Back in the late 1980s, Julie Downs was having the time of her life-exactly the rich cultural and intellectual experience an exchange student hopes to have. Downs, now a Carnegie Mellon social and decision sciences research professor, was a physical anthropology major from the University of California at Berkeley, spending a year in Nairobi, learning about physical evolution and working with the amazing collections at Kenya's National Museum. She had been fishing around for a big motivator in her life. Archaeology, she was finding, was awfully tempting.
It was an exciting time. Richard Leakey's team had just found a Proconsul bone. Downs had a part-time job at the museum, where she was getting to measure a tuberosity on the ischium-the curved bone forming the base of the hip bone-of different primates. She was getting so good at what she was learning that she could identify a tibia from a mere fragment of a bone.
But every day, as she walked from the university to the museum, she had to go past a sight that disturbed her deeply-crowds of children who were begging for food and money. Some were disfigured, and she heard stories about how this was done sometimes by parents to play on the heartstrings of tourists. It weighed on her.
She had seen homeless people before, of course, but it felt much more raw to see 5-year-old children on the street. She knew that if she gave them money, they would have to turn it over to a handler. But she could always give them food. So she made it a habit to pick up a bunch of rolls at the bakery as she was walking through town. She'd hand them out to the children, who would descend on her and eat what she gave them on the spot. The rolls were so inexpensive that, even though she was a college student and felt like she had little money, she could buy them without thinking about it. But for those children, the bread was something out of their reach.
"It was astonishing to see that level of poverty," she says. "I certainly couldn't solve the broader problem of poverty and begging, but I could very easily give food to these particular kids at this particular time. That was stunning to me: how many problems are out there that you could do at least something about. That was pretty eye-opening."
So eye-opening, in fact, that she rethought where she was headed. "I would think, 'Here I am walking by these real problems as I go to my kind of Ivory-Tower-question," she says. "It's still very fascinating, and I'm glad people are doing that, and I would have, I'm sure, enjoyed continuing to do that-but it's hard to pass by real problems."
At the end of her year abroad, Downs took some time off to think things over and work a bit before going back to college. When she returned, she changed her major to psychology, taking a psychology of justice course taught by a prominent decision scientist, Barbara Mellers. She found it exhilarating to, as she puts it, "look at fundamental psychological processes that underlie problems in the world."
Since then, Downs says she's been more interested in what she can do personally, more so than concentrating on the kind of basic research that contributes to the broader literature, which, she is quick to add, is important as well. "But I want to see the effects of what I do," she says. "It's kind of an unusual path in academics to focus on such applied work, but I find it very rewarding, so I'm willing to make that trade-off."
That's why she came to Carnegie Mellon. "There are a couple things that are unique about Carnegie Mellon," she says. "One is the interdisciplinary collaborations that they actively promote. I find that incredibly useful and valuable. And Carnegie Mellon is doing more applied work and valuing it more." Since Downs, director of the Center for Risk Perception and Communication, came to Carnegie Mellon initially as a post-doc, she's been working with people in her department, the medical school at Pitt, the public health school, and nursing school. Although much of her research tackles decision making on health issues ranging from risky sexual behavior to genetic counseling to vaccination, she also has taken on topics that examine contemporary issues such as media file sharing, phishing schemes, and financial literacy. "I'll work on any question," she says. "What they all have in common is some real direct application. We're solving a real problem. It's problem motivated rather than theory motivated."
Downs is on maternity break from Carnegie Mellon for a few months. When she comes back, she has a nice, juicy project to sink her teeth into. In November, the U.S. Department of Health and Human Services awarded her a whopping $7.4 million grant to create a video to reach teenage girls grappling with decisions about sexual behavior. It will be an update of a video she and her colleagues produced in 1998, titled What Could You Do? At the time, the interactive video showed real results in increasing abstinence and reducing sexually transmitted diseases. With teen pregnancy again on the rise and statistics showing nearly one in four girls ages 14 to 19 with a sexually transmitted infection, Downs is hoping to help reverse those trends. Here's how:
In one scene in Downs' original video, long-haired, dark-eyed Caitlin meets a scruffy but cute boy named Mark at a party. You can see the chemistry between the two teenagers immediately. The room is crowded, so when Caitlin sees someone vacate the sofa, she all but jumps over a coffee table to claim the seats for herself and her new friend. But the coziness of the couch and the party atmosphere encourage intimacy. Before you know it, Mark is sweetly kissing the side of Caitlin's neck. What happens next? That's up to the viewer.
