Award Announcement: National Public Health Information Coalition by Kristina Wieghmink

National Public Health Information Coalition Vol. 25, No. 5 • October 2014

Inside President’s Message............................................1 Five More Public Health Communicators Earn CCPH Credential..........................................2 On Your Marks, Get Set, Get Certified!.................4 Arkansas Snares Most Awards For Excellence.....................................................5 Awards: Ottawa Proves Bigger Not Always Better...............................................7 NIAM Toolkit Smashes Record For NPHIC Website Visits.....................................8 Dr. Besser’s ‘Lessons From The Other Side Of The Camera’...................................9 California’s ‘Lost Moments’ Strikes Gold............11 Colorado’s PIO must field pot questions, too.............................................12 Are You Ready For Flu?......................................14 New Membership Information .........................15 ‘Texting For Public Health’ Toolkit Debuts...................................................15 Ebola Information Line Success In Nebraska..........................................16 Radiation Exercise Focuses On School Legal Questions................................17 Paralytic Poisoning and Fukushima Radiation: Alaska’s Fish Stories Have PIOs Hopping ...........19 Icky Germs, Dirty Hands, And Germ Fighting Heroes.......................................21 CDC Starts New Prevention Through Health Care Website..........................................22 Big Push To Boost Lagging Adult Vaccination Rates..............................................23

The NPHIC Update is published bimonthly by the National Public Health Information Coalition. 986 Hidden Hollow Dr. Marietta, GA 30068 (770) 509-5555 | Fax: (770) 565-8436

2014 Newsletter Committee Members: Mary Burt Polly Carver-Kimm Holly Cucuzzella Cathy Flanagin John Silcox Editor: Brad Christensen Layout & Design: Cheri Marone

President’s Message For the second year in a row, NPHIC co-hosted with CDC the National Conference on Health Communication, Marketing and Media, and it was another fabulous few days with great speakers, inspirational sessions, more than 25 exhibitors, poster presentations, and networking opportunities. For the first time this year, NPHIC melded parts of its own conference into the NCHCMM with some trepidation, but all went smoothly. Numerous NPHIC members were among the 902 attendees. We held our awards ceremony the first evening, which was open to all and hosted by Glen Nowak of the Grady College at the University of Georgia and our own Kerry Shearer. We also hosted regional meetings over breakfast, an update on the Ebola outbreak by CDC representatives to a packed room, and the Closing Keynote/Berreth Lecturer Presentation “Lessons from the Other Side of the Camera” by ABC News’ Dr. Richard Besser. It was a rousing success all around! The conference was a beehive of activity, from the pre-conference sessions through the closing minutes of Dr. Besser’s humorous, touching, and inspiring speech on how his job as Acting Director of the CDC during the H1N1 pandemic differs from his role as Chief Health and Medical Editor on network television. He delivered his NPHIC’s newsletter is published bimonthly. Articles, photos and story ideas should be submitted directly to editor Brad Christensen (bchristensen@nphic.org). The copy deadline for the next issue is November 6.

advice to a nearly full ballroom, which for the last session of a multi-day conference was quite an achievement. I want to express my appreciation and congratulations to the entire conference planning committee and the advisory board for all their hard work to make this such a valuable experience. I also personally want to extend my thanks to Dr. Dawn Griffin, our conference manager, for her tireless work, frequently behind the scenes, and her expertise and ability to handle any issue, on the spot, with nary a crack in her calm demeanor. It was a pleasure working closely with her this year and an experience I will never forget. I would certainly be remiss if I did not also thank our own staff, captained by Executive Director Laura Espino, Continued on page 3

2014

Executive Board

Ms. Nicola Whitley President & Representing Region I New Hampshire Dept of Health & Human Svcs Public Health Emergency Preparedness Public Information Specialist 129 Pleasant Street Hugh Gallen State Office Park Concord, NH 03301 Phone: (603) 271-9388 Fax: (603) 271-4332 Email: nwhitley@dhhs.state.nh.us Mr. Bill Furney Vice President & Representing Region IV North Carolina Office of Public Health Preparedness & Response Communications Coordinator 1902 Mail Service Center Raleigh, NC 27699-1902 Phone: (919) 715-4174 Fax: (919) 715-2246 E-mail: bill.furney@dhhs.nc.gov Mr. Thomas Slater Representing Region II New Jersey Dept of Health and Senior Svcs. Risk Communications Manager P. O. Box 360 | Room 707G Trenton, NJ 08625 Phone: (609) 984-5348 Fax: (609) 943-5116 E-mail: Thomas.slater@doh.state.nj.us Maribeth Brewster Representing Region III Virginia Department of Health 109 Governor Street Richmond, VA 23219 Phone: (804) 864-7008 E-mail: maribeth.brewster@vdh.virginia.gov Tom Schafer Representing Region V Illinois Department of Public Health 535 West Jefferson Street Springfield, IL 62761 Phone: (217) 785-1051 E-mail: tom.schafer@illinois.gov Appointment Awaited Representing Region VI Polly Carver-Kimm Representing Region VII Iowa Department of Public Health 2 Communications Director 321 East 12th Street Des Moines, IA 50319 Phone: (515) 401-7988 Fax: (515) 281-4958 Email: polly.carver-kimm@idph.iowa.gov

Jon Ebelt Representing Region VIII Montana Department of Public Health and Human Services Public Information Officer P.O. Box 4210 Helena, MT 59620 Phone: (406) 444-0936 Fax: (406) 444-1970 Email: jebelt@mt.gov Laura Oxley Representing Region IX Arizona Department of Health Services 150 North 18th Avenue Phoenix, AZ 85007 Phone: (602) 542-1094 Fax: (602) 542-0883 E-mail: oxleyl@azdhs.gov Thomas Shanahan Representing Region X Idaho Department of Health & Welfare Public Information Manager P.O. Box 83720 Boise, ID 83720 Phone: (208) 334-0668 Fax: (208) 334-5926 E-mail: shanahat@dhw.idaho.gov Monique Davis Member-At-Large Hudson Regional Health Commission Health Educator/Risk Communicator 595 County Avenue | Building One Secaucus, NJ 07094-2605 Phone: (201) 223-1133 Fax: (973) 583-0641 Email: mdavis@hudsonregionalhealth.org Ms. Jeanene Fowler Member-At-Large Maricopa County Dept of Public Health Public Information Officer 4041 N. Central Ave | Suite 1400 Phoenix, AZ 85012 Phone: (602) 506-4926 Fax: (602) 506-6885 E-mail: JeaneneFowler@mail.maricopa.gov Mr. Larry Hill Member-At-Large Virginia Department of Health Public Information Officer 830 Southhampton Ave. Norfolk, VA 23510 Phone: (757) 683-9175 Fax: (757) 683-2494 E-mail: larry.hill@vdh.virginia.gov Ms. Rita Obey Member-At-Large Harris Co. Public Health & Environmental Svcs Director, Office of Public Information 2223 West Loop South | Suite 715 Houston, TX 77027 Phone: (713) 439-6293 Fax: (713) 439-6080 E-mail: robey@hcphes.org

