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Incorporating Core Public Health Service Messages into Human Interest Stories as a Means of Increasing Understanding of

State: KS Type: Model Practice Year: 2009

Improved communications with our community to raise their awareness of public health issues and the value of public health services. Our program goals are to raise our community’s awareness of public health issues and the value of public health services. Our program objectives are to ensure that 100 percent of all human interest stories prepared for the public include a core public health service message; and to measure the effectiveness of incorporating a core public health service message into public communications. Including a core service message with a program story is effective but not as effective as the story itself. We have identified methods for assisting program managers in developing story concepts that will continue to be useful because we are committed to keeping our story bank current and relevant. We also now have a mechanism to solicit feedback from Web site visitors that will continue to help us measure the effectiveness of our media releases. The accreditation self-assessment process has given us a better understanding of our strengths and weaknesses as they relate to the essential public health services and have begun the process of using quality improvement tools to help us improve our capacity to fully deliver services to our community.
As a result of the systematic process we followed to determine the most relevant public health issue for our community, we chose to work on Essential Service III. A.4—LHD has a media strategy that includes formal and informal opportunities for communicating with the media and responding to media requests, along with routine communication to raise awareness of public health issues. Lawrence-Douglas County Health Department (LDCHD) included public health accreditation as one of our priorities in our strategic plan developed in April 2007. To determine what public health issues we needed to address to begin our accreditation preparations, we conducted a self-assessment using NACCHO’s Operational Definition Prototype Metrics Assessment Tool. We partnered with representatives from the Kansas Department of Health and Environment (KDHE) to facilitate our self-assessment process and to provide qualitative documentation of our responses. An independent evaluator from the Kansas University-School of Medicine-Wichita recorded quantitative responses. Responses were analyzed by averaging individual scores to produce a mean score for each indicator. We then used a prioritization matrix to assist us in determining which opportunity for improvement would give us the highest probability that changes we put into place really could result in improved performance. Prioritization criteria included importance to customer, both clients and the community; linkage to LDCHD’s strategic plan and vision; what probability is there that changes we put into place will make a difference; and how much do we need to improve this area. This indicator was chosen as the best one to address through our QI process. LDCHD already had some capacity in this area and improvements in our media strategy would help us not only to raise awareness of public health issues, but to address opportunities for improvement in other areas as well. In an effort to better communicate the value of public health to policymakers and the public, public health core service messages were developed through a project initiated by the Kansas Association of Local Health Departments in partnership with the Kansas Public Health Systems Group, the Kansas Health Foundation, the Bothner and Bradley Consultant Group, and Kirby Marketing Solutions. The resulting core service messages were developed after market testing the 10 Essential Services of Public Health and targeting the following four areas as having the greatest public acceptance: Monitor, identify, and address health problems—Kansas Public Health agencies are fostering healthy communities by assessing health problems, promoting wellness, and avoiding preventable diseases; Diagnose and investigate health problems and hazards—Kansas Public Health agencies investigate and identify today’s urgent, emerging, and everyday health problems; Safeguard public health laws and regulations—Kansas Public Health agencies work with communities and businesses to implement safeguards that protect health and ensure safety; and Develop plans and policies to protect health—Kansas Public Health agencies work with communities, businesses, and policymakers. This practice used a set of four core service messages that combined elements of the 10 Essentials of Public Health Service to better communicate the value of public health to policymakers and the public.
