The Sickness Lurking Beneath World Cup Fever

  The Sickness Lurking Beneath World Cup Fever Posted August 16, 2018 by Dean Schillinger post-info While watching the World Cup, Dean Schillinger was reminded of the ongoing back-and-forth matchup between the soda industry and public

Arizona’s ERIC Program Works to Improve Access to Emergency Information

Emergency Response Interpreters Credentialing (ERIC) program interpreter, Beth Kovatch, works with the Operations Section of the Southwest Incident Management Team 1 on the Tinder Fire to record an accessible video updating the public on the the status of the wildfire.

Vicki Bond is not surprised at how hot, but at how cold the temperatures can get out on a wildfire. “I’ve worked on responses to more wildfires in freezing temperatures than in extreme heat,” she says.

Coincidentally, making sure people aren’t left out in the cold in an emergency is why she has so much experience with the weather.

Bond works for the Arizona Department of Emergency and Military Affairs (DEMA) as a licensed American Sign Language (ASL) interpreter and deployment coordinator for the Emergency Response Interpreters Credentialing (ERIC) program. She helps prepare licensed ASL interpreters and Communication Access Realtime Translation (CART) captioners to deploy for emergencies throughout the state.

ERIC interpreters and captioners work alongside communicators to interpret and transcribe information presented at community meetings and media briefings, on websites and social media, and in evacuation shelters for people who are deaf and hard of hearing.

“The goal of the ERIC program,” said Bond, “is to ensure deaf and hard of hearing community members have access to critical information during emergencies and disasters in the State of Arizona.”

People in Arizona are at risk from a variety of hazards, including extreme heat, floods, and wildfire. More than 1,500 wildfires occur in Arizona each year.

Trial by Fire

Group photo of participants in the Emergency Response Interpreters Credentialing Program
The ERIC team is made up of American Sign Language Interpreters, Certified Deaf Interpreters, and Communication Access Real-time Translation captioners.

The pilot of the ERIC program was a literal trial by fire. In 2017, ERIC interpreters and CART providers deployed in response to one flood and nine wildfires, where long hours, limited supplies, and sleeping in tents are the rule, not the exception.

The ERIC staff of five captioners, 15 interpreters, and three certified deaf interpreters deployed to two major fires this season–the Tinder Fire and the Rattlesnake Fire in April—and, most recently, supported Coconino County’s response to flooding east of the City of Flagstaff.

ERIC staff have not worked with a public health department on an exercise or real-life emergency, such as a Point of Distribution (or POD) drill or activation as of yet, but Bond anticipates “many more” deployments with the recent enactment of State of Arizona Senate Bill 1296, which is meant to improve the accessbility of emergency communication.

Bond hopes the early success of the ERIC progam will help highlight the need for ASL translators and CART captioners on all emergencies.

Know Your Community

It is not a matter of if you will need an interpreter and captioner, but when you will need them. In Arizona, an estimated 1.1 million people are hard of hearing, and over 20,000 people are culturally deaf and use ASL as their primary language.

Public health and emergency management agencies can use tools like Community Assessment for Public Health Emergency Response (CASPER) surveys to assess local health and communication needs, and collect data that can help emergency planners know when to request resources like interpreters and captioners. The earlier the better in most cases.

Think Accessibility

In today’s “digital first” world, where half of visitors to CDC.gov come on mobile devices first, it is important to think about accessibility throughout the process of creating content, from conceptualization to publication.

Small print, videos without captions, and the use of long and technical language in printed materials and on websites are barriers to communication and possible violations of federal and state laws. Section 508 of the Rehabilitation Act and other laws like it help protect people who have disabilities that affect their ability to hear, speak, read, write, and understand information.

Here are 5 ways to create web and social media content that is useful, usable, and accessible:

  1. Add alternate text (or AltText) to images.
  2. Caption social media video and web video.
  3. Provide transcripts for videos and podcasts, and interpreters for livestreams.
  4. Improve the readability of print materials with large text.
  5. Write in plain language to increase understanding of your message.

