACON and gay men. While gay men commit to increase testing and treatment uptakes while sustaining a strong safe sex culture, ACON commits to play an active advocacy role to facilitate access to rapid and home testing, access to treatment, support, research on PrEP and microbiocides. ACON also committed to deliver the most up-to-date information, and regularly consult with and report back to the community. Paramount for facilitating the dialogue with gay men, engagement tools to interact and participate in the campaign were placed prominently on the portal. In particular, the ‘Ask an Expert’ tool, where users can submit questions on the campaign, testing and treatment which is answered by ACON and commented by other users who signed up to the web portal. Also, the blog section where new articles are regularly posted is another channel for gay men to share and interact.

The ongoing dialogue was also developed via very strong social media activities focusing on delivering relevant, engaging and informative content to our existing network of Facebook fans and Twitter followers. For this, a multimedia editorial content calendar was developed to ensure consistent delivery across the life of the campaign and continuous activity across the social network channels each day. This included an extensive mix of internal and external curated content, specific information and articles relating to the campaign, as well as some general content consisting of personal narratives around HIV, stigma, world news and advances in treatments. Social media activities focused on developing content for Facebook, however this content was replicated and adapted to Twitter. As an example, here is a typical weekly content schedule for phase 3 (focusing on ‘Stay Safe’):

  • Monday: Re-posts from the first phases of Ending HIV, call to action, education and current information on treatments and testing
  • Tuesday: Condom content from Ending HIV website /general content articles
  • Wednesday: Condom content from Ending HIV website, general content articles or rapid testing promotion
  • Thursday: Safe sex ACON campaigns through the years
  • Friday: Question of the week around the Stay Safe component
  • Weekend content would consist of two posts with lighter content.
  • Saturday: Video post of condom campaigns, commercials or general content articles
  • Sunday: Saluting public identities, celebrities who have supported and advocated safe sex campaigns and HIV/AIDS prevention through the years

Ownership

Making sure all stakeholders shared the same vision and ownership of the Ending HIV project was a priority. ACON started by developing 2 separate interfaces for people and organisations to demonstrate their support to the movement. Through this they could choose to stay connected and receive updates and news about the campaign.

These were ‘Join in’, a functionality to allow people to show their support and commitment to the campaign and share the website through their personal networks and ‘Sign up’ a functionality for people to sign up and be able to receive news, updates and participate in the website’s blogs and forums. So far, more than 30 organisations including the City of Sydney, the Kirby Institute (national research center in HIV), other HIV organisations, gay venues or commercial brands support the ACON initiative and their logos are featured on the web portal. Our main funder, the Ministry of Health also decided to use the Ending HIV design as its umbrella branding for all its HIV initiatives.

The campaign furthers this sense of ownership by encouraging face-to-face interactions with the gay communities. Several forums took place to encourage gay men to share their views on topics related to condoms use, testing and treatment and their critical role to end the HIV epidemic. Stunts took place regularly with crews of men wearing Ending HIV shorts and carrying campaign sandwich-boards engaging with the crowd and distributing branded safe packs in the gay areas on weekends. All gay parties and events were systematically covered with a huge Ending HIV branding presence. Our key partners such as gay sport or social groups were also mobilized to disseminate our messages and interact with their members during their events.

Impact, reach, relevance, dialogue and ownership. These five key principles found their full expression in the videos developed. Evaluations (Spina, 2013) showed that videos could potentially play a powerful role in communicating the details of campaigns, embody our vision, and generate a high level of mobilisation while giving a tool to community members and stakeholders to spread the word and increase the campaign’s reach.

Yes we can.

Using a comprehensive range of qualitative data collected in focus groups, quantitative data via online surveys completed by more than 500 men, as well as data from Google and social media analytics, two campaign evaluations have been completed (Spina, 2013a, 2013b). One in May and the other in December 2013. Both were conducted by an independent market research consultant.

So 12 months since the launch of Ending HIV, is this working? Have we met our education and mobilization objectives? Can we see a shift in gay men’s health literacy and behaviours

All data indicates the campaign evaluated extremely well across a range of key indicators. Ending HIV has been a very successful campaign at engaging, communicating and persuading the audience. It achieved a very high level of recall, communicated its message effectively and caught the attention of its target audience. The significant investment in the advertising budget has had a beneficial impact. Outdoor advertising (particularly bus shelters, but also street banners) and social media advertising contributed to high levels of campaign awareness in conjunction with the well-executed creatives.

The implementation tactic of engaging the audience’s attention through eye-catching advertisements, then encouraging them to seek out further information on the internet or social media has been shown to be effective. It is worth noting that those who sought out additional information tended to find the campaign messages more persuasive. Key evaluation findings are as follows:

  • Recall: A very high 66% to 70% of NSW survey respondent recall seeing the advertisements. This is by far one of the highest levels of recall ever achieved by an ACON campaign in recent years. Even more pleasingly (given significant advertising placement occurred in Sydney) this jumps to an even higher 76% recall among Sydney respondents.
  • Engagement: Apart from the high level of recall, there are other indications that the audience found Ending HIV an engaging initiative. One-in-two described the campaign as eye-catching. One-in-four respondents thought the campaign was a lot better than previous HIV advertisements they had seen, while another 30% thought it was a little better. Focus group participants responded well to the design indicating it caught their attention.
  • Communication: Approximately 63% of survey respondents thought the advertisements explain how we can end HIV. This was supported by focus group participants who were able to articulate, at times with a good level of detail, about the steps required to end HIV.
  • Impact on health information seeking behaviour: As there is a limitation to the amount of detail that can be addressed within the advertisements, a key strategy was to direct the audience to the website or Facebook page for further information. This approached worked extremely well with a very high 35% of survey respondents having visited the website or Facebook page and 21% watched the Ending HIV video. Furthermore the survey itself contributed to dissemination of the message, as 30% of survey respondents watched the Ending HIV video which was embedded in the survey.
  • Acceptance of the message: Focus group participants demonstrated acceptance of the campaign messages. They thought asking gay men to test at least twice a year as a minimum was reasonable (although, of course, behaviour does not necessarily match intent) and they were receptive to the Treat Early message as many understood treatments had improved significantly and had heard that increasingly the recommendation was for early testing.
  • Persuasion: Very importantly, the Ending HIV campaign contained a persuasive message. This is a necessary precursor to motivating individual behaviour change. 45% of survey respondents believe that we can end HIV transmission by 2020. Yet the more respondents engage with the campaign the more persuasive the message is as among those who had watched the video it leaps to 61% who believe we can end HIV by 2020 and among those who had visited the website or Facebook page 62% believe we can end HIV by 2020.
  • Impact on health literacy: Pre and post-survey of attitudes towards seven key statements indicate a shift in knowledge is underway
  • There is an increase in the number of respondents reporting having been tested for HIV in the last six months and a decrease in those respondents who have reported never having been tested for HIV.
  • There is an increase in recognition that we can now dramatically reduce HIV transmission.
  • There has been an increase in recognition of the importance of frequent HIV testing.
  • There is also an increasing recognition that early HIV treatment is better for your health and can help protect your sex partners.
  • The most significant change in knowledge has been an increase in the recognition that HIV treatments reduce the risk of passing on HIV, however, the surveys highlight that still one-in-two respondents are either neutral or disagree with this statement.

Critical feedback was minimal. Among respondents who were more critical it tended to be for one of three reasons: a) they were not persuaded by the message and didn’t believe HIV could be ended by 2020, b) they believed using the terminology ‘ending’ was inappropriate because an 80 per cent reduction in HIV transmission is not ‘ending’ HIV, or c) they were concerned about how others may interpret this message and that this may fuel complacency and have unintended impact on safe sex practices.

Many of these respondents raise legitimate issues. The last point regarding the campaign fuelling complacency is a significant risk in running this campaign. Although participants in the evaluation generally understood that the campaign is not saying ‘HIV has ended’ but that we now have the tools to work together to end it. It is important to note that some of the respondents who did not believe the message still indicated that they hoped it was true and often still commented that they liked the campaign.

The Facebook fan database grew from 2,200 to more than 7,700 in December 2013 and to 11,200 fans at the time of writing. These results are alongside other Facebook analytics demonstrating a high level of reach and engagement:

  • Facebook engagement indicator: up to 2.68% (industry average: 0.5% – 0.99%)
  • Average number of Facebook organic reach per week: 3,972
  • Average number of Facebook total reach per week (organic and paid): 211,468
  • Average number of engaged users per week: 2,507
  • Average number of likes, comments and shares per week: 501
  • Total number of Facebook users reached organically: 168,862
  • Total number of engaged users: 16,414
  • Total number of organic impressions: 315,840
  • Total number of impressions (organic + paid): 47,216,072
  • Traffic generated from Facebook to the Ending HIV website: 1,598 visits

The web portal attracted more than 90,000 visits with viewers spending 2 to 3 minutes at each visit. In regards to online advertising, the Google AdWords campaign was the most effective, generating alone more than a quarter of the total traffic generated to the Ending HIV web portal at the most cost-effective rate, successfully targeting NSW. This is followed by Facebook, generating over 12% of the total traffic. These 2 online advertising channels were essential to drive traffic to the Ending HIV web portal.

Survey findings highlight that (particularly among HIV negative men) there is still room to improve the understanding of developments in HIV treatment and the benefits of treatment as prevention. While testing practices appear to be changing, the surveys still find that the respondent’s own testing patterns do not match what they consider appropriate testing practices for gay men. Future iterations of the campaign need to give consideration to focusing on testing more and the benefits of treating early and their role in ending HIV. It is also important to recognise that there remain significant structural impediments to achieving the outcomes desired by the campaign. For instance, one respondent highlighted his difficulties in accessing early treatment.

Conclusion

In an era where information and imagery are ubiquitous, the positive reception accorded to Ending HIV indicates that the revised framing was an effective means to re-engage with a target audience that tends to view all HIV messages as ‘more of the same’. It was time to challenge what used to be unquestionable, and to explore new routes.

Ending HIV was built around 5 pillars: Impact, Reach, Relevance, Dialogue and Ownership. By focusing attention and developing strategies around each of these pillars a greater level of engagement was able to be developed. By tailoring this approach to the existing evidence base the campaign was able to leverage of what we already knew about our target demographic to re-engage them with our new messaging.

Innovative design-driven strategies combined to the power of outdoor media and online channels have proved to have the ability to transform the way gay men think and act for the ultimate cause of tackling HIV transmission by 2020. 2020:

Ending the decade, ending HIV?

Yes, we can.

References

AFAO, (2012) ‘Implementing the United Nations Political Declaration on HIV/AIDS in Australia’s Domestic HIV    Response: Turning Political Will into Action’, NSW (http://www.afao.org.au/library/topic/treatment/DP0912_Implementing-the-UNPD-in-Australia.pdf.pdf) Retrieved 19 August 2014.

Anderson, PL et al. (2012) ‘Emtricitabine-Tenofovir Concentrations and Pre-Exposrue Prophylaxis Efficacy in Men Who Have Sex with Men’ (http://stm.sciencemag.org/content/4/151/151ra125.full.html) Retrieved 1 July 2013

Holt, M et al. (2013) ‘HIV-Negative and HIV-Positive Gay Men’s Attitudes to Medicines, HIV Treatments and Antiretroviral-based Prevention’, AIDS and Behavior, 17(6).

Joint United Nations Programme on HIV/AIDS (UNAIDS) (2011). Political Declaration on HIV/AIDS: Intensifying our Efforts to Eliminate HIV/AIDS. UNAIDS, Geneva.(http://www.unaids.org/en/media/unaidscontentassets/documents/2011/06/20110610_UN_A-RES-65-277_en.pdf). Retrieved 1 July 2013.

Matassa, Matt (May 12, 2011). “Initiation of Antiretroviral Treatment Protects Uninfected Sexual Partners from HIV Infection (HPTN 052)”. Retrieved January 3, 2012.

NSW Health Notifiable Conditions Information Management System (NCIMS)(HOIST), (2014) Communicable Diseases Branch and Centre for Epidemiology and Evidence, NSW Ministry of Health.
(http://www0.health.nsw.gov.au/data/diseases/hiv.asp). Retrieved 21 August 2014

NSW Ministry of Health, ‘NSW HIV Strategy 2012 – 2015: 2013 Annual Data Report’ NSW, (2013). (http://www.health.nsw.gov.au/endinghiv/Documents/AnnualReportNSWHIVStrategy2012-2015DataReportFINAL.pdf ). Retrieved 19 August 2014.

NSW Ministry of Health, ‘NSW HIV Strategy 2012-2015: A new Era’, NSW, (2011). (http://www.health.nsw.gov.au/publications/Publications/nsw-hiv-strategy-2012-15.pdf ) Retrieved19 August 2014.

Prestage, G et al. (2006) Health in Men and Positive Health cohorts: A comparison of trends in the health and sexual behaviour of HIV-negative and HIV-positive gay men, 2002-2005), NCHSR, Sydney, Australia.

Prestage,G et al.( 2010). Pleasure and Sexual Health: The PASH Study, 2009. Monograph, National Centre in HIV Epidemiology and Clinical Research, Sydney Australia.

Spina, A. (2010). Drama Down Under Phase 2 Evaluation Report. Sydney.

Spina, A. (2013a). Whytest Evaluation Report., Sydney.

Spina, A. (2013b). Ending HIV Evaluation Report, Sydney.

Nicklas Dennermalm

Published Online: September 25, 2014
Full Text: HTML, PDF

Abstract

In Sweden, sex workers are often viewed as ‘victims in denial’ by public health authorities.  As a result, Swedish sexual health interventions have traditionally focused on women and utilised face-to-face interventions and exit strategies. Unmistakably, interventions targeting male and/or transgender sex workers that utilise harm reduction approaches or low threshold on-line interventions remain marginalised or non-existent.  This stands in opposition to recent Swedish research on the sexual health of men who have sex with men (MSM) and transgender people (TG).  This research stresses the need for targeted community-based sexual health services. Recent Swedish research also highlights the success of innovative on-line approaches that help male sex workers and TG understand personal risk to HIV and other sexually transmitted infections (STIs), their legal rights and how to access community-based health services. Responding to the research and not viewing sex workers as victims, this paper outlines the design of Sweden’s first bespoke online platform targeting male and transgender sex workers. We outline our unique approach and the steps we undertook to design the Röda Paraplyet webpage (http://www.rodaparaplyet.org[1]) in collaboration with male sex workers and Rose Alliance, a leading sex worker organisation. We argue the voices of sex workers are essential to shifting the Swedish discourse around sex work from one of victimisation that limits sex workers access to Sweden’s extensive evidence-based health care to one that is empowering and increases the safety of sex work, explores how to negotiate condom use and educates sex workers about their rights. In conclusion we illustrate how a broad coalition between organised and non-organised sex workers, LGBTQ organisations, academics and the health care system is essential for creating a sustainable platform of multi-disciplinary knowledge to improve the sexual health and legal rights of sex workers in Sweden and globally.

Keywords: Sex workers, discourse, HIV prevention and health, on-line intervention, human rights, MSM, TG

Recognising the lived experiences of Swedish male and transgender sex workers

This article describes the process of the Stockholm branch of The Swedish Federation For Lesbian, Gay, Bisexual, Transgender and Queer Rights (RFSL Stockholm) work to design an HIV prevention intervention based on the voices of male and transgender sex workers, two groups generally absent in the Swedish discourse around sex work. Sex work is not even a word used in the Swedish discourse, which favours ‘prostitution’ or ‘sex trade’. In Swedish the definition of ‘prostitution’, by default, signifies a degrading act of violence that does not only affect the individual woman (e.g. a ‘prostitute’), but all women. The negative aspect of the terms ‘prostitution’ or ‘sex trade’ in Swedish discourse are the result of the structural violence of men, rather than an effect of stigma from society at large.

In the Order of The Discourse (1993), Foucault illustrates three main procedures of exclusion: the forbidden speech; the division of madness; and the will to truth (p. 7ff). Within this emerges the concept of the prohibition, regulating, among other things, who is allowed to speak and about what. The tradition of these procedures has a long history in Sweden, not only in the case of sex work but other marginalised social phenomena including homosexuality, ethnic minorities, transgender communities, people with mental illness and others. The story of ‘prostitution’ is being filtered through the institutions of the police, social services and government, and reproduced over and over again, creating ‘knowledge’ by an ‘author’, not in the sense of an author of fiction, but an author and co-creator of the discourse. The knowledge produced is that of the Swedish Welfare State and of the ‘supreme’ morals of Sweden. Critically, it is not reflective of the lived experiences of Swedish male and transgender sex workers.

The official Swedish opinion is that sex work is harmful to both the individual and society; therefore efforts should focus on exit, rather than health improvement or harm reduction through information and other interventions. The general Swedish approach is a zero tolerance one firmly against sex work with the main focus on exit, not harm reduction, the latter of which is an approach common in other countries (SOU 2010:49, p 95). Sweden’s zero tolerance approach stands in stark conflict with the more empowering harm reduction approach. The Swedish government’s high priority of providing support for exiting might be the explanation for the lack of social interventions aiming to increase sexual and emotional health among sex workers in a context outside the prostitution units and similar interventions. The dichotomy between zero tolerance and harm reduction has been challenged by The National Board of Welfare and Health (2010, p.3).

RFSL Stockholm believes everyone has the right to define who they are and what they do. There is no one term available to describe people who work in the Swedish sex industry. Most terms in use connote different paradigms or beliefs. ‘prostitute’ and ‘exploited in prostitution’ are examples of terms used in Sweden reflective of an oppressive paradigm. RFSL prefers the terms: ‘sex worker’ or ‘person selling sex’; because these are reflective of an empowerment paradigm. RFSL has a rights based perspective deeply rooted in the empowerment paradigm on our successful work with the lesbian, gay, bisexual, transgender and queer (LGBTQ) community as well as HIV prevention targeting the MSM and the transgender communities. Because the intervention discussed in this paper is an HIV prevention project, we have chosen to use the term ‘sex worker’ as it is used by UNAIDS.

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Figure 1: The safer sex website http://rodaparaplyet.org

This article describes the work conducted by RFSL Stockholm in collaboration with sex workers and Rose Alliance—an organisation operated by and for current and former sex and erotic workers in Sweden—to design the safer sex website http://rodaparaplyet.org[2]. Figure 1 shows the poster marketing the website. The process was a semi-structured process with no ambitions to present the work in an academic setting. The overall design of the intervention reflects and draws on RFSL Stockholm’s experience working productively and successfully with MSM and transgender communities through online interventions via The Sexperts Program[3] (Dennermalm & Herder, 2009).

RFSL Stockholm

RFSL was founded in 1950 and the Stockholm branch was established in 1972. RFSL Stockholm is one of 33 local branches and represents approximately 1900 out of RFSL’s 6700 members. RFSL aims to provide social platforms for its members, address political issues and act as a community-based service provider on health and HIV. RFSL Stockholm was officially an organisation for lesbian, gay and bisexuals. Importantly the transgender community has been a part of the organisation for a long time, but was not recognised as an equal part until 2002. People with a queer identity or queer gender expression were officially added equally recognised members in 2014.

RFSL Stockholm conducts an annual two-day method lab in order to be at the forefront of Swedish HIV prevention efforts with reports written after the lab to document the lectures, talks and workshops. For the 2009 method lab we invited male sex workers, colleagues, clinicians and researchers from Malmö University and Gothenburg University together to set the direction of RFSL Stockholm’s future health interventions (Jonsson & Söderström, 2009). The sex workers did not represent any sex workers organisation but were free agents. To our knowledge, this was the first time sex workers were invited to co-design an intervention in Sweden, which was acknowledged by Niklas Eriksson, one of the researchers invited. The method lab process defined eight key areas from which RFSL and/or other actors could draw inspiration for future work. The ideas varied from research ideas, political statements and health-based interventions.

These eight areas were:

  1. Empowerment;
  2. Create platforms;
  3. Knowledge and openness;
  4. Complete a review on the legal situation, including the criminalisation of procuring;
  5. Highlight nuanced and experience-based images of men who sell sex;
  6. RFSL’s counsellors need tools to meet minors who sell sex;
  7. Identify how to work with the target group from an ‘arena’ perspective and initiate dialogue with the target group with focus on need assessments; and
  8. Identify strategies on safety and safer sex.

Drawing on the experience of RFSL’s HIV prevention work and the method lab, RFSL Stockholm formulated key principles on communication and collaboration with targeted stakeholders:

  1. HIV prevention is not only a question of promoting correct condom usage; it is a collection of tools that can be used as part of a comprehensive holistic health approach.
  2. The intervention should be conducted within the empowerment paradigm, similar to the rest of RFSL Stockholm’s HIV prevention work.
  3. Sex workers are the experts on what it means to be a sex worker, and their voices and multi-facetted experiences are key to making the intervention relevant and accepted by their community.
  4. Sex workers should be included in all key steps of the intervention design.
  5. Key stakeholders must be involved in the work, including local and national sex workers’ organisations, health providers, researchers and other relevant NGO’s. Sex workers and other experts should review all text before being published.

The need to confront the Swedish Model

The Swedish Model

Sweden was the first country in the world to introduce legislation that criminalised the purchase of sexual services rather then selling them. It has become known as The Swedish Model, but is sometimes also referred to as the “Nordic Model” since similar legislations were introduced in Norway and Iceland in 2009. The Swedish Model is being internationally promoted by the Swedish Government due to its self-claimed success of decreasing the amount of sex workers in the three largest cities by an average of 50 % between 1999 and 2008, based on the official evaluation report Criminalisation of Purchase of Sexual Service – An Evaluation 1999-2008 (SOU 2010:49). Both the legislation and its evaluation has been the subject of heavy critique from the several Swedish GOs, NGOs, academia as well as international actors. The legislation stands in stark contrast to health recommendations from UNAIDS and Network of Sex Work Projects (NSWP), among others.

Most Swedish research and reports on sex work have been written within the context of the oppression paradigm. Most of its data were derived from sex workers from a street work setting (Hulusjö, 2013, p.33) (SOU 1995:15, p. 11). The majority of Swedish research on sex work has been focusing on street based women. Women working in other settings, MSM and TG sex workers have been largely neglected, which has created a void in the research. The void further fuels the image of sex work as being an experience, which puts limitation on both the individuals and the Swedish health care system. A health care system designed for perceived needs of street based female sex workers within an oppression paradigm will be single minded and not appeal to sex workers with different needs.

Sex workers as a risk group within Swedish HIV prevention efforts

Within the context of the Swedish HIV prevention guidelines, sex workers of all genders are seen as one of the key target groups. There are no data on HIV prevalence among male sex workers in Sweden, but data from North America, South Africa, El Salvador and other settings state that HIV prevalence among male sex workers is as high or higher than MSM not engaged in sex work, but there are other data from Australia and China suggesting that HIV prevalence among male sex workers being lower than MSM not engaged in sex work (Baral et al, 2014, p. 75ff). Nor are there data on HIV prevalence within the transgender community, engaged or not engaged in sex work, but data from The Centre of Disease control from The United States of America tells us that that trans women in the USA are subject to a high prevalence of HIV, and the group trans men is understudied within the field of HIV (CDC, 2014).

In Consolidated Guidelines On HIV Prevention, Diagnosis, Treatment And Care For Key Populations from WHO (2014) it is stated that key populations with overlapping vulnerabilities (e.g. MSM who sell sex or inject drugs) are likely to have a higher HIV prevalence than key populations with no overlapping vulnerabilities. Sub-groups within key populations are also likely to have a higher prevalence of HIV, for instance MSM with a migrant background. (WHO, 2014, p.6.) In light of this, being ’the other’ becomes even more serious within the context of HIV prevention and other health contexts. Special focus should be placed on two or more overlapping vulnerabilities and/or belonging to sub-groups of the MSM and transgender communites.

Stockholm-based Spiralprojektet were the only programme in 2012 that had HIV prevention for sex workers as an objective. It is a clinic offering HIV/STI testing for all genders as well as pap smear, routine check ups and counselling on abortion and birth control. To our knowledge, there were no sexual health webpages targeting the needs of sex workers of any gender in Sweden before the Röda Paraplyet webpage. The websites on sex work were either political or had the purpose of informing sex workers about the existence of services within the prostitution units of the social service in Sweden.

