The involvement of communities is crucial for delivering effective sexual health interventions.1 There is strong evidence that community engagement leads to effective and cost-efficient impacts on key outcomes, such as providing care and support, advancing human rights and reducing gender inequalities.2 This is exemplified through programs where community engagement has been vital for achieving key outcomes such as improving sexually transmitted disease (STD)3 and human immunodeficiency virus (HIV)4 testing rates. However, it may be difficult to practically and effectively harness the knowledge, skills and resources of communities.5
Crowdsourcing has a group of individuals complete a task, often as part of an open contest.6–8 This has been widely used in businesses and is a methodology to democratize problem solving.8,9 In recent years, there have been increasing examples of its use within sexual health. For example, crowdsourcing has been used in the development of images promoting sexual health,6 videos promoting HIV testing,7 and policy development.10 To date, there has not been any published data on evaluating the use of crowdsourced contests to engage with communities during a medical conference. This may be an innovative way to connect with and involve a broad range of communities the medical conference aims to engage.
For the first time in its history, the International acquired immunodeficiency syndrome (AIDS) Society (IAS) conference organizers chose to obtain their AIDS conference logo from a logo contest instead of from a design company. This can be referred to as a crowdsourcing contest because the organizers solicited conference logos from a group, instead of employing a single design company. Similar to existing design crowdsourcing platforms,11 each participant worked independently from one another and submitted their design directly to IAS. The logo contest was open from October 26, 2012, to April 23, 2013, to anyone under the age of 30 years. The contest was publicized through the IAS website and IAS members were encouraged to broadcast the contest amongst their HIV networks. The winner of the contest received the prize of paid registration, accommodation and travel to the conference for two, financed by the IAS. The winner captured the people’s attention because he was a nonexpert who had never left his home country before, and yet was able to participate in the conference in an integral way.
The purpose of this research was to evaluate the value of a crowdsourced logo contest as part of medical conference, and to discuss how crowdsourcing could be used within a sexual health context.
The logo contest website page was viewed a total of 2,059 times during the time of the contest with a total of 265 participants entering the contest. Over 90% of submissions were from low and middle-income countries with high HIV prevalence (i.e., HIV prevalence > 1% of the general population). Nearly two thirds of contest contributors were male (63%) with a median age of 20 (range, 12–30) years. After the winning logo was chosen, the local conference organizing committee sought further community input, including consultations with Australian Aboriginal elders to ensure the logo was culturally appropriate. The 2014 logo contest cost was less than the cost of the AIDS 2012 logo development.
After ethics approval was attained, the IAS was contacted by J.J.O. to send an email to the contest organizers to invite them to participate in an interview regarding the logo contest, all three of whom responded (Fig. 1). A series of three emails (two weeks apart) was sent from IAS to all contest contributors of the AIDS 2014 logo contest (7 of 265 responded). This email invited voluntary participation in a Skype call to share their experiences of the contest. J.J.O. and J.D.T. purposively chose conference attendees whom they knew attended both AIDS 2014 and AIDS 2012 conferences to ensure they could describe their experiences of seeing the two conference logos. Further, J.J.O. and J.D.T. picked conference attendees from a diverse background: local and international researchers, clinicians, laboratory scientists and HIV community organization leaders. Conference attendees were reminded after 1 week if no response was received, resulting in 12 of 15 who participated. The recruitment and interviews were conducted between January and March 2016. No financial compensation was provided for the interview.
This study used a qualitative descriptive research approach, which is a pragmatic rather than theory driven approach commonly used in health science research to address questions of specific clinical interest.12 It is particularly useful in providing insight into largely unexplored issues or trying to answer questions of particular interest or relevance, including views and opinions on a certain events or services.13 Qualitative descriptive aims to provide straight descriptions of events or topics in everyday language rather than an interpretive or theory based analysis.12,13
The Research Team
The research team consisted of J.J.O. (PhD), J.E.B. (PhD), and J.D.T. (PhD). At the time of the study, J.J.O. (male) was a sexual health clinician and researcher, J.E.B. (female) was a sexual health researcher and J.D.T. (male) was a sexual health researcher. All 3 researchers have been trained and have published qualitative research in peer reviewed journals. J.D.T. has expertise in using crowdsourcing within sexual health research. J.D.T. and J.J.O. knew the conference participants in the study, and all participants knew the reason for conducting the interviews was to publish a research paper. In the email introduction to potential participants, the researchers were identified as sexual health researchers who were interested in evaluating the IAS logo contest.
