CDC's Response to Ending Neglect
GOAL V: Mobilize and sustain support
Mobilize and sustain support for TB elimination by engaging
policy and opinion leaders, health care providers, affected communities,
and the public. Implement a comprehensive health communication campaign
that supports TB elimination and ensures the development and delivery
of effective TB elimination messages. Improve communication efforts
through consistent monitoring and evaluation of the plan's methods
A comprehensive CDC health communication effort will develop momentum
for TB elimination at the national and local levels. At the national
level, the communication plan will include the use of news media
and outreach to national organizational partners. At the local level,
CDC messages and strategies should be an integral component of a
data-driven, community-specific plan to foster strong linkages among
health departments, community leaders, organizational partners,
and the affected community. CDC's communication efforts will be
national in scope, but strategies will vary according to TB morbidity
levels in a particular area. The use of existing surveillance data
will be a key determinant in defining specific target audiences
and developing communication strategies to reach the targeted groups
of the general public.
Develop and implement a health communications effort focusing
on the achievable goal of eliminating TB.
To secure needed resources and support, all partners policy
makers, leaders from affected communities, clinical and public health
organizations, and the general public must support and advocate
for TB elimination. Policy makers must understand the importance
of and need for TB elimination and become armed with the tools to
become effective advocates and spokespersons.
- Develop and implement a national health comunication campaign
to raise the awareness of policy makers, health care providers,
and the public about the ongoing toll of TB and to create support
for elimination efforts. Elements of this campaign include but
are not limited to the following:
Encourage support for new diagnostic, treatment, and prevention
methods by informing TB prevention leaders and policy makers about
progress in TB elimination using local data and the resources
needed to ensure continued progress.
- Identify key messages to communicate to these specific audiences.
- Identify and train national spokespersons. Include representatives
from CDC, affected states and communities, and key organizational
- Create sustained media outreach. Working with national and
local TB program staff, plan a calendar of newsworthy events,
including data releases, journal articles, conferences, program
milestones, grant awards, and other items of interest. Focus
outreach on major national print, electronic, and news media
outlets as well as outlets associated with affected areas and
- Develop features highlighting local success stories and outbreak
responses. Examine how these efforts affect individuals and
communities and can help prevent the spread of TB.
- Explore how local outbreak responses can support national
communication objectives. Implement protocols for obtaining
outbreak information from local health jurisdictions and funneling
the information to neighboring and other jurisdictions and to
organizational partners, policy makers, and community groups.
Develop communication partnerships with national organizations.
- Develop routine and coordinated communication with state health
officers, TB prevention leaders, and other policy makers on
TB morbidity in their communities.
- Create or enhance mechanisms to disseminate TB information
rapidly. Tailor the data presented and method of communication
to the needs of target audiences.
- Create a systematic, yearly plan to highlight TB elimination
activities at conferences, meetings, and events attended by
policy makers and TB prevention leaders.
- With consultation from members of the National Coalition
to Eliminate Tuberculosis (NCET), create a list of the top ten
national organizational partners. Selection criteria might include
credibility with target audiences, organizational reach to target
audiences, and ability to mobilize organizational networks.
- With consultation from the American Lung Association (ALA),
identify key leaders from the top ten organizational partners.
Initiate contact, and assess each group's availability to work
on the communication campaign.
- Work with each local and national organization to customize
program messages and develop initiatives at the community level.
Obtain input from partner organizations during the development,
implementation, and evaluation of communication activities.
Help communities foster nontraditional, multisectoral, public-private
partnerships to improve the effectiveness of their communications
activities, with particular attention to culturally appropriate
TB elimination will require significant community buy-in, support,
and involvement. State and local health departments must build support
in affected communities; develop mechanisms for ongoing communication
with organizational staff, community leaders, and policy makers;
and encourage the community to join the elimination effort. Community
groups can help define local needs and assets and specify how needs
can be appropriately and effectively addressed and how assets can
be deployed. Community partners can facilitate the implementation
of rapid outbreak response, provision of clinical and laboratory
services, and enhanced health promotion interventions. Credible
community leaders can deliver messages and distribute materials
that promote health careseeking behavior in at-risk populations.
