To Make Science Engaging, We Need a Sesame Street for Adults
This article is part of the magazine, "The Future of Science In America: The Election Issue," co-published by LeapsMag, the Aspen Institute Science & Society Program, and GOOD.
In the mid-1960s, a documentary producer in New York City wondered if the addictive jingles, clever visuals, slogans, and repetition of television ads—the ones that were captivating young children of the time—could be harnessed for good. Over the course of three months, she interviewed educators, psychologists, and artists, and the result was a bonanza of ideas.
Perhaps a new TV show could teach children letters and numbers in short animated sequences? Perhaps adults and children could read together with puppets providing comic relief and prompting interaction from the audience? And because it would be broadcast through a device already in almost every home, perhaps this show could reach across socioeconomic divides and close an early education gap?
Soon after Joan Ganz Cooney shared her landmark report, "The Potential Uses of Television in Preschool Education," in 1966, she was prototyping show ideas, attracting funding from The Carnegie Corporation, The Ford Foundation, and The Corporation for Public Broadcasting, and co-founding the Children's Television Workshop with psychologist Lloyd Morrisett. And then, on November 10, 1969, informal learning was transformed forever with the premiere of Sesame Street on public television.
For its first season, Sesame Street won three Emmy Awards and a Peabody Award. Its star, Big Bird, landed on the cover of Time Magazine, which called the show "TV's gift to children." Fifty years later, it's hard to imagine an approach to informal preschool learning that isn't Sesame Street.
And that approach can be boiled down to one word: Entertainment.
Despite decades of evidence from Sesame Street—one of the most studied television shows of all time—and more research from social science, psychology, and media communications, we haven't yet taken Ganz Cooney's concepts to heart in educating adults. Adults have news programs and documentaries and educational YouTube channels, but no Sesame Street. So why don't we? Here's how we can design a new kind of television to make science engaging and accessible for a public that is all too often intimidated by it.
We have to start from the realization that America is a nation of high-school graduates. By the end of high school, students have decided to abandon science because they think it's too difficult, and as a nation, we've made it acceptable for any one of us to say "I'm not good at science" and offload thinking to the ones who might be. So, is it surprising that a large number of Americans are likely to believe in conspiracy theories like the 25% that believe the release of COVID-19 was planned, the one in ten who believe the Moon landing was a hoax, or the 30–40% that think the condensation trails of planes are actually nefarious chemtrails? If we're meeting people where they are, the aim can't be to get the audience from an A to an A+, but from an F to a D, and without judgment of where they are starting from.
There's also a natural compulsion for a well-meaning educator to fill a literacy gap with a barrage of information, but this is what I call "factsplaining," and we know it doesn't work. And worse, it can backfire. In one study from 2014, parents were provided with factual information about vaccine safety, and it was the group that was already the most averse to vaccines that uniquely became even more averse.
Why? Our social identities and cognitive biases are stubborn gatekeepers when it comes to processing new information. We filter ideas through pre-existing beliefs—our values, our religions, our political ideologies. Incongruent ideas are rejected. Congruent ideas, no matter how absurd, are allowed through. We hear what we want to hear, and then our brains justify the input by creating narratives that preserve our identities. Even when we have all the facts, we can use them to support any worldview.
But social science has revealed many mechanisms for hijacking these processes through narrative storytelling, and this can form the foundation of a new kind of educational television.
Could new television series establish the baseline narratives for novel science like gene editing, quantum computing, or artificial intelligence?
As media creators, we can reject factsplaining and instead construct entertaining narratives that disrupt cognitive processes. Two-decade-old research tells us when people are immersed in entertaining fiction narratives, they loosen their defenses, opening a path for new information, editing attitudes, and inspiring new behavior. Where news about hot-button issues like climate change or vaccination might trigger resistance or a backfire effect, fiction can be crafted to be absorbing and, as a result, persuasive.
But the narratives can't be stuffed with information. They must be simplified. If this feels like the opposite of what an educator should be doing, it is possible to reduce the complexity of information, without oversimplification, through "exemplification," a framing device to tell the stories of individuals in specific circumstances that can speak to the greater issue without needing to explain it all. It's a technique you've seen used in biopics. The Discovery Channel true-crime miniseries Manhunt: Unabomber does many things well from a science storytelling perspective, including exemplifying the virtues of the scientific method through a character who argues for a new field of science, forensic linguistics, to catch one of the most notorious domestic terrorists in U.S. history.