Collaborating with male sex workers to design an online HIV intervention

The importance of working online, where sex workers recruit potential clients, and providing them with HIV prevention information is a reoccurring theme in the literature on sex work (Björndal, 2010, p. 53) (Eriksson & Knutagård 2005, p 77) (Johansson & Turesson, 2006, p. 39). MSM in general are in favour of online interventions in the context of HIV prevention (Tikkanen, 2010, p. 85). Other needs described in the literature are counselling, strategies for exit, safe spaces, tools to handle clients, legal assistance etc.

Rose Alliance is the only Swedish sex workers’ NGO with a clear empowerment perspective, and therefor RFSL approached them to assist in designing a bespoke Swedish HIV prevention web-based intervention as critical stakeholders. Besides establishing a collaboration, RFSL Stockholm wanted to make sure that the two organisations did not compete regarding funding or initiated overlapping programmes.

After dialogue with Rose Alliance, RFSL Stockholm submitted an application to the Stockholm County, which is in charge of the health care system as well as distribution of national HIV funding for a three-year project which included research, design, launch and marketing of a safer sex website, a series of empowering short films inspired by Dr Joyce Hunter’s Working It Out program, integration with The Sexperts Program for low-threshold safer sex information, an expert network with broad competence and representation, an easy to use safer sex conversation methodology that could be adapted to fit a clinical setting, as well as a peer education setting, and safer sex kits for distribution free of charge.

RFSL did not incorporate all eight aspects from the Method Lab into one project but it did an overview on what was 1) the most effective interventions within realistic budget, 2) possible within the Swedish discourse of ‘prostitution’, since our intervention conflicted with it, 3) which interventions can be sustained in the case funding was cut short and 4) what can be done with sex workers rather than by sex workers.

RFSL Stockholm were given 38, 000 USD, less than what was asked for, so we focused on three areas: A) setting up an expert network including sex workers, using a model developed by LAFA (Knöfel Magnusson, 2009, p. 11) and inspired by the mixture of expertise from the 2009 method lab.  B) Setting up a health website aimed for male and transgender sex workers later named Röda Paraplyet, which is Swedish for The Red Umbrella, the symbol of sex workers rights. C) Explore how we could use mobile phone technology and commercial mobile phone apps as platforms for health interventions.

This paper describes mainly area B and C but will briefly mention the concept of the expert network, area A. The expert network was a network active during the first 18 months of the intervention, the aim was two-fold, first; to collectively raise the awareness and competence about sex work among the participants of the network. Second, to provide feedback on the design of the webpage. We invited Rose Alliance to represent sex workers, staff from key HIV/STI clinics, researchers, other relevant NGO’s and staff from The Stockholm Prostitution Unit.

RFSL began with literature studies and researching existing resources from sex worker initiatives from Sweden and the English speaking world, as part of the formative process resulting in an interview guide (hips.org, hook-online.com, rosealliance.org, Akers & Evans 2010). The expert network provided input on several stages, both in the formative process as well as feedback during the production of the webpage.

The interview guide included personal information such as age, sexual identity, if the person was currently selling sex, et cetera. It also included reasons for selling sex, positive and negative aspects of selling sex, need of knowledge and support, safer sex strategies, strategies concerning personal safety, personal relations in the light of selling sex and strategies for setting boundaries. The aim of the interviews was to gain pragmatic strategies to make a useful and realistic website rather than to generate new knowledge about the target group as a whole.

The strategy to recruit participants included the network of Rose Alliance, the project manager’s personal network as well as an editorial article on qx.se, the main Swedish LGBTQ on-line community. From the thirteen people who RFSL Stockholm got into contact with (twelve MSM and one transgender woman) RFSL Stockholm was able to initiate seven interviews (all MSM) creating a convenience sample. The participants were informed about the purpose of the interviews, they were given the option of not answering specific questions and also to withdraw their participation. RFSL Stockholm viewed the people being interviewed as consultants, rather than participants of research. Therefore we offered a 500 SEK (less than 80 USD) as compensation for their time.

The interviews were conduced in a multitude of ways; in-real life interviews, telephone and via Skype depending on the wishes of the informant. For some of the Skype interviews RFSL Stockholm used the chat interface and for other we used the videophone option, with or without their face showing. The interviewer’s face was always visible to the informant. RFSL Stockholm decided not to record the interviews but to do a word by word typing simultaneously as the interviews were conducted to minimise the risk of the informants becoming uncomfortable. RFSL’s impression is that the organisation gained a high degree of trust with the informants, if this was the result of above-mentioned strategy or something else is unclear. Additional interviews will be conduced during 2014 to include a transgender perspective since we were not able to conduct any interviews with transgender sex workers. These interviews will be based on an updated interview guide and be recorded and transcribed according to academic standards for further research in the field.

The interviews did not provide practical health information on sex as a strategy of self-harm, apart from one informant who stated that he had sold sex as a way of self-harm after being raped as a child. The text on how to balance the private sex with the commercial sex was withdrawn since Rose Alliance were not satisfied with the quality of the text. A new text on that topic as well as more in-depth texts on some key areas will be published later 2014.

As the legal owner of the website RFSL Stockholm were the one choosing which feedback to heed and which to discard. RFSL Stockholm did not look for consensus in the larger expert group but our main principle was that the reviewers from Rose Alliance and medical staff from The Gay Clinic would find consensus. No texts that they did not agree on made it into the published site.

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Figure 2: RFSL’s Formative Process

The content

The content can be divided into eight categories; these categories do not match the layout of the webpage. Most articles begin with putting the theme into a sex work context to make the information more relevant to the reader and to avoid a sense of us merely providing generic HIV prevention to them.

Condom and lubricant

The page provides basic information on condoms and lubricant with focus on condom size to minimize risk for breakage. There are also texts on condom negotiation and how to make sure that the condom is on throughout the sexual intercourse.

Sexual practices

In this section we provide information on sexual technics from the aspect of control, safety and ergonomy. There are texts on oral, vaginal and anal sex, plus BDS. Vaginal sex is written from both cis and trans perspective.

Facts on HIV/STI and legislation

The fact sheets on HIV and STI are up to date basic facts on routes of transmission and treatment. The texts on legislation are written from a pragmatic point of view, they are not political statements but more on what to consider as a sex worker.

Where and how to get tested

Getting tested on a regular basis is important for all MSM/TG; we included general information on how HIV/STI tests are conducted, addresses and what to keep in mind beforehand. We altered the recommendation for regularity from every six or twelve months to every three months. Partner tracing is standard procedure if one is testing positive for HIV or an STI and in the context of the Swedish Model this is problematic since the people the sex worker might name are, from a legal point of view, criminals. Our recommendation is to name them as casual sex partners rather then sex buyers, and to contact them themselves, rather than having the clinic contact them. There is also a free of charge test reminder service via SMS, more about this below.

Setting boundaries

Setting one’s own boundaries and being empowered to uphold these were key findings during the interviews, so this is an important message that was weaved into several articles on the page.

Personal safety

This section is based on recommendations from Rose Alliance used by kind permission rather than the interviews since they did not provide enough recommendations. We also included a piece on where to seek help if you are subjected to sexual violence.

Alcohol and drugs

We have included basic harm reduction information on alcohol and the most commonly used drugs in Sweden with a referral to the LGBT addiction centre.

Support

The project does not provide support but the website do have a referral service via e-mail.

Using mobile phone technology and commercial Apps

Mobile phones are widely used in Sweden, and a useful tool for sex workers in a variety of ways. Dating apps like Grindr, Scruff and Growlr are being used for pleasure and finding buyers or sellers of sexual services. Within the limited budget we received, we identified three activities: 1) Design a mobile phone adaption of the webpage for increased accessibility, 2) Creating a short message HIV testing reminder service and 3) Looking into the possibility of starting an on-line hotline on the main commercial app. Each is described below

Mobile phone version of rodaparaplyet.org

When looking into Google Analytics connected to our web pages, we noticed a high level of users using their smart phone to look for information about safer sex, a majority of them using Apple iPhones rather than other devices. In order to make all of our safer sex web pages more accessible and user friendly, we invested in an adaptation of the web pages to fit smart phones and other mobile devises better (Figure 3).

nicklas1

Figure 3: Rodaparaplyet.org phone APP

Creating a short message HIV testing reminder service for sex workers

RFSL Stockholm provide a short message HIV testing reminder service targeting MSM and TG with reminders every six or twelve month according to our recommendations for the general MSM/TG population. This intervention was inspired by an intervention described and evaluated by Bourne et al (2011). In the original design, the clinic connected the medical record of their consenting HIV negative patients to a short message system sending out text messages reminding them to get tested for HIV in order to facilitate re-resting. This resulted in this group being 4.4 times more likely to get re-tested (95% CI 3.5 to 5.5) compared to the control group of the study. After consultation with The Gay Men’s Clinic on the medical record system of the hospital, we decided not to connect the short message reminder service to any medical records but to use a default mobile phone subscription sending out the reminding texts. The reason for the decision was the lack of clear regulations at the time regarding confidentiality in the context of digital security and mobile phone technology within the Swedish health services. Also, we identified an advantage in opening up for collaboration with several clinics rather than one. This created a minor change in the method.

When launching a version aimed for sex workers marketed via rodaparaplyet.org and leaflets, we created a three-month interval option according to recommendations from the Expert Network. We also added a feature promoting the option to order free condoms and lube. For discretion, the text reminders come from our general MSM/TG sexual health site http://www.sexperterna.org rather than the sex worker specific http://www.rodaparaplyet.org. One negative aspect of this is that we are not able to identify how many of the users of the intervention are sex workers or how many condom kits are being sent out, since there may be sex workers subscribing to the six or twelve month interval as well as non-sex workers subscribing to the three month interval.

Communicating with sex workers on commercial apps

There is no up-to-date Swedish data on the usage of mobile technology for sex workers but through our contacts with male sex workers we know that it is widely used by sex workers and sex buyers to initiate contact. RFSL Stockholm has been working with peer education chats on commercial LGBTQ on-line communities since 2005 using multi-lingual profiles on-line where MSM and transgender can ask questions, get referrals and order free condoms and lubricant (Dennermalm & Herder, 2009). One of the key aspects of the intervention was that it was set within a context of an existing and, among MSM/transgender, popular platform, thereby being as close to the sexual encounter possible digitally as well as being part of the culture of the community. During 2012 we looked into complementing the Röda Paraplyet webpage and adjust the method to fit into the context of commercial MSM dating apps like Grindr. The adjusted method would be the base of an application for new funding for sex workers within the framework of our intervention.

When one log on to the app, the free app uses location technology to display the closest 100 profiles/users in a grid. Each profile can contain one photo and various kinds of data; distance, age, body type, “tribe” and free text. It can also contain direct links into a variety of social media like Facebook and Instagram. By paying a fee, one can subscribe to Grindr Xtra for additional functions and the ability to watch the nearest 300 profiles. When logged on, there is a green dot visible on the users profile. This green dot will disappear after not being active for 15 minutes the profile remains in the grid. After being un-active for another 45 minutes, the profiles disappear as you become off-line. When off-line, one can only be texted by profiles who previously marked your as a “Favourite” or already texted you. There is no search functionality in the app in order to display non-active users.

The design provided new challenges for us:

  • First, one smartphone based at our central office in Stockholm would provide the service to users in downtown residents or workers while multiple phones strategically located over the region would require a higher level of logistic work and less cost effectiveness.
  • Second, the lack of search functionality would require us to have constant on-going chats with the target group or manually stay active to remain visible in the grid. And last, since we would not been able to digitally “visit” the profiles, we had to re-think our main marketing strategy.
  • Purchasing advertisement space on the apps would be a secondary strategy for two reasons. First, the online hotline would not be in the frame of the app they were using but on our external webpage e-mail questionnaire which does not operate in real time. Our fear was that this might create impatience within the target groups since they had to swap between the app and the phones browser. Second, people purchasing the Grindr Xtra feature also pay not see advertisement, which means that they would not be able to identify and use the intervention.

Ideally, this problem could be solved by a special status of the profile showing endorsement and collaboration with the owners according to our previous work and emphasized by Mowlabocus et al (2014). This special status could also provide a key to the issue of the users only seeing the 100 or 300 closest profiles that had been on-line the past hour, if Grindr could make our profile by default the nearest profile. This would require a deeper collaboration with Grindr benefiting HIV prevention globally. Unfortunately, Grindr were not interested in a collaboration and we were not given permission to pilot an intervention. This setback led to the decision to start buying traditional banners in 2014 to market the Röda Paraplyet webpage.

Conclusion and lessons learned

The Röda Paraplyet webpage was developed on national HIV funding, yet the website turned out to be controversial. The funders did not express concerns with the design or content. Several actors within the field of HIV/STI, as well as the sex workers who participated in the interviews, expressed positive feedback to the page. We did, however, receive unofficial criticism, most of which reached us through third parties. The criticism came from a coalition of social workers, health care professionals and representatives from feminist NGOs. The webpage was accused of encouraging people to sell sex, to ‘normalising’ sex work, and of not representing the experience and needs of the average ‘prostitute’. To boot our illustrations were said to have nothing to do with what ‘prostitutes’ actually look like. The webpage did not correlate with the Swedish discourse of ‘prostitution’: exiting was not the paramount objective of the program. Instead of recognising that the experience of sex work is multi-facetted and therefore needs multi-facetted health interventions, the reactions were hostile.

The concept of a broad coalition has been part of RFSL Stockholm’s work for decades in the fight against HIV and AIDS where we have engaged the target groups, commercial actors, the academia, key clinics and other NGO’s in our work and participated in other’s efforts and as a collective stated: We stand united. As we have described in this paper, this effort has continued within the Röda Paraplyet project and even though the expert network does not exist anymore, the broad coalition of sex workers, clinics, NGO’s, the academia and other key actors still does as we are about wrap up the project’s third and final year in which we are trying out a pilot training on sex worker’s health for Venhälsan, the Gay Men’s Clinic together with Rose Alliance as well as launching a safety guide written by a former male sex worker.

The authors of the policy document Implementing Comprehensive HIV/STI Programmes with Sex Workers compare two different programme approaches from a community empowerment perspective, interventions “done for sex workers” and “done with/led by sex workers”. Our program qualifies into the second category, but not the highest standard of it since RFSL is a LGBTQ organisation; it is not an organisation run for and by sex workers, although some of our members are or have been sex workers. During the editing of this paper, The Lancet released an issue on sex work in which they highlighted that sex worker led health interventions as the most effective.

Inviting sex workers and sex worker’s organisations into one small NGO run project is not enough. More is needed to ensure that the voices of sex workers are heard. First, sex workers organisations must be funded in order to create more professional organisations, which is crucial for a sustainable dialogue. Second, sex workers must be invited to participate, respected and listen to when key political decisions are being made, when official governmental reports are written and within the overall discussion on sex worker’s health.

Health is always politics, and this seems more true than ever in the context of sex work in Sweden. The Swedish Model and the Swedish discourse of ‘prostitution’ stand in stark conflict with international guidelines, recommendations and evidence-based interventions. Röda Paraplyet is forced to exist in the intersection of the two paradigms, a pragmatic health programme confronting and resisting the Swedish discourse of ‘prostitution’. Sweden must realise that its ‘supreme morals’ preclude the health and well-being sex workers, of those they purport to protect.

References

Akers, N., Evans, C. (ed) (2010) Occupational Health and Saftey Handbook, 3 ed. San Francisco: St James Infirmary.

Baral, S. D., Friedman, M. R., Geibel, S., Rebe, K., Bozhinov, B., Diouf, D., Sabin, K., Holland, C. E., Chan, R., Cácares, C. F. (2014). Male Sex Workers: Practices, Contexts, And Vunlnerabilites For HIV Acquision And Transmission. The Lancet, July 2014, p. 74-87.

Björndahl, U. (2010). Et Usynlig Market – En Feltbeskrivning Om Gutter, Menn Or Transpersoner Som Selger Sex. Oslo: ProSentret.

Bourne, C., Knight, V., Guy, R., Wand, H., Lu, H, McNulty, A. (2011). Short Message Service Reminder Intervention Doubles Sexually Transmitted Infection/HIV Re-testing Rates Among Men Who Have Sex With Men. PMID: 21296796

Dennermalm, N., Herder, T. (2009). We Are The Sexperts. Stockholm, RFSL Stockholm

Diskrimineringsombudsmannen (2010). Yttrande över “Förbud Mot Köp Av Sexuell Tjänst. En Utvärdering 1999-2008”. Stockholm: DO.

Department of Criminology, Stockholm University. (2010). Referral Comment On ’Förbud Mot Köp Av Sexuell Tjänst. En Utvärdering 1999-2008, SOU 2010:49’. Stockholm: Stockholm University.

Dodillet, S. (2009) Är Sex Arbete? Svensk Och tysk Prostitutionspolitik Sedan 1970-talet. Stockholm: Vertigo Förlag.

Eriksson, A., Gavanas, A. (2007). Kännedom Om Prostitution 2007. Stockholm:The National Board of Social Welfare and Health.

Eriksson, N., Knutagård, H. (2005) Sexmänsäljer.se/x – Nöje Blir Funktion. Malmö: RFSL Rådgivningen Skåne.

Foucault, M (1993). Diskursens Ordning. Stockholm: Brutus Österlings förlag.

Gäredal, M., Jonsson, J., Larsdotter, S. (2010). Osynliga synliga aktörer. Stockholm: RFSL.

Hulusjö, A. (2013). The Multiplicities of Prostitution Experience. Narratives About Power And Resistance. Malmö: Malmö University.

Knöfel Magnusson, A. (2009). Samverkan Med Framgång in Lafa 1:2009 FOU Stop hiv! Erfarenheter av kampanjsamverkan och onsitetestning riktat till män som har sex med män, p 9-34. Stockholm: Lafa.

Levy, Jay. (2013) Swedish Abolitionism as Violence Against Women. Conference paper. Retrived from http://www.sexworkeropenuniversity.com/uploads/3/6/9/3/3693334/swou_ec_swedish_abolitionism.pdf  (2014-06-15)

Mowlabocus, S. (2014). Reaching out online. A Report Into The Challenges And Benefits Of Using Digital And Social Media Platforms For Community Outreach Work. Sussex: University Of Sussex.

RFSL. (2010) Referral comment on ’Förbud mot köp av sexuell tjänst. En utvärdering 1999-2008, SOU 2010:49’. Jonsson, J., Larsdotter, S., Westerlund, U. Stockholm: RFSL.

Jonsson, J., Söderström, K. (2009) RFSL Stockholm Andra Sexhälsokonferens Med Fokus på Sex Mot Ersättning, Konferensrapport. Unpublished rapport. Stockholm: RFSL Stockholm.

Stockholm Läns Landsting. (2009). Handlingsprogram STI/hivprevention 2009-2013. Stockholm: SLL.

Regeringspropsitionen 2005/06:60. Nationell Strategi Mot Hiv/Aids Och Vissa Andra Smittsamma Sjukdomar. Stockholm: Socialdepartementet.

SOU 1995:15. Könshandeln. Betänkande av 1993 års Prostitutionsutredning. Stockholm: Socialdepartementet.

SOU 1995:17. Tiby, E. (1995). Homosexuell Prostitution – En Kunskapsinventering. Stockholm: Socialdepartementet.

SOU 2010:49. Skarhed, A. (2010). Förbud Mot Köp Av Sexuell Tjänst – En Utvärdering1999-2008. Stockholm: Socialdepartementet.

The National Board of Social Welfare and Health. (2010). Socialstyrelsens yttrande över betänkandet ‘Förbud mot köp av sexuell tjänst – en utvärdering 1999-2008 SOU 2010:49’. Stockholm: Socialstyrelsen.

Tikkanen, R. (2010). MSM-enkäten Riskhandlingar, Hivtest Och Preventiva Behov Bland Män Som Har Sex Med Män. FOU 2010:4. Malmö: Malmö University.

World Health Organization United Nations Population Fund, Joint United Nations Programme on HIV/AIDS, Global Network of Sex Work Projects, The World Bank (2013) Implementing Comprehensive HIV/STI Programmes With Sex Workers. Geneva: WHO.

World Health Organization (2014) Consolidated Guidelines On HIV Prevention, Diagnosis, Treatment And Care For Key Populations. Geneva: WHO.

On-line resources

  • www.cdc.gov/hiv/risk/transgender
  • www.enannanhorisont.org
  • www.hips.org
  • www.hookonline.org
  • www.rfslstockholm.se
  • www.rosealliance.se

Bibliographic Statement

Nicklas Dennermalm has a Bachelor’s Degree in Peace and Conflict Studies from Uppsala University. Since 2004, he is the Head of HIV/STI programmes at RFSL Stockholm where he has co-developed the Sexpert intervention on sexual health for MSM and TG. He has also participated in several international collaborations, including the TLBz Sexpert intervention in Thailand and the pan-European Correlation Network’s Internet Expert Group. He is currently working on new media communication strategies and safer sex for the BDSM and sex work communities.

Contact: nicklas@rfslstockholm.se

[1] An English version of the website can be accessed here: http://rodaparaplyet.org/en.

[2] An English version of the website can be accessed here: http://rodaparaplyet.org/en.

[3] See http://the-sexperts.org

Sora Park

Published Online: August 12, 2014
Full Text: HTML, PDF (694 KB)

Abstract

This study explores how new users of mobile tablet devices experience and learn to adapt to an environment in which there is a ubiquitous internet connection. A mixed methods study combining netnography and online surveys was conducted among 35 university students in Australia. The portable and mobile nature of tablets enabled participants to be engaged in continuous internet access throughout the day, expanding the situations in which they could engage in multiple tasks. This study focused on the way users prioritise tasks, particularly within the context of studying. Over the course of one year, participants developed their own methods of dealing with the new challenges they encountered. Most participants managed demands on their time and attention by switching between productive and distractive multitasking. Self-regulation strategies were developed through the process of managing the distraction, the main strategies being physical disconnection from the device and mental planning.

Keywords: iPads; mobile tablet devices; digital media; multitasking; productivity; distraction; self-regulation; young adults

Introduction

Mobile media have dramatically changed the media landscape by tethering users to their devices and changing the ways in which they behave around technology and other people (Scolari, Aguado & Feijóo, 2012; Turkle, 2008). Users connected to the network via mobile devices can choose the main space in which they function and interact with others without being physically present. They can switch between multiple realities, constantly realising ambient virtual copresence (Horst, Herr-Stephenson & Robinson,  2010). In the physical space, mobile media enables the state of absent presence, whereby they can be colocated with others without necessarily being copresent (Gergen, 2002). Tablets, mobile phones, and laptops are designed to increase mobility and enable users to access the internet anytime and anywhere. In particular, mobile tablet devices are designed as small, portable computers that can be used seamlessly in both private and public spaces. This ubiquity forces users to make continuous choices about when and where they are going to use the device and whether to apply existing norms or develop new ones.

In the context of learning, digital devices such as laptops and mobile tablet devices expand the potential of effective learning both in and out of the classroom. At the same time, digital devices can be a cause of distraction that diverts students, allowing them to stray from the main task. Although the true benefits of using technologies in learning have yet to be determined, mobile devices have become prevalent in classrooms and learning spaces. This is a new challenge for educators and students alike, who are trying to embrace new technologies for effective learning. This paper discusses how the portability of mobile tablet devices creates new multitasking situations, and how users respond to the new challenges.

The challenges arise from the fact that tablets provide a gateway to the outside world via ubiquitous internet access. In this exploratory study, mobile tablet devices were distributed to students who had never used them before. Students were then observed for a period of one year. Although participants had prior experience with computers and mobile phones, tablets were regarded as unique in the sense that they could be used in any context and that continuous access to the internet was possible. This flexibility of use created situations in which users were challenged to exercise control over the way and the extent to which they used the device. Ubiquitous access to the internet increased both productivity and distraction. This paper reports on the way users responded to and devised new strategies to cope with this constant connectivity.

