By Joe Arney

Deepfakes. Distrust. Data manipulation. Is it any wonder American democracy feels like it has reached such a dangerous tipping point?  

As our public squares have emptied of reasoned discussion, and our social media feeds have filled with vitriol, viciousness and villainy, we’ve found ourselves increasingly isolated and unable to escape our echo chambers. And while it’s easy to blame social media, adtech platforms or the news, it’s the way these forces overlap and feed off each other that’s put us in this mess.

It’s an important problem to confront as we close in on a consequential election, but the issue is bigger than just what happens this November, or whether you identify with one party or another. Fortunately, the College of Media, Communication and Information was designed for just these kinds of challenges, where a multidisciplinary approach is needed to frame, address and solve increasingly complex problems. 

“Democracy is not just about what happens in this election,” said Nathan Schneider, an assistant professor of media studies and an expert in the design and governance of the internet. “It’s a much longer story, and through all the threats we’ve seen, I’ve taken hope from focusing my attention on advancing democracy, rather than just defending it.”

We spoke to Schneider and other CMCI experts in journalism, information science, media studies, advertising and communication to understand the scope of the challenges. And we asked one big question of each in order to help us make sense of this moment in history, understand how we got here and—maybe—find some faith in the future.  

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Newsrooms have been decimated. The younger generation doesn’t closely follow the news. Attention spans have withered in the TikTok age. Can we count on journalism to serve its Fourth Estate function and deliver fair, accurate coverage of the election?

Mike McDevitt, a former editorial writer and reporter, isn’t convinced the press has learned its lessons from the 2016 cycle, when outlets chased ratings and the appearance of impartiality over a commitment to craft that might have painted more accurate portraits of both candidates. High-quality reporting, he said, may mean less focus on finding scoops and more time sharing resources to chase impactful stories.

How can journalism be better?

“A lot of journalists might disagree with me, but I think news media should be less competitive among each other and find ways to collaborate, especially with the industry gutted. And the news can’t lose sight of what’s important by chasing clickable stories. Covering chaos and conflict is tempting, but journalism’s interests in this respect do not always align with the security of democracy. While threats to democracy are real, amplifying chaos is not how news media should operate during an era of democratic backsliding.”  

***

After the 2016 election, Brian C. Keegan was searching for ways to use his interests in the computer and social sciences in service of democracy. That’s driven his expertise in public-interest data science—how to make closed data more accessible to voters, journalists, activists and researchers. He looks at how campaigns can more effectively engage voters, understand important issues and form policies that address community needs. 

You’ve called the 2012 election an “end of history” moment. Can you explain that in the context of what’s happening in 2024?

“In 2012, we were coming out of the Arab Spring, and everyone was optimistic about social media. The idea that it could be a tool for bots and state information operations to influence elections would have seemed like science fiction. Twelve years later, we’ve finally learned these platforms are not neutral, have real risk and can be manipulated. And now, two years into the large language model moment, people are saying these are just neutral tools that can only be a force for good. That argument is already falling apart.

 The U.S. news media has blood on its hands from 2016. It will go down as one of the worst moments in the history of American journalism.”

  Mike McDevitt
  Professor, journalism

“You could actually roll the clock back even further, to the 1960s and ’70s, when people were thinking about Silent Spring and Unsafe at Any Speed, and recognizing there are all these environmental, regulatory, economic and social things all connected through this lens of the environment. Like any computing system, when it comes to data, if you have garbage in, you get garbage out. The bias and misinformation we put into these A.I. systems are polluting our information ecosystem in ways that journalists, activists, researchers and others aren’t equipped to handle.”  

***

One of Angie Chuang’s last news jobs was covering race and ethnicity for The Oregonian. In the early 2000s, it wasn’t always easy to find answers to questions about race in a mostly white newsroom. Conferences like those put on by the Asian American Journalists Association “were times of revitalization for me,” she said.  When this year’s conference of the National Association of Black Journalists was disrupted by racist attacks against Kamala Harris, Chuang’s first thoughts were for the attendees who lost the opportunity to learn from one another and find the support she did as a cub reporter.