We must also appeal to the audience's curiosity. We know curiosity is such a strong driver of human behavior that it can even counteract the biases put up by one's political ideology around subjects like climate change. If we treat science information like a product—and we should—advertising research tells us we can maximize curiosity though a Goldilocks effect. If the information is too complex, your show might as well be a PowerPoint presentation. If it's too simple, it's Sesame Street. There's a sweet spot for creating intrigue about new information when there's a moderate cognitive gap.
The science of "identification" tells us that the more the main character is endearing to a viewer, the more likely the viewer will adopt the character's worldview and journey of change. This insight further provides incentives to craft characters reflective of our audiences. If we accept our biases for what they are, we can understand why the messenger becomes more important than the message, because, without an appropriate messenger, the message becomes faint and ineffective. And research confirms that the stereotype-busting doctor-skeptic Dana Scully of The X-Files, a popular science-fiction series, was an inspiration for a generation of women who pursued science careers.
With these directions, we can start making a new kind of television. But is television itself still the right delivery medium? Americans do spend six hours per day—a quarter of their lives—watching video. And even with the rise of social media and apps, science-themed television shows remain popular, with four out of five adults reporting that they watch shows about science at least sometimes. CBS's The Big Bang Theory was the most-watched show on television in the 2017–2018 season, and Cartoon Network's Rick & Morty is the most popular comedy series among millennials. And medical and forensic dramas continue to be broadcast staples. So yes, it's as true today as it was in the 1980s when George Gerbner, the "cultivation theory" researcher who studied the long-term impacts of television images, wrote, "a single episode on primetime television can reach more people than all science and technology promotional efforts put together."
We know from cultivation theory that media images can shape our views of scientists. Quick, picture a scientist! Was it an old, white man with wild hair in a lab coat? If most Americans don't encounter research science firsthand, it's media that dictates how we perceive science and scientists. Characters like Sheldon Cooper and Rick Sanchez become the model. But we can correct that by representing professionals more accurately on-screen and writing characters more like Dana Scully.
Could new television series establish the baseline narratives for novel science like gene editing, quantum computing, or artificial intelligence? Or could new series counter the misinfodemics surrounding COVID-19 and vaccines through more compelling, corrective narratives? Social science has given us a blueprint suggesting they could. Binge-watching a show like the surreal NBC sitcom The Good Place doesn't replace a Ph.D. in philosophy, but its use of humor plants the seed of continued interest in a new subject. The goal of persuasive entertainment isn't to replace formal education, but it can inspire, shift attitudes, increase confidence in the knowledge of complex issues, and otherwise prime viewers for continued learning.
[Editor's Note: To read other articles in this special magazine issue, visit the beautifully designed e-reader version.]
Podcast: Has the First 150-Year-Old Already Been Born
Steven Austad is a pioneer in the field of aging, with over 200 scientific papers and book chapters on pretty much every aspect of biological aging that you could think of. He’s also a strong believer in the potential for anti-aging therapies, and he puts his money where his mouth is. In 2001, he bet a billion dollars that the first person to reach 150-years-old had already been born. I had a chance to talk with Steven for today’s podcast and asked if he still thinks the bet was a good idea, since the oldest person so far (that we know of), Jeanne Calment, died back in 1997. A few days after our conversation, the oldest person in the world, Kane Tanaka, died at 119.
Steven is the Protective Life Endowed Chair in Health Aging Research, a Distinguished Professor and Chair of the Department of Biology at the University of Alabama Birmingham. He's also Senior Scientific Director of the American Federation for Aging Research, which is managing a groundbreaking longevity research trial that started this year. Steven is also a great science communicator with five books, including one that comes out later this year, Methuselah’s Zoo, and he publishes prolifically in national media outlets.
See the rest of his bio linked below in the show notes.
Listen to the Episode
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Steven Austad is featured in the latest episode of Making Sense of Science. He's a distinguished professor of biology at the University of Alabama Birmingham and has a new book due to be published in August, Methuselah's Zoo.
Photo by Steve Wood
Show notes:
2:36 - Steven explains why a particular opossum convinced him to dedicate his career to studying longevity.