The experience of multitasking

Multitasking has existed since long before digital technologies were introduced. Secondary activities such as passing notes in class while the teacher is not watching or listening to the radio while reading are good examples. With multifunctional digital devices, opportunities to multitask have increased significantly, and multitasking has become more of the norm than the exception. People are constantly engaged in “continuous partial attention,” whereby they simultaneously process multiple streams of information without fully committing to a single activity (Jones, 2005). Multitasking, in the context of digital media, usually describes the phenomena of dividing attention between simultaneous activities or rapidly switching between two or more tasks. There are two distinct areas in the literature, in which multitasking is usually regarded as a negative outcome of digital media: media multitasking and multitasking in the context of learning.

In media studies, media multitasking occurs when users engage in other activities while consuming media content. Due to the increase in the number of platforms and devices in the home, people can access multiple media sources simultaneously. The simultaneous use of multiple media increases overall exposure, but diminishes the quality of the information that is being processed (Jeong & Fishbein, 2007). Ophir, Nass and Wagner (2009) found that heavy media multitaskers are distracted more easily and are less efficient at switching tasks. Simultaneously performing two cognitive tasks result in less favorable responses (Bolls & Muehling, 2007). In advertising, multiple media consumption reduces the effects of commercial messages (Jeong & Fishbein, 2007; Petty & Cacioppo, 1986; Voorveld, 2011).

Certain media activities are more suitable for multitasking. For example, a study by Pool, Koolstra and van der Voort (2003) showed that listening to music has less impact on students’ homework than viewing television. This is reflected in the activities people choose to engage in when they multitask. Preteens tend to engage in more multitasking when talking over the phone, communicating online, and listening to music (Pea et al., 2012).

Multitasking poses a more substantial problem in the context of learning. Many studies suggest that unless learning activities are built into the technology use, the technology is usually more of a distraction than a learning tool (Fried, 2008; Junco & Cotton, 2011; Kraushaar & Novak, 2010; Wainer et al., 2008; Wood et al., 2012; Wurst, Smarkola, & Gaffney, 2008). For example, computer use has been found to have a negative impact on learning, and this effect is greater among younger and poorer students (Wainer et al., 2008). Those who use laptops in class have lower overall learning outcomes because of the distraction laptops entail (Fried, 2008). A study conducted among young students between the fifth and eighth grades found that numeracy and literacy skills decline when computers are introduced into the household (Vigdor & Ladd, 2010). Even when constructive learning does appear to occur through laptops, the overall satisfaction of student learning has been found to be lower among laptop users than non-laptop students (Wurst et al., 2008). Among older students, Wood et al. (2012) also found that attempting to multitask in lectures had a detrimental impact on learning outcomes.

Students are increasingly challenged by various multitasking activities unrelated to the task at hand, such as Facebook and MSN. Rosen, Carrier and Cheever.’s (2013) observational study confirmed that engaging in social media during study periods negatively affected students’ grades. Junco and Cotten (2011) found that engaging simultaneously in schoolwork and instant messaging (IM) had a negative effect on studying; and, that student GPAs were negatively correlated with the social use of information and communication technology (ICT; Junco & Cotton, 2012). Bowman et al. (2010) tested whether the use of IM during reading hinders the reading process; they found that students took significantly longer to complete the reading task, even when subtracting IM time. Beentjes and Koolstra’s (1996) survey of 8th to 10th graders revealed that student learning was impaired by background media use when studying at home.

Certain activities are more distracting than others. Kraushaar and Novak (2010) distinguished between productive and distractive multitasking, distractive being the non-course related activities performed on students’ laptops during class, such as email, IM, and entertainment surfing. In their study, academic performance was lower when the proportion of distractive multitasking was higher. Learning is less effective when students engage in activities that are not related to the goals of the task. This is because off-task activities increase the extraneous cognitive load (Wood et al., 2012).

The problem with engaging in multiple tasks is that people cannot simultaneously process multiple messages centrally. Peripheral message processing is known to reduce the long-term effects of the messages (Jeong & Fishbein, 2007; Petty & Cacioppo, 1986; Srivastava, 2013). A response-selection bottleneck occurs because cognitive processes are limited in this capacity. When confronted with multiple tasks, the brain must choose among the many stimuli (Borst, Taatgen & van Rijn, 2010; Meyer et al., 1995). The way the brain handles multiple-task performance is to rely on adaptive executive control, which enables substantial amounts of temporal overlap among stimulus identification, response selection, and movement-production processes for concurrent tasks (Meyer & Kieras, 1997). The cognitive load imposed by engaging in multiple tasks negatively affects the learning process because there are limits to the quantity of information that can be retained (Lee, Lin & Robertson, 2012). Learning and storing information are two different activities, involving different areas of the brain. The learning that occurs during multitasking is less flexible and more specialised, which makes it harder to retrieve the information after learning (Rosen, 2008).

There may be a difference between dividing one’s attention and switching rapidly between tasks (Posner, 1990). Multitasking divides the attention among activities, making the selection of information imperfect and resulting in delayed or slowed processes (Smith & Kosslyn, 2007). On the other hand, rapid attention switching occurs when a person rapidly shifts his or her attention among different activities. Since the individual is only attending to one stimulus at any given time, the multitasking doesn’t necessarily compromise the quality of the process. However, when people engage in rapid attention switching, there is a time lag before full attention is restored to the new tasks (Butler, Arrington & Weywadt, 2011; Rubinstein, Meyer & Evans, 2001). In contrast, one area of cognitive psychology suggests a potential benefit of multitasking, having found that training can improve multitasking skills (Meyer et al., 1995). According to scholars who suggest an adaptive view of the brain, information processing is considered to be “massively parallel” and “distributed” throughout components of interconnected neural networks (Anderson & Hinton, 1981). Multitasking in certain tasks can be trained or learned (Saunders & Klemming, 2003). Multitasking affects the type of learning that takes place in the brain and involves a different area of the brain than single-task activities (Foerde, Knowlton, & Poldrack, 2006). Constant multitasking by young people today may train them to juggle multiple activities and use time more efficiently (Carrier et al., 2009).

Adapting to the challenges of multitasking

Multitasking is more prevalent than ever before, especially among youth, and the trend is certainly growing. According to research by the Kaiser Family Foundation, the average amount of time that children aged 8 to 18 report media multitasking increased from 16% in 1999 to 29% in 2009 (Rideout, Foeher & Roberts, 2010). If multitasking is among the cognitive activities that can be learned, then we can assume that exposure to certain technologies will enhance users’ ability to multitask. Carrier et al. (2009) compared the Baby Boomers, X Generation, and Net Generation in their multitasking behaviour and found that the youngest generation exercised a greater amount of multitasking, but that the types of activities engaged in were similar across all generations. This implies that multitasking is an acquired skill and that people have to learn how to do it efficiently. Cognitive flexibility is a characteristic of the human brain that helps people pursue complex tasks, such as multitasking, and adapt to changing demands (Ionescu, 2012).

However, most studies about multitasking are cross-sectional and thus cannot identify long term changes over time. Furthermore, most studies that measure the distracting impact of new technologies do not acknowledge the novelty effect of a new device when it is introduced into the user’s existing digital environment. New digital devices are presumed to be inserted seamlessly into the users’ everyday context. Users adjust to the multi-platform, multi-device environment by devising their own strategies. Self-regulated learning can be used to manage multitasking with digital devices. Studies on self-regulation conclude that effective learning occurs when students block out distractions while engaged in learning activities (Sitzman & Ely, 2011). For example, Wei, Wang and Klausner (2012) tested the relationship between self-regulation, text messaging in class and cognitive learning. Students who have higher self-regulation levels are less likely to text in class and more likely to sustain their attention, and thus achieve better learning outcomes. The will to consciously sustain focus is a vital factor in self-regulated learning (Roeser & Peck, 2009).

Research Questions and Methodology

Previous studies suggest that multitasking using digital devices compromises the overall quality of learning outcomes. However, less is known about the user experience during the multitasking process and the way they deal with the challenges that arise. This study examines how users of mobile tablet devices respond to the ubiquitous access to the internet, particularly in a learning environment, with a focus on their perception of their multitasking behaviour.

Drawing on previous studies, we can conclude that (1) multitasking behaviour is becoming more prevalent in the digital age; (2) certain activities impose less cognitive load and are thus easier to multitask; and, (3) human brains are adaptable to the environment, within limits. It is expected that, due to ubiquitous access to multiple platforms, people are faced with an increased demand for multitasking and that they learn to adapt. The following exploratory research questions were developed to explore the experience of users while adapting to a new digital device.

Research Question 1. What are the perceived negative and positive effects of multitasking among young adults after they are given mobile tablet devices?

Research Question 2. How do young adults adapt to and balance productive and distractive multitasking after they are given mobile tablet devices?

The data analysed in this study was drawn from a larger longitudinal study of young adults conducted between August 2011 and August 2012. A total of 35 first and second-year full-time university students at an Australian university were recruited through on-campus bulletin boards and the university’s online portal site. Voluntary participants were directed to a Web link, where they were asked to complete a short screening survey. Screening questions included age, gender, and ownership of digital devices, including mobile tablet devices. A quota sample was selected on the basis of the population’s gender and age composition. Only those who did not already own a tablet device were invited to take part in the study. For a summary of participants’ demographic profiles, see Table 1.

Table 1. Summary of participants

Variables N %
Gender Male 15 43
Female 20 57
Type of residence Live with family 19 54.3
Off campus residence 6 17.1
On campus residence 10 28.6
Age 18-20 21 60
21-25 14 40

In order to track changes throughout the course of one year, both quantitative and qualitative methods were used. Two sets of longitudinal surveys were conducted. The first set consisted of pre-study, mid-study, and post-study surveys. The second set was a monthly survey conducted from September to November 2011 and from February to July 2012. An online community discussion forum was open throughout the study, enabling researchers to engage in netnography. Netnography is a participant-observational research strategy conducted in online spaces (Kozinets, 2010). The researchers actively participated in the online environment by posting questions, prompting answers and engaging with the participants. This study reports mainly on the findings from the online discussions.

With the exception of the pre-study survey, all of the data were collected after students had been given their mobile table devices. The model that was given was the iPad II, with Wi-Fi and 3G access. Wi-Fi was available on campus at no extra cost. Students who wished to use 3G technology were required to purchase a SIM card and a subscription to a mobile 3G service. All names used in this study are pseudonyms. Prior to the study, appropriate ethics approval was obtained from the National Health and Research Council through their National Ethics Application Form (NEAF).

The participant recruitment procedure resulted in a cohort of students who owned various digital devices and were regular users of the internet. In all, 74.3% of participants owned a smart phone and 94.3% owned their own laptops or computers (see Table 2).

Table 2. Device ownership prior to the study

Type of device

Ownership before study

N

%

Mobile phone Smart phone

26

74.3

Regular mobile phone

8

22.9

Do not own

1

2.9

Laptop or PC Personally own

33

94.3

Do not own*

2

5.7

*Students who did not own their own computer/laptop were still able to get access to a home computer/laptop

Multitasking behaviour in continuum

Multitasking behaviour is not new to the digital era. In modernity, time is a basic unit of measurement used to determine value. High productivity is regarded as the completion of a certain process in a reduced amount of time. According to Southerton and Tomlinson (2005), “time squeeze” is a general characteristic of contemporary suburban households and people are expected to manage multiple tasks within a limited timeframe.

Media multitasking was already prevalent among study participants before the study. In the pre-study survey, participants reported that they frequently engaged in an additional activity, such as using the computer, playing games or text messaging, while watching TV or listening to music. Among the participants, 14.3% reported doing so every time they watched TV, and 31.4% did so every time they listened to music. This pattern did not change significantly after using mobile tablet devices for a year. For most participants, adding one more device did not significantly increase the amount of media multitasking.

However, new situations emerged in which they could engage in both media and non-media multitasking. For example, chatting with friends online while watching television was reported as a new advantage of having a portable device that they could carry around within the home. During classes, they frequently used their iPads to multitask. During lectures, 91.2% of participants searched for information on their iPads. A total of 82.4% said they shared information with others outside of the lecture through tweeting, posting, and emailing. Similarly, 85.3% reported reading on their iPads during lectures and 91.2% engaged in iPad activities that were not related to the lecture.

The co-existence of distractive and productive multitasking

After receiving their iPad, participants reported identifying new situations in which they could multitask. These included using their iPads on public transportation, in classrooms, while engaging in conversations with others, and at home while watching television. Most multitasking activities were accepted as natural, efficient and “becoming the normal trend” (Neil). Using their iPads for social network sites, emails, and browsing during a conversation with other people was not regarded negatively, but was rather considered complementary to the primary activity and “fantastic for time management” (Jean). When Heather was in Peru, for instance, she was able to engage in a conversation with the locals using her iPad for translation. Other examples of complementary multitasking included tweeting during a television program that invites audiences to participate via Twitter (Aiden), and seeking information related to the main task (Mia).

While consuming media content, iPads were used not only to search for information related to the media content, such as visiting the homepage of the broadcaster (Elizabeth), but also to use time efficiently, such as browsing for used cars while watching TV and “looking up other spur of the moment ideas” (Jacob). At times, it was used to co-view a television program with a remote friend. “The Friday night AFL game was on and whilst watching the game at home on my couch I had my iPad out having a conversation with a friend from home about the game that was unfolding in front of my eyes” (Donald). “Using my iPad, I accessed the SBS website that was rating Australia’s vote for Eurovision, which added another angle to watching the show” (Rita). Many participants found multitasking to be a positive experience, whether it was during a conversation or watching television.

I think it is natural to try to multitask in today’s society and the dual conversation is an element of that. Today, I was setting up my mother on Facebook and teaching her how to use it, when my work rang. I continued to teach mum [the] technology while on the phone… Technology has given me the ability to hold these multiple conversations for longer and more stealthily.” (Patrick)

I feel that since I got the iPad I tend to engage in technology multitasking because while I’m watching Foxtel on the one hand, I’m also reading lectures on my laptop, while flicking through Facebook on my iPad.” (Mary)

At the same time, participants were aware of the distraction that iPads presented to them due to this capacity to multitask.

“When watching Q&A on ABC, I would engage in a Twitter conversation using the hashtag for the television show with other viewers… Though this is encouraged by the producers of the show itself, it would at times distract [me] from the actual show itself because of the enormity of the online conversation.”(Henry)

The cause of distraction was the continuous access to the internet through the iPads. This led participants to procrastinate on their main task in lieu of the various applications that caught their attention.

“[The] ease of carrying around the iPad also has contributed to its ability to distract. I also find the iPad not only a distraction, but a good option for a form of procrastination—always better to be playing games or chatting on Facebook than working on an assignment.” (Rene)

iPad users easily tune out because it is “too easy to access information quickly, whether it be relevant or not” (Jacob). The push service was found to be distracting because “messages from Facebook pop up at the top of the screen when working on something else” (Rene). In most cases, the additional tasks were habitual behaviours that they engaged in without purposely thinking or planning. Elizabeth suggested that the distraction was due to the ubiquity. “Checking Facebook and email whenever logged on to the internet is habitual” (Elizabeth). The constant accessibility of the internet is the source of distraction and iPads have made it easier to tap into that opportunity.

Being connected to the internet constantly, especially in lectures, makes it very tempting and very easy to tune out.” (Jacob)

The escapist notion of media can be applied to such situations. iPads provide users the opportunity to avoid activities that occur in confined spaces. Instead of engaging in the main task, participants often shift their attention into their own virtual spaces.

“[It is] quite easy to take it to [class] and every now and then stray from what we are doing to look at my Facebook.” (Elizabeth)

It is, in a way, leaving the physical space to be elsewhere—in the online space. Noah often “tunes out” when the “class becomes boring.” Similarly Aiden “constantly refreshes Facebook and Twitter, hoping something interesting might appear during dry lectures.” However, the purpose of their multitasking extended beyond simply trying to avoid a task. Participants were feeling a constant need to be connected to their virtual world.

“While studying for my final exams last semester, I got into the habit of keeping Facebook open on my iPad, which was sitting in front of me. This allowed me to look at the flow of information coming in from the Facebook news feed while studying.” (Aiden)

Participants considered their iPads to be an efficient tool to maximise their use of time, but also a playful device that distracts them when they have to engage in serious tasks such as studying or attending lectures. Both sides of this duality of distraction and efficient multitasking were well accepted among the students. They did not consider the two concepts to be mutually exclusive; both behaviours co-existed in their everyday context.

“It has taken procrastination to a whole new level! Also, it has taken productivity to a new level.” (Brian)

Most participants grew up in media-rich environments. They had had their own mobile phones since approximately the age of 12 and had computers in their houses before the age of five. As such, it is not surprising that they have practiced backchannelling or experienced ambient virtual copresence (Horst et al., 2010) in classrooms. The difference is that in secondary schools, there were rules at school that prohibited or banned such activities, but in a university setting, there are no explicit rules governing their behaviour in class; they are left to decide for themselves.

The survey results confirm the participants’ duality in their perception of multitasking. In the post-study survey, 29.4% of participants thought that iPads had made them better learners, and 88.2% thought that iPads were useful in the classroom during lectures or tutorials. On the other hand, 58.8% admitted that when they were using the iPad, they were easily distracted by other functions or apps. Most students reflected on how distracting, yet helpful, the device was during their studies. In all, 20.6% of the participants thought that even though the iPad has some features that help in studying, the overall impact was distraction. A full 73.5% reported that even though it was a distraction at times, the iPad had helped them to study more efficiently. Only 5.9% thought it helped without any distraction.

Negotiating multitasking by adopting self-regulation strategies

Tablet users encountered situations in which they had to process multiple threads of conversation. Learning to manage time across various activities was one of the challenges many of them mentioned.

I was once in a lecture taking notes on the given subject. While this was happening, I was receiving notifications from Facebook that someone was trying to contact me about a group project for another subject. I have then had to answer these questions on the group project, which has prohibited me from taking any more notes on the given lecture. I was trying to still listen to what was being presented, yet it was too difficult to maintain this attention while trying to organise a meeting with my group for a different subject.” (Anna)

When this happened, they had to devise their own rules and boundaries by experimenting and negotiating with themselves to find an optimal solution. The way they coped with this can be described as a self-regulation process whereby they acquired appropriate “skills” to control their use of the device. Self-regulation is a process that guides an individual through a goal-oriented task over time when circumstances are changeable. This usually occurs when a routine is disrupted (Karoly, 1993).

Similar to the findings reported by Quan-Haase (2010) in a study on instant messaging (IM), participants in this study adopted physical disconnection strategies when coping with distraction. Disconnection is the act of banning physical access to the device altogether, either by “leaving the iPad behind” (Diana), “not using it in lectures” (Kathryn), or “banishing the iPad to the lounge room” (Jean). Simply not leaving it on the desk when they needed to study was one of the banning methods (Jean). Another method was to customise the iPads during certain periods so that they would be less tempted to use it for off-task activities. Anna reported deleting distracting apps during the exam period and re-installing them afterwards. Andres exerted self-control by closing all apps that were not relevant to the main task and deleting some until after the work had been completed. In contrast, Elizabeth’s strategy was to open useful applications that were directly related to the main task so that she would not be tempted to visit Facebook. Additional effective ways of minimising distraction, included turning the volume down so that they would not be distracted by the noise (Donald), or in other cases, turning the volume up so that they would not feel inclined to play games in the presence of others (Brian).

In contrast, some users chose to mentally plan ahead for the distracting activities in order to exercise greater control when the situation presented itself. For example, one method was to pre-schedule the distraction so that they could minimise the temptation when they were engaged in the main task. By anticipating the distraction, users could proactively deal with it before it actually occurred.

When I do a day of study I generally give myself set breaks for 10–15 minutes and will play on my iPad in those breaks, but I rarely spend longer on it than I’ve given myself.” (Evelyn)

Time management and self-control skills were both necessary to implement this strategy. Evelyn used “technology breaks” to address her internal needs. She reported spending about 20 minutes on studying, allowing herself to be distracted for a few minutes, and then returning to her studying. In Heather’s case, she would reduce the temptation to be distracted during her main activity by engaging in all of the distracting activities first, and then focus on her studies.

Both placing a physical ban on the use of the device and pre-scheduling distraction can be characterized as self-regulatory techniques employed when acquiring digital media literacy. Being able to access, use, critically understand and appropriate the device are important aspects of digital media literacy (Park, 2012). Digital media literacy is a multidimensional concept that includes not only the device literacy, but also the ability to engage and exercise social norms. These strategies were adopted once users were comfortable using the device, after several months of exploring it. The time it takes to become digitally literate is reflected in the fact the method of self-regulation was not always effective. Participants reported that it required a lot of “self-control” (Rita) and the user must be “strong” (Chloe). Some reported difficulty with this self-regulation: “If [distraction] is going to happen, it usually does” (Mason); and, “no matter what I do, I always find myself on Facebook, and it is so easy to just tune out of the lecture or tutorial” (Noah). Coping with distraction is an ongoing process of negotiation. Dylan deleted all of his distracting apps from his iPad, but found himself pulling out his phone with the same apps.

Rather than attempting to increase the ability to multitask across all activities, participants closely monitored their use and limited their multitasking activities that were distracting. For example, when they were studying, they chose not to engage in multitasking, but rather to manage their time so that they would not have to multitask. It may be that one year was not sufficient time for them to train themselves in effective multitasking during focused activities. Nevertheless, participants quickly learned how to switch between productive multitasking and regulating distraction depending on the context and the task at hand.

Unless learning is motivated and directed by goals and positive outcomes, using digital technologies may not be an immediately rewarding experience. According to Bandura (2001), intentionality is the power to originate actions for a given purpose. Self-reactiveness suggests that an agent “has to be not only a planner and forethinker, but a motivator and self-regulator as well” (p.8). Considering how a person acts, reacts and reflects upon his or her own behaviour is a useful way to analyse the manner in which mobile tablet users cope with and negotiate their device usage practices.

Self-regulated learning is a general disposition that students bring into the classroom in an engaged and motivated manner (Boekaerts, 2005). It defines the way students learn the subject matter. In this case, self-regulated learning was used as a strategy for dealing with distraction. In an era in which multiple digital devices are being introduced into and used in the classroom, the effectiveness of learning is increasingly dependent on students’ abilities to exert self-regulation. This involves the process of learning how to use new devices per se, but also devising rules and routines of appropriate usage from the user’s standpoint. The process of self-regulation when learning how to use mobile tablet devices in the context of studying illustrates how young people acquire digital media literacy.

Conclusion

This study observed young adults over a period of one year and examined how they learned to manage and address the new challenges posed by adding another digital device to their digital environment. Young adults who had never owned a mobile tablet device were given iPads and observed over the course of one year. Mobile tablets, while similar to laptops and smart phones, presented the participants with a novel situation, i.e., continuous connection to the internet. The ubiquity of internet access was regarded as an added convenience in most settings. In many situations, multitasking was regarded as productive and helpful in improving time management. However, multitasking posed a challenge in the context of studying.

Participants struggled to balance their studies as they faced intensified multitasking situations. Despite the fact that they all had prior experience with multitasking to some extent, they encountered new situations in which they were now habitually engaging in multiple tasks. Situations emerged in which they needed to devise coping strategies to focus on one task. The main methods of dealing with such challenges were either to physically disconnect themselves from the device or to plan ahead and manage the anticipated distractions.

Learning to use a new device requires not only technical skills, but also an understanding of the broader social meaning of using devices in various contexts. Due to the portability, students were able to carry their tablets everywhere. Participants explored, experimented, and negotiated various uses of the device according to the different contexts in which they found themselves. At first, participants went through a novelty period. This is when they experimented with the device and spent enormous amounts of time using it. After this phase passed, they were able to reflect upon their usage patterns and establish what they thought to be optimal use. During the process, self-regulatory strategies were adopted, whereby they eventually found a place for the new device amongst the various digital devices they used.

Acknowledgements

This research was supported by the Public Communication Research Cluster at the Faculty of Arts & Design and the Information and Technology Management at the University of Canberra (2011-2012).An earlier version of the paper was presented at the 14th annual conference of the Association of Internet Researchers.