“What’s lost in this discussion is the entire event shifted to this focus on Donald Trump and the internal conflict in the organization, and I’m certain that as a result, journalists and students who went lost out on some of that solidarity,” she said. And it fits a larger pattern of outspoken newsmakers inserting themselves into the news to claim the spotlight. 

 I think 2024 will be the first, and last, 
A.I. election.”

  
Brian C. Keegan
Assistant professor, information science

How can journalism avoid being hijacked by the people it covers?

“It comes down to context. We need to train reporters to take a breath and not just focus on being the first out there. And I know that’s really hard, because the rewards for being first and getting those clicks ahead of the crowd are well established.”  

***

Agenda setting—the concept that we take our cues of what’s important from the news—is as old an idea as mass media itself, but Chris Vargo is drawing interesting conclusions from studying the practice in the digital age. Worth watching, he and other CMCI researchers said, are countermedia entities, which undermine the depictions of reality found in the mainstream press through hyper-partisan content and the use of mis- and disinformation.

How did we get into these silos, and how do we get out?

“The absence of traditional gatekeepers has helped people create identities around the issues they choose to believe in. Real-world cues do tell us a little about what we find important—a lot of people had to get COVID to know it was bad—but we now choose media in order to form a community. The ability to self-select what you want to listen to and believe in is a terrifying story, because selecting media based on what makes us feel most comfortable, that tells us what we want to hear, flies in the face of actual news reporting and journalistic integrity.”  

“I can’t blame the reporters who feel these moments are worth covering, because I feel as conflicted as they do.   
Angie Chuang
Associate professor, journalism

“I do worry about our institutions. I don’t like that a majority of Americans don’t trust CNN. 
Chris Vargo
Associate professor, advertising, 
public relations and media design

***

Her research into deepfakes has validated what Sandra Ristovska has known for a long time: For as long as we’ve had visual technologies, we’ve had the ability to manipulate them.  Seeing pornographic images of Taylor Swift on social media or getting robocalls from Joe Biden telling voters to stay home—content created by generative artificial intelligence—is a reminder that the scale of the problem is unprecedented. But Ristovska’s work has found examples of fake photos from the dawn of the 20th century supposedly showing, for example, damage from catastrophic tornadoes that never happened. 

Ristovska grew up amid the Yugoslav Wars; her interest in becoming a documentary filmmaker was in part shaped by seeing how photos and videos from the brutal fighting and genocide were manipulated for political and legal means. It taught her to be a skeptic when it comes to what she sees shared online. 

“So, you see the Taylor Swift video—it seems out of character for her public persona. Or the president—why would he say something like that?” she said. “Instead of just hitting the share button, we should train ourselves to go online and fact check it—to be more engaged.”  

Even when we believe something is fake, if it aligns with our worldview, we are likely to accept it as reality. Knowing that, how do we combat deepfakes?

“We need to go old school. We’ve lost sight of the collective good, and you solve that by building opportunities to come together as communities and have discussions. We’re gentler and more tolerant of each other when we’re face-to-face. This has always been true, but it’s becoming even more true today, because we have more incentives to be isolated than ever.”   

***

Early scholarly works waxed poetic on the internet’s potential, through its ability to connect people and share information, to defeat autocracy. But, Nathan Schneider has argued, the internet is actually organized as a series of little autocracies—where users are subject to the whims of moderators and whoever owns the servers—effectively meaning you must work against the defaults to be truly democratic. He suggests living with these systems is contributing to the global rise of authoritarianism. In a new book, Governable Spaces, Schneider calls for redesigning social media with everyday democracy in mind.

If the internet enables autocracy, what can we do to fix it?

“We could design our networks for collective ownership, rather than the assumption that every service is a top-down fiefdom. And we could think about democracy as a tool for solving problems, like conflict among users. Polarizing outcomes, like so-called cancel culture, emerge because people don’t have better options for addressing harm. A democratic society needs public squares designed for democratic processes and practices.”  