6:48 - Steven's billion dollar bet that someone alive today will make it to 150-years-old.
9:15 - The most likely people to make it to 150 (Hint: not men).
10:38 - I ask Steven about Elon Musk’s comments this month that if people lived a really long time, “we’d be stuck with old ideas and society wouldn’t advance.” Steve isn’t so fond of that take.
13:34 - Why women are winning maybe the most important battle of sexes: staying alive. This is an area that Steven has led research on (see show notes).
18:20 - Why women, on average, actually have more morbidities earlier than men, even though they live longer.
23:10 - How the pandemic could affect sex differences in longevity.
24:55 - How often should people work out and get other physical activity to maximize longevity and health span?
29:09 - Steven gave me the latest update on the TAME trial on metformin, and how he and others longevity experts designed this groundbreaking research on longevity not in their offices, not on a zoom call, but in a castle in the Spanish countryside.
32:10 - Which anti-aging therapies are the most promising at this point for future research.
39:32 - The drug cocktail approach to address multiple hallmarks of aging.
41:00 - How to read health news like a scientist.
45:38 - Should we try a Manhattan project for aging?
48:47 - Can Jeff Bezos and Larry Ellison help us live to 150?
Show links:
Steven Austad's bio
Pre-order Steven's new book, Methuselah's Zoo - https://www.amazon.com/dp/B09M2QGRJR/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1
Steven's journal article on Sex Differences in Lifespan - https://pubmed.ncbi.nlm.nih.gov/27304504/
Elon Musk's comments on super longevity "asphyxiating" society - https://www.cnbc.com/2022/04/11/elon-musk-on-avoid...
Steven's article on how to read news articles about health like a pro - https://www.nextavenue.org/how-to-read-health-news...
AFAR's research on Targeting Aging with Metformin (TAME) - https://www.afar.org/tame-trial
New therapy may improve stem cell transplants for blood cancers
In 2018, Robyn was diagnosed with myelofibrosis, a blood cancer causing chronic inflammation and scarring. As a research scientist by training, she knew she had limited options. A stem cell transplant is a terminally ill patient's best chance for survival against blood cancers, including leukaemia. It works by destroying a patient's cancer cells and replacing them with healthy cells from a donor.
However, there is a huge risk of Graft vs Host disease (GVHD), which affects around 30-40% of recipients. Patients receive billions of cells in a stem cell transplant but only a fraction are beneficial. The rest can attack healthy tissue leading to GVHD. It affects the skin, gut and lungs and can be truly debilitating.
Currently, steroids are used to try and prevent GVHD, but they have many side effects and are effective in only 50% of cases. “I spoke with my doctors and reached out to patients managing GVHD,” says Robyn, who prefers not to use her last name for privacy reasons. “My concerns really escalated for what I might face post-transplant.”
Then she heard about a new highly precise cell therapy developed by a company called Orca Bio, which gives patients more beneficial cells and fewer cells that cause GVHD. She decided to take part in their phase 2 trial.
How It Works
In stem cell transplants, patients receive immune cells and stem cells. The donor immune cells or T cells attack and kill malignant cells. This is the graft vs leukaemia effect (GVL). The stem cells generate new healthy cells.
Unfortunately, T cells can also cause GVHD, but a rare subset of T cells, called T regulatory cells, can actually prevent GVHD.
Orca’s cell sorting technology distinguishes T regulatory cells from stem cells and conventional T cells on a large scale. It’s this cell sorting technology which has enabled them to create their new cell therapy, called Orca T. It contains a precise combination of stem cells and immune cells with more T regulatory cells and fewer conventional T cells than in a typical stem cell transplant.
“Ivan Dimov’s idea was to spread out the cells, keep them stationary and then use laser scanning to sort the cells,” explains Nate Fernhoff, co-founder of Orca Bio. “The beauty here is that lasers don't care how quickly you move them.”
Over the past 40 years, scientists have been trying to create stem cell grafts that contain the beneficial cells whilst removing the cells that cause GVHD. What makes it even harder is that most transplant centers aren’t able to manipulate grafts to create a precise combination of cells.