- Develop consistent and routine communication channels for sharing
TB-related information with state and local health departments.
Create unifying TB elimination messages and a partnership-building
tool kit for states.
- Sustain existing communication systems, and develop additional
systems (e.g., electronic mailing lists, broadcast fax, broadcast email) as
needed to facilitate the receipt and use of TB-related information
by state and local health departments.
- Provide health departments with access to TB-related health
communication and community participation materials.
Support state and local health departments in their efforts
to engage community representatives in TB elimination activities.
- Conduct formative research with community representatives
to develop community involvement messages.
- Develop and evaluate a prototype partnership-building tool
kit, guided by qualitative research and pretest findings.
Equip community representatives with local data and tested materials
to help them develop interventions and materials that promote
TB awareness among at-risk persons.
- Create mechanisms for dialogue among community representatives,
health departments, and CDC staff (e.g., on-site consultations,
electronic mailing lists, discussions at regional meetings).
- Conduct research on models for conceptualizing, planning,
and implementing appropriate community input mechanisms (e.g.,
town hall meetings). Examine the use or adaptation of the popular
opinion leader HIV/AIDS prevention intervention package for
TB elimination. Host small meetings to learn what works in states,
and disseminate the findings.
- Create materials (e.g., slide shows, fact sheets, brochures)
in collaboration with health departments and community leaders
to inform community groups, managed-care organizations, and
provider groups about the TB elimination effort.
- Conduct formative behavioral research with at-risk persons
to determine their knowledge, attitudes, and beliefs about TB
and TB testing. (See IIB.)
- Review and incorporate relevant information gleaned from
World TB Day efforts.
- Develop and implement a health communication training/technical
assistance strategy for community representatives. Design training
courses to enhance health communication capacity in local areas
beyond the TB elimination effort.
Support the development of state- or area-specific TB elimination
plans that contain communications activities to build public support
for TB elimination.
- Provide ongoing technical assistance to state health officers,
TB controllers, and other leaders in developing TB elimination
strategies, approaches, and plans.
Conduct "Mobilizing for TB Elimination" workshops
for state TB controllers and their partners to train them in the
development of state- or area-specific TB elimination plans that
contain communications activities to build public support for
- Use existing surveillance data to identify successful programs
and program challenges.
- Use the information gathered about successful TB elimination
activities to develop tools (e.g., best-practices information,
newsletter articles, op-eds) for other states.
- Host a meeting or session at the National TB Controllers Workshop,
American Public Health Association (APHA) annual meeting, and
other key national conferences to showcase best practices and
lessons learned and to disseminate tools for replication.
Stages in the Health Communication Process
All activities undertaken as part of the CDC communications
campaign will be planned and conducted according to the following
Stages in the Health Communication Process67:
Stage 1: Planning and Selecting a Strategy
- What do we know about the health problem?
- Who are the target audiences? What is known about them?
- What are the program goals?
- What measurable objectives can be established to define
- What are the messages?
- How will the initiative be evaluated?
Stage 2: Selecting Channels and Materials
- What existing materials can be used or adapted?
- What formats will best suit the channels, messages, and
Stage 3: Developing and Pretesting Materials
- How can the messages be presented to the target audiences?
- What has message testing revealed about audience reaction,
message clarity, recall, acceptance, and value?
- What changes need to be made to the messages or their
format, based on testing responses?
Stage 4: Implementing the Program
- Are the messages making it through the communication
channels to the audiences?
- Do any channels need to be changed? Do any new ones need
to be added?
- What modifications need to be implemented?
Stage 5: Assessing Effectiveness
- Were the communications objectives met?
- Were the changes that took place the result of the program,
other factors, or a combination of both?
Stage 6: Feedback to Refine the Program
- What made this program work or not work?
- What changes should be made to improve the program or
better reach the target audience?