Related resources:

Other Public Health Matters posts you might like:

10 Health Literacy Tips for Reporting Data

A social worker and senior woman seated on a couch, looking at a tablet device.

We live in a complex world. Just as humans have left an impact on the environment, the environment also leaves an impact on us. Being exposed to certain physical and social environmental factors, like chemicals in the water, secondhand smoke, or poverty, can affect our health.

Understanding oral health data in MinnesotaCDC’s National Environmental Public Health Tracking Program helps to better understand the connections between our health and the environment by bringing together data and information about the population, the environment and related health effects.

The Minnesota Department of Health (MDH) Oral Health Program is committed to communicating data in a way that is understandable and easy to use. As part of the CDC’s Tracking Program, the MN Tracking Program allows us to do that by hosting our Minnesota Oral Health Statistics System (MNOHSS) data on the Minnesota Public Health Data Access portal.

The MN Data Access portal allows users to quickly find, interact, download, and visualize data through charts, infographics and maps. We also have been able to shed light on oral health disparities and use chronic disease data about diabetes, heart disease and cancer from the portal to look at shared risk factors with dental disease.

Oral health is key to overall health and the MN Public Health Data Access portal has brought greater visibility to this hidden chronic disease.

Taking health literacy into account

Nearly 90% of people struggle to understand health communication messages. This means that the data and reports we publish from our data tracking systems should take health literacy into account and provide health information that is easy to find, understand, evaluate, communicate, and use. Based on my experience, I have compiled 10 easy ways you can consider health literacy when you’re reporting data.

 

  1. Consider audience and outcome. Think about what actions or interventions you are hoping to achieve from your data and who needs to know about the data in order to make those changes. Your data should be presented in a way that is understandable, relevant and action-oriented for your target audience. This could include the media, policymakers, educators, researchers, students, clinicians and other health professionals, as well as the general public.

 

  1. Use storytelling to convey key messages. Think about your favorite novel, television show, or website. What keeps your attention and motivates you to tune in for more? I am learning a lot from communications and behavior change theories and from professionals such as Dr. Neil deGrasse Tyson, Alan Alda, and Dr. Randy Olson who are able to bring science to life through storytelling. Communicating data is a science, as well as an art. We can all take cues from Hollywood’s narrative structure to tell compelling stories that humanize our data and drive action.

 

  1. Reach people where they are. Research your target audience to find the best outreach strategies. You will need to use different strategies depending on their existing level of knowledge, motivating factors, and whether or not they are information seekers and early adopters. Does your audience prefer to receive information verbally (e.g. town hall meeting, webinar, television, radio or podcast), in writing (e.g. website, data brief, social media), or both? As an example, the Minnesota Department of Health’s MN Tracking Program developed a social media campaign that communicates data on the MN Public Health Data Access portal — Land of Healthy Kids — targeting public health professionals, schools, parents/guardians and caregivers of school age children.

 

  1. Make data digestible. When communicating your findings present data in bites, snacks, and meals. Not everyone who looks at your data is going to have the time or expertise to read your entire report so you need to make sure they can find information that is relevant and understandable.
    • Bite: Use anchors and headers to help users quickly find data and information. Brief headers that use a declarative statement to interpret a chart or map helps with data literacy.
    • Snack: Develop simple charts and maps with clear titles, legends, and axes. Charts and maps should be standalone features that do not require additional text to understand. They should communicate the who, what, where and when of the data you are presenting. Do not overwhelm viewers with p-values and confidence intervals. These can be added to accompanying tables and information pages.
    • Meal: Tables, data downloads, and information pages should be added for researchers, health professionals, and those who want to dig deeper into the data. You might include additional information about study design, sample and weighting methodologies, indicator definitions, sample or population size, confidence intervals, unreliable estimates or data suppression to help this audience to further analyze and interpret the data.

