How Discourse About Homeopathy Was Affected By The 10:23 Campaign: A Case Study In Public Engagement
This is a summary of the report of a research project I carried out for the Science and the Public module of my MSc in Science and Society with the Open University. The OU bars publishing of assignments (for obvious reasons) so I have written this as an alternative. I got a distinction for the module, and comments on the research project included “timely”, “innovative” and “thorough”.
A campaign led by skeptical amateurs aimed to change the way the public thinks about homeopathy by participating in a mass “overdose” event. Mainstream press media, blogs and tweets from timeframes around that event were analysed to identify how the campaign, plus other events, changed public discourse on homeopathy.
It is noted that there was a shift from technical discourse to political discourse calling for changes in public policy on homeopathy. I conclude that skeptics have great potential to act as agents for citizen engagement with science, but that professional support is essential for pro-am programs to be effective.
On 30 January 2010, at 10:23, more than 300 campaigners took an “overdose” of homeopathic remedies in a selection of towns across the UK and internationally. This campaign, the 10:23 campaign, happened in a broader political context in which a Select Committee of the House of Commons were undertaking an investigation into the evidence supporting Government policies on homeopathy.
This event interested me because the campaigners self-describe as ‘skeptics’ who have been described as “anti-antiscientists”. In undertaking the campaign, the skeptics sought to challenge “an unscientific and absurd pseudoscience”. However, the campaign was criticised, with one commentator, Michael McRae, suggesting it was a placebo protest.
Unusually, skeptics are not professional scientists or science communicators, but passionate citizens who, in this case, feel strongly that evidence should be a key factor in making policy decisions, and want to. Groups like this have been described as ‘professional amateurs’, or pro-ams. This type of science activism has not be been studied extensively, and there is very little academic writing on the ways in which skeptics can influence public perceptions of science and science policy.
I wanted to explore the impact that the 10:23 campaign had on the way people are thinking and talking homeopathy in a variety of public media: mainstream press media (MSPM), blogs and Twitter.
What I Did
I started by interviewing the 10:23 campaign organisers to identify what the desired key outcomes were; this was a wide-ranging discussion which considered not only the formal objectives, but also personal and informal – often unspoken – objectives.
I captured three groups of data which I hoped would reflect three inter-related streams of discussion. Searches were carried out using the terms ‘homeopathy OR homoeopathy’ with no other modifiers in order to capture as broad a sample as possible. I had to restrict the number of samples in order to be able to do the research in a reasonable timeframe – hundreds of posts might have been interesting but would have been unmanageable!
Mainstream Press Media Articles
I captured article from four periods from the Nexis database, using the publication type “UK Newspapers”.
- 30 Jan – 5 Feb 2009 (12 months prior to the 10:23 overdose event)
- 30 Jul – 5 Aug 2009 (6 months prior)
- 30 Jan – 5 Feb 2010 (date of overdose plus one week)
- 30 Jul – 5 Aug 2010 (6 months after)
I captured 1 and 2 to use them as a control for periods 3 and 4. All of the data was classified into one of the eight sub-categories in the Nexis publication type (Newspaper, Industry Trade, Magazine, Scientific Material, Web-based, Newswire or Journal). I excluded some of the articles if they were irrelevant (for example, if all that was said was that a homeopath was going to attend a village fair), but otherwise kept all of the results.
I collected a sample of blog posts using Google Blogs, and covered periods 2, 3 and 4, with the first 50 blog posts taken for periods 2 and 4, and the first 100 taken for period 3.
I took a single sample of Tweets for period 3. In addition, I recorded the numbers of Tweets mentioning “homeopathy OR homoeopathy” for each week in the 12 months starting with period 2.
What the Samples Showed
Some of the objectives of the 10:23 weren’t amenable to the type of analysis I was undertaking, so I focussed on the objective “To educate the public about the full story of Homeopathy, to cause them to question and become opinionated about homeopathy” and on an objective which, although not stated by the team was implicit in another objective, “to bring about policy change”.