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Biographical Statement

Sora Park is Associate Professor and Course Convener of Media and Public Affairs at the University of Canberra. She is an inaugural member of the News & Media Research Centre. Her research focuses on digital media users and implications for media policy.

Contact: sora.park@canberra.edu.au +61-2-6201-5423

Owen Barden

Published Online: August 12, 2014
Full Text: HTML, PDF (694 KB)

Abstract

This paper examines the role of identities in underpinning and activating literacies learning in a small class of adolescent students labelled with dyslexia. It derives from a project in which teacher-researcher and student-participants co-constructed a Facebook group page about the students’ scaffolded research into dyslexia. The study investigated an apparent paradox: that although literacy demands are often cited as barriers to learning and participation for students labelled with dyslexia, social networking technologies seem to motivate at least some such students to willingly undertake significant amounts of reading and writing. Two interrelated potential explanations are investigated to attempt to resolve this paradox. Firstly, that the social and collaborative nature of Facebook literacy events and practices, which promotes a sense of shared identity amongst the participants, is itself motivating. Secondly, that identity strongly influences engagement with texts. Three intertwined strands of identity work emerged from analysis of the data. These three strands underpinned the students’ literacy events and practices. Each strand is elaborated, through reference to interview data and classroom dialogue. The study concludes that Facebook offered an affinity space in which the students inhabited projective identities which reciprocally shaped their literacy practices

Keywords: Facebook; dyslexic; identity; adolescents; social network site; new literacies

Facebook and education

Digitally mediated social networks are a relatively new phenomenon, yet use of social network sites (SNS) is one of the most popular everyday activities on the World Wide Web (Stirling, 2011). One person in twelve on the planet has a Facebook account (Aydin, 2012), and the site is almost ubiquitous in some countries, with approximately 1.3 billion current monthly users worldwide (statisticbrain.com, 2014).  Some people’s engagement with the site is so intense, and such are its communicative affordances (O’Brien & Voss, 2011), that Allen (2012, p214) claimed Facebook offered “something of an equivalent to the internet.” That is, their experience of the internet could be almost entirely mediated through the site. The appeal of digitally-mediated social networks to students and young people is widely documented (e.g. boyd 2008a, 2008b; boyd & Ellison 2007; Davies 2012). Despite some signs that UK teenagers are now abandoning the site in favour of others, at the time of this study the UK had the second largest number of users worldwide at 29.8 million, or 58% of the 54.1million people online (Arthur, 2011). True to its heritage at Harvard, students are amongst the most prolific Facebook users, with the site part of the fabric of their lives as they weave complex tapestries of communication which combine multiple online and offline threads (Allen, 2012; Hulme 2009; Facer 2011). Despite this ubiquity, there is a large degree of uncertainty over how, and even whether, educators should use SNS like Facebook to engage students in academic study. For instance, there are claims that Facebook has a detrimental effect on engagement and grades (Kirschner & Karpinksi, 2010), and that some students simply don’t want Facebook in the classroom, preferring to keep the social sphere separate from the academic (Prescott, Wilson & Becket, 2013). Although there is an emerging body of research on pedagogical applications of SNS,  as yet knowledge in this area remains limited (Coates, 2007), the evidence is mixed, and the student voice is largely absent from the literature (Prescott, Wilson & Becket, 2013). In addition, there is some evidence that a significant proportion of young people are prolific yet unsophisticated internet users (Crook, 2008; Pangrazio, 2013; Zimic, 2009).  Therefore, one task facing researchers is investigating and developing understanding of the educative practices and tools afforded by digitally mediated social networks (Asselin & Moayeri, 2010; Greenhow & Robelia 2009; Moayeri, 2010).

Decisions about whether to exploit SNS in education will inevitably be determined by context as well their affordances (Allen, 2012). What cannot be denied is that many young people seem to be interested in and motivated to learn by digitally-mediated social networks, and many are open to the idea of using them in the classroom (Roblyer, McDaniel, Webb, Herman & Witty, 2010).  A number of advantages are posited for exploiting SNS.  There is the claim that the kind of collaborative learning SNS promote is in tune with broader cultural, Web 2.0 influenced shifts towards social constructivist epistemologies (Dede, 2008; Kress, 2010). Such learning can be deemed more authentic by students because it involves collaboration in the construction and distribution of knowledge, and may combine informal and offline elements (such as classroom discussion) with more formal aspects (Deng & Taveres, 2014; Moayeri, 2010.)  There is also the claim that SNS offer opportunities to think creatively and solve problems, again working collaboratively (Alvermann, 2011). Moayeri (2010) claims that SNS can foster closer classroom communities. Echoing this, Alvermann, Hutchins & McDevitt (2012) write that SNS can bridge space between more and less popular or shy students, and between genders, promoting sociality.

Dyslexia, literacies and identities

Identity is shaped in reciprocal relationships with texts (Alvermann, 2011; Barden, 2009; McCarthy & Moje, 2002). Dyslexia is almost invariably defined and conceptualised through reference to significant difficulties with meeting normative cultural and curricular literacy demands (Bell, McPhillips & Doveston, 2011; Hornstra, Denessen, Bakker, van den Bergh & Voeten et al 2010; International Dyslexia Association 2002; Miles, 1996). Students labelled as dyslexic therefore frequently inhabit identities as literacy ’strugglers’ or failures. Rather than being valued as “thriving, literate, intelligent human beings with important contributions to make” (Greenleaf & Hinchman, 2009 p.4), all too often students labelled with dyslexia become protagonists in socially constructed narratives of failure (MacDonald, 2009).  Exclusion from, and rejection of, reading and writing, frequently has negative long-term effects on self-concept and senses of identity, educational trajectories and hence life chances  (Alvermann, 2001; Collinson & Penketh, 2010; Gee, 2001; Madriaga, 2007; Tanner, 2009; Williams, 2003 & 2005).  To use Foucault’s (1975 & 1980) terms, such students become ‘docile bodies’, disciplined by the normalising gaze and techniques of the social institution of the school into internalising identities as failures.

Issues of identity are particularly pertinent in adolescence when identities are relatively fluid and particularly susceptible to influence from peers and role models. Although identities are lived by individuals, they are also socially constructed (Pangrazio, 2013), and paradoxically both possessed by and possessive of the individual (Jabal & Riviere, 2007). SNS make social networks that might otherwise remain invisible visible (boyd & Ellison, 2007), and demand that users construct, manage and perform what (Gee 2000, 2001; see also Alverman, 2011) terms their Discourse-identities within those social groups. Discourse-identities are ways of being, belonging and being recognised, sustained in part through literacies. Mallan (2009) argues that SNS provide new ways for virtual identities to be constructed, presented and narrated in public.  Identity is therefore not simply a manifestation or marker of an individual’s internal states or dispositions, nor merely how individuals are recognised; individual and group identities in SNS are also performative, collaborative and collective.

Using Facebook to communicate with peers requires encoding, decoding, interpreting and analysing significant amounts of text, often whilst simultaneously ‘dealing with’ several conversations (Lewis and Fabos 2005). Given that  Facebook demands not only significant amounts of reading and writing, but reading in writing in public, where potentially stigmatising weaknesses are exposed,  we might reasonably anticipate that students labelled dyslexic, and who may inhabit identities as literacy strugglers or failures, would avoid the site. Put another way, such students might perceive the literacy demands of Facebook threatening their Discourse-identities within peer groups. Unsurprisingly, studies have found that students labelled with dyslexia continue to struggle in virtual environments like chat rooms and discussion fora that require them to work read and write in much the same way as they would be expected to with pen and paper (Woodfine Baptista Nunes & Wright, 2005; Williams, Jamali & Nicholas, 2006; Hughes, 2007). In addition, and as Alvermann (2011) observes, social networking  – and other online activities – require adolescents to decode and encode a complex mix of words, symbols, and genre-specific syntax as well sounds and images – skills not typically taught in traditional literacy classrooms, but which are nevertheless gaining social value (Moayeri, 2010). We might anticipate that this multimodal complexity would act as a further deterrent to those deemed to struggle with literacy. In addition, SNS can  create anxiety and pressure to appear popular (Pangrazio, 2013).  However, rather than exacerbating the difficulties associated with typographic literacies, it seems, the shifting balance from linguistics to multimodal semiotics (Kress, 2003 & 2010), combined with developing economies of recognition and recognition (Allan, 2012 p214; Mallan 2009 p57), participatory cultures (Jenkins, 2006), opportunities to connect with others based on interests and personality (Mallan, 2009; Alvermann, Marshall, McLean, Huddleston, Joaquin & Bishop, 2012), and the ability to draw on diverse digital materials and tools (Moayeri, 2010) suggest the potential to realise the possibility of positive shifts in self-esteem, power and agency for students labelled ‘dyslexic’ and therefore literacy failures. They may thus enable such students to use power positively and productively to resist dominant epistemologies and discourses of deficit (Foucault, 1980).

For example, some evidence suggests that undergraduates reporting low satisfaction and low self-esteem, a group likely to include those with labelled with dyslexia (Pollak, 2005), gain more social capital from intensive Facebook use than their non-dyslexic peers (Ellison, Steinfeld & Lampe, 2007). Barden (2012) found that Facebook offered an arena for critical and playful learning about and through literacy for a small group of adolescent students labelled as dyslexic. The social imperative to maintain peer networks and increased exposure to language have also been shown to improve spelling and contribute to motivated wordplay by some dyslexic students when SMS “texting” (Veater, Plester & Wood, 2011). Hughes, Herrington, McDonald & Rhodes (2011) describe the ways in which social learning via e-portfolios boosted two dyslexic university students’ perceptions of their literacy skills. Positive reframing of dyslexic selves as successful learners resulted (Gerber, Reiff & Ginsberg 1996; Tanner, 2009). As part of the shift towards social constructivist epistemologies, SNS thus appear to offer opportunities for meaningful, authentic “knowledge work” (McNely, Teston, Cox, Olorunda, & Dunker, 2010) and developing agency. A sense of an appreciative audience motivates authorship (Alverman, Hutchins & McDevitt, 2012). Motivation to engage with multimodal content in order to write their worlds into existence means students produce texts which help construct Discourse-identities in ways that allow them to present themselves as literate beings, rather than literacy failures (Alvermann 2011). They can also prepare for the future by developing critical digital literacies, engaging with web-based resources to foster literacy skills that are rapidly gaining symbolic capital in our increasingly high-tech world (Alvermann, Marshall, McLean, Huddleston, Joaquin & Bishop, 2012). Developing a sense of agency, with students engaging in knowledge work that helps them write themselves into the future through participating in digital networked publics (boyd, 2008a, 2008b; Facer, 2011; McNely, Teston, Cox, Olorunda, & Dunker, 2010; Merchant, 2007), may also be valuable in preparing young people for future careers and life choices.

As Hall (2012, p.369) notes, and remedial literacy programmes for dyslexic students endlessly exemplify: “What gets ignored in the rhetoric of helping students become “good readers” is that doing so requires more than helping them learn specific skills. It requires a shift in their identities.”  Identity thus has important literacy pedagogy implications, especially among those who have been characterised as “slow” or “struggling” readers (Anderson, 2007; Lenters, 2006; McCray, Vaughn & Neal, 2001). However,  the available literature currently “comes up short in terms of detailed analyses of the ways in which youth use web-based resources to construct their online identities, while simultaneously developing the digital literacy skills needed for learning in a world where attention, not information is in short supply”  (Alvermann, Marshall, McLean, Huddleston, Joaquin & Bishop, 2012 p185).

The fact that digitally-mediated social networks are so popular and can motivate learning through literacies amongst students traditionally marginalised by school literacy suggests that their classroom use is an issue which has not been sufficiently explored. Technologically-mediated emerging literacy practices also challenge assumptions about the relationships between so-called ‘dyslexics’ and literacy. The deficit model of dyslexia assumes literacy is an individual technical skill, whereas Facebook exposes both the social and ideological nature of literacy practices, and the deployment of new literacies (Street, 2003, 1984) Against this backdrop, the study reported here investigated the classroom use of Facebook by a small group of adolescent students labelled as dyslexic. It attempted to answer the following research questions: What does the students’ engagement with Facebook reveal about their motivation to learn through literacy, and their sense of identity? It was hoped that investigating these questions would generate ideas for developing a more inclusive contemporary pedagogy. This study therefore represents an attempt to let go of tired practices and join in the exploration of new forms of text, and enable students to engage meaningfully in learning that both extends and elaborates on the literacy practices they already own and value (Alvermann, 2011).

Methodology & methods

Methodology

For this study, a “fledgling methodology” (White, Drew & Hey, 2009 p.21) combining elements of action research and case study with an ethnographic sensibility (Green & Bloome, 1996) was devised (Barden, 2013). This methodology and combination of methods was deliberately complex in order to try and provide thick descriptions of what was happening “on the ground”, here-and-now, in what Selwyn (2011, p164) calls the “messy reality” of digital technology use.

Williams (2008) counsels that in thinking seriously about students’ identity figures in their literacy practices, we must talk to students about how and why they write online, in order to find out from them about their practices and social skills. Accordingly, the methodology of this study permitted an extensive range of qualitative methods including participant-observation, classroom video recordings, semi-structured interviews, dynamic screen capture (Asselin & Moayeri, 2010; Cox, 2007) and protocol analysis (Ericsson & Simon 1993; Lewis & Fabos, 2005). Dynamic screen capture involves making, with participants’ informed consent, video recordings of everything that happens on a user’s computer screen over a given period; in this case, during two of the five 90-minute project sessions. Protocol analysis is a procedure for obtaining participants’ verbal reports about their actions, thought processes and emotions whilst or after completing tasks. In this study, retrospective verbal reports were obtained by playing back the participants’ screen capture videos and asking them to explain what they were doing and why (Barden, in press).  Through the constant comparison procedure advocated for grounded theory (Corbin and Strauss, 2008 p259), this data was aggregated with that obtained through the more orthodox methods to reconstruct a strongly emic account (Brantlinger, Jiminez, Klinger, Pugach & Richardson, 2005) of how and why the students read and wrote online, the sorts of literacy practices that shaped literacy events, and how all this was underpinned by identity work.  In addition to these methods, a doctoral candidate working on his own, unrelated investigation of children and young peoples’ perceptions of their experiences of being researchers (Hughes, 2011) asked to collect Q-Sort data (Van Excel, 2005; Watts & Stenner, 2005)  from the participants.  Q-Sort is a systematic way of studying viewpoints, opinions, beliefs and attitudes, in which participants sort by ranking a carefully worded and selected set of statements into a quasi-normal distribution, with these “sorts” then subjected to a statistical pattern-analysis called by-person factor analysis. Having an independent researcher use statistical methods to explore my participants’ views of themselves as researchers on my project helped triangulate and add additional depth to inform my own analysis of their identity work.

The classroom setting

The empirical work for this study took place in a classroom in a sixth-form college in north-west England[i]. The five volunteering participants were a sample of convenience: had I not been doing this research, I would have been teaching them conventional literacy and study-skills anyway.  The participants professed interest in the project, and had a variety of experiences and knowledge of dyslexia. Three of the group had been identified as dyslexic through educational psychologists’ assessments earlier in their school careers. Two were formally assessed shortly after enrolling at the college. The five expressed different attitudes towards and purposes for online social networking. The collaborative research used a strategy of “scaffolded co-construction” (Lankshear & Knobel, 2003, p.180). This involved me as teacher-researcher and participant-observer, designing, facilitating and documenting the students’ largely self-directed online research into dyslexia.    The students’ regular “study support” classroom was reconfigured as “an inquiry-oriented learning environment that positioned students as active collaborators investigating their learning, personal responsibility, and construction of identities as self-sufficient learners” (Greenleaf & Hinchman, 2009, p.11; see also Coffield, 2008). The classroom thus combined with the group’s Facebook page to become an “affinity space” (Gee, 2005) for the collective endeavour of exploring interest in dyslexia. The space was  dissociated from institutionalised literacy norms, with “no requirements concerning ‘correctness,’ style or format” (West, 2008 p.588).

We worked together to co-construct a Facebook page over five 90-minute sessions. As teacher-researcher l initiated the project, helped set its direction and ensured progress was made. The students chose to construct a group Facebook page, recording their largely self-directed research into their freely chosen topic, dyslexia. The participants decided to use Facebook to explore and record ideas around dyslexia, hypersensitivity to sensory stimuli, disability and diversity. I encouraged them to bring their pre-existing “funds of knowledge” (Moll, Amanti, Neff & Gonzalez 1992; also Davies & Pahl, 2007: 119; Wellington, 2001 p.236 ) to the endeavour, and take the opportunity to link curriculum content to personal experiences, local knowledge and relevant artefacts of popular culture, such as songs, press articles and online videos. Over the weeks as the students pursued their own interests the page developed organically, with little direction from me. We had regular, spontaneous discussions about their learning as well as more formal weekly progress meetings.

Ethical considerations

A major ethical principle was that the students’ preferences and curriculum demands had to take precedence. This significantly influenced the timing of the project and some opportunities for data collection and analysis. For example, at points in the term coursework and revision had to take priority over research activity. Some students participating were under 18 years old. Having undergone formal diagnostic assessment for dyslexia, all were legally classified as disabled. Both these factors mark them out as potentially vulnerable and high-risk. Although I thought that participating was something they would enjoy and benefit from, before starting I warned them that people might post hostile comments on their Facebook page: one danger of SNS is that have the potential to reinforce stigma and stereotypes, owing in part to the way they unsettle the public/private distinction (Mallan, 2009).  I attempted to manage this risk by piloting the project using the closed SNS Ning, but like Moayeri (2010), found that students were reluctant to use this site. Instead, the participants were unanimous in wanting to use Facebook as a vehicle for promoting better understanding of dyslexia amongst their peers, and so were willing to accept the risk. They also had an explicit political agenda, set out in the aims they authored for the project, wanting to persuade the College to overturn its Facebook embargo by proving to senior management “that Facebook can benefit education.” As a practitioner I felt it was ethical to support the students in trying to make education work better for them.  All students gave informed consent for confidential audio and video recordings to be made. I used a dedicated Facebook profile for myself, isolated from my personal one, to maintain my professional identity.

Data Analysis & Presentation

The project generated a considerable quantity and variety of data (summarised in Table 1).These data were analysed using the rigorous, reflexive procedures advocated for constructing grounded theory (Charmaz, 2006). Essentially, this involves multiple iterations of ipsative coding of the entire dataset, moving from initial open coding through focused coding to inductive, thematic categories which offer explanations of all the collected data. Because of the large volume of my data, and because I felt I had already immersed myself in my data enough to have some inkling of the major emerging themes, I switched from manual coding to using NVivo9 at the focused-coding stage of the analysis. Waiting until this point takes account of the criticism that computer programmes are not sensitive or “clever” enough to do grounded theory analysis (Becker, 1993).  A final stage of theoretical sampling and integration analysis rendered three intertwined strands of identity work which underpinned literacy practices These categories and their interdependencies are elaborated in the subsequent sections:

  1. Developing individual dyslexic identities
  2. Developing a shared dyslexic identity
  3. Becoming experts

Table 1: Data summary

Data Type Number of Instances Volume of Data
Duration (mins) Words
Initial Interviews 5 130 19722
Second interviews 5 104 16615
Observation notes[ii] 5 n/a 11055
Video recordings 5 356 n/a
Video transcripts 10 n/a 11687
Wink recordings 10 20 n/a
Protocol analysis 7 n/a 1155
Q-sort 1 n/a 11333
Total n/a n/a 71567

Charmaz’s (2006) approach is reflexive and pragmatic, recognising “that the viewer creates the data and ensuing analysis through interaction with the observed” (p.273), and  demands sensitivity to one’s own influence on the participants and the analysis. Constructivist grounded theory attempts to give opportunities for participants to tell their stories in their own terms and to clarify their perceptions of their own lived experiences. In this sense, it is emic and ethnographic. Authenticity is sought, as opposed to positivist notions of validity. Indeed, Charmaz (2006) rejects the concept of validity, yet her methods for attaining ‘authenticity’ are so similar to those Silverman (2006) advocates for ‘validity’ that this debate risks being reduced to the level of semantics: both insist on the systematic and rigorous application of strategies for data collection, and for analysis of the entire data set. These procedures, together with the relatively naturalistic classroom setting (I had already taught the group literacy- and study-skills for two months before starting the project) go some way to addressing potential experimenter effects inherent in such a research design.

Figure 1 is a screenshot of the group Facebook page, which illustrates the kinds of contributions the students posted, and how these evidenced identity work. The top post is a link to research from the Dyslexia Research Trust, which  attempts to explain the visual distortions some people labelled with dyslexia experience when reading. The bottom post is a video which attempts to simulate these perceptual effects. In the middle is a YouTube video of the British stand-up comedian Eddie Izzard, who identifies as dyslexic and is performing a routine about dyslexia. This supplied the audio for a video the students produced, which is discussed later.

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Figure 1: Screenshot of the group Facebook page

Developing individual dyslexic identities.

Participating in the group and contributing to the Facebook page was itself a significant signalling of a dyslexic identity for each individual: dyslexia is frequently a source of shame and my participants admitted as much, yet they publicised themselves as dyslexic to a potential global audience of 500m Facebook users. The actual size of the audience who joined the group was only around 70 people, but this is still a significant number to make a potentially stigmatizing disclosure to (Riddick, 2000). Early on Danny,  for example, talked about how he wanted to ‘smash’ a friend and fellow rugby player who had mocked him as a ‘cheat’ for being entitled to extra time in exams, and how he wanted to make people understand dyslexia ‘by force.’ Much of the students’ subsequent individual work during the project could be interpreted as them making sense of, and sometimes then communicating, their personal experiences of dyslexia. The motivation to make meaning through literacy was such that quite often the students would engage with texts that they would probably otherwise consider too difficult. As evidenced on the screenshot above, Chloe, for example, investigated the magnocellular theory of dyslexia (Stein, 2001) and undertook reading on the influence of chromosomes on literacy acquisition. In her post-project interview she spoke about “getting really nerdy” and “enjoying the sciencey part” of the research. In the context of the project, she was happy to engage with challenging academic texts she would otherwise have avoided. Likewise, Charlotte talked enthusiastically about an article from a Singapore Medical Association journal she had read (Lyens, 2002), which helped her understand the purported relationship between dyslexia and creative thinking. The article is written for clinicians, and demands some understanding of the psycho-medical domain and its vocabulary in order to be fully understood. Charlotte was a seventeen year-old Arts student. Despite our work earlier in the year on the nature and theories of dyslexia, she did not have the command of the subject-specific technical vocabulary anticipated by the author. Yet she was motivated enough to persist with the text, and then post a link to it on the group page, because it helped to answer her research question. In addition, the article resonated with her lived experiences,  and with the offline classroom discussions about dyslexic “geniuses”, dyslexic role models, and the group’s own perceptions of their being creative, independent thinkers:

“…I was just like oh woh yay!”

OB: How does madness promote genius do you remember adding this?

Charlotte: Yeah it’s the whole thing about dyslexics being able to be superhuman and um having like erm one of their senses being heightened…and like how a blind person has really good hearing and they can find a way around it like that but then we’ve got…certain things that are better for us…like being able to look at something completely different to everyone else…and see round the different ways around like think outside the box and stuff and yeah this one was quite long this one and this is one that you were like oh you’re reading this!

OB: Do you remember how you came across this?

Charlotte: Erm my question was something to do with advantages of being dyslexic or something and I think I just typed it into Google and something came up but…

OB: Okay yeah it is quite a tricky article but you were obviously you took something from it… how did you go about reading this article …I’m asking you what motivated you to read this…when you probably wouldn’t read usually something that was this difficult to read?

Charlotte: Well I think it is an actual experimental like write-up or something so I thought that would be quite an accurate look onto how dyslexics work and how other people with disabilities work…so I think it I was just like oh woh yay!

OB: So because it was, it had accurate information and would be a reliable answer to your question?

Charlotte: Yeah.

