My colleague Melissa Davies published findings earlier this year on the role of the Internet in healthcare, which found that while doctors are still the primary source for healthcare information, the Internet is a close second. In this new era of collaborative care, patients have access to an array of online tools to arm them with more detailed information about their conditions and treatments than ever before. Specifically, social media vehicles are expanding and accelerating the pace at which patients and caregivers can gain access to drug treatment ratings. Similar to how an online shopper may peruse consumer reviews and ratings for, say, a flat screen TV on WalMart.com, today’s patients can get a similar quick fix.

A new crop of sites such as PatientsLikeMe.com and iGuard.org enable patients to quickly access a trove of treatment ratings based on the results of its online participants. Each site varies a bit (PatientsLikeMe.com is intensely personal, featuring user images and detailed personal accounts, whereas iGuard.org presents limited demographic data) but they are similar in their approach. PatientsLikeMe and iGuard both field surveys to capture patient treatment experiences, including dosing, length of treatment, side effects and efficacy. The results are tabulated and presented as an aggregate of all patient experiences. With just a few clicks, users can learn why a patient takes a prescription and why they’ve stopped taking it. Another site, DailyStrength.org, publishes “success” rates based on the efficacy of all users currently taking a medication.

By literally putting a human face on this vast repository of patient information and fostering social networking, these sites distinguish themselves from predecessors like DrugRatingz.com, and even established sites like WebMD.com, which also allows users to rate treatments. I was curious to see what traffic to the sites looked like. As yet, traffic is quite low and below our minimum reporting levels, but directionally this data seems to indicate that awareness of review sites is gradually increasing.

My instincts tell me that patients are not going to make a wholesale change and stop engaging in discussion forums, but they will incorporate a search or two on these sites as part of their information gathering. I expect that we’ll see discussion of these ratings pop up in the leading forums as well. At the end of the day, managing a disease or condition is not a simple task and no single site is going to be the silver bullet to allay all consumer questions and concerns.

Early this morning it was reported that the Salmonella outbreak (Salmonella Saintpaul) has now sickened more than 750 consumers. As inspectors investigate farms from Mexico to Texas and southern Florida, consumers have been expressing concern and raising questions in online communities. Much of the buzz came in immediate response to the FDA warning on June 10, 2008. In total, we’ve documented nearly 8,000 messages posted on blogs, boards and groups during the month of June. And this is just buzz. The Associated Press uploaded a video to YouTube.com on the June 5, which has received nearly 20,000 views. Salmonella Saintpaul has also prompted scores of inbound links to the FDA page: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html

Buzz volume for Tomato Salmonella FDA Warning

Source: Nielsen BuzzMetrics service. Buzz expressed as raw number of messages.

One of the most vocal bloggers is Salmonellablog.com (voice of the Marler Clark firm), which has dedicated more than 20 posts in recent weeks to the outbreak and calling out the FDA’s snail-like response. On boards, we tend to see more conversation related to how consumers are adjusting in the interim. Weightwatchers.com in particular has spurred a couple of hundred messages related to the outbreak. Many dieters punt questions to the community about which types of products are tainted and some mention substituting tomatoes in recipes.

“Have they found out where this started? Is it safe to eat tomatos now? Also, is it safe to eat the ones in the cans? I know this is silly, but my children asked me that last night and I can’t answer that!!”
Source: Weightwatchers.com; June 12, 2008

“Normally I’d say a tomato /mozzarella salad, but with the salmonella, go for roasted peppers with mozzarella.”
Source: Weightwatchers.com; June 21, 2008

The discussion has already dropped off precipitously. There are few indications from the nature of the current conversation that this scare will have long terms effects on category sales. If we can take any cues from the e.Coli outbreak in 2006, we may see a softening in sales in the weeks to follow. The spinach outbreak had something of a ripple effect because of the back-to-back outbreaks that year. Ultimately fresh bagged salad approached previous year levels, though sales for fresh spinach were sluggish to recover.

Sales for Precut Fresh Salad Mix and Fresh Spinach

Source: Nielsen LabelTrends; usda.gov

Beyond sales, this latest outbreak does nothing but chip away at consumer confidence in foreign-produced food and the our own government’s food inspection systems. Earlier this week, the Harvard School of Public Health released findings of a recent survey that queried consumers on just this topic. 37% of respondents believed U.S. produced food was very safe. What raises eyebrows is that 58% believed it was only “somewhat safe”; 47% deemed food from Mexico unsafe and 56% were concerned about food from China.

Memories of past outbreaks linger. In the same survey, 74% remembered the spinach recall and 82% remembered the recent ground beef recall. It remains to be seen how memorable Salmonella Saintpaul will be, but surely if the FDA doesn’t find the source soon, it will likely further instill consumers sentiment toward globally produced food and call into question US production as well.

There has been much speculation in the past few weeks about how consumers will react to rising fuel and grocery prices. On June 24th, we’ll host a Webinar to shine a light on pricing sensitivity from the consumer perspective. Leveraging our BuzzMetrics data, we’ll present data from our research of unprompted and unfiltered conversations to reveal how consumers are coping with rising prices.