Innovative Cell Sorting
Ivan Dimov, Jeroen Bekaert and Nate Fernhoff came up with the idea behind Orca as postdocs at Stanford, working with cell pioneer Irving Weissman. They recognised the need for a more effective cell sorting technology. In a small study at Stanford, Professor Robert Negrin had discovered a combination of T cells, T regulatory cells and stem cells which prevented GVHD but retained the beneficial graft vs leukaemia effect (GVL). However, manufacturing was problematic. Conventional cell sorting is extremely slow and specific. Negrin was only able to make seven highly precise products, for seven patients, in a year. Annual worldwide cases of blood cancer number over 1.2 million.
“We started Orca with this idea: how do we use manufacturing solutions to impact cell therapies,” co-founder Fernhoff reveals. In conventional cell sorting, cells move past a stationary laser which analyses each cell. But cells can only be moved so quickly. At a certain point they start to experience stress and break down. This makes it very difficult to sort the 100 billion cells from a donor in a stem cell transplant.
“Ivan Dimov’s idea was to spread out the cells, keep them stationary and then use laser scanning to sort the cells,” Fernhoff explains. “The beauty here is that lasers don't care how quickly you move them.” They developed this technology and called it Orca Sort. It enabled Orca to make up to six products per week in the first year of manufacturing.
Every product Orca makes is for one patient. The donor is uniquely matched to the patient. They have to carry out the cell sorting procedure each time. Everything also has to be done extremely quickly. They infuse fresh living cells from the donor's vein to the patient's within 72 hours.
“We’ve treated almost 200 patients in all the Orca trials, and you can't do that if you don't fix the manufacturing process,” Fernhoff says. “We're working on what we think is an incredibly promising drug, but it's all been enabled by figuring out how to make a high precision cell therapy at scale.”
Clinical Trials
Orca revealed the results of their phase 1b and phase 2 trials at the end of last year. In their phase 2 trial only 3% of the 29 patients treated with Orca T cell therapy developed chronic GVHD in the first year after treatment. Comparatively, 43% of the 95 patients given a conventional stem cell transplant in a contemporary Stanford trial developed chronic GVHD. Of the 109 patients tested in phase 1b and phase 2 trials, 74% using Orca T didn't relapse or develop any form of GVHD compared to 34% in the control trial.
“Until a randomised study is done, we can make no assumption about the relative efficacy of this approach," says Jeff Szer, professor of haematology at the Royal Melbourne Hospital. "But the holy grail of separating GVHD and GVL is still there and this is a step towards realising that dream.”
Stan Riddell, an immunology professor, at Fred Hutchinson Cancer Centre, believes Orca T is highly promising. “Orca has advanced cell selection processes with innovative methodology and can engineer grafts with greater precision to add cell subsets that may further contribute to beneficial outcomes,” he says. “Their results in phase 1 and phase 2 studies are very exciting and offer the potential of providing a new standard of care for stem cell transplant.”
However, though it is an “intriguing step,” there’s a need for further testing, according to Jeff Szer, a professor of haematology at the Peter MacCallum Cancer Centre at the Royal Melbourne Hospital.
“The numbers tested were tiny and comparing the outcomes to anything from a phase 1/2 setting is risky,” says Szer. “Until a randomised study is done, we can make no assumption about the relative efficacy of this approach. But the holy grail of separating GVHD and GVL is still there and this is a step towards realising that dream.”
The Future
The team is soon starting Phase 3 trials for Orca T. Its previous success has led them to develop Orca Q, a cell therapy for patients who can't find an exact donor match. Transplants for patients who are only a half-match or mismatched are not widely used because there is a greater risk of GVHD. Orca Q has the potential to control GVHD even more and improve access to transplants for many patients.
Fernhoff hopes they’ll be able to help people not just with blood cancers but also with other blood and immune disorders. If a patient has a debilitating disease which isn't life threatening, the risk of GVHD outweighs the potential benefits of a stem cell transplant. The Orca products could take away that risk.
Meanwhile, Robyn has no regrets about participating in the Phase 2 trial. “It was a serious decision to make but I'm forever grateful that I did,” she says. “I have resumed a quality of life aligned with how I felt pre-transplant. I have not had a single issue with GVHD.”
“I want to be able to get one of these products to every patient who could benefit from it,” Fernhoff says. “It's really exciting to think about how Orca's products could be applied to all sorts of autoimmune disorders.”