Three scenarios are rolled out. In the first, Caitlin smiles at Mark and tells him it was nice. In the second, she coos, "Don't stop." In the third, she pushes him away gently and says, "Don't." Click on one of those scenarios and the interactive video quickly presents two or three more choices to follow. For instance, in the "Don't stop" selection, the characters continue to kiss until Mark suggests they go somewhere they can be alone. You can watch what happens when Caitlin agrees or when she tells him she's fine where she is. If you pick the first scenario, you watch Caitlin deal with the issue of protection. In one scene, she has a condom with her. In another, neither she nor Mark has one. In that case, she tells him nicely but firmly that if he doesn't have a condom, nothing is going to happen.
With an ensemble cast of three main characters made of up of Carnegie Mellon acting majors, the video manages to model a variety of situations adolescent girls might find themselves in. It gives them language to deal with uncomfortable situations, offers clear information about sexually transmitted diseases, and even teaches them how to use a condom correctly. Engaging and comfortable, it's a serious educational tool delivered via conversations among girlfriends rather than an adult-to-child discussion.
The video is infused with insights-gained by Downs and her colleagues from several universities-through interviews with sexually active teenage girls. Among other questions, the girls were asked to talk about the conditions under which they had sex that they might not have wanted. "We have all these lay theories about why adolescents engage in sexual behavior," Downs says. "But when you sit down and talk to teenagers, it's not necessarily what you would have expected. And that speaks to the need to do in-depth psychological research, finding out what's going on rather than just going in based on our intuition. We think we know what kids need, but without doing the research, we don't really know."
Baruch Fischhoff, head of the decision science major, calls Downs a model-applied scientist, committed to solving problems rather than advancing pet theories. "Try to figure out how it is people see the situation, give them credit for trying to lead their lives reasonably, and then offer some respectful kind of help," he says. "I think that's characteristic of everything that Julie does-taking people seriously, treating them respectfully, trying to help them run their own lives."
Downs expected the girls in the study to talk a lot about boys pressuring them or even about why someone would want to have sex. What they talked about instead were the social forces that led them down the road toward sex.
"They talked about, 'Well, there you are at this party, and, of course, you're going to have sex. That's what people do, that's what happens,'" says Downs. "We were hoping in that original research to identify different places where they were making a decision. And what we got was a lot of description about no decision at all. Here you are, and once you're started along this path, it's almost inevitable it will lead to sex. At least from the girls' perspective, neither the girl or the boy are deciding to have sex. It's just kind of happening. The way they talk about it is like it's a scripted situation."
Going into a restaurant is a good example of a scripted situation. "If you went into a restaurant, of course you're going to sit at a table, and of course you're going to look at a menu, and of course you're going to order food, and of course you're going to eat the food," she says. "You don't decide, well, maybe I won't pay the bill. It just happens. And that's very much the way they talked about sex happening."
What Downs did was tease out the places where decisions were happening, albeit by default, and dramatize them in the video. "We really hit them over the head," she says. "There's nothing subtle about this video. We say, 'What do you want to see Caitlin do? You might not have thought she could do something other than this, but she can. Here are some things she can do.' It's really saying, 'Let's make this into a choice."
Downs calls the video nontraditional. "A lot of interventions are classroom-based or small group-based where you have a facilitator who would be getting kids to engage in discussions and learn in that way. Those programs tend to be more effective. But they require a facilitator," she says. "That person would be trained. You'd have a curriculum to follow. Obviously if you want to scale that up nationwide you'd need a lot of facilitators, a lot of training, a lot of effort. Ours is kind of unique in that it's just a DVD that you stick into a DVD drive and play. Scaling that up just means burning another DVD."
The new grant will give Downs the opportunity to bring the video up to date, starting with the medical content. Thirteen years ago, for instance, a vaccine didn't exist for the human papillomavirus (HPV), which can cause genital warts and cervical cancer. Creatively, the new version will be shot in wide-screen, high-definition, ready for streaming on the Web, and look less like a health-class video and more like a mock-reality TV show along the lines of "The Office" and "Modern Family." She vows, though, that there won't be any dialogue mentioning Facebook or Twitter. She still cringes when one of the characters in the first video tells another she should get a pager. "How embarrassing," she says. "Like we couldn't see that was going to be dated within a year."
The message, however-that there are ways to take control of sexual situations and moving toward something safer-will stay the same. After all, you just don't mess with a good thing.
Sally Ann Flecker is an award-winning freelance writer. She is a regular contributor to this magazine.
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