Five More Public Health Communicators Earn CCPH Credential By Kris Smith

Confident. Committed. Principled. Hardworking. Those adjectives describe someone who strives to become a Certified Communicator in Public Health (CCPH), and in particular, the five NPHIC members who most recently earned the CCPH designation. Representing state, county and city health departments, each of the newly minted CCPHs has had many years of practice in shaping, spreading and understanding the impact of a public health message. Now they appreciate that their contributions are being recognized and acknowledged by their peers and public health leadership. “Credentialing is one more step in showing how qualified you are at your position and the experience you have gained,” said Larry Hill, CCPH, public information officer for the Virginia Department of Health—one of five who passed a rigorous portfolio review as part of the beta test 2 phase of NPHIC’s certification program. “I think in our world of public information, you need to continue to learn and share your experiences. The opportunity to be certified by your peers makes it that much more special.” Laurie Boston, CCPH, public information officer, Southwest District Health in Idaho, couldn’t agree more. “To be certified by NPHIC as an outstanding public health communicator recognizes the time and hard work I have dedicated to my Continued on page 3

President’s Message, continued from page 1

for all their hard work in advance of and during the entire event. Few people realize just how much goes into planning something of this magnitude. We also officially announced the Certified Communicator in Public Health program to great acclaim during the conference. There was much interest and many people stopped by the NPHIC booth for more information. Great job everyone! The conference theme this year was “What’s Your Story?” I love this for its seeming simplicity, until you give it some thought and realize all it can mean to different people and all the ways storytelling impacts our work. From the opening plenary with Paul Smith, who gave a fascinating and practical talk on how to use stories to achieve your goals and captivate your audience, to all the terrific breakout sessions, the theme was illustrated in topic after topic. There were social media updates, sessions on gamification (now I know what it means), using plain language, reaching vulnerable populations, the Inspiration Shop 2014 for Communicators Earn Credential, continued from page 4

profession. The CCPH places me in a group of the ‘Top Gun’ health communicators across the country.” For John Silcox, MA, CCPH, certification equates to a “stamp of approval” from his colleagues and a validation of his professional skills. But while the director of communications for the FortWayne-Allen County, Ind. Department of Health savors his individual achievement, he sees a wider impact to getting certified. “I think it also raises the profile of our health department. We strive to be a center for excellence in public health, so any time a member of our staff receives recognition it is a validation of the quality and professionalism of our entire agency.“ Douglas Schultz, CCPH, communications specialist for the Minnesota Department of Health, says the CCPH not only rewards him for all those real-world and classroom hours of learning, it “commits me to continuing education.” He adds that a designation

change with Craig Lefebvre, and lessons from master storyteller Eva Grayzel. If you were not able to attend the conference, I invite you to visit the new NPHIC website and view some of the great sessions, including the Ebola update, watch the Who We Are video, and check out the NPHIC award winners. Also be sure to read about the CCPH certification in this issue and consider submitting your portfolio. In closing, I would like to leave you with this observation from Paul Smith, master storyteller, opening keynote speaker, and author of the book Lead with a Story: Experience is the best teacher, a good story is second, and everything else is third.

of experience and skills and a commitment to continuing education indicate “a level of professionalism that those inside and outside of public health can expect from me and the department I work for.” “I am grateful for NHPIC’s role in recognizing the need for this among professionals and making it happen,” remarked Richard “Rocky” Merz, CCPH, public information officer, Cincinnati Health Department. To date 10 individuals have been credentialed following a CCPH pilot and two beta tests. More are expected to earn their CCPH soon during the full program roll out. Applications will be accepted beginning Oct. 1. Candidates should read the following article and check the NPHIC website for eligibility guidelines and required core competencies and related skillsets.

On Your Marks, Get Set, Get Certified! After a pilot and two beta tests, NPHIC’s Certified Communicator in Public Health (CCPH) credentialing program is officially open for business starting Oct. 1. A total of 20 applications for CCPH portfolio review will be accepted October 1-31 on a first come/ first served basis from candidates—NPHIC members and nonmembers, alike—who meet eligibility requirements.

Candidates for portfolio review will pay a non-refundable fee at the time of application.

To be eligible, you must be a public health communicator in government, academia, industry or the not-for-profit sector with a four year degree in any discipline and two years of practical experience, or six years’ experience as a public health communicator, without a degree. Click here for some examples of a public health communicator.

The fee will be refunded only if an application is not accepted because of ineligibility, late registration or the maximum number of candidates has already been reached. No refunds will be made if accepted candidates fail to submit a portfolio on time or do not pass the portfolio review. Portfolios may be submitted between December 1, 2014 and February 27, 2015.

The CCPH assessment process comprises a rigorous portfolio review in which candidates describe and document how they have demonstrated core competencies and related skillsets necessary to be an effective public health communicator. All of these are specified in the CCPH job analysis. Counting supporting documentation including work products and letters of endorsement, expect to spend a minimum of 40 to 60 hours in preparing a portfolio. But it will be time well spent, agree all who have already achieved CCPHs in beta testing.

• • •

NPHIC members: $175 Early applicants: $200 (October 1-10, 2014) Regular applicants: $250 (October 11-31, 2014)

So that’s the “What” of the CCPH credentialing program. The bigger question is “Why”? You may wish to become a CCPH for professional advancement, to set you apart and stand out to those who make decisions on hiring and promotions, even if you are just starting your career. For more senior public health communicators, having a CCPH will be another testament to your career-long accomplishments. You also can take personal satisfaction in knowing that you have demonstrated a commitment to push your field forward and foster excellence in public health communication. While earning a CCPH will be hard work, calling for confidence, commitment and a dedication to professional principles, the result will be worth it. “The application process was challenging, yet rewarding,” says Richard “Rocky” Merz, CCPH, public information officer, Cincinnati Health Department. “I would strongly encourage anyone working in the field to pursue the opportunity.”

Ditto for John Silcox, MA, CCPH, director of communications for the Fort-Wayne-Allen County, Ind. Department of Health. “Go for it!” he says. “Just the act of putting together the portfolio will give you a great sense of satisfaction and accomplishment as you look Continued on page 5

Arkansas Snares Most Awards For Excellence By Bill Walker

The Arkansas Department of Health grabbed 14 awards, including five Golds in the 2014 NPHIC-Grady College Awards for Excellence in Public Health Communication. Winners were announced during the opening reception at the annual National Conference on Health Communication, Marketing and Media on Aug 19.

“We always learn a lot from other states – how they do things and what we might want to try.” Click here to see all of the award winners.

Continued on page 6

2014 Awards Totals

Cathy Flanagin, director of Arkansas’s Office of Health Communications and Marketing, was not able to attend the conference, but she knew when the awards ceremony was to take place. “We were watching the website,” she said. “We knew it was coming. It is very Cathy Flanagin exciting when you do something a little different to see it recognized.” The California Department of Health had second largest haul with nine awards, followed by Texas Department of State Health Services with eight. Right behind them, with seven each, were Georgia Department of Health and Ottawa County Department of Public Health. “I thought there was some great stuff this year,” Flanagin said.