***

It may be derided as dull, but the public meeting is a bedrock of American democracy. It has also changed drastically as fringe groups have seized these spaces to give misinformation a megaphone, ban books and take up other undemocratic causes. Leah Sprain researches how specific communication practices facilitate and inhibit democratic action. She works as a facilitator with several groups, including the League of Women Voters and Restore the Balance, to ensure events like candidate forums embrace difficult issues while remaining nonpartisan.

What’s a story we’re not telling about voters ahead of the election?

“We should be looking more at college towns, because town-gown divides are real and long-standing. There’s a politics of resentment even in a place like Boulder, where you have people who say, ‘We know so much about these issues, we shouldn’t let students vote on them’—to the point where providing pizza to encourage voter turnout becomes this major controversy. Giving young people access to be involved, making them feel empowered to make a difference and be heard—these are good things.”   

***

Toby Hopp studies the news media and digital content providers with an eye to how our interactions with media shape conversations in the public sphere.

Much of that is changing as trust and engagement with mainstream news sources declines. He’s studied whether showing critical-thinking prompts alongside shared posts—requiring users to consider the messages as well as the structure of the platform itself—may be better than relying on top-down content moderation from tech companies.   

Ultimately, the existing business model of the big social media companies—packaging users to be sold to advertisers—may be the most limiting feature when it comes to reform. Hopp said he doubts a business the size of Meta can pivot from its model.

How does social media rehabilitate itself to become more trusted? Can it?

“Social media platforms are driven by monopolistic impulses, and there’s not a lot of effort put into changing established strategies when you’re the only business in town. The development of new platforms might offer a wider breadth of platform choice—which might limit the spread of misinformation on a Facebook or Twitter due to the diminished reach of any single platform.”   

***

 Images have always required us to be more engaged. Now, with the speed of disinformation, we need to do a little more work.” 
Sandra Ristovska
Assistant professor, media studies

CU News Corps was created to simulate a real-world newsroom that allows journalism students to do the kind of long-form, investigative pieces that are in such short supply at a time of social media hot takes and pundits trading talking points.  

“I thought we should design the course you’d most want to take if you were a journalism major,” said Chuck Plunkett, director of the capstone course and an experienced reporter. Having a mandate to do investigative journalism “means we can challenge our students to dig in and do meaningful work, to expose them to other kinds of people or ideas that aren’t on their radar.” 

Over the course of a semester, the students work under the guidance of reporters and editors at partner media companies to produce long-form multimedia stories that are shared on the News Corps website and, often, are picked up by those same publications, giving the students invaluable clips for their job searches while supporting resource-strapped newsrooms. 

With the news business facing such a challenging future, both economically and politically, why should students study journalism?

“Even before the great contraction of news, the figure I had in my mind was five years after students graduate, maybe 25 percent of them were still in professional newsrooms. But journalism is a tremendous major because you learn to think critically, research deeply and efficiently, interact with other people, process enormous amounts of information, and have excellent communication skills. Every profession needs people with those skills.”

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William W. White Outstanding Seniors are chosen by department faculty to recognize academic merit, professional achievement and service to the college. The Outstanding Graduate award honors the CMCI student with the highest overall GPA in his or her graduating class.

White, a Boulder native, graduated from CU’s School of Journalism in 1933. He was a reporter in Boulder, Denver and New York before becoming the foreign editor of Time from the early 1940s through the mid-1950s, based in London, Brazil and Montreal. At the advice of his friend Edward R. Murrow, who told him “it doesn’t matter what you do, what matters is that you do it where you want to live,” White returned to Boulder, where he started the White and White public relations firm. White and his wife, Connie, established this endowment in 1998.

Meet our graduates and read their stories.

Andrew Schwartz: College of Media, Communication and Information

Andrew's advice to students is to try everything and talk to as many people as you can—especially outside your major. That way, you'll broaden your perspective.

   When it comes to impact and being able to make something I’m proud of, a big part of that is being able to make technology for the people to use it, and make things that people enjoy using and improve their lives. Info places a big emphasis on that."

  Read more 

Lisa An: Department of Critical Media Practice

Lisa started her CU career as a computer science major before switching to media production. She said this was one of the best decisions she ever made because through the program, she discovered a passion for photography.

