The Flu Ends with U: CDC Flu Vaccination Communication Plans for the Flu Season

Transcription

1 The Flu Ends with U: CDC Flu Vaccination Communication Plans for the Flu Season National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention July 28, 2010

2 Objectives Review ACIP recommendations for the influenza season and expected vaccine supply Share highlights from CDC s influenza vaccine communication research Provide a broad overview of CDC s influenza vaccination communication campaign plans 2

3 Influenza Basics Influenza is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. One study found that during the 1990s, flu-related deaths ranged from an estimated 17,000 during the mildest season to 52,000 during the most severe season (36,000 average). 3

4 Influenza Basics (cont.) Certain people are at greater risk for serious complications if they get the flu, including: older people, young children, pregnant women and people with certain health conditions. During a regular flu season, about 90 percent of deaths occur in people 65 years and older. During , a new and very different flu virus called 2009 H1N1 spread worldwide causing the first flu pandemic in more than 40 years. It is estimated that the 2009 H1N1 pandemic resulted in more than 12,000 flu-related deaths in the U.S. In contrast to seasonal flu, nearly 90 percent of the deaths from 2009 H1N1 occurred among people younger than 65 years of age. 4

5 Composition of Current Vaccines Against Seasonal Influenza The seasonal flu vaccine protects against three influenza viruses that research indicates will be most common during the upcoming season. The vaccine will protect against 2009 H1N1, and two other influenza viruses an A/Perth/16/2009 (H3N2)-like virus (change from the influenza vaccine formulation) a B/Brisbane/60/2008-like virus (the same as last year) About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body. 5

6 Who Should get a Flu Vaccine? The single best way to prevent the flu is to get a flu vaccine each season. In February 2010, CDC s Advisory Committee on Immunization Practices voted that everyone 6 months and older should get a flu vaccine each year starting with the influenza season. eliminates the need to determine whether each person has an indication for vaccination emphasizes the importance of flu vaccine for everyone flu is unpredictable; even healthy children and adults can get the flu and it can be serious remains especially important that certain people get vaccinated either because they are at high risk of having serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications 6

7 When to Give/Get Flu Vaccine? Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. The timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. 7

8 Vaccine Supply for the Influenza Season Vaccine manufacturers project they will supply the U.S. with about 170 million doses of vaccine, with a substantial amount available by the end of September However.. 8

9 Production of Egg-based Seasonal Influenza Vaccines Virus Selection FDA advisory panel selects 3 strains CDC provides new strains of the seed virus to the FDA FDA distributes the 3 seed viruses to manufacturers FDA Testing, Licensure Filling/ Packaging Vaccine is filled into vials and syringes; packaged for distribution Product Release/ Shipping Vaccination Begins Immunity develops approximately 2 weeks after vaccination Jan-Mar Apr-Jun Jul-Sep Oct-Jan FDA = Food and Drug Administration; CDC = Centers for Disease Control and Prevention. 9

10 CDC s Influenza Vaccine Communication Campaign: Research

11 Efforts Grounded in Audience Research Gauge knowledge, attitudes and behaviors related to seasonal influenza, H1N1 influenza, and the seasonal influenza vaccine, which will contain the 2009 H1N1 strain. Receive feedback on key messages that may be used to communicate about the seasonal influenza vaccine in the flu season. Assess messages and communication products for their ability to motivate people to get vaccinated against influenza. 11

12 Audience Groups and Segmentations Mixed Race/Ethnicity Low Education High Education African American, Caucasian, Hispanic Mothers of Children and Adolescents (0-18 years) Young Adults (19-24 years) Mixed Race/Ethnicity Living on Campus Commuting to Campus Working Adults Focus Group Audiences Asthma Diabetes Mixed Race/Ethnicity Low Education High Education African American, Caucasian, Hispanic years of age years of age Chronic Medical Conditions (Ages 25-49years) Seniors (65-75 years) Low Education High Education African American, Caucasian, Hispanic 12

13 Key Findings Many perceived the 2009 H1N1 strain to be serious and deadly This belief motivated some to get seasonal and/or 2009 H1N1 vaccines Others did not get vaccinated even if they perceived the risks of diseases to be high Safety concerns about the 2009 H1N1 vaccine remain high Those wary of the monovalent vaccine were concerned that including the 2009 H1N1 strain in the seasonal vaccine would not be safe; they preferred to have the choice of obtaining the vaccines seperately. Old misperceptions/concerns remain I got the flu vaccine once and it gave me the flu Health care providers highly trusted and influential 13