Get Certified, continued from page 4

back on the work you have done in your career and think about what you still hope to do.” “It’s not just about the personal accomplishment,” adds Silcox. “I think anything that enhances our credibility and visibility inside and outside of public health is good for our profession as a whole.” Public Health Leaders agree. Rex Archer, MD, director of the Kansas City, Mo. Health Department and former NAACHO President, says, “Communication is as important as any other area that we credential in public health. In fact, it is a foundational capability that is necessary for practically everything else we do.

Unfortunately, most public health leaders have not been trained in the skillsets required for effective communication. This is a way to add to the professionalism of this field and the overall effectiveness of public health. “ All good reasons to raise your profile and show your value by becoming a CCPH! For more information, go to http://www.nphic.org/career/ credentialing.

Awards For Excellence, continued from page 5

Four of Arkansas’s Gold, two its Silver and two of its Bronze awards were connected to its Stamp Out Smoking “Pack of Lies” campaign, created with the help of CJRW, a Little Rock PR and advertising firm. The “Pack of Lies” campaign included traditional components of online, outdoor and print advertising. All of those components were more than well done, with a Gold awarded for its posters/ billboards entry. What set the campaign apart was its “Arkansas Times Takeover” project.

The “Takeover” was designed to make a statement. Arkansas purchased the majority of ad space in one issue of the Arkansas Times, a weekly alternative newspaper which reaches over 100,000 readers, or about 25 percent of the adults in central Arkansas each week. Flanagin said young adults are a big part of the newspaper’s print and online readership – and a major target audience for the “Pack of Lies” campaign. The paper also is widely read by legislators and policy makers. According to the entry form, the idea in part was to “give readers one issue free of all tobacco advertising and illustrate a literal and figurative alternative to Big Tobacco.” “We’re very proud and have had some very good feedback on it,” Flanagin said. “It was something a little different. The Arkansas Times is very popular in Central Arkansas. Very politically oriented, progressive, leans a little left. It had recently started running tobacco ads. We didn’t like that.” Arkansas and its tobacco program have been working with CJRW for several years, using tobacco settlement funds to support the Stamp Out Smoking campaign. Flanagin acknowledges that using vendors can be expensive. “We have been very fortunate in Arkansas to be able to use those dollars for health programs. Other states have used them to build roads and other things,” she said. Looking ahead to next year’s competition, Flanagin has some advice for colleagues:

One of multiple graphics produced in the “Pack of Lies” campaign.

“Start early. The earlier the better, especially if you are trying to get information from other parts of your agency.”

Awards: Ottawa Proves Bigger Not Always Better By Bill Walker

Something unprecedented happened in the 2014 NPHIC-Grady College Awards for Excellence in Public Health Communication program. One small, local health department, with a one-person communication department, proved you don’t have to be big to win; you just have to be good and a shade or two better than the rest. The Ottawa County Department of Public Health won seven times – three Golds and four Silvers. Even more impressive, Ottawa submitted only eight entries. No competitor had a higher winning percentage; none was even close. And no local health department has ever won so many awards in a single year.

Three state health departments – each with more staff and a larger communications budget – topped Ottawa’s seven awards. Arkansas won 14 awards, followed by California (nine) and Texas (eight). But Arkansas and California each submitted more than 20 entries. All of Ottawa’s entries were developed “In House,” with small budgets and without the help of an outside contractor. Kristina Wieghmink is the one-person communication department at the Ottawa County Department of Public Health. Her communications career started years ago, but her work in public health covered just 17 months by the time the entry deadline last June.

During her public health initiation, she began hearing things that would lead to a Silver certificate in the Print Graphics Specialty Project category for the agency’s Brand Guidelines. “When I first started here, I asked people, Kristina Wieghmink ‘What are we called?’ and I heard various things,” Wieghmink said. “I heard ‘I don’t know’ … ‘I’m not sure’ … ‘Ottawa county health department’. Inconsistency was a problem.” She also found that agency letterhead and brochures varied in their identification of the department. Planning for the Guidelines project began in March 2013. Moving quickly, Wieghmink and select agency staff developed a logo, guidelines for its use and key messages. The package went through an internal approval process and then through the County Board of Commissioners before the guidelines were officially rolled out in July 2013. Click here to see the Guidelines. Each of Ottawa’s additional entries this year were developed after the Guidelines went into effect. How did she get it done so well and so quickly? She may be a one-person office, but Wieghmink says, “I do have a great working relationship with staff in the department. And, my family life is centered around health and well-being. So, what I do day to day isn’t work. It’s fun.”

NIAM Toolkit Smashes Record For NPHIC Website Visits By John Stieger

The 2014 National Immunization Awareness Month communications toolkit broke a record for the number of visits to any area of the NPHIC website. It was viewed more than 25,000 times between late June, when it was launched, and the end of August. This is more than double the number of times it was visited last year, the first time the toolkit was posted on the NPHIC website. This means that many organizations and individuals not only used the valuable resources in the toolkit, but also learned more about NPHIC. One of the new features of the toolkit was an online form for people to submit information about NIAM activities they coordinated during August. This kind of information helps us measure the extent of our reach and gives us ideas for next year. It also provides visibility for organizations since all of the activities they submit are being displayed in the toolkit. More than 20 organizations submitted information about their NIAM activities, ranging from sending Tweets about immunizations to conducting a college-focused social media campaign about meningitis. One example of NIAM activities came from the Colorado Department of Public Health and Environment. They celebrated NIAM by promoting immunizations across the lifespan. They hosted a campaign on a local radio station focusing on whooping cough and back-to-school immunizations. They also ran a

mobile billboard campaign showcasing the website www. immunizeforgood.com at two Colorado Rockies games and a Lady Gaga concert. Additionally, they used social media to promote NIAM using each week’s theme with relevant photos, videos and articles. Great work, Colorado! Special thanks to Catherine Martin, executive director of the California Immunization Coalition, and Nancy Erickson, communications director of the Vermont Department of Health, for co-chairing the NIAM work group that shaped this year’s toolkit. This work group is part of the broader NPHIC Immunization Committee. And special thanks also to our colleagues in the CDC’s National Center for Immunization and Respiratory Diseases, especially Michelle Basket, Ian Branam and Amy Callis. The toolkit would not have been possible without their great expertise. Keep the toolkit in mind if you need its resources beyond August; much of the information can be used throughout the year.

Dr. Besser’s ‘Lessons From The Other Side Of The Camera’ By Brad Christensen

We were honored to have ABC News Chief Health and Medical Editor Richard Besser, M.D. as the Berreth lecturer to close out this year’s National Conference on Health Communication Marketing and Media. And he closed it out in style. First he talked about his work as a pediatrician, his work with the CDC beginning with the Epidemic Intelligence Service and finishing as Acting Director. He joined ABC in 2009, where he already has received an Overseas Press Club award and two Peabody Awards as part of healthcoverage teams.

NPHIC President Nicola Whitley presents Dr. Besser with a Berreth Lecturer plaque.