J.J.O. interviewed all study participants: face-to-face for 4 Australian participants or phone/Skype interviews for the remainder. Participants were required to read a participant information and consent form. Verbal informed consent was obtained from all participants before the interview commenced. No one else was present during the interview besides the participant and the researcher. Data were collected through a single semistructured interview, which included 7 structured demographic questions and a series of open ended questions about participants' views on the importance of logos, what makes a good logo and, comparisons between the crowdsourced logo (AIDS 2014 conference) and a company designed logo (AIDS 2012 conference). These questions were pilot tested with 5 of JJO’s colleagues for comprehensibility. Conference organizers were also asked why they chose a crowdsourcing method, about the contest submission, promotion and voting process and their overall satisfaction with the contest. Contest contributor questions included reasons for entering the contest, the contest process, experience, and impact. Conference attendees were given the images of the two logos from AIDS 2014 and AIDS 2012 (Figure 2) and asked their opinion on each, which they preferred and why. The preference for the logos were asked before revealing that one was crowdsourced and the other was a company designed logo. After this, a snippet of the story behind the logo contest was shown to conference attendees (https://www.youtube.com/watch?v=IXL5TyBtjAw&feature=youtube) and further reactions to this story were elicited. Interviews lasted between 30 and 45 minutes, and field notes were made after each interview. All interviews were digitally recorded with the permission of participants. Transcripts were not returned to participants for comment and/or correction.
Data Preanalyses and Analyses
Each interview was deidentified and transcribed to allow a preliminary review of the data to identify new themes and additional lines of questioning to be included in subsequent interviews. During the data collection process, J.J.O. and J.D.B. met twice to discuss and review the preliminary data and identify emerging themes. After 22 interviews were completed, it was decided that no new themes were emerging and data saturation had been reached within each of the subgroups.
To commence data analysis, all interview articles were re-read by J.J.O., and content analysis was performed to code the data and identify similar patterns or categories.12 A modifiable coding system informed by the data provided a descriptive summary of the themes and identified commonalities and differences in the data.13 After initial coding, the articles were re-read by J.J.O. to refine the coding system before a sample of transcripts were provided to J.D.B. and J.D.T. to independently review and confirm themes and coding. J.J.O. then conducted the final coding of the transcripts. J.D.B. and J.D.T. confirmed J.J.O.'s analysis with no differences in interpretation evident.
The reporting of the findings of this research adhere to the COREQ checklist.14 This research was approved by the Alfred Health Human Ethics Committee (Project 565/15) on January 20, 2016.
Demographics of Interviewees
There were 3 conference organizers interviewed, 2 were women, with a median age of 43 years (range, 41–53 years), including one international representative and two local representatives from conference coordinating committee. There were 12 conference attendees interviewed with a median age of 51 years (range, 29–67 years). Seven of 12 were men. Occupations included sexual health physician, public health nurse, chief executive officer or chairpersons of nongovernmental HIV community organizations, sexual health educator, Aboriginal elder, pastoral care practitioner, HIV community center coordinator, registered nurse, and basic science researchers. The median years of involvement in HIV work was 21 years (range, 6–30 years). Conference attendees were based in Australia, Switzerland, Canada, France, and United States. Contest contributors had a median age of 28 years (range, 24–33 years). Five of 7 were men. Occupations included community activist, medical doctor, communications executive, graphic designer and clinical researcher. Contest contributors were based in Jamaica, Nigeria, Papua New Guinea, Kenya, Tanzania, and India.
The Importance of a Logo for an HIV Conference
All participants noted the importance of having a logo at an HIV conference.
[a logo] creates brand recognition, so people see it and they know exactly what space they’re going into, what the values represented under that logo are (Conference attendee, male, age 67).
Table 1 outlines the other key reasons participants felt a logo was important. Two conference attendees saw the HIV logos as iconic, as they served as historic markers in time of the progress of HIV research, while three others considered them a rally point as they connected with the aspirational themes of the conferences (e.g. Turning the tide, Stepping up the pace). Furthermore, some participants felt that having the contest winner acknowledged at the opening ceremony set the tone around valuing community engagement.