 

  1. Numbers count. Adults in the United States have lower numeracy skills than adults in other developed countries. Many do not understand percentages or ratios, have difficulty making comparisons (across years, geographies, or against a target goal), and do not know the difference between absolute versus relative risk. Dashboards, infographics or icon arrays, risk tables, ladders and scales help to visually display data, the magnitude of effect or risk, and can help individuals make comparisons if presented on the same scale.

 

  1. Think about accessibility. To ensure everyone has the same access to your data, familiarize yourself with 508 Standards for Electronic and Information Technology. People with visual, auditory, and motor skill impairments may not be able to access information on the web, even using assistive devices. Simple modifications can make a big difference, such as:

 

  1. Report data in meaningful, culturally, and linguistically appropriate way. Analyzing and presenting data by geography, sexual orientation and gender identity (SOGI), age, race/ethnicity, preferred language, disability, and chronic disease status helps to identify health disparities and prioritize resources. This should be done in concert with the affected community to ensure that data is collected, analyzed, interpreted, and reported accurately, meaningfully and in a culturally and linguistically appropriate way.

 

  1. Conduct audience testing. The best way to ensure your data can be found, accessed, and understood is to test your communication product with your target audience. Generally 5-8 people will suffice. The key is to make sure the group is representative.
    • Usability testing identifies whether or not your audience can find data and information, successfully complete specified tasks, and helps you to understand how your audience searches for information or completes tasks. You can also observe how long it takes them to complete tasks and determine ways to modify or enhance user experience.
    • Accessibility testing determines whether or not online content is 508 compliant. Using a screen reader or only a keyboard (not mouse), can you still navigate and access web content? Consider testing products with individuals who use assistive devices.
    • Health literacy testing identifies whether or not your data and information is understandable. Can your audience easily interpret the data in charts, tables, and maps? Is your narrative description of the data clear?

 

  1. Evaluate your work. To improve future communication about data, you should always evaluate your work.
    • Web and digital analytics applications allow you to monitor audience reach and user engagement. They can help you set goals, tell you what search engine terms are common, and whether or not users are accessing your page directly or are being directed from a different website. It can also tell you which pages are popular and which are not. Infrequent traffic or high bounce rates on a particular page may indicate lack of interest, lack of awareness, or perhaps a usability or health literacy issue.
    • Track different modes of communications. How many presentations, webinars, social media posts, etc. have you delivered in a specified amount of time? Who was the audience? Are there groups you have not yet reached?
    • Monitor how your data is being used. User surveys, in-person interviews, and external communications such as articles, reports, website links, and social media posts can tell you how your data is being used and if it is being used appropriately.

 

  1. Share best practices. Talking and listening to others is a great way to discuss new methods, share resources, and spark inspiration.
    • Join professional organizations and working groups on surveillance, epidemiology, and health literacy and discuss the importance of data literacy.
    • Engage with programs, like CDC’s Tracking Program, who use health literacy and numeracy principles to inform how they communicate about data.

Communicating data can be difficult and takes time and practice. But remember, we all appreciate clear communication. When you address health literacy, you improve data quality and consumer satisfaction and make data truly accessible to everybody.

The Minnesota Public Health Data Access portal is managed by the Minnesota Environmental Public Health Tracking Program (MN Tracking). MN Tracking is part of the CDC’s National Environmental Health Public Health Tracking Program, which collects, integrates, and analyzes environmental hazard and public health data from a nationwide network of partners.

Learn more

The Communication Research and Evaluation blog series highlights innovative research and evaluation methods used at CDC to improve behavior change campaigns.

APHL Receives $7.5 Million Award to Strengthen Newborn Screening Systems

APHL Receives $7.5 Million Award to Strengthen Newborn Screening Systems | www.APHLblog.org

Congratulations to APHL’s Newborn Screening and Genetics team and the NewSTEPs team! Below is the official announcement of the award.