14 Key Findings Those who perceived themselves and/or their children to be at low risk from flu reported that this concept resonated with them: Every flu season is different, and influenza can affect people differently. Even healthy children and adults can get very sick from the flu and spread it to others Using data and statistics makes messages more credible and relevant. The more tailored the data for specific audiences, the more motivating the message. Few observable differences in responses noted by race, ethnicity, or education. New products and channels have potential for reaching audiences with flu messages (e.g., foto novellas, prescription 14 inserts, s from college health clinics)

15 Research Objectives - Physicians Explore facilitators and barriers to obstetricians/gynecologists recommending influenza vaccines. Explore facilitators and barriers to primary care physicians recommending influenza immunization. Test draft materials designed for the upcoming communications campaign. 15

16 Objectives Health Care Workers Explore changes in attitudes about influenza immunization resulting from 2009 H1N1 influenza. Explore attitudes about inclusion of 2009 H1N1 in seasonal influenza vaccine. Test draft materials designed for the upcoming influenza-communication campaign. *Allied Health Professions include: Respiratory Therapist, Medical Assistant, Certified Nursing Assistant, Physical Therapist, and Occupational Therapist 16

17 Methods 30-minute in-depth interviews with physicians Specialty City Totals Hollywood, FL June 3-4 Chicago June 7-8 San Francisco June OB/GYN Internal Medicine Family Medicine Pediatrician Cardiologist Pulmonologist 1 1 Endocrinologist 1 1 Otolaryngologist 1 1 Totals

18 Methods 1-hour discussions with health care workers Less experienced: Less than 3 years More experienced: 3 or more years Specialty City Totals Hollywood, FL June 3-4 Chicago June 7-8 San Francisco June Registered Nurse (RN) Licensed Practical Nurse (LPN) Allied Health Professions* Hospital Service Workers Totals *Allied Health Professions include: Respiratory Therapist, Medical Assistant, Certified Nursing Assistant, Physical Therapist, and Occupational Therapist 18

19 Summary: Physicians Primary barriers, facilitators: Supply, cost, and patient awareness Enthusiasm for inclusion of H1N1 in seasonal vaccine Very strong support for universal recommendation Most rely on injectable vaccine Familiar and dependable 19

20 Summary: HCW H1N1 (disease and vaccine) did not demonstrably increase interest in seasonal flu vaccine. Have similar misperceptions and concerns as the general public HCW assert that a universal recommendation will have little/no impact on their intention to be vaccinated. Short, bulleted facts and figures preferred in communication from CDC. Messages addressing protecting self, patients and family resonated best. Appeals to team, finances, guilty messages disliked. 20

21 CDC s Influenza Vaccine Communication Campaign: Overview

22 Communication Goals and Objectives Create high awareness of universal vaccination recommendation and flu-related key messages Foster knowledge and favorable beliefs regarding influenza vaccination recommendations Maintain, extend confidence in flu vaccine safety Promote/encourage vaccination throughout the flu season 22

23 Campaign Theme The Flu Ends with U Developed for CDC by AED and Arnold after extensive examination of focus group data; tested well with diverse audiences. The theme is a call to action, communicating that in addition to protecting ourselves, we each can have a hand in protecting those who may be at high risk of having serious flu-related complications. The theme is a good fit for promoting universal recommendations to the general public 23

24 Campaign Elements Formative research and message testing Partner outreach and activities Provision of key messages to partners Earned media (mattes, radio and satellite media tours, ethnic media roundtables) Paid media (PSA placement, print ads, NAPS distribution) Web and social media Print materials such as posters, brochures, flyers Education and outreach to healthcare workers Process and impact evaluation 24

25 The general public Audiences Parents of children age 18 and younger Older Americans Adults with chronic health conditions Young adults Pregnant women People who live with or care for those at high risk for complications from flu, including: Health care workers Household contacts of persons at high risk for complications from the flu Household contacts and caregivers of children <5 years of age with particular emphasis on contacts of children <6 months of age Minority populations (African Americans, Hispanics) 25

26 DRAFT

27 DRAFT 27

28 Example of Audience-Specific Communication Strategies: Reaching Pregnant Women Utilize ObGyns to encourage and/or administer influenza vaccination Conduct research to better understand barriers and facilitators Provide information and resources Collaborate with partners on events and outreach Acknowledge that pregnant women are, and should be, careful about medications they take. Explain that influenza causes risk to mom and baby and stress the safety of the vaccine during pregnancy and while breastfeeding. First time mom s-to-be are high information seekers. Get vaccination messages into publications and websites for pregnant women and new moms (including via content syndication). 28

29 Outreach to Pregnant Women Tactics Outreach to online sites such as BabyCenter.com, ivillage s pregnancy channel Pregnant and new moms on Twitter will be identified and recruited to participate in the Flu campaign Family vaccination day during NIVW Distribution of matte article Posters and flyers Paid placement of ads (e.g., on Oxygen, Lifetime, targeted websites) Key Partnerships ACOG, AAFP, WIC, nurses, hospital administrators, hospital maternity wards, birthing hospitals and pharmacy associations who all communicate with pregnant women 29