I remember on the night watching [the contest winner] on stage and just thinking that after seeing people like… [famous HIV researchers] and all these people on stage talking and then seeing [the contest winner] up there and then meeting him afterwards, it was just such a warm fuzzy feeling. Such a humbling feeling that any of us could be up there. It gives a sense of community (Conference attendee, female, age 29).
The winner’s story (Box 1) encapsulates his reasons for participation and the impact of winning the contest particularly in empowering him to continue working within the HIV industry.
Table 2 outlines the key characteristics participants felt made a good logo. One conference attendee expressed how the logo must also resonate with a wide range of people, not just those affected or infected by HIV. This was important as conference logos are prominently displayed within the conference city and media outlets, locally and globally.
Unlike other HIV conferences that utilize the same logo for each conference, the IAS HIV conferences change their logo with every conference. The majority (10/12) of conference attendees were supportive of changing logos as it showed ‘a difference between each conference… each time with a new focus and a new theme’ (Conference attendee, male, age 45), ‘a way of personalizing [the conferences]’ (Conference attendee, male, age 61), and ‘variety just keeps people interested’ (Conference attendee, female, age 55). Others felt the changing logos reflected the evolving response to the HIV epidemic.
I love the fact that they are changing it. I think they should change it because the HIV epidemic is evolving and we want to develop different research along the different years (Conference attendee, male, age 39).
Two conference attendees however raised concerns around the loss of brand recognition with the logo changes.
By changing your logo every two years you’re losing brand recognition, in marketing terms it’s crazy (Conference attendee, male, age 67).
The suggested advantage of a consistent logo is being able to readily identify the conference by the logo.
…like the car companies that have the same logo and you can identify them from a mile away and identify their cars from a mile away’ (Conference attendee, female, age 29).
Crowdsourced logos vs. design company logos
When asked which logo they preferred (2014 or 2012), the majority of conference attendees (11/12) reported a preference for the 2014 logo which was only reinforced when the interviewer revealed the 2014 logo was crowdsourced.
The footprints were also the red ribbons of HIV/AIDS, which I think is brilliant. So I really love this  logo actually. I love the colours, I love the graphics; I love everything about this one (Conference attendee, male, age 39 years).
Well I actually didn’t like it [2012 logo], it was more like bars. You need to understand, my other ministry is prison… and thought why are we dealing with all those bars, all those crosses. I didn’t get why we had blue and grey. I mean actually there needed to be a contrasting colour within it. (Conference attendee, female, age 60 years)
Most attendees (11/12) felt the 2014 logo was well designed, integrated the HIV ribbon in a unique manner, captured the local Australian flavor, was simple and yet had a multilayered meaning. Table 3 outlines participants’ positive comments about the 2014 logo. Although most feedback on the logo was positive, 3 people felt the 2014 logo was too Australia-centric for a world conference, the design was too complex, and it did not use the archetypal red for the HIV ribbon.
Although there were some positive comments about the 2012 (design company) logo including that it contained the archetypal AIDS ribbon and looked ‘a bit more professional… finished’ (Conference attendee, male, age 37), most participants (11/12) preferred the 2014 logo as they felt the 2012 logo did not capture the conference theme well (Turning the Tide), did not cause any ‘reaction to it at all’ (Conference attendee, male, age 54), was not creative in incorporating any deeper meanings and the colours chosen for the logo were ‘meaningless’ (Conference organizer, female, age 43).
Overall, participants felt there were many benefits to a crowdsourced logo contest including creating a logo which resonates with a variety of audiences, increases community involvement and has positive effects on the contest contributors (Table 4). One contest contributor encapsulated these themes well when he stated:
…This contest brings about a lot of ideas, a lot of opinions to choose from so it benefits the organizers, it benefits the person who won, it benefits the community as a whole, it benefits the work being done on HIV/AIDS (male, age 28).
Contest contributors expressed a variety of reasons for submitting their logo design with most (5/7) stating the prize or being recognized for the work was not the motivating factor for submitting their design. Instead, they were motivated by non-financial reasons, including contributing to the fight against HIV, ‘gets you to step outside of the box that you’re used to’ (Contest contributor, male, age 28) and being a natural extension from what they were already doing: ‘…it’s my hobby. It’s something I like to do’(Contest contributor, male, age 27). Most contest contributors (5/7) reported continuing in HIV work in some capacity two years after the contest.