The Association of Public Health Laboratories (APHL) has been awarded a five-year cooperative agreement of up to $7.5 million by the Genetic Services Branch of the US Health and Human Services Health Resources and Services Administration (HRSA) to maintain and manage the Newborn Screening Technical assistance and Evaluation Program (NewSTEPs). A component of the APHL Newborn Screening and Genetics Program, NewSTEPs provides quality improvement initiatives to strengthen newborn screening systems, a data repository, technical assistance and resources to state newborn screening programs and stakeholders.

“We are honored to receive this award,” said Jelili Ojodu, director of APHL’s Newborn Screening and Genetics Program and director of NewSTEPs. “This funding will allow us to continue provide states with robust and comprehensive tools that will allow them to improve the efficiency of the services they provide to newborn babies.”

Named one of the ten greatest public health achievements of the 20th century, newborn screening saves or improves the lives of more than 12,000 babies annually in the US. For babies who test positive for one of the genetic, metabolic, heart or hearing conditions, newborn screening can prevent serious health problems or even death.

NewSTEPs helps facilitate newborn screening initiatives and improve programmatic outcomes to enhance the quality of the newborn screening system through data driven quality improvements.

 

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This project is 100% supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,500,000. The contents are those of the author(s) and do not necessarily represent the official views of, nor endorsement, by HRSA, HHS or the U.S. Government.

The Association of Public Health Laboratories (APHL) works to strengthen laboratory systems serving the public’s health in the US and globally. APHL’s member laboratories protect the public’s health by monitoring and detecting infectious and foodborne diseases, environmental contaminants, terrorist agents, genetic disorders in newborns and other diverse health threats.

The post APHL Receives $7.5 Million Award to Strengthen Newborn Screening Systems appeared first on APHL Lab Blog.

Using Trauma-Informed Care to Guide Emergency Preparedness and Response

Exposure to a traumatic event or set of circumstances can negatively affect a person’s mental, physical, social, emotional or spiritual well-being for a long time after the initial incident. We know that not all individuals respond to trauma in the same way and we know that individuals with a history of trauma, especially childhood trauma, are more likely to experience psychological distress and are at increased risk for the development of Post-traumatic Stress Disorder (PTSD) with future exposure to trauma.

The chemicals in our bodies change during stressful or traumatic situationsEmergency responders are vulnerable to trauma during or after a disaster the same as survivors. Hazardous work conditions, being away from family, and exposure to human suffering can cause new and intensify existing feelings of stress, anxiety, grief, and worry in responders.

When the body is threatened, stress hormones are released to help you survive (fight or flight response). These hormones cause our bodies to minimize non-essential tasks, including growth, reproduction, and immune function and to maximize body functions that are necessary to prepare the body to fight or flee from a stressor.  Functions such as breathing, heart rate and alertness are useful for the body to survive the stress.   If someone is regularly exposed to trauma, stress hormones are repeatedly released and the brain can become exposed to these powerful stress hormones that would normally be present in the body for short periods of time. Over time repeated exposure to stress may cause your body’s natural stress response system to malfunction and can result in potentially unhealthy mental and physical responses to current or future stress.  These responses can include irritability, emotional reactivity, intrusive thoughts about the event, emotional numbing and avoidance, loss of one’s sense of safety, or diminished capacity to trust others.

Exposure to trauma can affect a person’s normal coping and stress management skills.  A person’s mental health during an emergency may be impacted by:

  • Direct exposure to the disaster, such as being evacuated or witnessing others (including family members) in life-threatening situations
  • Prior experience with and exposure to trauma
  • Pre-existing conditions, such as mental health conditions
  • Socioeconomic factors, such as family resources available
  • Family variables, for example, how parents react

Take trauma into account when responding to emergencies

When someone has experienced trauma, he or she can be re-traumatized if emergency medical service providers, healthcare professionals, and community service providers are not aware of and sensitive to the possibility of re-traumatization. Emergency responders should be aware that individuals and communities may have experienced a variety of traumas in their lives and need to consider a survivor’s physical, psychological, and emotional safety and well-being after a disaster.