Having recounted his experiences as a TV news interviewee and interviewer, he finished the lecture with lessons for health communicators “from the other side of the camera.” He said he has five lessons, starting with “The Expert Mistake.” He said do your best to keep the disease expert – the person who’s done the study or knows the most about a topic – away from the camera. “They’re usually horrible because they know too much about their subject and they usually haven’t been trained in communication,” he said. “And they’re dreadful.” Instead, find a few people in key positions in your department, train them to communicate well and let them talk about everything. “The public will get to know them and trust them,” he said. “They’ll

speak at the level you’re looking for and you only need four of five of them. It’d be terrific.” “Time Out” was lesson two. Dr. Besser said that often by the time someone gets back to him with the information he needs, “time has run out and I could care less about what they have to say. Deadlines really, really matter and it’s very hard sometimes to convince the scientific staff of that fact. If you get there on time with your message and your information you could reach for free seven or eight million people, and if you’re five minutes late you reach nobody.” He said he knows public health agencies get very little money for health marketing. “You get nothing, or literally close to nothing… So when media calls and they want to interview someone in your organization, it should in a sense be a public health emergency because someone is willing to give you a million dollars in free exposure but only if you get there on time with someone who can communicate.” Number three in the lesson book was “The Bad Pitch.” He said a pitch or news release about “National Disease X” day or month or week is dead on arrival. “Unless it’s pink, unless it’s breast cancer, forget about it. Because if you Google any day of the year you’ll find that there are about five different causes that are attached to that. And none of our shows cares at all about national something day.” There’s also no interest in covering a meeting. “We never cover a meeting – ever. You can send it and we’ll delete it.” Even the launch of a major health program is a tough one to get on the air. He said he thought the Million Hearts program was terrific, “but I couldn’t sell it to any of our shows. They said, get back to us with results, then we’ll cover it. The idea that we’re gonna save Continued on page 10

Dr. Besser’s Lessons, continued from page 9

a million lives from heart disease – no. Come back when you’ve saved them.” Disgusting material or terms such as vomit, diarrhea, and poop will be accepted by newspapers, but not by network television. “I started on my career working on diarrheal disease and I’m a pediatrician, so I’m totally focused on poop, but our audience and our executive producers, not so much.” So he can talk about norovirus outbreaks, he said he replaces vomiting and diarrhea with the phrase “typical stomach flu symptoms, and then you leave it to their imagination.” Lesson four was “The Good Pitch.” He said a good pitch typically has a character –somebody viewers can relate to – with an important or interesting story and great visuals. He said the visual of Dr. Kent Brantly being released from Emory University Hospital and hugging those who treated him for Ebola was “like, boom, terrific.” Also it is strategic to have all your information ready to go on a disease or other health issue and then pounce when there’s a news hook. “It’s like emergency preparedness,” he said. “Have your material ready and when there’s a news peg, go for it. Everyone wanted me to talk about HPV when Michael Douglas said he got throat cancer from having oral sex with Catherine Zeta Jones. I was on Entertainment Tonight, I was on Inside Edition, I was on all our shows. No one wants to talk about HPV otherwise. So you wait. Whenever a celebrity has anything, pitch it.” It’s also good to have something in your pitch that inspires hope or fear, but mostly hope. Having Fear works early on, like in the first days of the Ebola outbreak, and now people are looking for hope, he said, noting interest in ZMapp, the experimental drug.

10 Ebola survivor Kent Brantly (back to camera) hugs Emory University Hospital staff.

The “Press Is Not Your Friend” was the final lesson. “Don’t think of us as your friends,” he said, adding: “Early on in a crisis, yes, after that, no.” He said when he was speaking to a group of epidemiologists someone asked if they could partner with him. “And I said, you can’t,” he said. “That’s not our role. That’s what a PR department does…. There’s nothing in the ABC News mission that has anything to do with improving the health of people here or around the world.” So while health communicators may no longer be Dr. Besser’s friends, we most certainly remain in very high regard. He finished his remarks with this: “Thank you for all that you do. Health communicators, you are my heroes. You are so important to accomplishing everything in public health.”

Dr. Besser with NPHIC Executive Director Laura Espino and Communications Director Brad Christensen

California’s ‘Lost Moments’ Strikes Gold By Cathy Flanagin

“Imagine your best moments taken away. Tobacco is still killing 1 in 5 Americans.” That’s the tag line for this impactful ad, which is one of six “Lost Moments” TV ads that won California’s Tobacco Control and Cessation Program (CTCP) a Gold Award of Excellence in Public Health Communications from NPHIC and Grady College. The spots are short, only 31 seconds, and designed to have an emotional impact. The unusual aspect of the campaign was that short, already existing clips from YouTube were used because they were considered authentic and real by focus groups, according to Valerie Quinn, communications/media Strategist with the California Department of Public Health, Tobacco Control Branch. One participant said, “we are from the YouTube generation and if I saw this on air I would stop and look.” Focus group participants noted that more polished or Valerie Quinn professionally produced videos were not seen as effective and considered less genuine. So the CTCP set out to find authentic, real-life special moments to highlight its “Lost Moments” campaign. While the spots might be short, the list of YouTube videos they viewed to find just the right moments wasn’t. Quinn admitted, “They looked through hundreds, if not thousands, of videos in many different categories to find moments that were moving. They ultimately stumbled across some of the ones they used.” One surprise was how hard it was to locate people who posted the videos in order to ask for permission to use them. The people who agreed to share their stories were compensated, but noted they were happy to share their stories for the anti-tobacco cause. The six ads were rotated throughout the year. This allowed the campaign to stay fresh and appeal to different audiences. The ads appeared during both Network and Cable commercial breaks. The project was very cost effective. “We were able to do all six ads cheaper than one commercial,” said Quinn. It also allowed them to appeal to a broader array of people – different races, ethnicities, urban, rural, than if they had done one ad. For example, media

tracking results showed that the rate of awareness in African Americans was over 60 percent. The Big Shoes and Hop Scotch ads particularly resonated with African Americans. Overall, the annual online media tracking survey showed that almost half (over 45 percent) of California adults could recall the Lost Moments campaign. This was an increase from previous years. Of those recalling Lost Moments, over 70 percent responded that the ads made them feel somewhat- to-very emotional. Smokers also had a high awareness of the ads. Almost 60 percent of smokers who recalled the ads said that it made them think about quitting. Results also showed that attitudes about the way people felt about the tobacco industry had changed, with 80 percent responding that it made them angry at cigarette companies. In addition, the TobaccoFreeCA website garnered 104,000 hits from people watching the ads and looking for more information. View all of the ads here. The campaign was effective at motivating non-smokers to speak to smokers about their smoking habit. Quinn said, “Even when they could not relate to a specific experience that was shown, respondents were able to immediately relate to the idea of special moments loved ones may miss if they died from their tobacco addiction.” Quinn recommends pre-testing the ads to see if they reach people in your state. Anecdotally, CDC TIPS ads were found to be more impactful in formative testing among Florida residents based on their media objectives, while feedback from California residents said they were tired of gruesome faces. CTCP wanted the ads to be emotional and to target the tobacco industry. In California, messages like “Which moments are you willing to give away since every cigarette shortens your life?” accomplished that goal.

