Enabling the Public and Partners: Delivering the Message of TB Nuala Moore American Thoracic Society John Bernardo Pulmonary Center Boston University School of Medicine September 18, 2012 Objectives Upon completion of this presentation, you will be able to: Upon completion of this presentation, you will be able to: Explain the significance of presenting TB data effectively; andExplain the significance of presenting TB data effectively; and Describe how educating the public and partners about TB can advance the goal of TB eliminationDescribe how educating the public and partners about TB can advance the goal of TB elimination Your Audience The Public The Public Communities (groups) at-riskCommunities (groups) at-risk The population at-largeThe population at-large Health Providers Health Providers Direct careDirect care Public HealthPublic Health Policy Makers Policy Makers Jurisdictional, nationalJurisdictional, national We ALL are partners The Public: Communities Understand priorities and needs of your people Understand priorities and needs of your people Where does your message fit?Where does your message fit? How do people get health information? How do people get health information? What medium is best for communication?What medium is best for communication? Whom do they trust?Whom do they trust? Develop credibility Develop credibility Introduce your message Introduce your message Personal Barriers to TB Prevention and Treatment Knowledge/beliefs about TB infection, prevention, disease, transmission Perceived consequences about TB and its prevention or treatment Social, clinical Attitudes towards seeking treatment: Realities and conflicting priorities Fears Limited access to care Loss of income - inability to work Meet Your Population Engage community groups and events Engage community groups and events Churches, CBOs, health fairs Put a face to the message Focus Groups Focus Groups Identify barriers before you can devise strategies Existing health beliefs; stigma Previous history You just may develop a nose for this business! Identify gate- keepers Identify gate- keepers TrustTrust Take advantage of preferred media: Take advantage of preferred media: Newspaper, TV, radio, corner market, barber shopNewspaper, TV, radio, corner market, barber shop You may be surprised at what you learn You are the white people in the white coatsin the white building You are the white people in the white coatsin the white building Research is when you experiment on people who cannot tell on you Research is when you experiment on people who cannot tell on you My skin test means that my vaccine is working. My skin test means that my vaccine is working. How come your medicine is the right one and mine isnt? How come your medicine is the right one and mine isnt? TB Prevention in the Homeless Communities: at-risk The Message: The Message: Engage your peopleEngage your people Develop dialog, trustDevelop dialog, trust Provide access - on their termsProvide access - on their terms The Outcome: The Outcome: Access to reliable information, servicesAccess to reliable information, services Better understanding of TBBetter understanding of TB Improved Public and Personal HealthImproved Public and Personal Health Are YOU prepared for this? You just might want to be there on Friday... The Public Perceptions about TB: TB??? What??? Perceptions about TB: TB??? What??? Develop plan for unexpected events Develop plan for unexpected events Identify responsible personnel, protocolIdentify responsible personnel, protocol Anticipate: High-Profile notificationsAnticipate: High-Profile notifications Maintain contacts with media: Be availableMaintain contacts with media: Be available Leverage data into a positive message Leverage data into a positive message Provide accurate information: The TRUTHProvide accurate information: The TRUTH Maintain controlMaintain control Educate: Social Media; Marketing Educate: Social Media; Marketing StopTB USA: Patient ForumStopTB USA: Patient Forum Facebook: TB PhotovoiceFacebook: TB Photovoice Rachel Orudno: Rachel Orudno: TB Photovoice The Public: at large The Message: The Message: Be pro-activeBe pro-active Opportunities to engage public Opportunities to engage public Anticipate needs, events Anticipate needs, events Provide reliable, timely informationProvide reliable, timely information Improves awareness of the disease Improves awareness of the disease Reduces fears, stigmatization Reduces fears, stigmatization The Outcome: The Outcome: Recognition of Public Health, TBRecognition of Public Health, TB Facilitates advocacyFacilitates advocacy Providers: Direct Care Competing priorities in clinical care Competing priorities in clinical care Poor understanding of epidemiology of TB in their population and area Poor understanding of epidemiology of TB in their population and area Lack of informationLack of information Poor training clinical and public health Poor training clinical and public health Medical, nursing schoolsMedical, nursing schools Residency, fellowship programsResidency, fellowship programs Lack of resources Lack of resources Radiography, laboratory, outreachRadiography, laboratory, outreach They just dont see it! They just dont see it! Direct Care Providers Identify providers to at-risk groups Identify providers to at-risk groups Where do people usually get care?Where do people usually get care? Engage health care systems Engage health care systems Define needs, resources, expertiseDefine needs, resources, expertise Develop education programs: C ompetence Develop education programs: C ompetence Base it on Evidence be Credible!!Base it on Evidence be Credible!! Adapt educational strategy to need:Adapt educational strategy to need: Academic Detailing in EDs, Lunch didactic or workshop, Academic Detailing in EDs, Lunch didactic or workshop, Be a presence Be a presence Regular inservices/updates; service evaluationsRegular inservices/updates; service evaluations Be available !!! Be available !!! It always comes down to. EDUCATION EDUCATION EDUCATION.. EDUCATION.. EDUCATION EDUCATION and knowing where to turn when you need help! Providers: Public Health TB is a victim of its own being TB is a victim of its own being Unique in clinical and public health domainsUnique in clinical and public health domains Yet, TB Programs are being subsumed Yet, TB Programs are being subsumed Program IntegrationProgram Integration Private Sector: Everyone is insuredPrivate Sector: Everyone is insured Need to Manage Up Need to Manage Up Educate Public Health decision makersEducate Public Health decision makers Inform and educate LegislatorsInform and educate Legislators Public Health Maintain visibility Maintain visibility Interact with collaborating programs and management to foster understanding of the unique needs of Public Health-TB: PoliticsInteract with collaborating programs and management to foster understanding of the unique needs of Public Health-TB: Politics Participate in Public eventsParticipate in Public events Health Promotions, World TB Day Health Promotions, World TB Day Assure competence Assure competence Clinical, laboratory, and public healthClinical, laboratory, and public health Assure access to services Assure access to services Remove barriers: social, behavioral, financialRemove barriers: social, behavioral, financial Providers and Public Health The Bottom Line: We are the Safety NetWe are the Safety Net OUR PATIENTS NEEDS HAVE TO BE MET, OR OUR PATIENTS NEEDS HAVE TO BE MET, OR