As many contributors were from low and middle income countries, some contest contributors felt they were disadvantaged in terms of the resources available to them and opportunities to hear about the contest.
It’s much easier for somebody who has a computer, who knows about graphic design—it’s much easier for them to go and do some things over somebody who basically only have their pen and paper (Contest contributor, male, age 28).
I think for a country like Papua New Guinea, internet is not always accessible so a lot of people will not get the information about the contest and when they want to submit too then a lot of people are not computer literate so this will be the disadvantage (Contest contributor, age 33, female).
Overall, while all participants agreed that the logo contest should continue, a number of areas for improvement were suggested including wider promotion of the contest to encourage broader participation, greater transparency in the selection process and a different prize structure which acknowledges the contribution of more contestants (Table 5).
This study provides an example of how crowdsourcing could be used within a sexual health context. It confirmed that the International AIDS Conference logo contest was a powerful way to engage communities. Our data extends previous research by evaluating the impact of a logo contest, examining how the contest contributed to engagement. The AIDS 2014 crowdsourced logo contest benefitted: (1) the conference organizers by engaging the community to spur creative ideas, (2) conference attendees who felt the contest had produced a more engaging and meaningful logo, and (3) contest contributors who felt empowered to participate in the HIV response. All participants were highly supportive of the ongoing use of the logo contest, suggesting a number of ways the contest could be improved for the future. These findings should be confirmed in quantitative surveys of future conferences using creative contributory contests.
The IAS effectively harnessed the collective wisdom of the crowds through the logo contest. Surowiecki proposes that groups are remarkably intelligent, and are often smarter than the smartest people in them.8 He noted that diversity of thought and independence are essential ingredients for leading to the best collective decisions. Indeed, the logo contest created diversity of thought and independence by recruiting young people from around the world. This is consistent with other global literature demonstrating that “bottoms up” methods like crowdsourcing, may be increasingly important as it is a cost-effective means to generate creative, new ideas.6,15 In contrast, “top down” approaches may not be as effective due to lack of community engagement and cost issues.16 Through this study, we found that the logo contest engaged the community by harnessing the creative participation of “nonexperts” who would not otherwise be involved in an international conference. This empowered the contest winner and other contributors because they felt they were contributing toward the fight against HIV in their own way. This deeper community engagement is consistent with the historically strong focus of community oriented HIV programs and research.2
Although the crowdsourcing logo contest was linked to many benefits, we identified several ways to improve future contest development. These included wider promotion of the contest to encourage broader participation, greater transparency in the selection process and a different prize structure which acknowledges the contribution of more contestants. These suggestions are consistent with other literature regarding creative contributory contests in health6 and other settings.8 For instance, having more than one single prize may encourage broader participation. Prizes need not be financial and may be as simple as a certificate of participation from IAS or displaying logos on the conference website. A recent contest ran by World Health Organization’s Global Hepatitis Programme and the Social Entrepreneurship for Sexual Health to identify innovative examples of hepatitis testing gave commendations to nearly half of those who contributed.17 Indeed, our study revealed that financial reward was not the major motivator for contest participation, but there were elements of interest in the contest itself or interest was driven by prosocial motivations. This is consistent with other research demonstrating the importance of creating the right environments to spur creativity or greater involvement18; and harnessing intrinsic motivations of contributors that may be based on enjoyment or desire to contribute back to society.9 The advantage of altering the current prize structure is that increased acknowledgement may lead to a greater number of contest contributors benefitting from the contest experience, thereby multiplying the effect of the empowerment.
Our findings must be considered in light of some limitations. An individual's preference for a creative piece like a logo is often subjective, but we were able to deconstruct the features of the logo and the contest that led to their reasoning for preference. It may be possible that those who were impacted by the logo were more likely to participate in this study, thereby producing a skewed group of respondents. In stating this, we interviewed a diverse group of people until data saturation was reached. The response rate from contest contributors was low despite a series of three emails to contest contributors. This may be due to lack of interest in contributing to the research two years after the contest and/or email addresess were no longer in use. Therefore, our results from contest contributors’ experience may not be representative for all contest contributors. Further, for those who responded, it may be possible that there was a bias towards those who spoke English fluently or had a strong opinion about the logo contest. Because English was not the first language of many of the contest contributors, there were difficulties in communication beyond simple questions for some participants. Further, as the interview was held nearly two years since the contest was completed, there may be a risk of recall bias. However, an advantage may have been the opportunity for contest contributors to reflect and describe the impact of the contest on their lives since the contest. Due to pragmatic reasons (e.g. international or interstate participants), 18 of 22 interviews were conducted through Skype or a phone call. While this limited the interviewer’s ability to assess non-verbal communication and may have impacted on participants responses, the subject matter did not involve sensitive issues, rapport was quickly achieved by the interviewer and no significant differences in data quality or results by mode of interview were noted.