Colorado’s PIO must field pot questions, too By John Silcox

Coloradans may be experiencing a new Rocky Mountain high this year, but for Mark Salley and his colleagues at the state’s Department of Public Health & Environment it’s mostly been business as usual. Yes, when on January 1 Colorado became the first state to license the recreational sale of marijuana, it sparked some reefer madness among the media. But Salley, the department’s communications director, isn’t blowing smoke when he says the marijuana issue isn’t all that new. While his department doesn’t regulate grow operations, license retail sales or run addiction programs, it has been responsible for managing the state’s medical marijuana registry for more than a decade. Still, even Salley admits that talking about pot isn’t in the job description of most public health communicators, or something this former journalist and one-time deputy press secretary to the governor ever thought he’d be doing.

Washington is the only other state that currently allows retail sales of marijuana for recreational use. Efforts to legalize recreational marijuana are under way in Alaska, Massachusetts, New York, Oregon and the District of Columbia. Twenty-three states and the nation’s capital permit marijuana use for medical purposes. Under Colorado’s medical marijuana law, created by constitutional amendment in 2000, only a licensed physician may recommend marijuana for a patient and only for one of eight medical conditions: cancer, glaucoma, HIV or AIDS, cachexia (severe weight loss related to chronic disease), persistent muscle spasms, seizures, severe nausea and severe pain. Patients under 18 can also be approved for medical marijuana so long as they have permission from their parents and recommendations from two doctors, not just one. The law also allows for designated “caregivers,” people with permission to grow pot on behalf of a medical marijuana patient. But with little scientific evidence to support the claims made about the therapeutic benefits of marijuana, the department has struggled to add conditions like post-traumatic stress disorder and Tourette Syndrome, as well as to place appropriate limits on the number of plants patients can have or the number of patients that medical pot growers can serve, Salley says. With the new retail sales law, adults can now purchase up to 1 ounce of marijuana at licensed stores and grow up to six plants for personal use.

12 Colorado Department of Public Health & Environment home page.

Some thought after full legalization went into effect, continued on page 13

Colorado Pot Questions, continued from page 12

the medical registry would fade away. But it continues to grow – there are more than 113,000 people registered as of June – and there is concern that some medical marijuana growers and smokers are abusing the system to avoid the higher taxes and stricter regulation put on recreational pot, Salley says. In an effort to tighten regulations, the Colorado Board of Health will meet this month to consider a proposed rule that would limit medical marijuana caregivers from serving more than 10 patients at a time – the current cap is five, but waivers are available. Salley’s department also recently announced the availability of $9 million in research grants to fund credible studies on the general efficacy of marijuana as a medical treatment. Now that recreational use of marijuana is legal, Salley has had to work even more closely with his counterparts throughout state government to educate and inform residents about Colorado’s marijuana laws, the health effects and the methods of use. There’s already a website, www.colorado.gov/marijuana, devoted to the subject and soon the state will launch a $5 million public education and awareness campaign aimed at getting people to make informed decisions about the use of marijuana, Salley says.

Colorado marijuana shop’s retail offerings.

But if you think he is hunkered down in his office responding to half-baked tweets from tokers looking to harvest the best buds or posting low-cal pot brownie recipes on the department’s Facebook page, think again; the truth is much more mundane, he says. While he has fielded interview requests from as far away as Austria and France, mostly he answers questions about the registry or refers reporters to the regulatory agencies that enforce the retail sales laws. Like all controversial social issues, the decriminalization of marijuana has its supporters and detractors, but Salley says it’s not for his department to pick a side. They are simply charged with educating residents about the marijuana laws and the potential risks involved. “We don’t have a view,” he says. “Our aim is to help the state safely manage medical and recreational marijuana, while informing the public of potential risks of marijuana use.” And that’s the straight dope.

Another day at work – preparing marijuana buds for sale.

Are You Ready For Flu? By John Stieger

Autumn is upon us. Are you ready for school activities? Cooler weather? The flu? NPHIC and the California Immunization Coalition sponsored a Virtual Immunization Communication (VIC) Network webinar on Aug. 13 called, “Are You Ready for Flu?” The webinar featured CDC officials and partners talking about vaccination recommendations, communication strategies, and grassroots approaches for reaching disparate populations during this year’s flu season. Cindy Fowler, health communication specialist with the National Center for Immunization and Respiratory Diseases, said the primary goal of this year’s communications campaign is to raise awareness and knowledge of the flu and to promote behaviors that support vaccination. She said this year’s campaign elements will include partner outreach; digital and social media; traditional media; and education and outreach to health-care professionals. One of the key communication activities will be the annual National Influenza Vaccination Week, Dec. 7-13. Strategies during

the week will include a press event, a radio media tour, social media and social gaming. Fowler also showed examples of communication resources on the CDC website that will be helpful to public health communicators: Animated images (GIFs), free communication resources, health professional resources, and partner resources. Carlos Velazquez, senior vice president of community engagement for HMA Associates, provided an overview of grassroots approaches that will be used to reach health-disparate populations. The key outreach components will be partner engagement, media outreach, partner recognition and research, he said. “The media outreach will include webinars, social media, traditional media, and engagement with subject matter experts,” he added. Blake Harper, project manager with Kauffman and Associates, wrapped up the webinar by describing special outreach to American Indian and Alaska Native populations. The main theme of the outreach is “Protect the Circle of Life: Your Flu Vaccine Protects Me, My Flu Vaccine Protects You.” This theme will be featured on posters, fact sheets, social media messages and radio PSAs.

The webinar attracted more than 900 participants, the largest number since the VICNetwork began in 2009. The webinars are coordinated by NPHIC and the California Immunization Coalition and regularly feature CDC officials discussing important immunization topics. The VICNetwork includes more than 3,000 public health communicators, health educators, immunization coalition members, doctors, nurses and others who are all interested in doing a better job of explaining why immunizations matter. If you were unable to participate in the webinar, you can find a recording and the slide presentations here.

‘Texting For Public Health’Toolkit Debuts By Tara Bostock

This summer, the Communications Department at Seattle & King County Public Health and the Northwest Center for Public Health Practice released the free Texting for Public Health Toolkit. This interactive toolkit was built off of several years of CDC-funded research and the implementation of pilot texting programs. Why texting? Because 90 percent of all adults in the U.S. have a phone and 97 percent of people aged 18-49 use their phones to text. Texting is ubiquitous, dependable, and nearly universal.

People carry their cell phones with them everywhere they go, so texting offers a way to engage audiences and distribute the health information people need and want in a timely fashion. Our research shows that text messaging is an affordable, reliable, and efficient means to communicate with most public health audiences about many topics, including: appointment reminders, medical adherence, surveillance, situational awareness, and health promotion. The Texting for Public Health Toolkit has everything that anyone needs to start their own texting program, from information about how to craft and target texts to how to navigate legal issues. It’s an incredible resource that would benefit many public health departments and organizations. And we believe that readers of the NPHIC News will find this toolkit very helpful. The toolkit is located here: http://www.nwcphp.org/training/ opportunities/toolkits-guides/texting-for-public-health-toolkit.

