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U.S. Department of Health and Human Services


CDC's Response to Ending Neglect

The Plan

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 and strategies.

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.

Objective V-A

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.


  1. 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:
    • 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 partners.
    • 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 high-risk populations.
    • 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.
  2. 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.
    • 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.
  3. Develop communication partnerships with national organizations.
    • 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.

Objective V-B

Help communities foster nontraditional, multisectoral, public-private partnerships to improve the effectiveness of their communications activities, with particular attention to culturally appropriate materials.
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.


  1. Develop consistent and routine communication channels for sharing TB-related information with state and local health departments.
    • 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.
  2. Create unifying TB elimination messages and a partnership-building tool kit for states.
    • 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.
  3. Support state and local health departments in their efforts to engage community representatives in TB elimination activities.
    • 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.
  4. Equip community representatives with local data and tested materials to help them develop interventions and materials that promote TB awareness among at-risk persons.
    • 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.

Objective V-C

Support the development of state- or area-specific TB elimination plans that contain communications activities to build public support for TB elimination.


  1. Provide ongoing technical assistance to state health officers, TB controllers, and other leaders in developing TB elimination strategies, approaches, and plans.
    • 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.
  2. 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 TB elimination.

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 success?
  • 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 audiences?

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?



Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

Please send comments/suggestions/requests to:, or to
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333