Trauma-informed organizations and emergency responders need to be sensitive to the potential impact that widespread trauma can have on individuals. An essential underpinning of trauma informed care and approach is the awareness that procedures and interactions can be re-traumatizing.

Training emergency responders in trauma-informed care

The CDC’s Office of Public Health Preparedness and Response (OPHPR) collaborated with SAMHSA to develop a trauma-informed care training for CDC. Working with Mary Blake (SAMHSA) and the Technical Assistance Center, SAMHSA’s National Center for Trauma-Informed Care (NCTIC) developed and led a new training for OPHPR employees about the role of trauma-informed care during public health emergencies. The training aimed to increase responder awareness of the impact that trauma can have in the communities where they work. Participants learned the six principles that guide a trauma-informed approach, including:

  1. Safety
  2. Trustworthiness and transparency
  3. Peer support
  4. Collaboration and mutuality
  5. Empowerment, voice and choice
  6. Cultural, historical, and gender issues

Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity and it may require a cultural change at an organizational level. On-going internal organizational assessment and quality improvement, as well as engagement with community stakeholders, will help to imbed this approach which can be augmented with organizational development and practice improvement. The training provided by OPHPR and NCTIC was the first step for CDC to view emergency preparedness and response through a trauma-informed lens.

Resources:

The Power of the Pediatrician’s Voice: Reflections on PAS 2018

The Power of the Pediatrician’s Voice: Reflections on PAS 2018   post-info Organizers and award recipients from the Pediatric Academic Societies (PAS) Meeting provide their impressions of this year’s meeting. The Pediatric Academic Societies (PAS) Meeting, held

What a Day! Day 3 of the APHL Annual Meeting

What a Day! Day 3 of the APHL Annual Meeting | www.APHLblog.org

Day 3 of the APHL Annual Meeting was a big one! We had several captivating sessions including this year’s Katherine Kelley Distinguished Lecturer, Maryn McKenna, renowned journalist and author. Listen to today’s episode to hear a few attendees share what they took away from the day.

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

The post What a Day! Day 3 of the APHL Annual Meeting appeared first on APHL Lab Blog.

A Focused Intervention: The Provider’s Role in Firearm Violence Prevention

  A Focused Intervention: The Provider’s Role in Firearm Violence Prevention post-info Rocco Pallin and Garen Wintemute of the UC Davis Violence Prevention Research Program discuss the physician’s responsibility to discuss firearm safety with patients

Reporting from the Exhibit Hall: Day 2 of the APHL Annual Meeting

Reporting from the Exhibit Hall: Day 2 of the APHL Annual Meeting | www.APHLblog.org

A huge component of any APHL Annual Meeting is the exhibit hall. This year we were joined by 68 exhibitors, all of whom were sharing new and interesting products, services and technologies with meeting attendees. In today’s episode, we chat with representatives from Roche, Bio-Rad Laboratories and Hologic.

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

Learn more about APHL’s corporate membership and other opportunities.

The post Reporting from the Exhibit Hall: Day 2 of the APHL Annual Meeting appeared first on APHL Lab Blog.

Reporting from the Exhibit Hall: Day 2 of the APHL Annual Meeting

Reporting from the Exhibit Hall: Day 2 of the APHL Annual Meeting | www.APHLblog.org

A huge component of any APHL Annual Meeting is the exhibit hall. This year we were joined by 68 exhibitors, all of whom were sharing new and interesting products, services and technologies with meeting attendees. In today’s episode, we chat with representatives from Roche, Bio-Rad Laboratories and Hologic.

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

Learn more about APHL’s corporate membership and other opportunities.

The post Reporting from the Exhibit Hall: Day 2 of the APHL Annual Meeting appeared first on APHL Lab Blog.