New Membership Information Jonny Andia, Centers for Disease Control & Prevention, Ga.

Monica Mahaffey, New York State Department of Health, N.Y.

Shirley Arvey, Global Impact Solutions, Ga.

Nathan Matney, Independence Health Department, Mo.

Frank Balak, Central Valley Health District, N.D.

Anna Perea, Centers for Disease Control & Prevention, Colo.

Jenny Barrie, unspecified affiliation, Ill

Mandy Qualls, Oklahoma City-County Health Department, Okla.

Patti Carter, County of Nevada Health & Human Services, Calif.

Rosario Quintanilla Vior, U.S. Food & Drug Administration, Calif.

Arantxa Cayon Nieto, Pan-American Health Organization, D.C.

Tom Schlueter, Kane County Health Department, Ill.

Michael DAgostino, New York City Dept. of Health & Mental Hygiene

Doug Seubert, unspecified affiliation, Wisc.

Beatrice Dewberry, Mason Square Health Task Force, Mass.

Dara Shapiro, New York State Department of Health, N.Y.

Jamie Dukes, Oklahoma State Dept. of Health, Okla.

Victor Wahby, unspecified affiliation, D.C.

Richard Foster, Virginia Foundation for Healthy Youth, Va.

Loyedi Waite, Housing & Urban Development, D.C.

Heidi Helsley, Washington State Dept. of Health WIC, Wash.

These folks are the newest members of NPHIC. Now is the time to invite the communicators you know to join NPHIC, too. Let’s keep NPHIC growing!

Meredith Hurston, M Squared Healthcare Consulting, Md. Kim Kelly, New York State Department of Health, N.Y. Mark Linderman, Wayne County Health Department, Ind.

Ebola Information Line Success In Nebraska By Phil Rooney

It didn’t take us long to respond to the first call. Word came from the Nebraska Department of Health and Human

Services and the Nebraska Medical Center that the U.S. State Department was sending a doctor infected with the Ebola virus to Omaha – in this case, about six blocks from our offices at the Douglas County Health Department. There were going to be a lot of questions. A couple of teleconferences later, including one with CDC personnel, we had our plans in place for an Ebola Information Line – not a hot line – and the work was under way. We started with the Q&A document posted on the CDC’s website, and then began developing a set of questions that could be expected from our community.

Helen Giambrone, Mary Amend, and Chad Wetzel field calls at the Ebola Information Center.

Nebraska Medical Center, the state and the CDC. The phone lines were set up with the capacity to handle 20 callers at once, which was more than was needed. Callers were greeted by a recorded message with three key points, and two Spanish lines were provided. The call center was established in a meeting room of the Douglas County Health Department. It was staffed entirely by public health employees, including epidemiologists who are used to discussing communicable diseases, and some individuals from our emergency planning section. A physician was on hand to answer specific medical questions and handle the “cranky” callers.

Those were worked and reworked by the staff, vetted by the From the beginning, the Nebraska Medical Center was transparent about what was happening. At a news conference in advance of the patient’s arrival the information line was announced, including plans for it to be open 9 a.m. to 4 p.m. Monday through Friday. Calls placed to Nebraska DHHS and the Omaha Mayor’s hotline relating to the Ebola patient were forwarded to the Douglas County Ebola Information Line to maintain a consistent message. 16 An American doctor who contracted Ebola in West Africa arrives at Nebraska Medical Center.

About 10 percent of the calls were people calling to vent, while the largest number, 20 percent, wanted to know how Ebola was spread. Another 15 percent wanted to know about community safety or if it was safe to attend appointments at the Medical continued on page 17

Radiation Exercise Focuses On School Legal Questions By John Silcox

On Aug 1 around noon, a 10-kiloton nuclear device detonated in downtown Fort Wayne, Ind.

for, responding to, and recovering from radiation incidents.

The blast leveled buildings for a half-mile in every direction killing thousands, and the resulting radiation plume drove thousands more to seek shelter inside homes, schools and offices for the next 48 to72 hours.

“Educational facilities play an important role in community preparedness,” says Roszak, NACCHO’s senior director of environmental health, pandemic NACCHO’s Andrew preparedness & catastrophic response. Roszak “On any given day, there are more than 60 million students, faculty, and staff housed in both public and private K-12 schools.”

Okay, so the bomb was not real, only hypothetical. But for the public health officials, first responders, school administrators, hospital workers, emergency managers and others who participated in the exercise, it was a scary enough proposition to stimulate plenty of discussion on how the community would handle such a catastrophic event. The exercise was part of a nationwide Radiation Preparedness Project, a joint effort between the National Association of County and City Health Officials and the CDC. Andrew Roszak, the NACCHO team lead, says the ongoing national project seeks to identify best practices and key challenges regarding legal considerations for educational facilities preparing Ebola Information Line, continued from page 16

He says the project provides a rare opportunity “to further develop community partnerships, educate educational professionals about radiological emergencies, examine the legal responsibilities and authorities of educational facilities and advance community planning efforts.” That’s no easy feat as the laws governing the legal rights and responsibilities of educational facilities vary by state and policies often vary by district. For instance, many schools have lockdown policies as a result of active shooter incidents but might also be continued on page 18

Center, with another 14 percent asking about procedures at the biocontainment unit.

about what was happening. We didn’t want them to be caught off guard by questions, and potentially it made them ambassadors of our messages.

The Medical Center has provided daily updates in various forms. Social media was used – especially Twitter – and picked up by the media and other followers.

In addition to generating this story/column from the Omaha World-Herald, the state’s largest newspaper, we had coverage from all four local TV news stations, and NPR.

Answers to questions specific to the Medical Center’s internal procedures were answered when possible but with the qualification that it was: “According to the Nebraska Medical Center, they are…” or messages were taken and forwarded to their PIO.

We were open, honest, responded promptly to media requests, but also gave thought to the messages we wanted to get out. We made sure that all of us – DCHD, NDHHS, and the Nebraska Medical Center – were consistently speaking with one voice in what we were telling the public.

The Douglas County Health Department and Nebraska Medical Center also made it a priority to keep their own staffs informed

And, as you can tell by the pronouns that have been used – us and we – this was a team effort.

Radiation Exercise, continued from page 17

designated as public shelters during radiation incidents. Year one of the proposed five-year study (2013-2018) involved visiting four cities to engage educational facilities and community stakeholders in key questions and decisions they may face in the six hours after a radiation incident. Besides Fort Wayne, the other cities visited were Salt Lake City, Utah; El Paso, Texas; and New Orleans, La. About 60 people, including representatives of the Department of Health, law enforcement agencies, the American Red Cross, Office of Homeland Security, local hospitals, school districts and universities participated in the exercise in Fort Wayne. For the tabletop exercise, the participants were given basic information on radiation and were then asked to think through some legal issues in the aftermath of an improvised nuclear device detonation in downtown Fort Wayne. In the scenario, the city-county government, police, fire and emergency management offices were destroyed, telecommunications systems were rendered largely inoperable, fires raged throughout the city and injuries and fatalities numbered in the tens of thousands. Some of the questions that were explored related to lock-down protocols, notification to parents, restriction of movement and decontamination of persons exposed to radiological material.