Although this contest focused on using crowdsourcing to develop a logo for an HIV conference, this finding has several implications for STD researchers. First, the process of crowdsourcing could be used to develop logos for regional or international STD conferences. Logos are a powerful means for people to identify and associate with a trustworthy organization, and has even been demonstrated to improve institutional performance.19,20 Previous STD conferences have unique conference logos21 but none have utilized contests to develop these logos. Crowdsourcing may be less expensive and more strongly rooted in the local host community. Second, crowdsourcing could be used to develop a logo for an STD research project or program. Logos have been effectively used to create brand recognition for a variety of sexual health projects.22 Third, sexual health campaigns that originated from community based organizations have reported objective impact to increase health-seeking behaviors, STD testing and HIV/STD knowledge in men who have sex with men in Australia.3 In recent years, there is increasing evidence demonstrating how crowdsourcing methods such as hackathons and innovation contests may also be used for more substantial outcome deliverables (promotional videos or educational images, full campaigns, spurring medical innovation).6,7,23 In circumstances where community engagement is crucial for reducing stigma and discrimination, which is often the case for sexual health promotion, the adaptation of an innovation contest to promote key messages can be effective because people are familiar with contests in other settings. Moreover, innovation contests can generate cost-effective solutions for intervention treatments with quick turn-around times.
This study provides an example of how crowdsourcing, through conducting a logo contest, may be used within a sexual health context to effectively engage with communities. Beyond the creation of a conference logo, it produced ancillary benefits for conference organizers, conference attendees and contest contributors. Crowdsourcing methods could be considered for other sexual health interventions where community engagement is important.
Box 1 Story of the winner
The winner was a 21-year-old Tanzanian semiprofessional graphics designer. He started to learn how to draw in 1999, and was part of a drawing school for 10 years before the contest. After his aunty passed away from HIV, he was motivated to “just do anything with what I can to make sure I omit HIV in this world.” He was made aware of the contest through a US work colleague who attended the previous IAS conference in 2012. He was not motivated by the prize—“It's not the reason for me to [participate]… but the reason was to make something for the world, to make something for the other people and to change the community.” To design the logo, he researched the “relationship between the Australian people and the other people about the HIV and AIDS and the culture for Aborigines and other peoples in Australia.” His design included three human footprints that symbolized the steps forward being made in advancing the scientific, medical and social understanding of HIV/AIDS. In addition, every footprint illustrated the individual journeys people take once they are living with HIV. Although these journeys are individual, the logo also depicted a collective journey by all to overcome the HIV epidemic. The different sized footprints also represent how people of all ages are affected by HIV. With this in mind, they are all headed toward the same purpose: to end the HIV epidemic with nobody left behind.
The immediate impact of becoming the winner was that “people they want to work with me…I’ve been working more than the past.” However, this impact was not as large as he hoped: “when I came back in Tanzania I start to work with the people living with HIV in Tanzania. The impact was not too big… even though when I came back in Tanzania there’s no anybody to tell about my winning… When I was in Melbourne there was one [person who] said that they come to provide the community and to show my speech to the community but… when I came in Tanzania there’s not anybody want me to talk about this issues and no any TV or media wants to talk about this issue. So I was alone. As I go and as I back it's the same.” He reported that the main increase in work was not related to HIV. Although the local community impact was not large, there was a deep personal impact: “it increased my momentum to make more works for HIV because for example… I was trying to make a comic especially for changing the community in Tanzania about HIV, to increase the education of new issues to the HIV.” Through the logo contest, his life purpose had been strengthened: “I'm just going to change the community for anything anywhere…I have more interest to make sure that I’m just doing anything for HIV.”
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