Table 1 shows the mainstream press media articles; the media are in fact moderately critical of homeopathy generally, and number which were critical increased across the four periods from 66% to 87% of articles. It’s impossible to say the degree to which 10:23 influenced this increase, which is likely also to have been influenced by other contemporary events, such as the Evidence Check report.
|Total number of returned articles||10||1||41||12|
|Number of articles included in analysis||6||0||25||8|
|Number containing critical content||4||0||19||7|
|Percent containing critical content||66%||0%||76%||87%|
|Number mentioning 10:23 campaign||n/a||n/a||17||1|
|Number mentioning evidence check||n/a||n/a||6||6|
Turning to the blog posts, I started by analysing the blog posts for bias (see table 2). Half of the posts across all samples were pro-homeopathy; this, coupled with the dramatic surge in posts in period 3 (around the overdose event) suggests that unless the subject is a live-wire topic, there is more interest in promoting it than there is in countering its claims. Arguably, there is a massive economic imperative to saturate the blogosphere with content promoting it!
|Anti-homeopathy||7 (14%)||37 (37%)||7 (14%)||51 (25.5%)|
|Balanced||1 (1%)||6 (12%)||7 (3.5%)|
|Neutral||15 (15%)||2 (4%)||17 (8.5%)|
|Pro-homoeopathy||35 (70%)||31 (31%)||31 (62%)||97 (48.5%)|
|Excluded||8 (16%)||16 (16%)||4 (8%)||28 (14.0%)|
|Grand Total||n = 50||n = 100||n = 50||n = 200|
When analysing the Twitter posts, I realised that analysing the way in which the content was framed – whether it was being considered a scientific debate, a clinical discussion, a debate about policy or a discussion of values – would be more revealing that mere bias analysis. As you can see in Table 3, frames cut across the bias, so both pro- and anti-homeopathy biases will write commentaries or satire (for example).
|Bias||Frame||Total (n)||Total (%)|
I went back and reanalysed the blog posts to look at frame instead of bias, and found there had been a substantial change in frame over the periods studied (see figure 1).
During period 2 (six months before the overdose event), the bulk (90%) of discussion was framed in terms of science, clinical applications or information about homeopathy; by period 4 (six months after the overdose), this had dropped to 52%.
The slack was taken up by a massive increase in reporting on events related to homeopathy (a 400% increase over the 12 months), which is likely related to events such as the overdose event, the release of the evidence check report and the BMA’s decision to demand that homeopathy is not offered on the NHS.
However, even ignoring that, 25% of the blog posts now consist of people questioning the way in which homeopathy is regulated and the politics associated with allowing homeopaths to provide their services at public expense.
Interestingly, satirical blog posts comprised about 4% of the posts across all of the periods sampled. It seems that satire is often ahead of the curve ;-)
I also carried out a frequency analysis on Twitter, which I felt would suggest public consciousness of the subject over time. The numbers represent specific events:
- House of Commons Science and Technology Select Committee announces Evidence Check 2 Inquiry into the governments policies on homeopathy;
- 10:23 teaser campaign starts;
- 10:23 overdose event;
- Report of Evidence Check 2 published by House of Commons Science and Technology Select Committee;
- World Homeopathy Awareness Week;
- British Medical Association’s Junior Doctors Committee votes against provision of homeopathy by the NHS;
- British Medical Association vote against the provision of homeopathy on the NHS;
- Government releases its response to the Evidence Check report
It’s worth noting that until the 10:23 campaign started, there was little or no traffic on Twitter about homeopathy. It’s likely that without the actions of the 10:23 team, subsequent peaks would not have occurred.
What Does This Mean?
I think it’s worth noting first of all that blogs and Tweets may not be representative of the totality of the ways in which people are talking and thinking about homeopathy; indeed, it would be impossible to capture such a sample. For example, a good proportion of the world’s population don’t have regular access to the Internet, and of those that do, only a small proportion write blogs or use Twitter. However, this doesn’t mean the information is worthless; it is likely that this subsample represents wider trends (just as it’s also likely that skepticism as a movement is quite dependent on the Internet, so will be over-represented).