Charlotte’s choice of research question indicates a desire to make sense of her own experiences of dyslexia, and thus engage in individual identity work. Charlotte was a visually creative “alternative” Arts student, studying Graphic Design and Photography. The article she chose to read reported on perceived links between “madness”, “genius”, “powers of creativity” and dyslexia. It made positive associations between dyslexia and visual- and creative-thinking, and gave examples of “eminent people” with dyslexia (Lyens, 2002, pp4-7) who were thereby offered as potential role models.  The article thus spoke to Charlotte’s sense of self as a creative, visual-thinking dyslexic person. The research question, the overall tenor of the article and the specific role models given provided Charlotte with an opportunity to engage with re-framing work, developing an individual dyslexic identity that included “being able to be superhuman  [...] certain things that are better for us [...] the thinking like being able to look at something completely different to everyone else [...]and see round the different ways around like think outside the box…” Although positive, this re-framing does evidence a potential tension between developing an affirmative dyslexic identity  – of not being part of “the grey amorphous mass” of non-dyslexic people (Swain, French & Cameron, 2003 p.27) -  and reinforcing ‘superhuman’ disability stereotypes  which in turn perpetuate the Othering of disabled people (Barnes, 1992; Wendell, 2006). With hindsight, this tension could have been useful to explore with the group. Nevertheless, Charlotte’s reading here can be interpreted as an important part of her re-framing her dyslexic identity as something more positive for her.

This data also speaks to the other two elements of identity work identified in the analysis. The second identity in play is that of the group dyslexic identity. By posting a link to the article on the group Facebook page, Charlotte is contributing to the shared identity. She is also providing her peers (and wider audience) with an opportunity to undertake similar re-framing work and hence come to understand dyslexia in a more positive light. Charlotte’s account of her engagement with the article also shows that the third “becoming expert” identity is also in play. Charlotte positions herself as diligent researcher who is judicious in choosing what she shares with others. This is evident in her celebratory “I was just like oh woh yay!” when she finds an authoritative source that “is an actual experimental like write-up or something.” In asserting that she values “actual” science and “accuracy” in the learning she shares with others, Charlotte can be seen to be positioning herself as someone who carefully chooses only reliable information to pass onto others via the group Facebook page. She chooses “accurate” information believing that this is the best way to inform and help others, even if the information is likely to make challenging reading for her audience.

Developing a shared dyslexic identity.

The students coalesced into what Gee (2007, p.212) calls an affinity group: people “bonded primarily through shared endeavours, goals and practices.” Their endeavours to understand and communicate experiences of dyslexia, habitual Facebook use, and digitally-mediated literacy practices helped establish the participants as affinity group. I interpreted much of the off-screen and on-screen dialogue and interaction as the group bonding through the tacit co-construction of a shared identity. This shared dyslexic identity reciprocally shaped individual identities. It was established and maintained through participants sharing aspects of their individual experiences of dyslexia in mutually supportive dialogue. Paradoxically, the students wanted to be seen as ‘normal’ whilst simultaneously establishing and promoting individual and group identities which were explicitly Other. For example, in a meeting to clarify the students’ aims and objectives for the project, Charlotte asserted that “we are normal” – by which she meant not being “weird” -  yet at the same time “greater than everyone else” with “great brains.” Danny on the other hand, distanced himself from “normal” and “great.” Although playing partly for laughs, Danny identified himself as “not great”, a “freak” and a “black sheep.” Josh, echoed by Chloe, wanted to identify the group as “not generic”, again asserting a group identity of Otherness. This Otherness was reinforced by the way “normies” and “muggles” – non dyslexic teachers, peers and family  – were frequently described in hostile terms. Over the weeks, there was conversational thread expressing the anger and frustration they felt as a consequence of negative interactions with normies. The affinity group seemed to be working towards a complex shared dyslexic identity, seeking acceptance as “normal” whilst at the same time being “non-generic.” In line with social models of disability and inclusive perspectives on education, the group appeared to be calling for an expanded definition of “normal” which includes dyslexia and themselves, and recognises that “normal” embraces a wider range of differences than current popular perceptions allow.

The strongest conversational thread which ran through the weeks was the nature of reading and writing and how English orthography worked to disadvantage the participants. These discussions were rich and often insightful, as the following example shows. It is taken from a session when the students, at my prompting, were expanding on ideas for a short film they were planning, summarising what they had learnt so far. In the full discussion, the students drew on knowledge of self, family, genetics, biology, neurology, medical science and role models as they tried to decide what to write down to answer the question “What is Dyslexia?” In doing so, they co-constructed a collective dyslexic identity by acknowledging shared experiences. The stated purpose of this conversation is to generate script ideas for a short film the students made about what they learned from their research. Throughout this sequence, one of the group is mindmapping key phrases onto a piece of flip chart paper. This exchange therefore constitutes part of a literacy event, with the students developing digital literacy skills that will help them compete in the online attention economy (Alvermann, Marshall, McLean, Huddleston, Joaquin & Bishop, 2012):

Josh: Erm what it is what dyslexia is just put down what it is.

Charlotte: We don’t know.

Chloe: Learning disability.

Josh: To me what I see is I see dyslexia is a thing it’s the problems y’get. There isn’t an easy way to describe it without y’know usin’ the problems.

Chloe: They don’t know what the cause is yet so…

Charlotte: Learning disability can’t read write.

Chloe: It can be genetic.

Josh: It is genetic isn’t it.

Charlotte: Yeah I think mine’s genetic.

Chloe: Mine’s genetic.

Josh: I think my Dad’s got it.

Chloe: Me Dad me Nanna and me Great Nan.

Charlotte: My mum and my Grandad.

Josh: I think it well it is in my stepdad’s family he’s got it his dad had it and his son’s got it but no-one in the female side’s got it.

Chloe: That’s just chance.

Charlotte: Yeah because it depends on the mixture doesn’t it cos my brother’s not got it he is clever he got he’s got an artistic flair but he’s not got a design flair if you get me.

This data illustrates the students sharing aspects of their individual experiences, in this case families and genetic inheritance, to construct a group dyslexic identity. Chloe and Charlotte talk of “my” dyslexia, before the group exchange information on how dyslexia has passed through their family lines. Then Charlotte notes how her brother is not dyslexic, and she seems to decide that this explains his lack of design flair. This remark helps maintain a group sense of Otherness, and with its undertone of superiority (West, 2009), hints at positive reframing of dyslexia (Gerber, Reiff & Ginsberg; Tanner, 2009).  The discussion shows the group constructing a shared understanding of dyslexia (”a genetic learning difficulty that means you can’t read and write”) and hence a shared identity (”we all have family members with dyslexia, are dyslexic, and find reading and writing difficult”). Note how they do so in a mutually supportive way, with no arguments or significant disagreements. Through this sort of dialogue, which is prompted by a writing activity, the students expanded their collective knowledge of dyslexia, which in turn helped them develop their identities as budding experts.

Becoming ‘experts

I detected a paradox in the student’s discussions and presentations of identity. When asked directly in their interviews, the students tended to try and give the impression that they “weren’t bothered” or didn’t have “strong feelings” about their own dyslexia. However, the anger and frustration expressed elsewhere in their conversations and interviews towards their peers, teachers and former schools is at odds with the emotional disinterest they professed in relation to their own dyslexia. In her pre-project interview, Chloe admitted that curricular literacy demands left her “feeling down and defeatist.” This contrasts strongly with her later claim that “I’ve never had never had an issue with being dyslexic…I never sort of had any major feelings towards it I still don’t.” Also, it is difficult to see why the group would be so keen to help others unless they felt the difficulties and challenges dyslexia presents were significant.  The students’ self-determined aims for the project included:

  1. Making people more aware of dyslexia and its effects; and
  2. To find ways to overcome dyslexia, and prove that the participants and other people with dyslexia aren’t stupid and are normal.

Throughout the weeks, the word “help” was used very often, with the group keen to position themselves as “helpers”, informing others about dyslexia. This suggests a developing sense of agency through writing and negotiating the self as an expert (Davies, 2006), with the students beginning to value the literate contributions they could make (Greenleaf & Hinchman, 2009). Of course, the students were already experts on their own experiences of dyslexia, but they were able to expand their understanding of other people’s experiences and perceptions of dyslexia, as well as the theoretical and scientific understanding gained through their research.  The Q-Sort data indicated that as well as being able to take on and exploit identities as ‘experts’, the participants were able to take on identities as ‘young researchers.’ Josh acknowledged that as their teacher I “went out on a limb to trust us with the use of Facebook.” This led to an appreciative sense of being involved in what Charlotte described as “a more grown-up way of working.” The Q-Sort data suggested that the five students reacted differently to their independence and research role. Mohammed felt satisfied with being involved with the project. He saw it as very teacher-led, but this did not stop him enjoying the activities. Through his research, he was able to become a more effective learner. For example, he changed his revision strategy in light of what he learnt about dyslexia and reading:

Yeah I do I feel I different now because before I just used to like read the page and then just write cover that up and write again but after I come here I changed my method of revising. I used to like just skip on my reading and then put it on mind maps or like structure the notes I have differently than I used to do before and I think it’s changed the way I revise now.

The Q-sort data also indicated that the students felt they were more-or-less equal partners in the project, but would sometimes have preferred greater involvement in decision making.   There was a sense that a different and more collaborative way of learning alongside adults was possible and even preferable:

OB: Danny, what are your thoughts about being involved in the project as a whole?

Danny: I thought it was good because y’get other people’s point of view on it and it’s not something boring either it’s not like a boring project it were quite good quite interesting.

OB: Why did you like it do you think?

Danny: I don’t know because we got to act pretty stupid for a bit y’know we weren’t taking it too seriously which were the thing like none of us took it proper serious…erm we did take it serious but not like we had a laugh with it as well so it just made it more enjoyable.

OB: Okay when you say taking it seriously d’you mean you think you think learning in College is generally too serious or d’you mean people tend to take dyslexia and deal with it in a really serious boring way?

Danny: No I mean like some people instead of laughing and joking about it they’d just like read the notes and be dead clear and boring and it’s not like that I don’t think and yeah College is boring the work it’s just it is too serious.

Danny’s comments are indicative of the way the students felt a sense of legitimation, ownership and control, and this sense of “grown-up-ness” was another motivating factor for their literacy and identity work. They also hint at the preference for self-directed learning through exploration, and of the importance of affirmation, partly through playfulness and humour: “we did take it serious but we had a laugh with it as well.”

Discussion

My analysis of the data suggests that, contrary to popular beliefs about dyslexia, these students were highly motivated to learn through literacy. Away from the constraints and expectations of the formal classroom and curriculum, the students were able engage in three important kinds of identity work, resisting and challenging dominant power/knowledge regimes, and mediated by their multiliteracy practices on Facebook. One of Josh’s first posts to the group Facebook page was an image of Professor Xavier from the X-Men movies. To the image, located through a Google search, he added the caption “Professor X is disabled and he’s epic” (Fig 2). Unfortunately he chose to work with a rather low-quality image but the message is clear:

barden2

Figure 2: Josh’s Professor X image

On one hand, the X-Men movies and the character of Professor Xavier can be read as deeply problematic in the way they perpetuate stereotypical views of disability (Berube, 2005). On the other, for Josh, creating and publishing this multimodal text was an affirmative expression of a dyslexic/disabled identity. His picture is just one of the wide variety of multimodal texts the students produced and interacted with: text-only compositions, text-image compositions, “poached” (Jenkins, 1992; also Hughes, 2009 & Williams, 2011) and “mashed” texts and text-image compositions, original graphic and photographic artwork, and original videos. These texts served, explicitly or tacitly, to communicate aspects of the students’ dyslexic identities. They also evidenced  playful,  new literacies learning (Davies, 2009; Veater, Plester & Wood, 2011; West, 2008). Josh’s picture  exemplifies the way many contributions and discussions were characterised by a somewhat defensive humour.  This evidence supports the contention that issues of identity are central to motivating dyslexic students to learn through literacy in Web 2.0 contexts (Greenhow, Robelia & Hughes, 2009; Hughes, Herrington, McDonald & Rhodes, 2011). The reach and affordances of digitally-mediated social networks are contributing to the state of flux in contemporary literacy practices. However, as Williams observes (2008 p.686):

What will not change, however, is the importance of identity in terms of literacy practices. If anything, new literacies reveal to us how important it will be to continue to consider how people position themselves in changing cultural contexts and how that influences their ability to communicate with others.

Consistent with the wider literature, the evidence suggests that the participants began the study with relatively low self-esteem and a sense of inferiority. This is evident in, for example, Chloe’s admission of “feeling down and defeatist” when confronted with some reading her peers seemed to have no difficulty with; in the way the participants associated dyslexia with deficiency and stupidity; in the way they saw their efforts at literacy as being childish and unsatisfactory; in the frequent use of humour as a defence mechanism; and in the oft-stated desire to help other students with dyslexia. By inhabiting ‘projective identities’ (Gee, 2007) as a ‘superhuman’, ‘nerdy scientist’ ‘creative genius’, or ‘expert-helper’ the students were able to reposition and affirmatively reframe their identities as “thriving, literate, intelligent human beings with important contributions to make” (Greenleaf & Hinchman, 2009, p.4).  In other words, the temporarily transformed classroom and the group Facebook page provided sites were the students were able to resist the dominant power/knowledge regime which usually casts them as failures or at least deficient in some way (Foucault, 1975). This is significant for four important reasons. Firstly, this type of inquiry based learning, solving personally meaningful real-life problems is known to be effective and appealing to many students labelled as dyslexic (Mortimore, 2003; Reid, 2009). Secondly, learners who perceive themselves to be capable and valued despite the difficulties associated with dyslexia, and who are able to envisage themselves as successful, tend to be more successful than those who don’t (Burden, 2005 & 2008; Mortimore, 2003). Thirdly, inhabiting and reflecting on projective identities in a safe and stimulating educational environment is a way of provoking active critical learning (Gee, 2007), in this case for soon-to-be undergraduates and “budding professionals” (Willett, 2009 p.14). Such learning is crucial if education is to involve students exploring ways of becoming and ways of being scientists, researchers and the like, rather than relying on simple transmission and drill-and-skill pedagogic models. Fourthly, at the end of the project, I showed the College Principal the stop-motion Lego video the students had made and posted to the Facebook page to summarise what they wanted to say about dyslexia (https://www.youtube.com/watch?v=1WA7ddfKp3E).  I explained how I saw it as evidence of the students learning through literacy, even though they saw what they were doing as “making a video.” As a consequence, she suggested convening a group of teaching staff to explore ways of exploiting social networking in the College for educational gain. Obviously, my position as a teacher will have had influence here, but the Principal would not have made her suggestion without seeing some value in the students’ work. She contacted them individually afterwards to thank and praise them for what they had done. The ability to influence your Principal and College’s approach to teaching and learning is, I would argue, a potent signifier of agency for any student, and moreso for a student who is from a traditionally disadvantaged educational minority.

I interpreted there being three conditions which fostered motivation to engage in literacy events, potentially with a challenging text or for a prolonged period: when the student had an inherent interest in the topic; when the student was seeking to develop further understanding of their experiences and/or self (the text content resonated with lived experience); and when the student was seeking (consciously or subconsciously) to communicate something about themselves. A contemporary inclusive literacy pedagogy could cultivate these conditions to capitalising on students’ intrinsic motivation, perhaps through ensuring students have access to a range of appropriate texts, choice and control, and critical awareness of different types of text and their own abilities. Designing a learning environment which enable students to positively reframe their ability to read would be one potential way of mobilising these principles.

I found it helpful to conceptualise Facebook as an “affinity space” which prompted active, critical learning through the literacy-based projective identity work done by the students (Gee, 2007). In such spaces, and with technologies and literacy practices changing, teachers may wish to consider approaches which fit with social-constructivist digital epistemologies (Dede, 2008; Kress, 2010). Maintaining the “building” metaphor, such approaches may cast teachers as designers or architects of learning experiences, scaffolding and framing collaborative tasks within affinity spaces. The primary role of the teacher in such settings may be characterised as facilitator and mediator (Somekh, 2007), providing direction, challenge, and access to the relevant technology (Davies, 2009). In this instance, the group Facebook page can be seen as a sort of collaborative blog (Davies & Merchant, 2009; Mills & Chandra, 2011). Its construction suggested two pedagogic principles similar to those observed in other blogging contexts. Firstly, play and playfulness. Much of the interaction was characterised by humour and playfulness. The students often posted what they described as, for example, “hilarious” pictures. They also “played” with different technologies including Powerpoint, digital cameras and video-editing software in the process of composing their texts. Secondly, it has been argued that blogging involves learning in a distinctive way: “read-write-think-and-link” (Richardson, 2006 cited in Davies & Merchant, 2009 p.88). The evidence from this study suggests that collaborative blogging is a literacy practice that can reciprocally and positively shape identity whilst developing collective subject knowledge and critical literacy skills (Davies & Merchant, 2009). For example, an extensive account of the students developing awareness, through this project, of the way orthographies and literacy norms and practices are culturally and temporally situated is given in Barden (2012).

The discourse of dyslexia has long been dominated by talk of deficits. Perhaps we now need to think about developing a literacy pedagogy which is neither predicated on deficit and failure, nor heroic stories of “conquering” literacy difficulties (Williams, 2003). Instead, it could recognise an expanded definition of “normal” and that every student has their own individuality, abilities and aspirations, reflected in different learning preferences and pace. In doing so, it might have to take into account stereotypical representations of disability in mass communications media; exploring ‘superhero’ characters might be one way of doing so (Dyson, 1997). The multiliteracy affordances of digitally mediated social networks like Facebook, coupled with the motivating identity work they precipitate, suggest they could have a significant role to play in such a pedagogy.

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Biographical Statement

Owen Barden is a lecturer in education, special educational needs and disability at Liverpool Hope University, Liverpool U.K. He is a core member of the university’s Centre for Culture and Disability Studies. Current research interests include changing conceptions of and relationships between literacy, technology and disability.


[i] Sixth form colleges are important stepping stones between high school and university in England and Wales. They almost exclusively teach 16 to 19-year-olds on academically demanding A-level programs which are generally a prerequisite for university entry.

[ii] This refers to contemporaneous fieldnotes later augmented by video observation.

Halvdan Haugsbakken and Inger Langseth

Published Online: July 5, 2014
Full Text: HTML, PDF (512 KB)

Abstract

This article argues that a new research trajectory in the Connectivism debate should be open to the K-12 system, and that education should consider the Web 2.0 application YouTube as a pedagogical tool in learning. We aim to show that YouTube facilitates students’ self-organised learning in informal and formal education. YouTube is potentially a meaningful tool that teachers can use to enhance students’ competences and digitalise classroom practices. This relates foremost to how YouTube content has the potential to trigger social dynamics that activate students’ capacity to connect sources of user-generated content to cognitive awareness on a given concept. When given the opportunity, students can use this competence in formal educational contexts. This ability, we argue, is partially self-regulated by digitally skilled students, and teachers can direct the students in an academic direction when scaffolding the literacies involved. The article is based upon research carried out in a vocational class in English at secondary level in Norway.

Keywords: YouTube, youtuber, to youtube, language learning, audio-visual literacy, connecting strategies, engagement, participation, and self-organised learning

Siemens’ (2005) Connectivism: Learning as Network Creation and Downes’ (2005) An Introduction to Connective Knowledge, have received considerable attention among scholars interested in the relationship between learning and new technologies in higher education. The works have introduced a new learning theory for the digital age, sparked an interest for MOOCs, and initiated the emergence of a new research discipline, Learning Analytics. Connectivism is also met with criticism, claiming that it is not different from older theoretical approaches. Critics also argue that the theory is – under-theorised and lacks empirical research.

We call for a new direction, due to the fact that Connectivism has mainly been discussed in the MOOC hemisphere. Connectivism should open a new research trajectory in educational systems at the lower levels, where most learning takes place today.  New social media user patterns among students also take place there, not only on turf known at universities. We are interested in applying two concepts related to Connectivism: self-organisation and learning as connections, which we frame as our connectivist approach. We analyse these concepts in relation to the social media platform YouTube and new emerging user patterns among students, who use YouTube on an everyday basis.

In this regard, the main goal of this article is to link aspects of Connectivism to educational research on YouTube, and we believe that this can add new insight to the debate on digital learning. We will show that YouTube videos can facilitate (1) students’ self-organised learning, (2) students’ connection between sources of informal and formal content, and (3) that there is a need to link the predominantly text-based approach to literacy to audio-visual literacy. Our objective is to exemplify this in a case study, showing how a class of Norwegian 18 years old vocational students, studying to become carpenters, uses YouTube content outside school contexts to learn about social practices that interest them, and how this connects to formal learning settings[i].

First, we account for the theoretical framework. We present important definitions and stress that a connectivist approach is needed in current educational research on YouTube. Second, we account for the use of our methods and data samples. Third, we present our data analysis, which establishes that YouTube use is a new social media user pattern among adolescents. In the analysis of student user stories, we show how students use YouTube content in informal learning contexts, as well as a vehicle for formal learning as part of a classroom setting.[ii] Fourth, we discuss the implications of our research, and see this in relation to addressing audio-visual literacy as a new competence in teaching and learning. Finally, we make some concluding remarks.

Theoretical framework – A connectivist approach to YouTube

Our theoretical approach is inspired by Connectivism. For the purpose of clarification and delimitation, we define some key concepts. Connectivism is defined as “the integration of principles explored by chaos, network, and complexity and self-organisations theories” (Siemens, 2004:4). The premise of chaos is that meaning exists and learners must discover connections and patterns of meaning in order to learn. Chaos recognises the network theory principle that everything is connected to everything (Siemens, 2005). As Downes (2006) argues: “to ‘know’ something is to be organised in a certain way, to exhibit patterns of connectivity. To ‘learn’ is to acquire certain patterns” (ibid.:2). Siemens (2004) theorizes that learning consists of connecting nodes, and that learning is the existence of nodes. The premise of complexity is that nodes exist both in the individual and as distributed knowledge online (Siemens, 2005).

The connectivist approach, as we see it, is that learning as connections happens when pre-established connections between nodes are activated – sending, receiving or forwarding information – in a short space of time, involving technical skills and critical thinking to judge the quality of the work process. Siemens defines self-organization as “the capacity to form connections between sources of information, and thereby create useful information patterns” from random initial conditions (2004:3). Siemen argues that self-organization is vital to the learning process. The premise of self-organisation is that nodes can take on a variety of modes of literacy. Connectivism includes certain interesting features in self-organisation: curiosity, creativity and randomness, and connections: concept learning and modes of literacy, which seem to explain aspects of social media use among students.

Connectivism evokes debate in different research streams. One trajectory forms around MOOC scholarship. Ebben and Murphy (2014) argue in their review that MOOC scholarship is characterised by different themes. Early research from 2008 to 2012 investigated the cMOOCs and argued that Connectivism was characterized by experimentation, innovation, and investigation of learning effectiveness. Canadian scholars fronted the work. From 2012 to 2013, Ebben and Murphy (2014) suggested a shift to behaviourist pedagogy with the deployment of xMOOCs, a work developed by U.S. based elite universities and start-ups. This era generated the discipline of Learning Analytics. MOOCs raise many organisational questions relating to university matters.

Another trajectory relates to the theoretical foundation of Connectivism. Early criticism maintained that it was no different from older learning theories (Kop & Hill, 2008). One main disagreement, which resides in fundamental epistemological approaches to learning, relates to what extent learning happens in the mind of the human and whether it can be attributed to the connecting of pieces of information embedded and transpiring from social structures like social networks outside the human mind. In recent criticism, Clarà and Barberà (2014) maintain that Connectivism has psychological and epistemological challenges. They (Clarà & Barberà, 2014) argue that it does not adequately conceptualise the role of agency, oversimplifies the meaning of social interactional approaches, and does not offer any framework that can explain learners’ concept development and how to apply the methodology in education.

We argue that an unexplored trajectory is how Connectivism can be applied in the context of secondary education. It is important to explore this territory, as connectivist orientated scholars are still locked in the domain of higher education. We pinpoint this aspect, due to the fact that schools across national educational systems are developing into IT networked organisations. This is attributed to social processes influencing educational systems; the increase in students’ private social media consumption and that educational authorities foster laptop and IPads as part of educational policies to increase students’ digital competence. Consequently, classrooms develop into material IT networks that rearrange the social situation in which most teaching takes place. This signals the need to push Connectivism in a new direction.

