# Presentation: 246322

## Targeting and Evaluating Public Health Communication

**Targeting and Evaluating Public Health Communication**

**Rosanna Westmoreland**
**California Department **
**of Health Services**

## Introduction

**Retrospective of California’s 2004 Public Education Efforts**
**Mid-Stream Enhancements**
**Evaluation Data**
**Harvard Study**
**LA County Survey**
**Embracing 2005**

**Notes:**
Hello.....My name is ......I came on board as a health education specialist with the CDHS in September of 2004. When people ask me about my background I jokingly replay that I moved from the California TPP program where we attempted to get teens to use condoms, to the West Nile Virus program where we are attempting to get Californians to use insect repellent. Since I arrived after the height of the epidemic, I am going to provide a retrospective summary of California’s Public Education Efforts and what we did to identify and implement mid-stream enhancements. Then I will review some interesting studies from Harvard and LA County, and wrap up with our proposed strategy for 2005.

## Rapid Progression of WNV in California, 2004

**Rapid Progression of WNV in California, 2004**

**Notes:**
As the virus was moving rapidly up the State (South to North), more and more media were picking up stories, and more public information was required to accurately disseminate information.

## Viral and Rickettsial Disease Laboratory

**Viral and Rickettsial Disease Laboratory**

**Vector-Borne Disease Section**

**Office of Public Affairs**

**Veterinary Public Health Section**

**Physicians**
**Local Agencies**
**Media **
**Public **
**Legislators**

**Notes:**
Without a point person for public education, the Vector Borne Disease Section, the Viral and Rickettsial Disease Lab, the Veterinary Public Health Section and the Office of Public Affairs worked collaboratively to provide county statistics to the public and the press, while at the same time emphasizing personal protective measures

## Choosing a Message

**Thank you Colorado!**
**California adapted the “Fight the Bite” materials **
**In addition links were provided to CDC materials on the web**

**Notes:**
For the public education message, California chose to adapt Colorado’s Fight the Bite campaign. In addition, media and members of the public were driven to the CDC West Nile Virus website.

## General Message Content

**What is West Nile virus**
**Eliminate standing water**
**Use Repellent**
**Report Dead Birds**

**Notes:**
Our main messages were an explanation of the virus, tips for eliminating mosquito breeding areas, personal protective measures including using repellent, and a call for the public to report dead birds to aid in California surveillance efforts

## 2004 Approach to Getting the Word Out

**“****Our goal was to hit everyone, everywhere they went....on the radio when they were stuck in traffic, in the newspaper, on TV, at the market, at the drug store.”**
**Kelly Middleton**
**Public Information Officer**
**San Gabriel Valley Mosquito and Vector Control District**

**Notes:**
Jointly and individually in 2004, each involved specialty area took up the messages and attempted to drive them deeper into our communities.  I think Kelly Middleton summed up the 2004 approach to getting the message out. She said......

## Mobilizing Our Networks to Get the Word Out

**Local Health Departments **
**Vector Control Agencies**
**Other Public Agencies**
**Large Employers**
**Legislators **

**Notes:**
Using the Fight the Bite look and content, California set out to mobilize its public health networks, to get the word out. Arrangements were made with a local printer to create order forms so that agencies and other interested parties could obtain materials. The order forms were emailed and posted to the California West Nile Virus website.

## Results

**Partners customized and distributed:**
**161,000 West Nile virus brochures **
**132,000 postcards**
**40,500 wallet cards in English and Spanish.**
**40,000 door hangers**
**15,000 posters**

**Notes:**
The results.......

## Media Efforts

**April to November, 2004**
**350 Public Service Announcements distributed to radio stations and other major media outlets **
**11 press releases issued to 340 media outlets and public health departments**

**Notes:**
In addition with no paid advertising campaign California relied heavily on its media partners to get information to the public. The media efforts included distributing California specific CDC public service messages in a radio and television format. Triggers for press releases included the confirmed presence of WNV in a new area, new human cases and/or a death in an area. All releases included source reduction and personal prevention messages.

## Media Results

**Staff fielded 440 media calls and coordinated interviews**
**From the 22 major print publications monitored 250 pertinent clips were logged**

**Notes:**
As you can imagine in July and August the phones were ringing off the hook. From the files I was able to determine that staff minimally fielded 440 media calls and of the 22 print publications that are monitored 250 stories were placed.

## Did the Public Hear our messages?

## Number of  Dead Bird Reports per 100,000 people

**30-150**
**151-250 **
**251-300**
**301-550 **
**551-1323**

_**#DBR per 100,000**_

**Notes:**
Did the Public Hear Us:	If we use one element and look at the number of dead bird reports per population in each county, it looks like our message to report dead birds to CDHS was received throughout the state, as all counties reported dead birds. (The greatest amount of dead bird reporting per 100,000 population occurred in the southern counties as well as in the north central counties.) 

## Mid Stream Enhancements

**CDC Communication and Education Team**
**Stakeholder Calls**
**Website Enhancement**
**A** **Point Person for Public Education**

**Notes:**
As more human cases were being identified CDC activated it Emergency Operation Center and stepped in in August, to further hone messages and to reach out to additional partner. CDHS along with CDC staff convened a series of statewide stakeholder calls, deployed a web redesign team to give www.westnile.ca.gov a facelift and provided resources for a CA point person for public health education – Me.