For the past few weeks, I’ve been analyzing online conversations (buzz) to try to understand how consumers may be altering their behaviors. Are they making fewer shopping trips? Buying more store-branded products? Is coupon use increasing? What’s compelling about this particular recessionary period is the extent to which consumers are leveraging social media to find solutions, ask questions and share ideas.

Online Buzz Growing

As we look at buzz over the past few months, we see online discussions about grocery prices, in particular, rise significantly in the first few weeks of 2008. While the post-holiday season is usually a time when consumers begin tightening their belts, the sentiments expressed during this time period express a sense of foreboding and anticipation.

Trended Buzz Volume for Gas Prices, Grocery Prices and Private Label Goods

Note: Buzz is expressed as an index of total online discussion from November 25, 2007 to May 18, 2008.

Do Rising Prices Lead to Private-Label Growth?

As we learned from the data above, buzz for private labels and store brands remains remarkably unchanged in recent months. It is important to note that in unprompted discussion, consumers infrequently discuss store brands generically, but will identify a brand by retailer, such as the “Aldi Fit & Active hot pocket brand,” for example. This obscures the rise in private growth that is ringing up at the register.

When we look specifically at private label buzz linked to milk, eggs and bread, we see a different story emerge. Buzz increases moderately in recent weeks for all three categories. This is consistent with recently reported sales trends, which reveal over half (52.7%) of sales growth for private label products were driven by milk, fresh eggs, cheese and breads and baked goods for the period ending March 29, 2008.

Private Label Buzz for Key Commodities

This is just a sampling of the data we will present during our Webinar on June 24^th. We will also present data on how rising fuel prices are changing buying and lifestyle decisions for millions of consumers—and how marketers can proactively respond to consumer sensitivities now.

Back in March of 2007, Nielsen Online (then BuzzMetrics) sought to bring understanding to a term that was just starting to get traction online – sustainability. My colleague Emily Sobol and I – and a team of fearless analysts – navigated millions of blog posts (227+ million to be precise) to help clients understand whether or not consumers were talking about going green with any substance or vigor, and if so, which brands and marketers might be implicated. Bloggers – by nature an opinionated bunch – gave us all sorts of insights to work with. We were able to advise clients that yes, in fact, this was not a blip on the radar screen (buzz shot up well over 100%). And no matter how left-of-center they thought some of these constituents were, they had a not insignificant following (TreeHugger stood out as a big driver of buzz and inspired considerable follow on).

In early 2008, we wanted to tell a new story. Simply telling clients that green buzz was on the rise seemed not only obvious (buzz continues to climb; up 54% in Q1 2008) but also to trivialize how much the discussion had matured. (For those who still need convincing, check out the chart below.) Instead we wanted to identify and quantify all the underlying tentacles of the online debate. How does discussion of alternative fuels compare to say, fair trade? For anyone who has studied sustainability, you know this is messy stuff. There are few definitions of what does and does not constitute “sustainability” and there is certainly no rubric for quantifying such a nebulous concept online.

Through an exhaustive process that required reading scores of online conversations (fortunately we happen to love what we do) we were able to define sustainability within 25 key topics, covering everything from climate change to packaging to greenwashing. We are certain that the list of 25 will change and we probably got some wrong, so I hope you use this forum to help us refine our approach and integrate new issues that perhaps aren’t as apparent today.

From my viewpoint, sustainability buzz has matured considerably in recent months. Bloggers are no longer only talking about broad issues like global warming. In fact, while global warming constitutes more discussion volume in aggregate than other topics, it is actually trending down. At the same time, buzz about renewable energy and resource conservation (think taking shorter showers) is rising. For every mention of what the government (energy bill), corporate America (greenwashing) or brands (packaging, organics, toxins, and on and on) are up to, there is another that indicates it’s high time for consumers to make some changes of their own. Community Supported Agriculture and the local food movement are just two examples of the measures consumers of all stripes are taking to reduce their footprint.

NOTE: Issues are empirically derived. Top 10 topics are ranked by total message volume among Sustainability bloggers in Q1 ‘08. Buzz*Trend calculated as percentage growth in Q1 ‘08 over previous quarter.

So what does this mean? And how should marketers react?

First, I believe strongly it means this is a long-term trend. Consumers describe being on a journey – a path towards a greener life. Moreover, they recognize – as do many companies who have dipped a toe into these waters – “going green” doesn’t happen overnight.

Any company with a green platform or related messaging needs to be cognizant that the bloggeratti is watching and listening and ready to pounce. Discussion about greenwashing rose significantly in 2007, and is up again another 64% in Q1 2008. It’s not a top 10 topic yet but the groundswell of blog reaction to marketing activity should warrant any marketer to pay close attention.

With recent gas prices nearing $4.50 in some towns, auto manufacturers and their media partners should understand how rising prices are potentially fostering greater interest in alternative fuels, hybrids and electric vehicles. Close analysis of CGM can help to surface some of these insights. Later this month, we’ll be hosting a webinar on how consumers are affected by rising prices at the pump. Details to come.

Social media will continue to play an important role in shaping how the sustainability trend evolves. Trust that we’ll be at the forefront, monitoring the discussion as it does.