We argue for a connectivist approach to educational YouTube use and practices in K-12 systems, especially the exploration of concepts like self-organisation and learning as connections. Use and research on YouTube is growing. A content analysis in 2010 listed 188 referred articles and conference papers on YouTube (Snelson, Rice & Wyzard, 2012:120). International experts concur that more studies on how users interact, and how to explore “the manner in which YouTube intertwines with societal, ethical, political and commercial interests” (ibid.:129) is needed, as well as the need to uncover “the nature and quality of video content” (ibid:129).  The earliest research on YouTube connected to education dates back to 2007 (cf. Burden & Atkinson, 2007). From that year onwards, the number of studies increases. Certain studies are characterised by what we call “critical pedagogy”. They have a theoretical approach and contain analyses of YouTube as a learning tool in relation to media activism (Kellner & Kim, 2010), intertextuality (Adami, 2012) and globalisation (Kenway & Fahey, 2011). Researchers have explored how YouTube can be part of learning regimes to foster learner autonomy (Hafner & Miller, 2011), and language learning (Ghasemi, et al., 2011).

Studies demonstrate how YouTube can activate students’ engagement (Callow & Zammit, 2012) and learning strategies. Studies show that exposure to video-content enables students to better retain a course syllabus (Chtouki, et al., 2012), fosters learner autonomy (Hafner & Miller, 2011), facilitates the retrieval of web content (Hrastinski & Aghaee, 2012), encourages music teaching and learning (Kruse & Veblen, 2012) and uploading and video sharing (Mohamad Ali, et al., 2011). YouTube has been connected to “multimodality”, showing that students watch and discuss video files just like any other text used in education (Callow & Zammit, 2012; Chun, 2012). Research also stresses the potential benefits and pitfalls in education. Researchers also argue that YouTube can be used in social studies and is a positive teaching resource in elementary classrooms (Jones & Cuthrell, 2011). Moreover, YouTube is found to have the potential to create mental models (Krauskopf, et al., 2012), to be a resource in open education as videos in the classrooms (Tan & Pearce, 2011) and to have a great potential in foreign language teaching (Terantino, 2011). We also find research that has identified new user patterns among students. Such studies have emphasised how YouTube videos can be remixed to learn about civic action (Dubisar & Palmeri, 2010) and can be used in large classes to personalise learning and improve conceptual understanding in chemistry (Franz, 2012). We also found studies that explored how YouTube has been used to create student motivation (Lee & Lehto, 2013), and as a tool in music education (Kruse & Veblen, 2012; Waldron, 2012, 2013; Webb, 2010).

Methods and data sample

We base our analysis on qualitative methods anchored in a social scientific research tradition. The data sample builds on one English class of 15 students in their second year of vocational studies at a secondary school in Trondheim, Norway. The students’ motivation in English, which is obligatory, is generally low, even though they are at level B1/B2 (COE, 2001).

The data was collected from August 2011 to May 2012. We used different qualitative methods in triangulation: (1) semi-structured interviews with the students, (2) passive observations in classrooms, (3) teacher’s logs, and (4) student produced texts in formal contexts. We interviewed 11 of the 15 students. Six interviews were completed between the researcher[iii] and the students, five in pairs, while one was done individually. The interviews lasted from 30-60 minutes. All interviews were taped and transcribed.

The observations took place every week for 90 minutes following the school’s calendar, and the researcher took notes from the lessons. The teacher wrote a log that was made available to the researcher. The students’ texts were collected through the school’s LMS. The students, the teacher, and the school administration signed a letter of consent to participate. After the data gathering, all data was coded  using the constant comparative method (Strauss & Corbin, 1990; 1998). This method of analysis is used to code and categorise data in order to identify local concepts, principles, structures and processes.

Data analysis – results and findings

In this part, we will explore the concepts of self-organisation and learning as connections in a connective approach to learning and give detailed empirical examples. The following data analysis will show that short YouTube videos can be used to trigger self-organising and connecting activities, both in informal and formal learning situations. The first part establishes YouTube as a digital space that the students regularly visit when online. We illustrate this by showing a collection of nodes of information drawn by the students themselves. The second part focuses on how the same students use YouTube to self-organize their learning in informal learning situations. User stories show how the students use YouTube to learn to play a musical instrument and to play games. The third part argues that YouTube videos can be applied as a vehicle for formal learning. This part demonstrates how the students in the English class retrieved YouTube videos and applied the content in a self-organised social setting in order to learn more about extreme sports in the English-speaking world, as part of a curriculum based and goal-driven activity initiated by their teacher.

Part I: The students’ network of nodes

In one of the English lessons, the teacher asked the students about their online networks and their digital user patterns. The aim was to detect areas of interest to be used in future lesson designs. The teacher instructed the students to draw the websites they visited every day as nodes in a network and to describe the usefulness of websites  in a few key words. She also asked them to rank the nodes, on a scale from the most to the least important ones. We used this task as a method to capture students’ digital user patterns: which web sites they interacted with and why. The students’ networks show that they have a narrow set of nodes, often ranging from 3 to 7 web sites that they visit every day. Some sites are recurring. Norwegian newspaper sites, e-mail systems, and common social media sites, like Facebook. Other sites like the school’s LMS and digital sources related to subjects or their vocational training, are absent in the data. Also, we see that YouTube and gaming sites are prominent features, and they are to a large extent in English. Seven of the fifteen students rank YouTube as an important site that they visit every day. We present three examples of students’ network of nodes.

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Figure 1. Example of student network of nodes

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Figure 2. Example of student 2 network of nodes.

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Figure 3. Example of student 3 network of nodes.

Part II: The students’ network of nodes in informal learning

Since YouTube opened in 2005, a variety of internal subgenres have emerged. These appear as suggestions when you type in a search word in the search tool bar. One subgenre is “YouTube tutorials”, a kind of do-it-yourself (DiY) instruction, which is based on traditional apprenticeship. The common feature is that a “master”, claiming expertise in a field, shares a video containing a step-by-step instruction about how to carry out an activity, with an anonymous online “apprentice”. The up-loaded tutorials are short and behaviouristic, covering a range of topics. Many videos last from two to five minutes, and they can be both easy and difficult to make. Among other devices, YouTube’s own system for video-production can be used. The videos are often produced as screen casts with a voice-over, or videos are recorded at a location where some sort of activity is going on. The tutorials take place in an informal and socially networked context, and they represent an emerging peer-to-peer-sharing “educational” network, which is scarcely described in the research literature on YouTube.  The majority of tutorials are in English.

YouTube offers a range of small music lessons made by amateurs, semi-professionals and professional music instructors. In the videos, they explain and show some of the basic skills, like how to play a cover song, different types of finger-picking techniques, chord progression, etc. As music theory is transformed into practice, the tutorials offer guitar playing for those who do not know how to read notes. The audio-visual tutorials contain a graphic display of the guitar tablature, the chords used in a song, and suggestions for a musical arrangement. Videos also allow learners to replay instructions. Songs are deconstructed and arrangements are visualised in very small details with accompanying explanations (audio), making it easier to learn to play a musical instrument. In an interview, one male student explained how he used two nodes – Ultimate Guitar and YouTube – in his network to learn how to play the guitar:

I’m on Facebook, for example, I find some videos on YouTube. I want to learn a song. I go to Ultimate Guitar, learn the song. I only go to a web page, so you can download the tabs or the chords. You can find everything. All kind of music you can find on that page.”

Three other students used YouTube tutorials to improve their online gaming, one of their favourite hobbies. In the interviews, they revealed how they extensively consumed YouTube tutorials in order to learn to play World of Warcraft, Halo and Counter Strike. There is a good reason for employing tutorials. Gaming is a massive undertaking, more than just a random pastime activity. The students can play for hours. It is also a complex social practice, which involves a long learning process and a steep learning curve to improve. Amazingly, YouTube tutorials are a web 2.0 service the students use to close the gap between their actual level and the level they want to achieve in the game. Experienced gamers record and show off their great triumphs, nice moves, and how they uncovered a game’s secret level in YouTube tutorials. Less experienced gamers employ these tutorials to learn or copy the tactics or tacit strategies of a particular game in order to ease the learning curve of a game. Some students referred to YouTube tutorials as “guides”.

Compared to learning the rules, tactics and strategies on your own during the gaming activity, YouTube tutorials offer shortcuts to the mastery of a game. YouTube tutorials reveal a cultural value system among gamers, which is centred on aesthetics, personal taste and a sense of humour. This seems to serve a learning purpose.

Student:                                 I use it very often. Every time I am at my PC, its YouTube, Twitter and Facebook.

Researcher:                         What’s so great about YouTube?

Student:                                They post a lot of funny videos, like famous people. I play PlayStation. There are many who make “commentaries”.

Researcher:                         What is that?

Student:                                They play and comment, find errors in games, and they make fun of it. If a FIFA player has only one foot. They forget sometimes to make a foot of a person.

Researcher:                         They point out errors?

Student:                               Yes, they find errors in all games.

Researcher:                        And then they make a gag out of it?

Student:                              They make it so that it is funny, while they comment on it.

This student indicates that he is using what experienced gamers publish in order to uncover design flaws, thus providing hints to the existence of an aesthetic value system, not dissimilar to the aesthetic belief system seen in the hacker culture. Hacking is often about finding technical flaws in computer systems, something that the student points out in his consumption of YouTube tutorials. Flaws in the system, refers to quality, the rating of someone’s work.

Another student revealed a personal value system underlying this production of YouTube tutorials. He uploads YouTube videos to show off to his friends, and not primarily for educational purposes. He evaluates his videos according to some inherent standards of content creativity, curiosity and quality, in order to decide whether to share them online:

Student:                              I did it very much before, when I gamed. For example, if I did something crazy, I edited them and posted them on YouTube. It was a simple way of sending and showing them to my buddies.

Researcher:                       What did you make?

Student:                              You know what CS is?

Researcher:                       No.

Student:                              It is Counter Strike. It is an army, shooting type of game. You play in teams. For example, we are five buddies, who team up against five other buddies. If you are alone, killing all five of them, it is                                                        very good. Then you could take the video, which shows how you killed all five of them. If you kill them in a good way, you can post videos of that. And you add the happy music.

Researcher:                       So, you created a video-collage?

Student:                              Yes.

The last transcript from our interviews, demonstrates how YouTube tutorials are used in social networks in a larger socio-cultural context, involving more than just one person:

Student:                            Most times when new games are out, all my mates meet to find out more about it. We often sit and look on YouTube to see new things. It happens when we have to learn that and that, and that’s the                                                     way to do it. It’s really that way we use YouTube.

Researcher:                     So you’re sitting around and talking together?

Student:                            Yes, we are discussing.

Researcher:                    It seems to very useful? It teaches you a lot?

Student:                          I learn a lot from it. I think that I couldn’t have been able to play, if it wasn’t for YouTube.

Part III: The students’ use of YouTube nodes in formal learning

In a later English lesson, the teacher introduced the students to the concept of “crossing boundaries” using “extreme sports” as a prompt. The aim of the lesson was to develop the students’ knowledge of the English-speaking world in line with the curriculum plan for English in the Knowledge Promotion (Utdanningsdirektoratet, 2012). She used three short informative texts about zorbing, heli-skiing and bungee jumping in a jigsaw reading. The students were divided into groups of three and instructed to read one part each, and then share their knowledge. The content seemed to spark an interest, since, for once, they all read their texts in silence.

In the following classroom discussion, the students to reflect upon where, when and why such activities take place, and who would engage in such sports. The questions created a rather lively debate in Norwegian and English, and gradually, the students “owned” the discussion, in the sense that the debate went on among the students without the teacher’s intervention. In this process, first one, then several students made use of their laptops, which are constantly available to all students on their desks. They opened YouTube on their own initiative, ran a quick search, selected a video and then invited other students sitting next to them to watch the videos with them. They also opened other websites that they connected to the topic, where for example accidents were described. These videos are represented by Figures 4 and 5.

They discussed and reflected upon the questions that were initially posed by the teacher in groups in front of the laptops. The students were divided about whether to risk trying these extreme sports, and they localised different sports to different locations and cultures all over the English-speaking world.

The first feature in this case is concerned with connectivity. The students used their existing network of connecting nodes to retrieve information that served as input in the discussion in the classroom. When the students connected the concept of “crossing boundaries” in written text to audio-visual texts retrieved from YouTube, they showed the capacity to form connections between text-based and audio-visual information in useful information patterns. In texts (meta texts) retrieved from the class’s LMS, several students emphasised their preference for audio-visual over written text. One student wrote: “YouTube is easier than reading” and he goes on to explain this phenomenon:

“On YouTube you can see pictures and movie clips and at the same time you learn. It can be a lot easier to search on YouTube than in an old book. I think YouTube makes working with the subjects much easier and a lot more fun.”

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Figure 4. Students’ selection of YouTube videos used to inform other students.

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Figure 5. Students’ selection of YouTube videos used to inform other students.

Another student writes: “When I’m working at school, I can use YouTube to search for things I haven’t done before, and learn some things from a movie on YouTube”. Yet another student writes: “The videos on YouTube can be based on drama, sketches, music, movies, knowledge, and so on that we read about at school”. These quotes indicate that students have developed cognitive connecting strategies for content-based learning, that they have developed patterns of connectivity between textual and audio-visual contexts and that they are bridging informal and formal learning. Our data suggests that YouTube has the potential to function as an agent for connectivity in concept based learning in formal education.

The second feature concerns students’ self-organisation. At one point, the researcher observed four reorganised groups of students engaged in watching videos and discussing the prompt that they had received. The teacher joined the groups on equal terms with the students, and worked as an encourager in the sense that she asked higher order questions. The students activated their self-organising strategies when they made use of YouTube in order to add additional information in a different mode of literacy. They searched for information in videos that had the potential to broaden and deepen the understanding of the concept that they had been introduced to in written texts (cf. figure 4 and 5). They demonstrated their capacity to reorganise heterogeneous and pedagogical group settings in groups based on curiosity, creativity and personal interest, much in the same way as they described doing in informal learning.

Students also demonstrated self-organizing skills when they narrowed their search down to videos that were relevant and acceptable in the educational context. One student wrote the following in his meta-text: “At school I use YouTube to get information related to things we are doing, to get a better comprehension of what the subject is all about”. Other students wrote:

“When you are at home you can search for whatever you want, but as long as you are at school or work, you can’t search for videos that are not suitable for the situation. (…) When I’m at school, I often search for what the theme is at school.”

“I think YouTube is a great website to learn from. If I wonder about something, I just search on YouTube, and I will find out of that. I use YouTube at school to learn. I like better to see something.”

These quotes suggest that students are self-organised, that they are highly aware of YouTube as a tool for learning, that they make use of YouTube regularly in school and that they are conscious about forms of use in educational contexts.

A fourth trait in this case is concerned with critical literacy. Students are aware of the nature of the user-generated content that they are exposed to. One student wrote:

“There are not all the videos on YouTube that are great. Some videos might be fake, horrible or incorrect/wrong. You should have a basic knowledge of how to use YouTube. If not, you might end up watching a midget getting beating when you were trying to find a video with an interview of Barack Obama.”

Another student wrote: “I can use YouTube in my work if I need to, but I can’t be sure that what I see is right, so you need to watch at your own risk”. Yet another student wrote:

“There are people taking videos where they are bullying other people, this is a problem YouTube is trying to solve. People can report videos they think are offensive to others. This is one big negative effect of YouTube.”

These quotes indicate that students have developed a conceptual understanding of critical literacy from experience with YouTube videos. They reflect upon the validity and value of the information they retrieve and the harm it may cause, maybe more so, we are tempted to say, than when they are presented with information in textbooks in educational contexts.

After some fifteen minutes of self-organised activities in reorganised groups, three students wanted to present one video to the whole class on the projector. The students connected their laptop to the Smart Board and reported on a fatal zorbing accident that had happened the previous week. All students were involved in watching the video. Going from chaos to classroom discussion, the teacher gave the lesson a clear direction through reflective questioning about students attitude to “crossing borders”: risk taking in terms of adrenaline kicks, lethal danger, courage, bravery etc. in different contexts. The discussion also included social situations, cultures and customs in the English-speaking world. All students were involved and eleven students contributed willingly to the classroom conversation in English.

The fourth trait in this case is connected to social learning. The students shared and discussed their digitally retrieved videos in small self-organised groups and as a class. The teacher cannot plan such student-initiated activities beforehand, and handing over authority to students can be experienced as losing control over the class (Sandvik et al., 2012). Chaos is, however, a necessary and fruitful stage in learning processes associated with connectivism (Siemens, 2010), as long as there is a clear direction. Collective self-organisation was initiated when one group of students shared their video with the whole class. In connectivist theory, this is described as sharing new information after having created new “nodes” of information (Siemens, 2004). The students handed back some formal authority to the teacher in the following classroom discussion. She could then ask follow-up questions in order to challenge her students at higher cognitive levels. This is also in line with connectivist theory, which stresses formative feedback on new nodes presented by the participants in a network.  If these processes are repeated, they might form patterns of self-organization in formal educational settings, based on written and audio-visual information in a mix of teacher and self-organised learning. Some schools in Norway have closed down social websites in order to reduce complexity in formal education, thereby missing out on students’ self-organisation, curiosity, creativity and engagement.

In the last sequence, the class evaluated the lesson, with reference to “crossing borders”. Was there a conceptual understanding, and did they have enough background knowledge to write a text? The students were then given a writing task, where they discussed their attitude to “crossing borders” in the English-speaking world, using extreme sports as one example.

The last trait is connected to sense making and engagement. In this case study, the students demonstrated engagement with text when they partially self-organised the learning process that provided them with background knowledge for the written text production. In their short essays that followed, the students demonstrated, to a certain extent, sense making and concept understanding as well as emotions in written English. Below are some short excerpts from their essays:

On the running of the bulls in Pamplona: “People over 18 participate to show their courage at their own risk. These people have to outrun a pack of angry bulls behind them (…). Personally, I have respect for these people, but I also think they are stupid sometimes. It is what makes them happy, but in the end it might be what kills them”.

On zorbing: “They get you into the ball and they roll you down a hill. (…) This sport is something I want to try during my lifetime. I love getting an adrenaline kick, so these sports are perfect for me”.

On zorbing: “Heli-skiing and bungee jumping:  I think these sports are fun to watch and read about, but I will not try it myself”.

These excerpts demonstrate students’ sense making and engagement with text production. We argue that the combination of reading and audio-visual text in a partly self-organised context contributed to their essay production, which is not always the case in these classes. In connectivist theory, sense making and engagement go hand in hand and constitute a driving force behind learning in Internet based surroundings. Lack of data tracks, as in no text production, suggests the loss of engagement and it needs, according to Siemens, to be followed up by the teacher (Siemens, 2004; 2010).

Discussion

In the beginning of our paper, we contextualised Connectivism in higher education and discussions of MOOCs, and pointed to the impact of social media on teaching at the lower levels in educational systems. We argued that the connectivist approach should open a trajectory towards secondary education. We stress this point, due to the fact that our findings raise important questions about how future teachers should approach, integrate, and design the connecting and self-organising aspects of network-based technologies. We argue that this competence is a literacy that teachers need. This is primarily related to our research findings; we have demonstrated that a group of Norwegian vocational students are partially self-organised. In informal contexts, they develop knowledge and skills to search for and retrieve information from YouTube, and they develop their competences when using this literacy in order to solve self-chosen tasks. Under the right circumstances, that is when teachers design lessons that empower students, students transfer this competence, their social networked practices, to formal learning situations. Consequently, we have validated and provided empirical research on two aspects of Siemens’ (2004, 2005, 2010) Connectivism – self-organisation and learning as connections, which implies a contribution to, as well as an extension of, this new approach to learning in the digital age. Our research suggests that students enjoy taking responsibility for their own learning when they can connect nodes of information retrieved from audio-visual media such as YouTube to their academic competences in reading and writing. The pedagogical question that remains, is how future educators can make use of this resource and more importantly, how teachers can make their social network practice congruent with their students’ in order to develop students’ literacy in academic subjects.

However, this is a difficult and complex endeavour, and we do not claim to have found the correct answers. But, we observe that much of the disagreement between scholars in the “connectivist debate”, revolves around learning and whether the construction of knowledge happens in the human mind or whether it is distributed and can be attributed to the connecting of pieces of information embedded and transpiring from social structures like social networks in the extension of the human brain. This scholarly disagreement generates ambiguity about how learning takes place in social dynamics that connect different types of nodes in a network. One way out of this scholarly disagreement is, for example, to acknowledge that learning manifests itself in social interaction embedded in social contexts characterised by the use of digital technologies and cognition, and to focus on the social dynamics manifest in the connections that are made. One way to address students’ YouTube knowledge and skills, and the academic resources it represents, could be to bridge informal and formal learning spheres. We suggest a connectivist approach to lesson design that we will discuss in the following.

Our first point is that the connectivist approach to self-organisation contributes to a digitally inclusive understanding of the term, and to the empowerment of students in the learning process. In pedagogy, self-organisation is generally described as being able to set goals, plan, monitor and assess learning and is now often associated with assessment for learning, feedback and learning analytics (Wiliam, 2010). Self-organisation in the connectivist approach is for example the act of spontaneously retrieving information from YouTube to get a deeper understanding of a concept or an idea that also connects to other sources of information in a pattern that is meaningful to the user. In the connectivist approach, learning feeds on inner motivation, curiosity and creativity, rather than pre-set goals and pre-designed learning paths that easily lend themselves to valid testing. In formal education, this demands a shift from teacher controlled instruction to learner centred self-organisation in contexts characterised by rich and open learning tasks with a high degree of authenticity (de Jong et al., 2008). It also involves a shift from information provided by the teacher alone (cf. textbooks, reading lists) to a shared provision of information by students and teachers alike. In practice, learning processes in the classroom are still mainly designed and lead by the teacher and the textbook, not by students (Sandvik et al, 2012). Recent studies on attention such as multitasking and parallel processing, focusing on how to be mindful of attention when operating in hyperlinked and social media, suggest that self-organisation is particularly important in digital learning contexts (Rheingold, 2012). We suggest that teachers apply such research-based concepts to make students aware of their digital user patterns and the consequences of their choices, rather than just telling students to get off the Internet. In digital classrooms, students’ access to information on the Internet, may well result in information overload, and management of complexities, with the aim of  complexity reduction, must be part of the educational construct (Biesta, 2004). The development of students’ self-organisation contributes to lifelong learning (Bartolomé et al., 2011; Rheingold, 2012).

The other point is that the connectivist approach to learning as connections between nodes, broadens the scope of connections available for the student to learn from, and that this raises the question of content in educational systems that prepare for the 21st Century. Such permutations have several consequences, like recognising that informal learning must be ascribed more value in formal educational contexts, and that retrieving information and ascertaining its true value, as well as acting upon it, is ever more critical for any learner and educator (Siemens, 2004). First, to meet some of the criticism that learning as connections has met (Clará & Barberá, 2014), we would like to add a distinction between two kinds of nodes to the theory: nodes of information and nodes of knowledge, where the former relates to distributed knowledge or skills residing in other humans or various types of texts, and the latter relates to information that has been processed, understood and retained in the brain of the individual as either knowledge or skills. In other words, one person’s knowledge, be it tacit or explicit, becomes another person’s access to information and vice versa, when networked. Exhibiting competence in a subject demands the ability to solve a task by means of existing knowledge and information patterns. In this perspective, we follow the connectivist argument that learning happens inside the human brain, when connections exist between nodes of knowledge (cf. neurons and astrocytes) and outside the human brain, when connections exist among nodes of information in a social network (cf. YouTube, Facebook, Wikipedia, Twitter), and that when connected, these two systems render the discovery of patterns within a field possible. Patterns can for example be displayed in concept maps, skills or in various types of texts.