30 Example of Audience-Specific Plans: Reaching Segmented Hispanic Subgroups Goal Objectives and Strategies Engage local community/grassroots organizations, media, and other stakeholders to promote and encourage influenza vaccination uptake Disseminate accurate/timely information and materials, encourage open dialogue, generate media pushes, encourage grassroots activities, secure measurable results Build on community/grassroots partnerships and engagement, drive partners to CDC website for downloadable materials, intensify and expand CDC outreach to Hispanic health providers, and help build capacity for community organizations to employ multimedia online platforms to amplify communication Audience All Hispanics, including segmented Hispanic sub-groups; and secondary audiences such as health care providers, family, caretakers 30

31 Example Activities Target top 25 Hispanic markets, including hyper-growth, border, farming, rural, and urban markets representative of Hispanic subgroups Collaborate with clinics, community-based organizations, Mexican and Central American Consulates, immunization and interest organizations to conduct immunization clinics and distribute collateral materials Leverage media through influenza education media kit, interviews, radionovelas and PSA placement, promotion on website, article placement, and news stories Reinforce messages such as protect family ; even healthy people are at risk of contracting flu; and everyone can spread flu Intensify and expand CDC outreach activities to Hispanic healthcare providers Websites and social media strategy development to reach diverse Hispanic communities Deliver dynamic Web 2.0 strategy training to grassroots organizations for capacity building and effective message reach to diverse Hispanic groups 31

32 National Influenza Vaccination Week December 5-11, 2010

33 Contact Us 33

34 Acknowledgements AED Center for Health Communication ORISE HMA Associates Glen Nowak Tony Fiore Alan Janssen Janine Cory Kris Sheedy Erin Burns Cindy Fowler Austyn Wilder Jacqueline Higgins Betsy Mitchell Holli Seitz and the social media team at CDC 34

35 Sneak Preview: CDC s Influenza Vaccination Campaign Plans Social Media Ann Aikin Electronic Media Branch Division of News and Electronic Media Office of the Associate Director for Communication Office of the Associate Director for Communication

36 Why Social Media? CDC should be (must be) where people are Increases the dissemination and potential impact of CDC s science Improves reach to diverse audiences Furthers the delivery of consistent, timely, repetitive and tailored/targeted messages Facilitates engagement, participation, transparency, collaboration, and interactive communication Enhances health communication efforts Image from: et_on_the_social_media/

37 Effective Health Communication Attributes Accuracy: Content is valid, without errors. Availability: Content is placed where audience(s) can access it. Balance: Content presents benefits and risks of potential actions and recognizes different perspectives. Consistency: Content remains consistent over time. Cultural Competence: Accounts for special issues, population groups, educational levels and disabilities. Evidence: Use scientific evidence (rigorous analysis) Reach: Content is available to largest portion of target audience. Reliability: Content comes from a reliable source. Repetition: Delivery and access of content is repeated over time to reinforce messages and reach new audiences. Timeliness: Content is available when audience is most receptive or in need of information. Understandability: Content language level and format are appropriate for From: Accessed November 3, 2009

38 Expanding Reach: Going Where People Are! Channel Key Stats Mobile Text Messages Mobile Internet Online Video Social Networks Blogs Microblogs Podcasts 285M or 91% Americans Subscribe to a Mobile Service Source: CTIA, 5/ T Yearly Messages Sent in US Source: CTIA, 12/ % of All Americans Use Mobile Device to Access Web Source: Pew Internet & American Life Project, 7/ % Online US Adults Watch Videos on Sharing Sites Source: Pew Internet & American Life Project, 6/ M or 50% Visit Social Networking Sites Sources: Nielson, 12/2009 and Forrester Research Q2/2009 (includes Canada) 39% Read Blogs 12% Publish, Maintain or Update One Source: Forrester Research Q2/2009 North America (includes Canada) 19% Online US Adults Update their Status/Use Twitter Source: Pew Internet & American Life Project, 10/ % Online US Adults Downloaded a Podcast Source: Pew Internet & American Life Project, 5/2008

39 Increasing Access & Reach: Leveraging Networks Build networks (e.g. CDC Twitter profiles) Utilize existing user networks (encouraging viral sharing of content to the networks that users have built; e.g. their Twitter followers) Work with partners and collaborators to leverage their existing networks (e.g. FDA and HHS

40 Increasing Access and Reinforcing Messages: Using Multiple Formats "People have to see messages in different places and from different people. That means experts as well as peers --Richard Edelman, president and CEO, Edelman. Source:

41 Increasing Access and Reinforcing Messages: Using Multiple Formats

42 Expanding Reach: Facilitating Viral Information Sharing

43 Increasing Accessibility: Creating Portable Content Users can interact It is important to distribute the content to other places. In order for that to happen, the content has to be portable. Source: NPR Blog: ontent_portable_content.html, Accessed 3/25/2010. with your brand and content beyond your web site! Example: The same H1N1 Flu Video had 160,000 views on CDC-TV and over 2M views on YouTube!