The question is whether the objective to educate the public was effective. Indeed, there have been some anecdotal reports that people have stopped taking – or not starting taking – homeopathic remedies as a result of the campaign.
However, in science communication, there has been a long-standing model of science communication known as the “deficit model”, which is based on the belief that if the public could only understand more science, and be more educated, they would view science, and evidence-based policy, more favourably. Unfortunately, this model, whilst attractive – all we have to do is educate people! – isn’t well-supported by evidence, and science communication generally prefers to talk about engagement with publics.
But I would argue that when considering consumer policy – protecting the public against exploitation by charlatans, for example – highlighting the types of claims is a good first step to changing the ways in which consumers are protected. Which brings us to another question, who are the publics that the 10:23 campaign were seeking to educate? If it was the general public – all 60 million people with different cultural backgrounds, values, beliefs and levels of scientific and medical knowledge – then clearly the campaign failed as not only are 60 million people not calling for tighter regulation, but there are still people promoting homeopath, who are presumably included in that 60 million people.
However, if we were to argue that the public intended by the campaigners is in fact “the people who protect the general public”, one might argue that the impact was broadly successful. Subsequent to the event, and coupled with the Evidence Check report, various NHS Primary Care Trusts (the people who decide how to spend the NHS’s money) have stopped funding homeopathy and the British Medical Association has called for homeopathy on the NHS to be banned.
Indeed, this was reflected in the way in which people were talking about homeopathy. There was a large increase in people discussing the ways in which homeopathy might be regulated and the politics of providing such services at public expense. Not all of these were anti-homeopathy, but the debate shifted from the technical sphere – where discussion is seen as a technical matter between scientific experts discussing effectiveness, efficacy, efficiency and ethics – into the public sphere. This shift, which is more visible and can engage more people, presents advantages and disadvantage both to the skeptics and to supports of homeopathy.
For example, if the debate is in the public sphere, supporters no longer need to provide lengthy technical discussions about the efficacy of their product, and can focus instead on promoting freedom of choice. At the same time, the shift also allows objectors to discuss financial cost-benefits and ethical implications. In short, the shift means a move away from scientific knowledge and to values, which can be exploited by all of the participants in the conversation.
Challenging beliefs is always difficult. In their book Mistakes Were Made, But Not By Me, Carole Tavris and Elliot Aronson highlight how dissonance – holding two contradictory beliefs – constantly shapes the ways in which we view new information:
“If the new information is consonant without beliefs, we think it is well founded and useful: “Just what I always said!” But if the new information is dissonant, then we consider it biased or foolish: “What a dumb argument!”” (p18).
I think it’s important that if we seek to change minds that we consider how we can do this whilst avoiding creating a dissonance in the people we are addressing.
Conclusion: What I Think
For me, the most amazing think about the 10:23 campaign was that it started with 3 people sitting in a pub. This model of ordinary citizens acting in a way as science activists is being echoed around the world. One of the organisers stated that the main reason they did it was because they could see the harm that belief in homeopathy was causing, which was facilitated by the ways in which it is regulated.
In Australia in 2009, Gloria Thomas, aged 9, died after her parents treated her eczema unconventionally, with homeopathic remedies. Had she been treated with conventional medicine, it’s extremely unlikely that she would have died. When explaining this motive to a friend at a barbecue, the friend asked “yeah, but other than that?”. The reply was a simple:
“I don’t want people to die.”
To me, that is an ethic and a motive from which we could all learn.
Sure, the 10:23 campaign wasn’t perfect, and I’m looking forward to the 2011 (and 2012, and 2013!) campaigns which will build on the successes, and improve on great model. But if we want a citizenry which is scientifically literate, this is the sort of event which is likely to happen, and the sort of event that science communication professionals should engage with and support. Indeed, criticising such events seems to me to be the ultimate in counter-productive behaviour for people committed to promoting public engagement with science.
Frankly, the 10:23 campaigners are at the forefront of true public engagement with science policy. It’ll be interesting to see how this model, and groups like 10:23, influence the ways in which we think about science engagement in the future.