The pedagogical consequences of this line of thought are that educators should include a networked environment in their classrooms. In our study, we have demonstrated how students self-organise their informal learning on YouTube. We see this user pattern as an argument in the current debate on flipped classrooms, and we suggest that formal education make use of expandable nodes residing in students’ digital network. We also see that students have developed digital networks that can be activated when needed in order to solve a task, which we see as an argument against spending too much time on presenting knowledge and testing reproduction of knowledge in school. Also, the fact that information is accessible at the fingertips with mobile technology, renders knowing where to find nodes of information, equally important as spending time and effort on gaining knowledge from within a limited set of nodes of information.  Our data shows that if school takes students’ informal learning seriously, teachers must develop students’ existing connecting skills through reflection and discussions, using higher order thinking, problem solving and critical thinking in meaningful tasks. We see this finding in the light of the debate on what literacies secondary school should offer to prepare students for the 21st Century.

The last point that we want to make is related to the conception of literacy pedagogy in a connectivist approach to learning. Reading and writing literacies in educational contexts give advantages to those who acquire the necessary skills. It has an impact on cognition and shapes the way we think (OECD, 2009). While linguistic literacy has played a dominant role in defining teaching for centuries (Cazden et al, 1996), patterns of YouTube use among socially oriented, digitally skilled and interest-driven high school students suggest a wider scope. We argue that the inclusion of audio-visual literacy in education has far reaching consequences for pedagogical practice. There is a clear motivation for claiming this; there is no single research based definition of the pedagogical nature of technology. As a result, the terms “multiliteracy”, (New London Group, 1996), and “digital literacy” (Martin, 2006) are only two of several concepts used with in the intent to disclose what technology implies in learning. Digital literacy can for example be understood as:

The awareness, attitude and ability of individuals to appropriately use digital tools and facilities to identify, access, manage, integrate, evaluate, analyse and synthesise digital resources, construct new knowledge, create media expressions, and communicate with others, in the context of specific life situations, in order to enable constructive social action; and to reflect upon this process. (Martin, 2006:156)

This is an example of a wide and inherently complex definition, which is difficult to transform into educational practices and may therefore run the risk of being overlooked. We argue that education in the digital age would profit from a conceptual framework of literacies that supports students’ strategic and metacognitive learning in a set of more “teachable” technological contexts. The concept of nodes of information in the connectivist approach to learning displays the need for connecting strategies between various types of digital literacies, and for a better understanding of the bridging between old and new literacies (Rheingold, 2012), where for example the connection between audio-visual YouTube use and written text production can be explored.

Bawden (2008) presents one literacy of possible interest to the connectivist approach to learning: information literacy, which we modify to actively seek, find, store and curate information. The literacy connects nodes of information to nodes of knowledge through curation, which means to make quality knowledge systematically available to others as information in a network and describes the existence of a network of quality nodes and the competence it takes to keep it readily available and updated (cf. Wikipedia, Scoop.it). Another literacy of interest is audio-visual literacy that we, for pedagogical reasons and in line with the separation of reading from writing, would like to separate into two entities related to: audio-visual consumption (input) and audio-visual production (output). The former is what we chose to call “watching” literacy, which describes the process where nodes of audio-visual mimetic information are connected to nodes of knowledge in a learning process that feeds on watching literacy. The process can for example be described as learning from watching a YouTube video and bears some similarities with the reading process. The latter is a more complex entity, meaning that there are several possible subject fields and literacies involved in the output of video consumption. We can think of three: oral literacy, where students talk about a topic they have watched using academic and subject related concepts (cf. cognitive apprenticeship), video production literacy, where students produce their own videos using occupational concepts and technology (cf. media production), and “Do-it-yourself” (DIY) literacy, where students literally imitate what they have watched using implicit knowledge and skills (cf. apprenticeship). We have primarily been concerned with the former, watching literacy, which we define as:

the awareness, willingness and ability of individuals to watch videos in order to construct new knowledge, form ideas, understand concepts, form concept patterns and engage with audio-visual text, participate in oral conversations or fulfil tasks in constructive social actions; and to reflect upon this process and the transfer to other literacies (domains.)

In our analysis, we discussed why there is a clear reason for adding audio-visual literacy to linguistic literacies taught in schools. YouTube content easily creates engagement across informal as well as formal learning contexts. YouTube mobilises students across ages, sexes, institutions and social backgrounds, and bears similar characteristics to engagement with written text as described in the assessment of reading in PISA:

the motivation to read, and is comprised of a cluster of affective and behavioural characteristics that include interest in and enjoyment of reading, a sense of control over what one reads, involvement in the social dimension of reading, and diverse and frequent reading practices (OECD, 2009:24).

Most of these characteristics are present in students’ consumption of YouTube content in our data. Using students’ self-organisation, connecting strategies and their ability to share user-generated YouTube content, has, as we have demonstrated, the potential to create student engagement and participation in formal educational contexts. We see a clear parallel between engaged readers and video watchers in the definition above. We believe that further research on these literacies may contribute to the “teachability” of technology in educational contexts, something that is supported by the growing use of YouTube and video in both formal and informal contexts (Dubisar & Palmeri, 2010).

Stating this argument, we dear postulate that learning through audio-visual literacy over the Internet contributes to a paradigm shift in learning, and calls for a broader understanding of how ideas, concepts and concept frameworks can be formed. In line with Treadwell (2011; 2013) we argue that since the printing press was invented and information became available other that through word of mouth, educational systems have succeeded in developing a high level of reading and writing literacies in most populations. The future in education does not solely lie in an effort to further develop these literacies. We believe, the future lies in embracing the learner’s capacity to form ideas, concepts and concept patterns from audio-visuals under circumstances akin to those of our forefathers before the invention of reading and writing. In this sense, we agree with Mizuko Ito and her research team (Ito et al., 2013), that if students can use their social, interactive and online media skills for academic learning and opportunity in the classroom, inequity in education can be diminished.

Conclusion

We have demonstrated that a connectivist approach to learning contributes to possible new research insight in formal education. Moreover, we have argued that the connectivist approach is valid in the lower levels of an education system, a factor calling for a new direction in the debate on Connectivism and digital learning. This is foremost related to the fact that aspects of YouTube use among adolescents show that self-organisation is developed in informal contexts outside school, and that under the right circumstances; students are willing to engage with academic subject matter using self-organisation and connecting strategies in formal learning situations. Students make connections between sources of informal and formal content; they bond and bridge information and knowledge in order to construct new meaning in sense making activities significant for them, like oral discussions, writing and skills development. We have also established a need to connect the predominantly text-based approach to literacy in education to audio-visual literacy in students’ digital networks. In sum, the main intention with this article has been to cast light upon a subject matter we consider to be important; to enhance our knowledge on YouTube use and to connect it to Connectivism. We therefore hope that future researchers will continue the trail we have opened, and provide new insight, research and ideas.

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Biographical Statement

Halvdan Haugsbakken is PhD Candidate in sociology and M.Sc in social anthropology. Haugsbakken is affiliated to the Department of Sociology and Political Science at NTNU, Norway. Haugsbakken has worked as Research Scientist in SINTEF Technology and Society and his main research interests are the impact of new web interactive technologies on organisations.

Contact: Halvdan.Haugsbakken@svt.ntnu.no

Inger Langseth is currently working as an associate professor at the Programme for Teacher Education at NTNU in Trondheim, Norway, where she teaches foreign language didactics. She is also working at Charlottenlund secondary school, where she teaches English and French. Her main areas of research are assessment, international and European Education for democratic citizenship and human rights and the use of ICT and MOOCs in teaching and learning.

Contact: Inger.Langseth@ntnu.no


[i] We would like to acknowledge our students, who volunteered to be informants. Without you, it would have been more difficult to fulfil this case study. We are also grateful for the comments and suggestions from the two reviewers who carefully read our paper.

[ii] In the classroom context, we are making a distinction between the researcher, who observed the lessons and interviewed the students, and the teacher, who taught the class and wrote the logs. Otherwise, when using the term “we” in the text, we are referring to the two as researchers and authors of this article.

Interview with Carl Sandler

Published Online: July 17, 2014
Full Text: HTML, PDF

sandler1

Introduction

Carl Sandler started as the founder of DaddyHunt.com, a website geared towards older men and people who like older men. DaddyHunt.com was founded in 2005 and quickly grew into the largest online community for men over 40 and their admirers. Sandler found that what the community of DaddyHunt users wanted was validation that they were still ‘hot’ and desirable even as they grew older. The interview below is a conversation between Sandler and Diego Solares on behalf of Digital Culture & Education (DC&E) on the role of  Apps and HIV in the modern age.

DC&E: Tell us about the origins of the MISTER App

Sandler: DaddyHunt.com was the immediate predecessor to MISTER. During a time when mobile Apps were becoming more popular, I saw an opportunity to build a community around the same principles as DaddyHunt, but in a mobile format. The challenge was finding a way to become more than a utility for hooking up within the constraints of the mobile format. To create a sense of community on MISTER we start by asking users to opt into a “MISTER code” when they join the App. The MISTER code of conduct encourages members to protect their health and the health of their partners and to treat others with respect, among other things.  It’s very basic and simple and yet, remarkably uncommon for an App or website. In fact the only thing similar I am aware of is the Cockyboys Manifesto on http://cockyboys.com.

DC&E: Are users forced to accept the code of ethics in order to use the App?

Sandler: We have considered doing this but no, we don’t make it a requirement. We simply ask users to opt in when they join. Users also have an opportunity to opt-in to the code in the future. Users who choose to opt-in get a MISTER CODE badge on their profile and this helps foster a nicer and less judgmental environment for men to meet men.

DC&E: What else does MISTER do with respect to HIV?

Sandler: The MISTER Manifesto encourages members to live HIV Neutral. We ask users if they are open to dating someone of any (HIV) status. We did this because our research found that users are not very willing to self-report status on an App or website. We took a novel approach and instead ask users to state if they are open to dating and loving someone of any status. Users who select this option get a badge on their profiles that state they LIVE STIGMA FREE next to an icon from MR. FRIENDLY. MR. FRIENDLY is a non-profit that works tirelessly to reduce HIV stigma and we partnered with them to do this initiative. We think this is the right approach towards expanding the conversation around HIV within the context of an App. It’s extraordinary but there is still a tremendous amount of misinformation, fear and stigma within the gay online and mobile communities. Unfortunately, there is little support from the public health sector for Apps and websites that wish to work to influence behavior and educate users.

DC&E: What is MISTER’s reach?

Sandler: MISTER has had over a million downloads and continues to get thousands of downloads per day. We know that people meet in the real world after using the App but we don’t know how frequently it happens. MISTER collects data on usage and messages sent but most of our queries are done via third party tools like Flurry and Google Analytics. We have yet to work with a non-profit or HIV organisation to look at the data and ways to design and test interventions.

DC&E: How did you become interested in public health as a mobile App developer?

Sandler: I have always been interested in providing support to the gay community, including those who live and love with HIV every day. In 1994, I produced a safe sex gay porn film called Leg Licking that won first place at the International Gay and Lesbian Film Festival in San Francisco. Leg Lickin’ sought to eroticise condom use in porn at a time when it was still a relatively new concept. It was sponsored by Falcon Studios and the San Francisco AIDS Foundation. I also worked on the San Francisco AIDS Foundation hotline in 1993 while I was  at Stanford University. I personally feel an obligation to try and do my part to encourage gay men using MISTER to stay safe. I also write a column on sex and ethics for Huffington Post (www.huffingtonpost.com/carl-sandler) where I’ve tackled issues around Truvada/PrEP, HIV stigma and important health-related issues. You can also find me on the Morning Jolt on Sirius/XM Radio talking about sex, health, dating and relationships.

DC&E: What changes have you noticed in the HIV response among gay men and the proliferation of Apps and social media?

Sandler: Before online/App culture, health organisations went into bathhouses to reach gay and bisexual men at risk for transmission of HIV to perform local interventions. That was bold. Unfortunately, public health organisations haven’t taken as bold an approach with mobile Apps, despite their proliferation in the past 5 years as the principal gay meet-up environment for many millions of sexually active gay, bi and trans men. It’s very disappointing to be honest and quite short-sighted to see public health so slow to recognise the power of Apps and the potential opportunities to working with Apps—particularly those like MISTER—to design and test interventions.

The concept of ‘gay’ isn’t the same as it was before. Mobile Apps has increased reach. There are many men whose ‘gay’ lives are lived online through Apps and whose first experience with the gay community (including safer sex messages) is through an App. Many men live their entire gay lives online, through porn, websites and Apps. Public health needs to learn how to reach these populations where they live, just like the brave people who went to bathhouses back in the 70s and 80s to do outreach.

DC&E: What challenges have you experienced in working with the public sector?

Sandler: I am sorry to say that our experience with the public sector has been disappointing at best. The Public Health Sector has not figured out how to efficiently work with Apps and websites to test, create and measure successful HIV interventions. Or if they are doing it, it’s not something I am aware of.

Additionally, it seems public health providers are ill prepared to leverage social media to reach key populations at risk of HIV and other sexually transmitted infections. When the Meningitis Outbreak hit New York City a few years ago, it took many months for the City’s Department of Public Health to coordinate any sort of Facebook based approach because all messaging required layers of approval.  Presently, public health departments at all levels seem ill-prepared for the rapid response and agile advertising and marketing environment that is crucial to designing successful campaigns. Even the payment of invoices in public health takes many, many months. Many website owners I know won’t accept those kind of payment terms. Public Health Sectors globally, need to evolve to be able to leverage both Apps and social media when responding to an epidemic to reach key populations.

Additionally, the public sector needs to develop an return-on-investment approach to public health marketing. Period. They also need to attract and hire people to manage their media who are savvy and understand how to influence target populations and partner with the Apps who already have scale and have developed vibrant, active online and mobile platforms.

DC&E: Have there been other instances of public health departments running ads through MISTER?

Sandler: A few, but to our knowledge, they don’t necessarily have good methods of testing whether the ads were effective or viewed widely.  It doesn’t appear that public health providers are doing much more than running banner ads with limited and un-engaging ads.

It is remarkably inefficient for each state or county in the United States to be managing their own health promotion program within their small catchment area without collaborating or coordinating at a national level. Everyone seems to be managing small piles of money and marketing departments are looking at how to spend this money locally.  However, this isn’t how the world works anymore. Geosocial Apps and online websites used by men, to meet men, have national and global reach. Ad buys need to be coordinated where campaigns are tested, optimised and then launched nationally so that effectiveness and the return on investment can be quantified. This is how savvy for-profit companies operate. The Public Health Sector can learn much from the private sector.

The real value in Facebook (or any mobile App) is  not simply to expose people to an ad, but to take a specific kind of action or to share a piece of content. We live in a time when people are willing to consume media and share powerful messages. Some key questions to ask when designing online interventions are: How can public health learn from mainstream viral sensations? Where are these powerful pieces of content? Who is managing these kinds of efforts on a national or global level?

DC&E: What can be done to promote collaboration between public sector health agencies and Apps like MISTER?

Sandler: I’ve heard many people in public health complain that Apps and websites are not willing to partner but I can tell you that MISTER has been open to collaborating with public health for years, and no one has approached us with a single innovative project for collaboration.  No one in the public sector has taken us up on our offers to collaborate.

In fact, the most significant contact we’ve had with the public sector has been vis-à-vis Positive Impact of Atlanta who sued us in the United States District Court for the Northern District of Georgia over trademark issues.   If HIV organisations like Positive Impact have enough time and resources to spend their government and state funding fighting Trademark lawsuits then surely there must be resources available to collaborate with Apps to drive increased testing, reduce HIV stigma and educate the community about PrEP, PEP and other STIs.

Public health departments think they have reach because they may serve a few thousand people a year. Consider that the top 10 mobile Apps reach tens of millions of members DAILY. Imagine what kind of reach they could have if they spend time and energy developing successful partnerships?

DC&E: Are there any changes that you believe should happen within the community of App developers?

Sandler: There’s a lot that can be done with the design of the App itself.  But to make that happen we need input from the public sector. We recently added the option for users to say they are open to dating someone of any status. Why would the public health community leave it up to a web developer to make these kind of critical, important changes that effect millions of users in a complete vacuum?  The public sector needs to lead here. We just don’t have the expertise. What we know how to do is to build sustainable communities.

DC&E: What can be done to motivate mobile App developers to be involved in this work?

Sandler: The Public Health Sector needs to put real resources behind working with Apps; not just buying banner ads but really working in concert with Apps. I don’t think the Public Health Sector has effectively worked with the websites that preceded Apps but there is a new generation of App owners, like myself. Then there needs to be serious resources allocated to supporting and working with Apps because this is not our focus. This includes financial resources but also expertise and time because anything we do involves a large investment and risk.

DC&E: How can we foster more collaboration among App developers in HIV programming?

Sandler: Appoint an App Czar for the gay community. Someone whose job is to sit down with each of the Apps and websites and identify top priorities in terms of public health goals.  This person can act as the liaison to the Byzantine world of public health to see how changes can be implemented on each App, tested, refined and supported over time.

DC&E: Do you have any suggestions for improving Apps for HIV messaging?

Sandler: In general, Apps are designed to work in the same way in every country (with the exception of language). However, there is a need to communicate with members from different countries in different ways due to cultural differences and levels of education required. The health needs of a developing nation can be very different from those of a country like the U.S.  Apps need different levels of partnership for each country and perhaps, a unique set of tools for messaging. These are complex issues that need to be studied and evaluated.

DC&E: How much communication happens currently among App developers?

Sandler: I think that in general we don’t talk to one another since we are competitors. This is why it’s more important that The Public Health Sector drive individual conversations with App developers, rather than trying to work with the App developers as a group.

DC&E: What challenges remain for those seeking to make public health-focused Apps?

Sandler: The Public Health Sector doesn’t have the resources or the expertise to support and build active and growing communities online. They should instead focus on partnering with existing Apps and websites that already have the audience if at all possible.

Acknowledgements

Digital Culture & Education (DCE) thanks Diego Solares, Policy Advisor, HIV & Key Populations for the Futures Group for interviewing Carl Sandler and transcribing the interview.  We also thank Diego, Darrin J. Adams (Futures Group) and Dr. Christopher S. Walsh (The HIVe and Torrens University Australia) for collaborating to author the interview questions.

Biographical Statement

Carl Sandler is the CEO of Daddyhunt.com and the MISTER APP on iOS/Android. He writes about dating, HIV and health in his columns on Huffington Post (http://www.huffingtonpost.com/carl-sandler) and can also be found talking about relationships on The Morning Jolt on Sirius/XM Radio. He has a degree in Economics from Stanford University and lives in New York City.

Contact: carl@daddyhunt.com

Kimberley Green, Phillip Girault, Samuel Wambugu, Nana Fosua Clement, & Bashiru Adams

Published Online: July 17, 2014
Full Text: HTML, PDF

Abstract

The prevalence of HIV among men who have sex with men (MSM) in Ghana is more than 15 times greater than the prevalence of HIV among adult males in the general population. The prevalence of HIV among MSM in Accra and Kumasi is 34.4% and 13.6%, respectively. In 2012, the USAID Ghana SHARPER project — which supports HIV prevention and care among MSM — reached less than half of the 30,000 estimated MSM at the project sites. In 2013, SHARPER tested the use of social media by MSM community liaison officers to identify unreached MSM networks. We reached 15,440 unique MSM through social media, and 12,804 MSM through traditional outreach activities involving peer educators. The combined total of 28,244 MSM represented 92% of the estimated number of MSM in the country. There was little overlap among the MSM reached by the two methods. The use of social media is a very important avenue for reaching MSM who are not reached by peer educators in Ghana. The method should be adopted as an integral outreach approach for HIV-prevention interventions in the future.

Keywords: MSM, HIV, social media, peer education, Ghana

Background

Deeply rooted social stigma towards men who have sex with men (MSM) in Ghana affects their ability to access critical information and services for the care and prevention of HIV. In 2011, the Ghana Men’s Study revealed a high prevalence of HIV (17.5%) among MSM at five sites in Ghana, with the highest rates in Greater Accra (34.4%) and the Ashanti region (13.6%) (Aberle-Grasse et al., 2013). The majority of study participants (>70%) were between the ages of 18-24, living at home and reported having no or low income. That study found that the prevalence of HIV was higher among older MSM (>35 years) and those with higher levels of income. The same study found that less than half (44.8%) of the surveyed MSM population had accessed HIV-prevention services in the previous year, and that 37% in Greater Accra and 23% in Kumasi had been reached by a peer educator. They also estimated a population of 30,579 MSM in Ghana.

Before 2012, the USAID/Ghana SHARPER Project employed conventional HIV-prevention outreach activities through MSM peer educators who were associated with community-based organization (CBO) implementing partners in Ghana. The peer-education program was branded by MSM (as part of SHARP, the precursor to SHARPER) with a rainbow symbol and the tagline “It’s my turn” — to indicate that it was their right to be acknowledged, respected, and to have access to the same information and services as anyone else. Peer educators were selected by the CBOs for their leadership and communication skills, interest in HIV prevention and in supporting peers living with HIV, and their ability to complete short reports on completed work.

All peer educators were trained over a five-day period using a standard curriculum that focuses on communication skills, the role of the peer educator, HIV risk-reduction counseling, use of condoms and lubricant, management of sexually transmitted infections (STIs), HIV testing and counseling (HTC), illicit drug and alcohol use, mental health and self-esteem, gender-based violence, familiarity with key services, and learning to facilitate referrals. After training, peer educators are equipped with a toolkit to guide peer interactions between individuals and within groups. In light of the repressive environment, most interactions with peer educators are one-on-one. Outreach events are organized in a safe, discreet location, where from 20 to 50 MSM can take part in role-playing games and on-site HTC and STI services. These are known as “Love n’ Trust” events, which focus on the promotion of safer sex, routine HTC and STI screening, and partner HIV-status communication.

In addition, 11 MSM drop-in-centers (DICs) staffed by MSM leaders and part-time Ghana Health Service (GHS) nurses, offer HTC, STI screening and other health services.  The SHARPER project also trained GHS nurses that were located in health facilities near “hot-spots” in key population-friendly service delivery to facilitate greater MSM access to public health care services. MSM can also use “Text Me, Flash Me, Call Me HelpLine” to speak anonymously (and free of charge) with a trained GHS nurse about their health, psychosocial concerns or gender-based violence. After proving counseling, the nurses make referrals to peer educators, DICs or GHS services based on the client’s wishes, and provide follow-up counseling where needed.

Peer educators and DIC staff assigned unique identifier codes to all MSM they reached (for the protection of their clients). National standardized monitoring forms are used to record key information about the clients and the counseling and services that were provided. Peer educators are supervised by peer leaders and CBO field supervisors. Peer educators meet once a week to plan their schedule; and they participate in monthly meetings to review challenges and successes, and to learn new or reinforce previously acquired skills.

Despite attempts by the CBOs to recruit peer educators that represented different MSM sub-groups, the majority were less than 25 years old. In 2012, peer educators reached more than 12,000 MSM, most between the ages of 15 and 24 years old (FHI 360, 2012). This amounted to less than 50% of the estimated number of MSM in Ghana (Aberle-Grasse et al., 2013). Peer educators and CBO staff members indicated that they were aware of other MSM networks — particularly those that were older or discreet about their sexuality, and who were not interested in being directly contacted by a peer educator.

Through discussions with MSM affiliated with the CBOs, SHARPER learned that social media were increasingly popular among MSM, and might be a new way to reach older or more discreet MSM who were not currently interacting with peer educators. The majority (88%) of the Ghanaian population uses mobile phones; 76% own their own mobile phone (CDD, 2012). There has also been a rapid expansion of social-media use in Ghana, especially Facebook, which is the most frequently used platform. In the United States, Europe, Latin American and Asia, social media have been increasingly used for communicating HIV-prevention information, promoting the use of HIV testing and counseling with MSM, and for recruiting and to a lesser extent retaining MSM in research studies (Ko et al., 2013; Sullivan et al., 2013; Young et al., 2013; and Young and Jaganath, 2013). Therefore, the SHARPER project piloted social media outreach among MSM with the aim of reaching sub-networks of MSM that were not being reached by peer educators. This case study describes this pilot and examines the resulting level of coverage of traditional peer education and social media outreach.