Representatives from the CDC also used the training as an opportunity to showcase their new public education materials related to radiation emergencies and sheltering guidance, including fact sheets and infographics depicting the importance of sheltering in place (although the term itself is losing favor in some emergency preparedness circles). Because the walls of a home or structure can block much of the harmful radiation, it is recommended that people get inside a building and stay there for at least 48 hours. Those exposed might also need to be decontaminated to remove radioactive particles from their clothing or bodies. Based on feedback received from each site visit, the NACCHO team already knows there is a strong interest in radiation preparedness and that the exercise was helpful in fostering communication and networking within those communities, says Lisa Brown, a NACCHO policy analyst. But there is much work that needs to be done. “Throughout the site visits, many participants noted that prescripting public messages and educating the public prior to a radiation event was crucial,” Brown says. “The main knowledge gaps included general radiological knowledge, lack of planning specifically for radiation on a local level, and lack of education and public messaging to residents and professionals related to this topic.” Now that the site visits have been completed, the NACCHO group is working on writing and disseminating a guidance document that will summarize its key findings, share best practices and identify knowledge gaps. “We are extremely grateful to the jurisdictions that participated in this project, and look forward to sharing our findings in the near future,” Roszak says.

Paralytic Poisoning and Fukushima Radiation: Alaska’s Fish Stories Have PIOs Hopping By Mary T. Burt

This is quite a fish story, but not about the big one that got away. Rather it’s a true story about how Alaskan public information officers handled three entirely different health events this past summer, including a probable case of deadly paralytic shellfish poisoning (PSP), and radiation risks on fish from the Fukushima nuclear disaster. Significant press coverage added to the challenges, underscoring the need for effective risk communication strategies and planning, which they did. There was a lot at stake. The events revolved around a treasured Alaskan resource – its wild seafood – and the nutritional, cultural and geographical importance of fish to Alaskans. The public needed to be informed and kept safe, as well. The events -- the PSP incident, the radiation impact on fish, and publication of an expanded list of fish species for “unlimited consumption” – each required a different public health message on safe fish consumption. Each also demonstrated the importance of testing and analysis in making public health recommendations. The PIOs needed to educate, not panic, the public with messages that had different calls to action. The PSP case and Fukushima radiation risk, for example, required different messages, which on the surface might seem confusing and contradictory. The PSP press release’s message was to avoid eating shellfish off the beach because they haven’t been tested. However, when the U.S. Food and Drug Administration confirmed that seafood in Alaska waters posed no radiation-related health concerns, the message changed to eat more fish. “The challenge,” says PIO Dawnell Smith who helped handle the events, “is always about distilling often complex or limited data, results, analysis, facts and procedures into easily understood messages.” “People dig clams in Alaska, always have, so the conveyance of

A big catch in Alaska.

the risk of paralytic shellfish poisoning must include information about the symptoms and the importance of seeking medical care,” Smith added. “When talking about the consumption of wild seafood in Alaska where it is a treasured and managed resource, the message must balance the known risk with the known nutritional and cultural value.” Here’s a summary of the press releases and key points/messages, with commentary by Smith. June 16 release, “Paralytic shellfish poisoning: An ever-present risk in Alaska

Message: Be careful eating or don’t eat recreationally harvested shellfish! The first risk communication challenge came with a suspected case of PSP, an ever-present risk in recreationally harvested Alaskan shellfish. Although clam diggers often look for signs of a “red tide,” there is no way to tell if a beach is safe for harvesting simply by looking at it. The toxins that cause PSP can be present in large numbers even if the water looks clear. Such toxins cannot be cooked, cleaned or frozen out of shellfish. Commercially grown shellfish are tested and considered safe, though. Early signs of poisoning often include tingling of the lips and tongue. Symptoms may progress to tingling of fingers and toes, then the loss of control of arms and legs. Death can continued on page 20

Alaskan Fish, continued from page 19

result in as little as two hours. The probable PSP case prompted the Alaska Department of Health and Social Services to identify the symptoms of the patient, the clam types, where they were harvested, and information about the neurotoxins that cause PSP. “We used a suspected case of PSP to alert people about the risk of eating recreationally harvested shellfish,” explains Smith. “There is no testing program on Alaska beaches, and therefore, no way to know if a particular fish is free of the toxin… After we sent our press release and handled multiple media calls, we received calls from people for a few weeks wanting to know if the clams they gathered over the weekend were okay to eat. We again repeated our message.” July 22 release, “Alaskan fish consumption guidelines expand species on unrestricted list”

Key Point/ Message: More Alaskan species of fish OK to eat! The message changed from previous weeks, but the reasons were clearly stated. About mid-summer, expanded fish testing data and epidemiological studies prompted the release of new fish consumption guidelines. The guidelines included more fish species on the “unrestricted consumption” list. New species such as small halibut, lingcod, and grayling were added. The environmental public health program manager was quoted as saying, “The

guidelines allow unrestricted consumption of many fish species, particularly those most frequently consumed by Alaskans.” The release also included the names of multiple agencies that collaborated to establish the guidelines to further underscore their expertise and credibility. July 31 release, “Further analyses confirms Alaska seafood is safe from Fukushima radiation“

Key point/Message: Alaskan seafood safe from radiation so you can eat it! Half way through summer, the FDA released its latest radiation testing, declaring Alaska seafood safe. The press release listed the fish species that were tested, how samples were analyzed, and where people could find the report. Smith said the guidelines and radiation releases do the opposite from the PSP release in terms of messaging: They encourage consumption rather than discourage. The Fukushima release came in response to public uncertainty about the fish in Alaskan waters. “Again, the message was tied to additional testing and analysis with the Alaskan Department of Environmental Conservation and the FDA,” Smith said. “The release on the guidelines extends the number of fish species on the ‘unrestricted consumption’ list based on expanded testing and epidemiological studies, again to promote the consumption of nutritionally rich food source.”