44 Improving Timeliness: Using Automatic Updates & Devices People Use Real-time search Status updates and notifications of new content Providing content where people are or where they spend a lot of time

45 Engaging Audiences Social Media provides many ways to engage audiences to further health communications objectives Two-way conversations Interactive tools Idea/content creation

46 Listening to Improve Health Communication Efforts Monitor for: To not participate in conversations that are taking place or to avoid monitoring trends is going to result in lost opportunities. Situational awareness Message development Analyze for themes Address rumors, gaps in knowledge and misconceptions -- Brian Dresher, manager of social media and digital partnerships at USA TODAY

47 CDC.gov s Social Media Visitors who use social media tools on CDC.gov: Have higher satisfaction ratings (a full 5-points higher) Are more likely to return and recommend the site to others Rate CDC as more trustworthy Satisfaction of those who use social media on CDC s Web site Satisfaction of those who DO NOT use social media on CDC s Web site N=16,506 N=32,745 Source: American Satisfaction Index (September 10, 2009 February, 10, 2010)

48 Follow CDC Twitter Immediate communication Wide range of uses Reaches engaged user networks Fosters collaboration and partnership building Expand research on the health impact of social media in health

49 CDC Twitter Profiles with Flu Messaging 2,395 followers (Newly launched) 1,239,536 followers 49,189 followers 42,648 followers 1,333,298 followers

50 Health Behavior Change Likelihood of Changing Health Behaviors Very Unlikely 4% Unlikely 18% Very Likely 16% Likely 62% 78% of Twitter users responded that they are very likely or likely to change their health behaviors based on their experience with CDC Tweets.

51 Real Time Updates: Content Syndication Content syndication provides a streamlined process for disseminating current and credible content in real-time. Launched in June of 2008 with 8,664 views of syndicated CDC.gov content, this number grew to over 770,000 monthly views in May : 70 partner sites & unique URLs 2010 Projection: 300+ partners

52 Fresh Content and Interaction: Widgets

53 Sign Up for Text Messages 4 Info On the Go Launched September 2009 Subscribers receive 2-3 msgs/week Everyday health tips Health message testing and user evaluation

54 Mobile Texting Pilot Overall Satisfaction (N=2,435) How would you rate UR overall satisfaction with the text messages: A) Very Satisfied, B) Satisfied, C) Dissatisfied, D) Very Dissatisfied 87% Satisfied How can we improve? Actionable Relevant

55 Health Behavior Change How likely are you to use any of the information in text messages to improve your health? How likely are you to recommend CDC's text messaging pilot to a friend?

56 Engage with CDC on The official CDC Facebook profile launched in May 2009 to share featured health updates and develop an active and participatory community. CDC s Facebook page currently engages almost 56,000 fans daily. Facebook

57 Participate Virtually in Whyville In-world vaccinations for two strains of flu Modeling of key hygienic behaviors: Hand washing: hand washing decreases likelihood of infection Covering: elbow covering of sneezes and coughs decreases spread of flu Vaccination celebration with CDC flu expert Engaging Video Contest and Flu Report

58 Connect on Blogs Guest blogging on WebMD About 100,000 views a month Second most popular blog on WebMD Expand reach to those who use WebMD: #1 health site

59 Embed, Share or View Flu- Symptoms of H1N1 (Swine Flu) 2,091,126 H1N1 (Swine Flu) 329,079 H1N1 (Swine Flu) Closed Captioned 289,014 H1N1 Influenza (Gripe porcina) (Swine Flu) 98,083 Clean Hands Help Prevent the Flu 87,143 CDC H1N1 (Swine Flu) Response Actions and Goals 86,043 Put Your Hands Together 41,437 Personal Flu Stories 27,363 Related Videos

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61 Send or Promote a Flu Prevention ecard Add a personal message to sciencebased messages from CDC! Currently almost 40 flu-related cards alone!

62 Final Sneak Peak Comprehensive Spanish Language Social Media Outreach Facebook App Expanding to Mom and Physician- Oriented Social Networking Sites Expanding Mobile Activities, including MMS Community Voice Mail Activities to Engage Bloggers and Other Social Media Users Social Media Evaluation of Flu Messages Continuing to Engage Online Collabortors!

63 Thank You! Ann Aikin Social Media Connect CDC_eHealth