Program Description

In early 2012, SHARPER canvassed its partner CBOs for recommendations of MSM leaders who might be at the center of MSM networks that included sub-group populations, such as older MSM, those who were more discreet about their sexuality, and others who might not be reached by peer educators. Three men who fit this profile were identified, one each in Accra, Kumasi and Tamale. These MSM were hired as community liaison officers (CLOs) to initiate social-media outreach activities in their respective communities. The CLOs recommended Facebook as the primary vehicle for reaching new networks of MSM, followed by Badoo, Whats App and Gay Romeo. The CLOs were supplied with a smart phone and a laptop computer and trained over the course of five days on HIV information and services – based on the same curriculum used to train peer educators. The CLOs were also trained how to count the MSM they reached and how to record monthly outputs.

The CLOs established new social media accounts and began to invite friends and contacts, while they conducted daily discussions on sex that interwove messages about HIV prevention, the use of condoms and lubricants, and routine HIV testing and STI screening. In addition, the CLOs operate a number of closed groups that discuss HIV, safer sex, sexuality, gender-based violence and psychosocial support needs. These groups are segmented by age and interests. The CLOs would also conduct private on-line and telephone conversations with MSM who requested more information or who were seeking referrals. In some cases, the CLOs physically accompanied their social-media contacts to the recommended services.

The CLOs also conducted outreach in bars, parties and other venues where their network congregated. In this way, they were able to increase their social-media contacts and to reach peers with information and referrals as needed. Peer educators rarely appeared at these venues, which typically attracted wealthier people.

The CLOs were recruited over different time periods; the one in Accra was hired first to test the original concept, learn from it, and then apply it to social-media outreach efforts in other locations. The CLO in Accra mentored and supported the CLOs in Kumasi and Tamale, explaining their roles and how to complete their monthly reports.

Project staff met with the CLOs every two weeks to review their progress, and once a month to discuss the CLOs’ monthly outreach reports. The CLOs tracked the number of unique MSM that were reached. For the SHARPER project, an MSM is defined as “reached” if he received all of the following: a risk assessment, information on HIV prevention and a referral to HTC (or another HIV service). Each MSM was assigned a unique identifier code to facilitate the counting of reached individuals. We assessed for client overlap between peer education and social media outreach and found that 18% of MSM in Accra and 27% in Kumasi were also contacted by a peer educator in the past twelve months. We adjusted the number of MSM reached through social media by these proportions.

Results from the pilot

In 2013, 15,440 unique MSM were reached through social media by three CLOs compared to 12,804 contacted by 110 peer educators. This amounted to 28,244 individual MSM reached which represented 92% of the estimated number of MSM in Ghana (FHI 360 2013). The majority of MSM reached through social media or by peer education were contacted two or more times during the reporting period.

Reporting data suggest that HTC service utilization may have increased as a result of social media outreach. In Accra, more than 99% of MSM reached through social media reported having accessed HTC in the past year. While only 64% of MSM reached by peer educators is the same period reported having been tested for HIV.

CLOs reported of high level of acceptability among MSM in their extended network of their on-line outreach. MSM found it to be a convenient and safe way of communicating about their sexual health needs and how to locate MSM-friendly services.

In addition, the CLOs report being sought by staff from MSM CBOs and others working with MSM in Ghana to advise them on their outreach strategies, and how to better utilize social media and tap into new networks of MSM needing access to HIV prevention and care information and services.

Discussion

This pilot study underscores the value of social media in reaching new networks of MSM in Ghana, and using a more diverse approach to reach MSM with HIV-prevention interventions. Studies in the United States, Europe, and Asia that compared internet-based and face-to-face approaches to recruit MSM for HIV-prevention interventions, research, or surveillance concluded that internet-based approaches not only tended to reach new networks of MSM, they also reach higher risk sub-populations (Evans, Wiggins, Mercer, Bolding, & Elford, 2007; Fernández et al., 2004; Tsui & Lau, 2010; Guo et al., 2011; Khosropour et al 2014; Sanchez, Smith, Denson, Dinenno, & Lansky, 2012).

There were a few important challenges experienced during implementation of the pilot. The first was managing accurate enumeration of MSM reached through social media. During the first several months of the pilot, the CLOs and SHARPER team tested a number of different approaches to accurately measure unique contacts until a method was devised that was both sound and acceptable to the CLOs (as described in the program description). The second challenge involved the difficulty of verifying service utilization among MSM contacted by the CLOs. Peer educators use carbon copy referral slips that are collected by implementing partners at service delivery sites once a month. With social media outreach, it was not possible for CLOs to provide MSM with referral slips, or to verify from the service provider that the service was accessed given the long list of public and private providers utilized by MSM across the three pilot cities. We were only able to collect self-reports as part of this pilot.

A number of questions need to be answered about the use of social media to reach MSM in Ghana. Formative research among MSM has touched on social media but more is needed to explore for which MSM sub-populations social media is most appropriate, types of information preferred and in what format, and frequency of use of different social media platforms (Sabin et al., 2013a; Sabin et al., 2013b).

We need to learn more about the risk behaviors of MSM contacted through the social media intervention, and whether they are at greater risk of HIV than MSM who are typically reached through peer education. We also need to determine the relative effects of social-media outreach and peer-education efforts on changes in HIV-prevention behavior and knowledge, including the use of condoms and lubricants, and the use of HTC and STI screening. In the United States, social-media outreach among MSM was associated with reductions in reported sexual risk-taking and an increased uptake of HIV testing (Ko et al., 2013; Young et al., 2013; Young and Jaganath, 2013).

Also, there may be ways to enhance the depth and quality of the social-media outreach experience. For example, more structured on-line HIV prevention “events” such as brief stories or case studies, video shorts or games could focus on generating discussion that may be more engaging to social media contacts (Jaganath et al 2012). MSM social media contacts could also interact with scenario-based applications where as avatars they navigate real-life challenges to HIV prevention (Christensen et al., 2013).

Facebook offers an opportunity to post advertisements for HTC. In the US, the Centers for Disease Control and Prevention (CDC) “Testing Makes us Stronger Campaign” is an excellent example of using social media to promote HTC uptake among MSM (CDC ND). We also need to identify ways to track referrals made through social media to HTC including the use of e-vouchers.

Conclusion

Social media is a very important avenue for reaching MSM not traditionally accessed by peer educators in Ghana and should be adopted as an integral outreach approach for HIV prevention interventions moving forward.

Acknowledgements

This work was made possible by the generous support of the American people through the U.S. Agency for International Development (USAID). The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government.

References

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Nehl, E. J., N. He, et al. (2013). Feasibility and willingness of using e-technologies for HIV prevention and research targeting Chinese MSM. AIDS Care, 25(7):926–930. Retrieved February 23, 2014 from: http://www.tandfonline.com/doi/pdf/10.1080/09540121.2012.726344

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Sabin, L., Beard, J., Agyarko-Poku, T., DeSilva, M. B., Green, K., Wambugu, S., Esang, M., Ashigbie, P., Rahman, Y. A. A., Akuoko, K., Opoku, K. B., Adu-Sarkodie, Y. (2013a). Exploring the beliefs, attitudes, and behaviors of MSM engaged in substance use and transactional sex in Ghana. Boston, Massachusetts: Center for Global Health and Development, Boston University, March 2013.

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Kathryn E. Muessig, Nina B. Baltierra, Emily C. Pike, Sara LeGrand & Lisa B. HIghtow-Weidman

Published Online: July 17, 2014
Full Text: HTML, PDF

Abstract

Young, Black men who have sex with men and transgender women who have sex with men (YBMSM/TW) are at disproportionate risk for HIV and other sexually transmitted infections (HIV/STI). HealthMpowerment.org (HMP) is a mobile phone optimised online intervention that utilises behaviour change and gaming theories to reduce risky sexual behaviours and build community among HIV-positive and negative YBMSM/TW. The intervention is user-driven, provides social support, and utilises a point reward system. A four-week pilot trial was conducted with a diverse group of 15 YBMSM/TW. During exit interviews, participants described how HMP components led to behaviour changes such as asking partners’ sexual history, increased condom use, and HIV/STI testing. The user-driven structure, interactivity, and rewards appeared to facilitate sustained user engagement and the mobile platform provided relevant information in real-time. Participants described the reward elements of exceeding their previous scores and earning points toward prizes as highly motivating. HMP showed promise for being able to deliver a sufficient intervention dose and we found a trend toward higher dose received and more advanced stages of behaviour change. In this pilot trial, HMP was well accepted and demonstrates promise for translating virtual intervention engagement into actual behaviour change to reduce HIV risk behaviours.

Keywords: Men who have sex with men, MSM, transgender, HIV, eHealth, mHealth, mobile, intervention, sexual behavior

Introduction

Within the United States (US), young, Black men who have sex with men (YBMSM) and transgender women (TW) who have sex with men face a disproportionate burden of HIV infection (Baral et al., 2013; Herbst et al., 2008; Johnson et al., 2013; Oster et al., 2013; Wejnert et al., 2013). Compared to older and non-Black MSM, YBMSM are less likely to know their HIV status and receive optimal HIV care_ENREF_18 (Millett et al., 2012; Oster et al., 2011; US Centers for Disease Control, 2010). Structural-level interventions are needed alongside  supported individual behaviour-change to reduce transmission and improve care for HIV and STI among YBMSM/TW. A few individual-level interventions for Black MSM have demonstrated reductions in unprotected anal intercourse (UAI) and increased HIV/STI testing (Maulsby et al., 2013). However, in-person delivery and sustained behaviour change demand significant resources, limiting intervention scalability and impact. 

High ownership of computers and mobile devices among YBMSM provides a cost-effective, familiar platform to deliver tailored internet- and mobile web-based (electronic health, or eHealth) interventions to improve HIV prevention and care (Community Marketing Inc., 2012). YBMSM’s widespread use of online social and sexual networking tools (Duggan & Smith, 2014) suggests that eHealth interventions that utilise social networking and other engaging strategies such as gamification have a greater chance of adoption and sustainability (Gay, Pollak, Adams, & Leonard, 2011; Gustafson et al., 1999). Virtual communities can act platforms through which to implement eHealth interventions by connecting like-peers who can share their experiences, exchange information, and provide mutual counselling, support, and encouragement (Meier, Lyons, Frydman, Forlenza, & Rimer, 2007; J. J. Prochaska, Pechmann, Kim, & Leonhardt, 2012).

Past internet-based interventions for MSM have shown preliminary success in increasing condom use (Carpenter, Stoner, Mikko, Dhanak, & Parsons, 2010; Chiasson, Shaw, Humberston, Hirshfield, & Hartel, 2009; Ko et al., 2013; Miranda, 2013; Rosser et al., 2010) and HIV testing (Ko et al., 2013; Rhodes et al., 2011; Blass et al., 2010; Chiasson et al., 2009). Numerous eHealth intervention components can support sustained engagement and behavior change including: tailoring and user-focus (Lustria, Cortese, Noar, & Glueckauf, 2009; Lustria et al, 2013), user engagement features such as gamification (Baranowski, Buday, Thompson, & Baranowski, 2008; Brox, Fernandez-Luque, & Tollefsen, 2011; Enah, Moneyham, Vance, & Childs, 2013; Primack, 2012), social networking and support (Gay et al., 2011; Gustafson et al., 1999), and access via mobile devices (Gay et al., 2011; Gabarron, Serrano, Wynn, & Armayones, 2012). Our goal was to incorporate all of these promising features in an HIV/STI eHealth intervention explicitly tailored for YBMSM/TW.

mussig1

Figure 1. Screen shot of the HMP.org intervention home screen

HealthMpowerment.org intervention

HealthMpowerment.org (HMP) (Figure 1) is a multi-feature eHealth intervention to reduce risky sexual behaviours, promote health and wellness, and support community-building among YBMSM/TW (Hightow-Weidman et al., 2012; LeGrand, Muessig, Pike, Baltierra, & Hightow-Weidman, 2014; Muessig et al., 2013). We developed HMP through consecutive rounds of evaluation among 130 YBMSM/TW. The website is user-driven and employs responsive web design to optimise computer and smartphone access.

Through HMP’s user-driven design, participants choose when and how to engage with the intervention. Each user creates a profile and an avatar to allow personalisation with anonymity. Information on HMP covers a range of health and lifestyle topics (Table 1) to support users’ diverse backgrounds and varying need over time. For example, HMP includes resources and support forums for those: never tested for HIV (Figure 2), recently diagnosed HIV-positive, starting antiretroviral medications (ART), and already on ART for a number of years. Health and HIV/STI information is provided through multiple site features including: Quizzes, Know Your Risk (behavioural risk assessments), Ask Dr. W (Figure 3), The Scene (choose-your-own adventure decisional balance game) and the House of Mpowerment (library of brief educational articles and videos) (Table 1). Participants can explore areas of interest and then use the forums, Ask Dr. W, and external resource links to gather additional information and feedback from other users.

Table 1. Components of the healthMpowerment intervention website

Site section Intervention user activities Intended outcomes
House of Mpowerment Read articles (HIV/STI, health) - Gain new knowledge
Ask Dr. W (Figure 3) Post anonymous health questions for HMP doctor who responds - Gain new knowledge

- Dispel inaccurate knowledge

- Decrease sexual health stigma

- Decrease risk behaviours

Judge Your Skills Complete health knowledge quizzes - Gain new knowledge

- Dispel inaccurate knowledge

Know Your Risk Complete HIV/STI risk assessment profiles - Increase risk awareness (e.g. sexual behaviours, alcohol/drug use)

- Gain new knowledge

My Life, My Goals Set steps to achieve health goals and receive links to support resources (e.g. tobacco quit lines) - Increase healthy behaviours (e.g. quit smoking, increase exercise, increase condom use)
The Scene Make behaviour decisions to navigate a choose-your-own adventure game for real-life scenarios. - Increase risk awareness

- Explore potential health outcomes of decision pathways (e.g. forgoing condom use with a new partner leads to an STD)

Journal Complete entries in private journal sections (medical history, sexual partners, free text) - Increase risk awareness

- Increase self-monitoring and assessment

Get Tested Use GPS locator for HIV/STI testing and care resources - Increase awareness of testing, counselling & care resources

- Increase self-reported HIV/STI testing

HMP Store (Figure 2) Earn points by using HMP to “purchase” prizes (e.g. condom wallet, HMP tshirt), order free HIV/STD test kits - Sustained intervention use

- Provide free self-testing resources

- Increase HMP social network

Local Flavour Read and post reviews of local businesses and health services - Build community among YBMSM by increasing social options, shared interests and raising awareness of gay-friendly venues and providers.
Events Read and post events to the community calendar application - Build community among YBMSM by increasing social connections/ options, shared interests and raising awareness of LGBTQ events.
Getting Real View, create and share multi-media submissions (e.g. poetry, videos, photos)on relevant health and life issues - Build community

- Decrease HIV, race-ethnic minority and MSM-related stigma

- Establish positive social norms

Forum Post and comment to message boards for health and life topics and advice - Build community

- Establish positive social norms

- Gain new knowledge

To encourage continued use, participants earn points for completing actions on HMP (e.g. submitting an event to the activities calendar, 5 points; achieving perfect scores on all the health quizzes, 100 points).  Points “level-up” users’ status within the site (“new face”, “statement”, “star” and “legend”) and earn prizes from the HMP store (e.g. water bottle, messenger bag, hoodie sweatshirt, condom wallet, Figure 2).

mussig2


Figure 2. Screen shot of the HMP.orgStore” and available prizes

Prior to HMP’s full randomised controlled trial, we conducted a four-week pilot trial. In this manuscript we demonstrate how HMP components led to changes during the pilot trial in participants’ health behaviour intentions and actions across the spectrum of the Stages of Change (J. O. Prochaska & DiClemente, 1992; J. O. Prochaska, Redding, Harlow, Rossi, & Velicer, 1994). We describe features of HMP that provided actionable health information for participants and facilitated sustained intervention engagement.

mussig3

Figure 3. Screen shot of the HMP.org intervention “Ask Dr. W” health care provider forum

Methods

Participants

Study methods and quantitative survey outcomes are reported elsewhere (Hightow-Weidman et al., under review). In brief, study announcements were posted in diverse settings in the North Carolina Research Triangle area and online. Inclusion criteria were: born biologically male, age 18 to 30, self-identify as Black or African American, report ever having sex with another man, and reside in North Carolina.

Procedures

At the baseline office visit, participants completed a computer-assisted, multi-domain survey (sexual behaviours, condom attitudes, HIV/STI test history, depression/anxiety, stigma experiences) and a hands-on, guided HMP.org tutorial during which they created a user log-on name and password. Participants were instructed to use the HMP site for at least one hour per week for four weeks. As there are currently no best practice guidelines for type or length of dose for internet-based interventions (Donkin et al., 2013; Lustria et al., 2009; Lustria et al., 2013) one hour per week was selected as a minimum desired dose to be comparable in length to a weekly in-person one-on-one or group counselling session. The user-driven design of HMP.org allows participants to selectively use site features most relevant and timely to them without regard for the length of time it takes to complete a particular activity. For example the length of time required to locate an HIV test clinic, complete a risk assessment, and contribute to a discussion forum might vary, but these activities could all be of equal importance in the behaviour change process of different (or the same) users. Text message reminders were sent to participants who did not log-on to the site at least once per week.

At the end of the four week trial, a second in-person follow-up visit included a repeat of the baseline survey with added website usability questions and a semi-structured qualitative interview exploring users’ evaluation of HMP.  During the exit interview study staff loaded HMP.org on a computer. Participants navigated through the site while commenting on each section including their use (or non-use) during the field trial, impressions, and assessments. All participants were asked to discuss how their use of the site changed over the four weeks and whether anything in their life changed as a result of using the site. Qualitative interviews lasted between 30 and 70 minutes and were recorded with participants’ consent. The analysis in this manuscript focuses on this qualitative interview data.

Theoretical framework

This analysis applies the Stages of Change behavioural theory as a conceptual framework and organisational tool to accommodate the diversity in HMP’s intervention components and to identify pathways and mechanisms through which HMP may affect participants’ behaviour change processes.  In the Stages of Change theory, also referred to as the transtheoretical model, an individual moves through five stages of behavioural change (precontemplation, contemplation, preparation, action, and maintenance, Table 2) from being unaware and having no intention to change, to ultimately maintaining long-term change in a desired behaviour (J. O. Prochaska & DiClemente, 1992). At each stage there are hypothesised mechanisms, processes, and cues to action that encourage movement toward the subsequent stage (J. O. Prochaska et al., 1994). This theory has been applied extensively to study condom use behaviours (Ferrer et al., 2009; Grossman et al., 2008; Gullette & Turner, 2004; Noar, Crosby, Benac, Snow, & Troutman, 2011; Prat, Planes, Gras, & Sullman, 2012; Tung, Lu, & Cook, 2010) and, less so, HIV medication adherence behaviours (Genberg, Lee, Rogers, Willey, & Wilson, 2013; Willey et al., 2000). While the Stages of Change theory is often portrayed linearly, individuals may cycle through stages multiple times during the behaviour change process (Chang et al., 2006).

Analysis

Interview recordings were professionally transcribed (© 2014 Verbal Ink) and entered into ATLAS.ti for analysis (qualitative data analysis software, Version 7, Berlin 2011). Three study team members reviewed all transcripts and developed a coding scheme. The code book was designed to capture all examples of health behaviours/actions and behavioural intentions that a participant related to their use of HMP during the four-week pilot trial, components of HMP mentioned, and the participant’s reflections on the outcomes of their actions. Codes were inclusive of all health areas discussed (e.g. diet, exercise, smoking, sexual health). Each coded behaviour/intention was assigned one or more stage(s) of change as summarised in Table 2 and informed by the context of the participant’s interview. For example, for the health behaviour change outcome of “establishing regular HIV testing”, an instance of talking about wanting to get a HIV test based on an article read on HMP was categorised as “Contemplation”, while an instance of describing an actual plan for getting an HIV test (e.g. clinic identified, appointment scheduled) was categorised as “Preparation”. Coders referenced participants’ quantitative survey data for additional information about behaviours reported during the interview.

Table 2. Stages of Change addressed by healthMpowerment components

Stage Definition HMP components Example user statements
Precontemplation Does not perform behaviour. No intention to change House of Mpowerment; Know Your Risk; Forum I didn’t really know what I was looking for until I happened to stumble upon it1
Contemplation Thinking about adopting the behaviour House of Mpowerment; Know Your Risk; Forums; Judge Your Skills; Ask Dr. W That’s what I would go on a website for, see what people are talking about…if I could benefit from anything. Made me want to post… questions2
Preparation Plans to perform the behaviour, may try out the behaviour but does not do it consistently House of Mpowerment; Ask Dr. W; Forum; My Life, My Goals; The Scene; Journal [The site] has gotten me to…go outside of my comfort zone. This gave me a stepping stone…I’m able to socialise a little bit more!3
Action Consistently performing the behaviour (<6 months) Ask Dr. W; Journal; My Life, My Goals; Get Tested; Forums; Point system My whole attitude about condom use changed…  [condoms are] one of the big things I’m working on now4
Maintenance Persisted in performing the behaviour consistently (> 6 months) Journal; Get Tested; Point system; Forum; Local Flavor; Events [The Forum] related to me…to see people reaching out for help…I’ve been through it too, and that’s where I will give advice.5

1 HMP13, HIV-positive, age 29; 2 HMP06, HIV-positive, age 23, TW; 3 HMP08, HIV-positive, age 27; 4 HMP04, HIV-negative, age 29; 5 HMP07, HIV-negative, age 23.

Two team members independently coded all interview transcripts within ATLAS.ti. Discrepancies were reviewed by a third team member and resolved by group consensus. Coded text and participants’ demographic information (e.g. age, education, HIV status) were used to generate matrices in Microsoft Excel to facilitate grouping and comparing behaviours, participants, HMP intervention usage, and stages of behavioural change.

Detailed analysis of the intervention site usage measurement and patterns is reported elsewhere (Baltierra et al., 2014). In brief, participant activity on the website was tracked through a secure administrative portal. Built-in site tracking included time stamps for each user’s activity on the site and automated log-out which occurred after 10 minutes of inactivity. Usage data was validated against aggregate statistics from Google Analytics reports and each participant was assigned a usage category based on total time spent on the site during the trial (low=less than one hour; medium=one to five hours; high=more than five hours). Participants’ usage categories were also checked against their total points earned on HMP. As expected, these measures were correlated: those who were high users had the highest total points, while low users had the lowest total points. The usage categories were applied in this qualitative analysis to explore patterns between intervention usage and stages of behavioural change.

Results

Sociodemographic characteristics

Table 3 presents the sample’s sociodemographic characteristics. Participants ranged in age from 20 to 30 years old. Six participants were HIV-negative and nine were HIV-positive. Participants were asked their: biological sex at birth (required “male” for study inclusion), current gender identity, and current sexual identity (Table 3). While these categories include some overlap (e.g. a transgender person may also identify as gay or bisexual), participants were asked to select the category that “best” describes them and allowed unlimited space for write-in options if they preferred to state their gender or sexual identity in their own words. Six men described their sexual identity as gay, four as bisexual, one as transgender, and four wrote-in a description (queer, same sex loving, MSM, agnostic). Six out of 15 men earned under $11,000 annually and 12 had greater than high school education.

HMP usage

Our field trial had 100% four-week retention: all 15 participants completed baseline and follow-up surveys and qualitative interviews. Two of the 15 participants did not log on to the site during the four-week trial. Among the remaining 13 active HMP users, average total time spent on the site was five hours and three minutes (range: 0.5 – 13.3 hours). Among the two participants who did not use the site during the trial, the first reported difficulty logging in and the second explained that they were too busy. However, both participants completed the guided tours of the site at baseline and four-week exit interview (described above). Thus, all 15 participants were exposed to HMP enough to comment on its design, desirability, and usefulness.

Analysis of participants’ usage of HMP and stages of change revealed specific patterns (Table 4). First, participants who were categorised as “high” users were more likely to describe behaviours across all the stages of behavioural change. Second, across all stages, low users were most proportionally represented in the Contemplation stage, while medium users were most proportionally represented in the Preparation stage and high users were most proportionally represented in the Action stage. Third, the Action and Maintenance stages were the least commonly represented overall, while the Contemplation stage was the most c