Last fall, at the height of the H1N1 epidemic in the United States, Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow Lisa Davis, R.N., B.S.N., M.B.A. and Deborah Washington, R.N., Ph.D.c. (2007-2010 cohort) met for dinner. Since both are deeply involved in improving the public health—Davis as the Chief of the Public Health Initiatives Branch for the State of Connecticut Department of Public Health, and Washington as the Director of Diversity for Patient Care Services at Massachusetts General Hospital—the conversation naturally turned to the impending second phase of the “swine flu” outbreak.
“We wondered if messages about influenza prevention were culturally appropriate or resonating with certain groups,” Davis said. They concluded that these messages were not effectively reaching Black Americans, and particularly Black women of reproductive age. We asked ourselves: “How do we bring that group in and produce a message that would catch their attention?”
Setting out to find the answer, Davis, Washington and colleagues from the Massachusetts Department of Public Health (DPH) leveraged funding from the U.S. Department of Health and Human Services’ Health Resources and Services Administration to conduct a series of focus groups, both in Massachusetts and Connecticut. With help from a consultant who specializes in diversity, their goal was to develop messages that would be appropriate for Black women and would convey steps they can take to prevent the flu and protect their families.
Department of Public Health staff engaged a marketing firm which used the messages that tested well in the focus groups to develop an advertisement, which Davis then tested with community members. We understood that “just because you change the ethnicity of the person in the ad or translate it into another language doesn’t mean it’s effective,” Davis said. “You really need to go out into the community to find out what message will work best for that community.”
Based on input from the community, Davis collaborated with the marketing firm to revise the ad to acknowledge how busy Black mothers are. Its headline: “You Can Stop the Flu, even with your hands full.” The photo shows a mother holding her young child.
The ad then goes on to say, “Like you need one more thing to worry about. But you have to fight the flu to protect your family, your community and yourself.” It offers four simple tips to stop the spread of influenza, and encourages readers to go to the CDC’s Web site or call the United Way’s information and referral line for further information.
With a grant from the Centers for Disease Control and Prevention’s Office of Public Health Preparedness and Response, the ad ran for nearly four months in small circulation newspapers. It also ran for three months on donated space in 200 transit buses in Connecticut’s major urban areas.
Right now, Davis is evaluating the impact of the ads in Connecticut through a point-in-time survey of women who have recently given birth, and is collaborating with the Massachusetts DPH staff to evaluate the impact of H1N1 on the target group. Davis hopes the feedback will help her craft a radio message, to launch in Connecticut at the beginning of this year’s influenza season.
“You never know what can come out of just an impromptu conversation with someone,” Davis says of her collaboration with Washington. The two are members of the same cohort of Executive Nurse Fellows, an RWJF leadership development program designed to prepare a select cadre of registered nurse executives for leadership roles in shaping the United States health care system of the future. “We talk about risk-taking and creativity, inspiring and leading others,” Davis said of her time in the Executive Nurse Fellows program. “You make these connections with so many other people… it’s about understanding how to leverage your resources.”