Agency Community RolesLDCHD has taken a proactive role in bringing together a collaborative partnership to begin our public health accreditation preparations by conducting a self-assessment using NACCHO’s Operational Definition Prototype Metrics Assessment Tool. We partnered with representatives from the Kansas Department of Health and Environment (KDHE) to facilitate our self-assessment process and to provide qualitative documentation of our responses. An independent evaluator from the Kansas University-School of Medicine-Wichita recorded quantitative responses. During the training phase of this project our communications coordinator led a training session on the core service messages. The LDCHD also identified and engaged clients as part of the story development process. Using these client interviews, stories were written and posted onto the ldchealth.org Web site. Stories will also be used as printed information is developed, such as the annual report, brochures, and program reports. In preparing to address our accreditation readiness gaps, the LDCHD has begun revising our strategic plan. This process began with a series of KDHE facilitated small group discussions with staff. During the training phase of this project, a local media representative was used to supplement our training on the core service messages. To equip program managers with a better understanding of QI processes and tools, a QI consultant was used to provide two days of on-site training with follow-up telephone consultation.. As part of the strategic plan revision process, the LDCHD on November 19, 2008, held a community public health forum where public health services were defined and prioritized. This forum was facilitated by an independent contractor and was attended by 60 individuals representing 36 community-based organizations. Our current strategic plan calls for a focus on relationships as defined in the following ways: between management and front line staff; between the health department and policymakers; between the health department and the community. Because we have worked to achieve the goals of our strategic plan, we have completed the following objectives: developed our first independent website at ldchealth.org; met individually with each county commission candidate and two of the five city commissioners giving them a tour of the department and describing our role in the community; released a detailed description of programs and services describing program service, outcomes, the level of resources required, and a program impact story; increased the number of annual report presentations; communicated to our partners a new willingness to engage, which was reinforced by our recent community forum. Costs and ExpendituresPersonnel: direct $5,504, in-kind $7,350; Contractual: (QI consultant) $8,000; Total = $20,854. ImplementationOur program objectives are to ensure that 100 percent of all human interest stories prepared for the public include a core public health service message. To accomplish this objective, we trained our staff on the set of four core public health service messages that were developed as a result of a partnership initiated by the Kansas Association of Local Health Departments in conjunction with the Kansas Public Health Systems Group, the Kansas Health Foundation, the Bothner and Bradley Consultant Group, and Kirby Marketing Solutions. These four core public health service messages were developed in an effort to better communicate the value of public health to policymakers and the public. Although these messages were introduced to staff in November 2006, there was no specific direction given regarding how to use them in our communications with the public, and as a result they had been underused. We held a training session for staff in August 2008 to ensure staff understood the four core service messages so they would be able to better communicate the value and mission of public health to our community. When a post-training survey showed the training alone did not ensure that staff incorporated a core service message in each of their human interest stories they developed for the public, a brainstorming session was held and a cause and effect diagram was developed. From this process, we developed a story template to be used as a checklist to assist staff. This resulted in 100 percent of the stories including a core service message. We have standardized the story template into our ongoing process for developing human interest stories as a means of communicating the value of public health to our community. Additional program objectives are to measure the effectiveness of incorporating a core public health service message into public communications. To accomplish this objective, we measured public understanding of public health services using human interest stories with a core service message as compared to those without. We collected data using both a voluntary online survey and paper surveys that were distributed to clients using clinical services, a community flu clinic, and a local civic group. The surveys used two stories per program:one that included a core service message and one that did not. The surveys measured the percentage of human interest stories that resulted in an increase in the public’s understanding of public health issues and value. Data showed there was an 88.7 percent increase in understanding after reading those stories that included a core service message as compared to 94.2 percent after reading those stories without a core service message. As a result, we will continue to include core service messages in those stories where it makes the message stronger. A modification will be to continue to use LDCHD’s current tagline, “Healthy People Build Strong Communities,” in all human interest stories. Also, we will consider adopting a new tagline such as NACCHO’s “Prevent, Promote, Protect.”
Lessons learned were that the barriers to using core service messages included that the wording of the messages is superfluous and hard to recall; combining essential services created confusion and made message difficult to understand; keeping message cards as visual reminders did not help; staff were too busy to implement; hard to understand the link between core service messages and better messages; and that reminders were still necessary after training. Modifications were made to provide staff with a story template as a checklist to ensure they used one of the four core service messages in their stories.
Staff engagement was significantly elevated with the implementation of a story concept template. Staff have also seen the results of the survey, which clearly demonstrates the power of stories to communicate our message. This has reinforced anecdotal evidence that our stories helped communicate our mission. Sustainability is achievable as the improvements made to our story development process do not add additional costs; they are simply a refinement of the previous process.