  "I learned that keeping your work to yourself because of the fear of not being good enough does no good. If you share your work and receive feedback, you are able to improve your craft and obtain opportunities you otherwise never would have been able to.

  Read more 

Elijah Boykoff: Department of Information Science

Going into college, Elijah's goals for himself were to learn as much as he could and make it to the finish line. He says he's made good on those goals, and this award is an exciting bonus.

   Your professors are people just like you. Get to know them—if you are able to resonate with your professors on a deeper level, you will be much more enriched by the knowledge they have to share."

  Read more 

Bianca Perez: Departments of Communication, Media Studies

Bianca is the first CMCI graduate to win outstanding student honors from two different majors. She's now off to a prestigious Ph.D. program.

  "What I have is like a wish coming true. You can work very hard and that can still not be enough, and I’ve seen that happen to people around me my whole life.

  Read more 

Sujei Perla Martinez: Department of Advertising, Public Relations and Media Design

For Sujei, a first-generation college student, graduating means she's carving a new path for her family.

   My community helped foster a place for self-discovery and encouraged me to be unapologetically myself while helping me grow within my values and beliefs."

  Read more 

Nic Tamayo: Department of Journalism

Nic's CMCI experience in three words: fulfilling, inspired, treasured.

  "I will take with me the connections I’ve been able to make with people from so many corners of life. They’ve taught me lessons that I may never have learned without their friendship and mentorship.

  Read more 

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By Iris Serrano
Photos by Kimberly Coffin (CritMedia, StratComm’18)

Sujei Perla Martinez was determined to take charge of her college career in the same way she takes charge of being a role model for her younger brother.

“Before college, I thought I had everything figured out since I’m the eldest sister. That couldn’t be further from the truth,” Perla Martinez said. “Over the years, I learned a lot about myself as I overcame many obstacles.”

  “My community helped foster a place for self-discovery and encouraged me to be unapologetically myself while helping me grow within my values and beliefs.”
Sujei Perla Martinez

And she did so in style: She’s graduating as the William W. White Outstanding Senior for the Department of Advertising, Public Relations and Media Design, having completed a degree in strategic communication with an emphasis in media design. The White awards are chosen by CMCI faculty and honor students for their academic accomplishments, professional achievements and service to the college.

Perla Martinez said when it came to overcoming those obstacles, the community she built at CMCI was key, especially the people she met through her countless volunteering experiences and her classes. 

Most important was her multicultural leadership scholars cohort, the Sigma Lambda Gamma sorority, and the UMAS y MECHA student group, as well as the classroom.

“My community helped foster a place for self-discovery and encouraged me to be unapologetically myself while helping me grow within my values and beliefs,” Perla Martinez said. 

Her academic and extracurricular achievements were not just due to her hard work. She said she recognizes the efforts of those who came before her who fought for her right to an education—in particular, her parents.

“Growing up, I saw my mother work hard jobs to raise my brother and me,” Perla Martinez said. “Every day, I stand on campus and try my hardest to show my mother that her sacrifice wasn't in vain.”

“I’m the first in my family to get a degree. It took a lot of blood, sweat and tears, but I can finally say we did it.”

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CMCI students from all departments develop their portfolios through classes, competitions, internships and more.

Here we have collected a variety of student work that highlights their personal and professional passions explored during their academic careers at CU Boulder.

  View the work

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By Hannah Stewart (Comm’19)
Photos by Kimberly Coffin (CritMedia, StratComm’18)

When Pepsi eventually comes out with its snack-focused campaign, one strategic communication student from the University of Colorado Boulder will smile knowing he was part of it.

Enzo Ewari, a senior in the College of Media Communication and Information, has been interning with Motive—a full-service marketing and advertising agency—since the summer. As part of his work, he assisted with campaigns for brands like Gatorade, Cheetos, Pepsi and more. 

Motive was impressed enough with his work to extend his internship into the fall semester, and Ewari hopes to stay at the company after graduation.

“As I get more involved, I’ll be working on my own campaigns, so hopefully by springtime, I’ll be solely working on one campaign,” he said. “I love Motive, it’s a great culture. They have sister agencies on every continent; I’ve been talking about moving to New York or Singapore. There are a lot of opportunities.”