Icky Germs, Dirty Hands, And Germ Fighting Heroes By Cathy Flanagin

Drawing icky germs or dirty hands. Making posters with tips of what to do if someone coughs or sneezes on your toys. Creating comic books showing everything you touch during the day that could have germs. Writing a poem about how vaccines keep you healthy. Creating germ-fighting heroes who use soap, water, and vaccines. Well, Pennsylvania children are being encouraged to do any of the above in the 2014 Get Smart Competition for Young Artists and Writers. More than two million Americans suffer antibiotic-resistant infections each year and more than 23,000 die as a result. The types of bacteria resistant to antibiotics are increasing and jeopardizing the effectiveness of these essential drugs. With children having the highest rates of antibiotic use, Pennsylvania is attacking the problem at the source through activities for kids with their 2nd Annual “Get Smart Kids’ Competition.” The contest is designed to let everyone know the importance of hand washing, getting vaccines and using antibiotics wisely. In the contest’s first year, there were 400 entries from children 8 years and younger. This year, the contest has been expanded to reach children 12 years and younger. The top three winners of each age group will receive a prize, have their creations featured on the Pennsylvania Get Smart Website, used in promotional materials during “CDC’s Get Smart Week” (November 17-23, 2014). “This is a way to lighten up the subject matter and talk about it without boring kids,” said Get Smart’s Amanda Reiff. Through the projects, children and parents are educated on the importance of antibiotic resistance and smart antibiotic use. Educating parents is particularly important, as they often are influential in a doctor’s decision to prescribe antibiotics. Research has shown doctors prescribe antibiotics 62 percent of the time if they perceive parents expect them, and only seven percent of the time if they feel parents do not expect them. “It takes lots of communication and partners to get the word out about the contest,” Reiff said, adding, “Childcare centers were very effective in getting the word out to participants.”

project, a survey is being developed for parents of the children who participate this year. Pennsylvania is attacking the overuse and misuse of antibiotics on other fronts as well, including the development of a sick-child exclusion policy for childcare centers. Childcare facilities often have sick-child exclusion policies but do not follow any standardized guidelines. Often these policies unnecessarily exclude children with mild illnesses and symptoms. Some policies require that ill children take antibiotics regardless of illness before they are readmitted, which is often unnecessary. Inclusion and exclusion criteria should not be dependent on antibiotic prescriptions since viral illnesses do not require antibiotics.

G ALL CALLTIIN VE K C R EA

2014 Get Smart Competition for Young Artists and Writers

IDS!

In 2012, the Pennsylvania Draw a picture, design a poster, or write a story about keeping healthy! Department of Health Get Smart Program and the Department of Public Welfare formed a Sick Child Exclusion Policy Advisory Group. The group included experts in pediatric medicine, childcare center directors, public health officials and childcare consultants. The main objective of the group was to www.KnowWhenToSayNo.org develop practical guidelines for childcare providers to help implement appropriate sick-child exclusion policies. The Pennsylvania Get Smart Program invites all children (up to 12 years old) to help build the National Campaign to say “NO!” to germs and “YES!” to being healthy! This involves ideas like washing your hands (to wash germs away), getting vaccines or “shots” (to help to prevent illness), and using medicines called antibiotics appropriately (to fight bacterial infections).

Here are a few ideas:

• Draw icky germs on dirty hands!

• Make a poster with tips for what to do if someone coughs on your toy. Yuck!

• Write about a classroom where you are sharing books and toys, but one day your best friend gets sick. What happens? Does she go to the nurse? Do you wash your hands?

• Write a poem about how vaccines help keep you healthy. • Create a germ-fighting hero who uses soap, water, and vaccines to fight off germs.

• Make a drawing of yourself getting a flu vaccine! • Show examples of children sick with germs that don’t need antibiotics—like colds or the flu. They need a Kleenex box and lots to drink but no antibiotics!

• Design a comic book of everything you touch in a day that could have germs.

Deadline for entries is 10:00pm EST, October 24, 2014

Three children each from five different age groups will win prizes! The winning work will be displayed on the Get Smart website.

For guidelines, information, and where to submit your entries, visit

Widespread use of antibiotics is one of the factors driving emergence of antimicrobial resistant pathogens. Children who are cared for in childcare facilities are at an increased risk of acquiring upper respiratory infections, which are frequently caused by viruses, not bacteria.

The contest asks children to draw a picture, design a poster, write a story or write a poem based on one of the following themes:

For more information about Pennsylvania’s Get Smart Program, please visit www.KnowWhenToSayNo.org.

• Importance of proper hand washing • Importance of vaccines • Knowing when NOT to use antibiotics They are reaching out to schools this year, hoping to directly involve them and increase participation. To better evaluate the

Antibiotic resistance is a growing public health threat and we must work together in a variety of ways to combat this problem. As CDC Director Thomas Frieden, MD, MPH says, “If we don’t act now, our medicine cabinet will be empty and we won’t have the antibiotics we need to save lives.”

CDC Starts New Prevention Through Health Care Website CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) has launched the Prevention Through Health Care Website to help stakeholders navigate the transitioning health system. State/tribal/local/territorial public health agencies, community-based organizations, and other partners will find critical information on this site to help leverage changes in the health care system to strengthen the delivery of HIV/AIDS, viral hepatitis, STD, and TB preventive services. The website provides information and resources to: •

Increase awareness of key health system changes relevant to NCHHSTP programs.

•

Describe the implications of the changes for program operations.

•

Offer guidance and resources to support programs in leveraging changes.

The three inter-connected transitions in the health system addressed by the website are: • • •

Medicaid Expansion Preventive Service Coverage Community Health Center Strengthening

These webpages will evolve and expand with the changing landscape of the health system; the availability of new information and resources; and input received from NCHHSTP staff, health departments, community-based organizations, and other NCHHSTP partners. Please contact NCHHSTP_PTHC@cdc. gov with questions or comments. Additional information, resources, and training opportunities related to changes to the U.S. health system can be found at CDC’s Health System Transformation and Improvement Resources for Health Departments.

Big Push To Boost Lagging Adult Vaccination Rates By Brad Christensen

CDC is in the midst of a major research-based, multi-media campaign to improve adult vaccination rates. The effort, themed “Don’t Wait. Vaccinate,” certainly is needed: Every year there are millions of influenza cases and thousands of deaths – yet only about 40 percent of adults are getting the flu shot. There are about one million shingles cases each year, but only 20 percent of those most at risk – adults age 60 and older – have received shingles vaccine. Pneumococcal and hepatitis vaccine coverage lags below 30 percent for those at risk for those diseases. And many are unaware of their need for a tdap shot to protect a newborn from pertussis. Michelle Basket of the National Center for Immunization and Respiratory Diseases explained the campaign at the recent National Conference on Health Communication, Marketing and Media. It has included posters, print ads, web buttons and banners, radio PSAs, radio interviews, national dissemination of matte articles, paid magazine ads, a Medscape commentary, WebMD digital ad and more, even a jumbotron ad in Times Square, New York that’s expected to garner nearly 110 million impressions by the end of September. Much of the effort has been focused on health care providers, and many of the tools for this group are here. “Our research found that while the health care professional is the top influencer for vaccination, most adults didn’t remember getting a

recommendation from their health care professional,” Basket said. That research included survey data from 3,503 households, 66 focus-group discussions conducted in Atlanta, Phoenix and Chicago, 28 in-depth interviews with health care professionals, and an extensive review of existing literature. In addition to the health care provider being the top influencer, the research found that adults are motivated to get vaccines to protect their own health and the health of loved ones, but they have some concerns about the safety, side effects, effectiveness and cost of vaccines. As a result, the campaign urges health care providers, in addition to recommending a vaccination, to share that they themselves have been vaccinated to help boost patients’ confidence in vaccines.