When you think peer pressure, you think sexting. Bullying. Smoking. Tina Rosenberg wants you to think instead about how positive peer pressure, or "the social cure," can be used to reduce AIDS in South Africa, cut teen smoking in Georgia, spread freedom and democracy around the world, and even help you lose weight. Her latest book, Join the Club, with its cheery, sweeping, Gladwellian claims, is somewhat of a departure. Rosenberg has won a Pulitzer Prize, a National Book Award, and even a MacArthur Genius Grant for her work covering war and revolution around the world, but, she said, "I was exhausted by looking at problems. I was getting interested in finding places where problems were being solved."
Her ideas about the social cure grew from finding two very different examples in two corners of the planet. Lovelife, a successful youth program in South Africa, fights AIDS by creating a positive youth culture around sports, parties, and multimedia storytelling, including SMS campaigns, advice columns, magazines, and a reality show. Otpor, a nonviolent youth political movement that arose in Serbia just before the 2000 elections, used "essentially the same strategy": rock music, parties, and fun, this time to get youth excited about democracy.
Before she knew it, Rosenberg was seeing examples of positive peer pressure everywhere, and not just for youth. "If you'd asked me a couple years ago to think of ways that peer pressure has been used for positive aims, I could have come up with Alcoholics Anonymous, but no others. Now I see many places where it could be used but it isn’t." For instance, she'd like to see it applied to encouraging people in the U.S. to follow their doctors' orders.
"The problem of poor patient adherence is huge. It’s billions we shouldn’t be spending. Diabetes, which is getting worse and worse, is largely an adherence issue."
But, she says, by enlisting friends or relatives to provide some accountability, and by providing positive role models, compliance can go way up. "There’s a proven strategy: directly observed treatment-short course (DOTS.) Basically, it's a buddy who comes to your house every day and watches you swallow your pills. When DOTS came to China, the cure rate for tuberculosis went from 54% to 90%. We give people medicine bottles that say 'Take with Food.' Why don’t they say 'Take with spouse'?"
Even though it's not the kind of peer pressure that involves a rock concert, plans like DOTS work and are cheap and effective. We should see more of them in the future.
[Image: Flickr user motumboe]