In high school, Ewari took a business class, and was instantly hooked by the fast-paced energy and possibilities it provided. However, he wanted something more creative, which led him to study advertising. In fact, one of his professors reached out with the opportunity to intern with his own advertising and marketing boutique and assist on a campaign for a whiskey company—just one of his internship experiences, which have included work for PHD Media, Special Olympics International and Volkswagen.

  “CMCI is your friend. Just talk to your professors, most of them are still doing work. That helped me get this internship.
—Enzo Ewari

When it came to Motive, not only did Ewari’s foundational courses prove incredibly helpful on his internship, various hands-on experiences both in and out of the classroom helped him grow and develop skills, as well. 

“Enzo has proven to a valuable member of our team because he's resourceful, a self-starter, a quick learner, and also a curious human,” said Andrew Lynch, vice president of strategy at Motive and Ewari’s supervisor. “He's doing real, meaningful work that is helping us arrive at smart and sharp strategies.”

That practical experience and networking opportunity was pivotal, as it helped boost Ewari’s confidence in the field by giving him a taste of real-life advertising.

“CMCI is your friend. Just talk to your professors, most of them are still doing work,” he said. “That helped me get this internship.”

Networking and access to the right people proved useful once again in landing his role at Motive. David Martinez, inclusive excellence and outreach coordinator at CMCI, connected Ewari with one of Motive’s senior vice presidents of creative, Spencer Trierweiler (Advert’06), who is based out of the company’s Denver office.

“He helped push me through the process,” Ewari said. “A lot of my team is spread out across the United States. Day to day, it was a lot of looking at trends of different industries and deciding what competitors are doing to find a pocket in the market that our clients can hold.”

During his hybrid internship, he has been responsible for market research, taking what he’s learned and creating presentations exploring different advertising strategies a brand could take. Depending on who attended the presentation, Ewari and his team emphasize strategic or creative elements of a given campaign. For example, some creative-focused campaign proposals had interactive elements like pop-up shops or meet-and-greets with professional athletes.

“It’s all about connecting the data—how can you find that new lightbulb idea?” he said. 

Lynch said an ability to find those ideas made Ewari such a valuable addition, especially when it came to brand positioning statements in competitive analyses. 

"Enzo has been leading these analyses throughout his internship, and always delivers focused and smart category insights that we work into our strategy decks," Lynch said.

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By Hannah Stewart (Comm’19)
Photos by Jack Moody

The Olympics. The Super Bowl. The Final Four. The Stanley Cup Final. 

Alumni from the University of Colorado Boulder have made their mark reporting on and working in the sports world. Many are award winners—including National Sportswriter of the Year—and many more have seen their love of the game reach millions of fans worldwide.

That track record of excellence led the College of Media, Communication and Information to develop its sports media minor, which prepares students for careers in sports, whether behind the scenes or in front of the camera. Students take classes covering traditional topics, such as writing and broadcasting, but also courses that look at sports from academic and business perspectives. 

And while a signature feature of the program is the opportunity to connect with the world-class alumni network in sports, there’s much more to the minor.

“Networking is just one of the components,” said Marina Dmukhovskaya, associate director of the sports media minor. “It’s also about finding their niche. By having a variety of classes, both conceptual and skills heavy, it can offer them a great choice.”

Interested in this minor?

If you are a CMCI major, you may discuss and declare the minor with your CMCI advisor. You can also declare by filling out a .

For students outside of CMCI, the minor can only be declared once you’re enrolled in CMCI 2001: Intro to Sports Media Practices. 

Senior Kennedy Pickering credited the minor with helping her discover her niche. She came to CU Boulder because she was interested in the relationship between people and social media. Thanks to the minor, she has had the opportunity to create replay packages for a CU volleyball game; develop technical skills, like working a camera; and network with media professionals when CU Athletics hosted Fox’s Big Noon Kickoff pregame show.

“With the sports media minor, I’ve been able to take classes that gave me more hands-on experience, like Sports Writing and Sport Broadcasting,” Pickering said. “One of my professors is in charge of , and through him I’ve been able to work with the camera. At first, I wanted to be a sideline reporter, but then I realized that being on the screen was not for me.” Her goal now is to work in social media for the NFL or Nike.