## Stakeholders identified a need for and CDHS and CDC developed:
Plain language materials
Ethnically diverse materials
A mechanism to share resources

**Plain language materials**
**Ethnically diverse materials**
**A mechanism to share resources**

- Results: Stakeholder Calls

## Results: Website Enhancement

**Redesigned **_[www.westnile.ca.gov](http://www.westnile.ca.gov/)_
**Easy for public to find information**
**Easy for media to find statistics**
**Multiple links to information and downloadable materials**

## Results: Public Education Point Person

**To work across specialties to coordinate messages**
**To provide technical assistance to local agencies **

**Results: Public Education Point Person**

## Viral and Rickettsial Disease Laboratory

**Viral and Rickettsial Disease Laboratory**

**Vector-Borne Disease Section**

**Office of Public Affairs**

**Veterinary Public Health Section**

**Notes:**
So remember one of the first graphs where each specialty area was disseminating messages to various audiences? I am in the thick of it now annoying everyone with my questions ........What does this mean to the public? Can we say that a bit differently to maximize impact within our target audiences?

## Statewide Public Health Education

**Notes:**
My approach is that of a messenger and partner. As the State health department we can drive the relevant messages out to our local agencies and partners but it is the agencies and partners that best know their communities. They can take our messages and disseminate them in the field. Our job is to make sure the information we develop is easy to use and easy to access and that real-time statistics are always available.

## Evaluation Data

**Harvard School of Public Health Study** **August 2004**
**Los Angeles County Survey of Residents About the West Nile Virus September/October 2004**

**Notes:**
To provide you with some evaluation information on the publics awareness of West Nile Virus and willingness to change behavior accordingly I would like to share excerpts of two studies.

## Harvard Behavior Study September 2004

**Harvard Behavior Study ****September 2004**

## Findings from a Survey of Los Angeles County ResidentsAbout the West Nile Virus

***Paul Simon, MD, MPH***
*Director, Office of Health Assessment and Epidemiology*
***Elizabeth Baraban, MPH PhD***
*EIS Officer, Health Assessment and Epidemiology*
***Los Angeles County Department of Health Services***
*Survey conducted by**Field Research Corporation*
***September 28 –October 1, 2004***

**Notes:**
I want to thank Los Angeles County for allowing me to present findings of their survey. Dr. Robin Civens from LA County, will be available during the question and answer period  as well.

## Nearly All County Adults Have Heard of the West Nile Virus

**93%****Yes, aware**

**No, not aware**

**7%**

_**When did you first hear about WNV?**_

*Source questions: Q1, Q2 (n = 801 adults)*

## Television Is Where Residents Received Most of Their Information About the West Nile Virus

**Television**

**Newspapers/magazines**

**Radio**

**Family/friends/other persons**

**Internet/Web sites**

**Other**

**Television Is Where Residents Received Most of Their Information About the West Nile Virus**

** Adds to more than 100% due to multiple mentions**Source question: Q3 (n = 801 adults)** Note: Asked of all residents, except those hearing about WNV for the first time*

## Greater Than Three in Four Correctly Believe Older Adults/seniors Are Most Vulnerable to Get Sick and Die From West Nile Virus

**Greater Than Three in Four Correctly Believe Older Adults/seniors Are Most Vulnerable to Get Sick ****and Die From West Nile Virus**

** Adds to more than 100% due to multiple mentions **Source questions: Q4 (n = 801 adults)*

## Public Reports Taking a Number of Actions to Reduce Chances of Being Bitten by Mosquitoes

**Public Reports Taking a Number of Actions to Reduce Chances of Being ****Bitten by Mosquitoes**

*Source questions: Q10, Q11b, Q13a-c (n = 801 adults)*

## Varied Reasons Offered for Not Using Mosquito Repellent

**Not too concerned about ****mosquito bites**

**Don’t like it’s smell or feel**

**It’s inconvenient**

**Forget/don’t usually think about it**

**Concerned that it might be harmful**

**It doesn’t seem to work well for me**

**Costs too much**

**Varied Reasons Offered for Not Using ****Mosquito Repellent**

*Source questions: Q12a-g**Asked of those who said they use mosquito repellent only some of the time, rarely, or never. (n = 640 adults)*

## Just 18% Report Using Mosquito Repellent All or Most of the Time When Outside for Extended Periods or When Mosquitoes Might Be Present

**19%****Some of****the time**

**Does the mosquito repellent **_**you use contain DEET?***_

**Just 18% Report Using Mosquito Repellent All or Most of the Time When Outside for Extended Periods or When ****Mosquitoes Might Be Present**

**20%****Rarely**

**18%****All/most****of the time**

**Don’t go outside****2%**

**41%****Never**

*Source questions: Q11a, Q11c (n = 801 adults)**Asked of those who said they use mosquito repellent all, most or some of the time. (n = 293 adults)*

## Embracing 2005

_**Media**_
**Redistribute electronic and print PSA’s**
**Schedule proactive media releases to follow 2004 message patterns, including requests for the public to report dead birds**
_**Public Education**_
**Provide assistance to counties to incorporate messages that emphasize behavioral changes**
**Use DEET-based repellents**
**Drain standing water**
**Implement a system for producing and distributing public education materials to counties with limited resources.**

**Notes:**
I am learning something new each day so any plans I make are fluid and open to suggestions. As I embrace this 2005 season I have these goals.....

## My Omi and Me

**Notes:**
My parting thought....This is my Omi and Me. She will be 94 this year. As I review our public education messages, provide consultation to counties, and talk to the media, I keep her in mind. Even though California had fewer deaths than anticipated, even one death is too many when it is someone you love. This is what the media picks up on to convey to the public. So we have to make sure we are clear enough to  get people to take preventive measures, while not invoking fear. Thank you.