Community through sport

More than 200 CU Boulder students are currently enrolled in the minor. Not all are athletes, but most aspire to work in the industry, like Eli Grimm, a lifelong figure skater who wants to get into the sports communications field. Beyond their own interests in athletics, Grimm said they see sports as a way to create impact because so many people engage with sports. Even less-mainstream events like Formula 1 races have become more popular thanks, in part, to the Netflix series Drive to Survive.

“Sports are a platform for mass communication. In the Sports Writing class, I got to write about the events I was already watching,” said Grimm, a senior majoring in strategic communication who learned about the program after arriving at CU Boulder as a transfer student. “It was nice to feel like the experience was personalized around my interests.”

  “With the sports media minor, I’ve been able to take classes that gave me more hands-on experience.”
Kennedy Pickering, senior

Jacob Dilling, a junior studying communication and a member of the CU ski team, chose the sports media minor as a way to develop a fuller perspective of the industry.

“I still plan on skiing professionally after school. But I think this will help me build connections within my sport and other sports, so that once I’m finished, I have something to fall back on,” Dilling said.

Both students said one thing they enjoy most about the program is the challenge to explore new perspectives on sports and topics they are passionate about. Dmukhovskaya said that enthusiasm is a good indicator of their success after graduation. She herself has worked in the sports media world for years—in addition to covering the Olympics four times, she has been a media manager for the Russian Skating Union, worked with the International Biathlon Union and wrote for the International Paralympics Committee.

“Our students feel equipped, competent and confident as they are entering the job market,” she said. Just as important to their success, though, is the students’ enthusiasm for the course material—key for aspiring professionals looking to enter a highly competitive field.

Those aspiring professionals also benefit from the extensive network of media experts, who offer mentorship and exposure to career opportunities. Winter graduate Cassidy Davis (StratComm’23) said she found professional guidance from alumnus Mike Davies (Jour’94), an executive vice president for Fox Sports based in Los Angeles.

“The best part of my time at CU has been getting such broad experience, including public relations, sports media and graphic design,” Davis said. “Being able to study all of my little niches and learning how to put them together has made me confident about applying what I’ve learned at work.”

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What's the catch?

There’s no getting back the one that got away, but a prototype app designed by a group of recent graduates could help anglers identify the fish they do catch.

COAI (for Colorado A.I.; pronounced “koi”) Fish, designed by Kendall Fronabarger, Ken Vue and Emerson Swan (all InfoSci’23), is especially aimed at those new to the sport who are curious about the fish they’re catching in Colorado’s waters. The app uses a modified machine learning tool that matches photos uploaded by users to a registry of Colorado species built by the students.

Art as activism

CMCI students are encouraged to use their creativity in building projects that allow them to interpret or reflect upon the challenges facing society. Mixed-media work in the last year has focused on topics such as the climate crisis, the plight of refugees and the struggle for gender equality.

Jamie Chihuan (StratComm’23),
“Soon we will all have nowhere to go” 

Citlally Ruedas, strategic communication,
“Homero Gomez” 

Isabella Pao, strategic communication,
“I am a woman, I exist” 

Pablo Aziz, critical media practices,
“Women demand peace and justice”

Sharing student perspectives

Students across CMCI find ways to bring together their personal interests and academic pursuits. Since the college’s founding, we have regularly showcased this diverse collection of student work.

McKenzie Jenkins (StratComm’22), Josh Harman (StratComm’23)

Katya Bollong (StratComm’23)

Hailey Schalk, communication

Olivia Lieberman (CritMedia’23)

Sophie Gould, TEDxCU executive board (Comm’23)

Noya Kinsland, critical media practices

Kelsie Kerr (MediaSt, Film’23)

Kara Wagenknecht (Jour’23)

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CMCI was founded amid change—an answer to how we could best organize the various communication- and information-related disciplines at CU Boulder in ways that enabled faculty collaboration and student success. We’re no stranger to disruption, so as generative A.I. tools like ChatGPT captured the public imagination early this year, I started wondering what the next chapter for communication—and education—might look like.

The dominant theme in the headlines has been one of concern, but as usual, I’ve found the best perspectives come from our alumni, students and faculty, who are on the front lines of change in these fast-moving times. In this issue, we asked members of our community for their reflections on change, and they shared insights on everything from A.I. and algorithms, to work and water.

If you find yourself overwhelmed by the enormity of the changes you’re facing, I hope you’ll find insight in this issue, which showcases how our community is researching the ways algorithms shape our worldview and the technology transforming how creative projects get done. It also offers a chance for you to reconnect with how our college is changing, including our new Washington, D.C., program.

Reading these stories helped me feel re-energized about the direction of our college and the ways our community is poised to lead through change. I may not have a crystal ball, but I’m confident that CMCI will continue to be a place where new ideas and tools are celebrated, not feared, and where possibility is embraced. I’m excited to be part of this community and to see where we go from here. And change is exciting—just look at the energy and attention Coach Prime has brought to the Buffs!

What about you? I’d love to hear your thoughts on CMCI and its future. Drop me a line or come say hello next time you’re in the Boulder area.

Lori Bergen, PhD
Founding Dean
College of Media, Communication and Information

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By Lisa Marshall (Jour, PolSci’94; MJour’22)

“Noticing a huge difference in my belly fat. It’s melting away!”

“Wildly happy after losing 70 pounds!”

“Just took my first dose. I’m nervous, but excited!”

In late 2022, TikTok was abuzz with such endorsements, delivered by hopeful dieters clutching blue syringes loaded with the diabetes drug-turned-celebrity “weight-loss miracle” Ozempic. The hashtag #Ozempic swiftly drew more than 1 billion views.

But as the craze went viral, diabetics worldwide faced dangerous shortages. Meanwhile, those using it off-label for its slimming qualities began reporting serious side effects, such as violent diarrhea and extreme facial thinning.

“This is a great example of the power of social media—and the unintended consequences,” said Erin Willis, associate professor of advertising, public relations and media design, and one of the few scholars studying a new kind of social media star—the patient influencer.

Her research has shown they often work closely with pharmaceutical companies, or are paid by them, and frequently offer advice about drugs even though they tend to lack medical expertise.

Ozempic is the most recent example of their power, but the phenomenon dates at least to 2015, when Kim Kardashian drew flack for endorsing a morning sickness drug, Diclegis, on Instagram without mentioning its many side effects. Federal regulators warned the drugmaker, the ad was taken down, and the government implemented new disclosure rules for influencers.

Eight years later, the phenomenon has continued to grow, bleeding into new platforms—like support groups for patients with specific medical conditions—where rules are open to interpretation and nearly impossible to enforce. That’s a concern for Willis: “There is virtually no research on this, and very little regulation.”

Willis has published some of the first academic papers exploring the patient influencer phenomenon, framing it as “the next frontier in direct-to-consumer pharmaceutical marketing.”

DTC marketing is the longstanding practice in the United States and New Zealand that allows drug companies to advertise to consumers, rather than through physicians. From a sales perspective, the practice is effective, according to Willis: About 44% of patients who ask their doctor for a drug they see on TV get it.

But, as always, when it comes to social media, there are plenty of unanswered questions. “The fact that patients with no medical training are broadly sharing drug information should alarm us,” she said.

In her work, Willis interviewed dozens of influencers to better understand their motivations. While the influencers she spoke to appeared to have good intentions, she said some might omit crucial information, such as the availability of a cheaper generic option, or unintentionally disseminate misinformation. And consumers might be unable to distinguish between a personal post and a paid endorsement.

That said, she does see some upsides. Patients often know more than their doctors about what it’s like to experience a specific health condition, and sharing their personal experiences on social media can be comforting for others, while potentially helping them discover new coping strategies.

And unlike other forms of DTC advertising, social media enables followers to weigh in with comments sharing both positive and negative experiences with a specific therapy.

Willis hopes her new research will ultimately lead to a set of best practices for both patient influencers and the companies they work with.

“There is both value and risk here,” she said. “Like anything, it has the potential to become dangerous if we’re not careful.”

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