Keep community outreach education organized with health calendar

Designated awareness months can guide activities and use of resources

Last September, staff in the public education office at M. D. Anderson Cancer Center in Houston focused their educational outreach efforts on preventing prostate cancer. During the month, they educated the public on the viability of PSA tests, prostate power foods, the cancer prevention properties of flaxseed and how to incorporate this food into a diet, and other information.

Why did they focus on this topic? September has been designated Prostate Cancer Awareness Month by Zero-The Project to End Prostate Cancer based in Washington, DC. It appears on the National Health Observance calendar published by the U.S. Department of Health and Human Services.

Four years ago, the M. D. Anderson public education staff began to rely on this calendar when creating educational outreach initiatives on cancer prevention.

"The calendar gives structure and a way to plan in advance. It has helped us to become more organized," says Stephanie Kim, MBA, associate director of Community Education Programs, Public Education Office at M. D. Anderson Cancer Center.

The fact that the medical center treats cancer patients automatically narrows the health observance selections. However, staff narrowed the list further.

To use the calendar effectively, patient education staffers look for cancer designations in which people can do something to reduce risk. For example, there could be screenings available or specific actions to take, such as the application of sunscreen to prevent skin cancer.

Audience identification is important, as well. M. D. Anderson staff focus on the general public with the goal of teaching ways to reduce their risk of cancer. Also, they teach about screening for early detection.

However, on occasion, the audience may be specific to gender or race. For example, April is National Minority Cancer Awareness month, so the focus would be on cancers that are more prevalent in certain minority populations.

Several months have cancer-related observances that have a prevention component. For example, January focuses on cervical cancer awareness, March on colorectal cancer awareness, April on minority cancer awareness, May on skin cancer awareness, September on prostate cancer awareness, October on breast cancer awareness, and November on the prevention of lung cancer.

When the months do not have designations that fit the selection criteria, they are assigned a topic that fits the season. For example, in December 2009, the focus was "Healthy Holidays." The educational messages covered during the outreach included alcohol and cancer risk, cancer prevention winter sports, and cancer prevention gift giving.

Once a designated health observance has been placed on the calendar, it provides guidance for all outreach efforts, says Kim. For example, if the institution receives a request to participate in a health fair during the month of May, the literature and focus of the booth would be skin cancer awareness.

"It helps us prioritize which health fairs we attend. If our main message is skin cancer, we will probably not go to a lot of African-American events that month. However, if it is April and we are trying to target a certain minority population, we will give priority to organizations that fit the target we are trying to reach," explains Kim.

Following the calendar for health observances also provides guidance for use of staff. It is impossible to cover the entire city, says Kim. Therefore, sending speakers out to discuss health issues pertaining to the designated observance, whether at a company lunch and learn or other public event, helps manage limited resources.

Many of the outreach efforts are staffed by volunteers called M. D. Anderson Ambassadors. Ambassadors are M. D. Anderson employees who volunteer to help educate the Houston community about cancer. They staff exhibits at health fairs and conferences, conduct tours of the institution, give presentations to community organizations or worksites, and present the "Too Cool to Smoke" puppet show to young children.

Delivering the message

While the theme for each month is determined a year in advance, specific messages are usually selected about three months before the health observance. Because the public education office assessed the needs of the community, staff know prevention and screening information is what the community wants and tailor the message accordingly.

"It is our job to get that information out in all kinds of ways, some online, some inperson, and some aimed at minority populations. If I had a bigger team, we would come up with more ways to deliver the message. We try to get the information out in any way the community will respond," says Kim.

About 30% of the people are reached by in-person techniques, such as sending speakers to churches, businesses, and organizations or setting up a booth at a health fair.

Kim says it has become evident over the past few years that it is less expensive to get health observance information to the public online, especially with the use of social networking.

An online monthly newsletter focuses on the health observance for that month. Articles are written in a format similar to consumer magazines. For example, one article listed the top six things a woman needed to know about having a Pap test. Another compared smoking cessation aids by having staff try them and report what they liked and didn't like about the product. Currently, the online newsletter has about 1,500 subscribers.

"We know magazines sell, and most of our readers are the women who buy these magazines. Therefore, our newsletter articles have an educational message but are written in a consumer magazine format," says Kim.

(To read articles from the various health observance months go to mdanderson.org/focused and review the archived issues.)

Also, social media avenues are used to get the message out. These include: Facebook, a social utility that connects people with friends, as well as businesses, organizations, and other entities for networking purposes; Twitter, a micro-blogging service where users send and receive short messages called Tweets; YouTube, a video-sharing web site on which users upload and share videos; and icyou, a site to post health and wellness videos. Kim says her department also bookmarks a lot of information through Delicious, a social bookmarking service.

For each health observance, the public education office contacts the department that treats patients who have the particular cancer to see if it has planned any activities. For example, during prostate cancer awareness month, the urology department is contacted to see if it plans to conduct screenings or other activities.

Kim explains that while the public education office organizes educational activities, there are no clinical components, such as screening. However, if a clinical department chose to do an outreach effort, the public education office would support the effort by promoting it and developing educational materials to be distributed.

Material is selected based on the target audience. Kim says the Hispanic population responds well to brochures that have a story within them about a person, while other minority groups, such as Asians, prefer a testimonial approach rather than storytelling. The type of brochure design is based on research, she says.

About 40% of the budget allocated for outreach is spent on printing materials developed for the health observance, says Kim. The rest of the funds cover additional expenses, such as bringing a well-known speaker to a health event. For example, a TV chef might be asked to do a cooking demonstration on the importance of healthy eating for cancer prevention.

Kim says the money is well spent. Surveys are conducted to determine whether the public finds the information useful and whether they intend to put the recommendations into practice, and the responses show participants are motivated. Kim says it would be helpful to contact people six months later to determine if they followed through and changed their eating habits or started an exercise program, but the public education office does not have the funds to do this type of research.

Surveys also are given to businesses and other organizations that request the services of the public education office for health fairs or speaking engagements to evaluate whether those attending benefited. Also, numbers are tracked as part of the evaluation.

Information from the surveys and tracking is used to issue an annual report on the work completed during the fiscal year with information on the number of programs held, the audience reached, number of posts on social networks, and audience reached via online programs.

This report helps staff track variances in numbers from year to year. Current economic conditions have had an impact, says Kim. For example, a hiring freeze has made departments shorthanded, so many M. D. Anderson Ambassadors who might staff health fairs or speak at an event cannot get time off, because there is no one to cover their duties.

"When we don't have enough ambassadors to do events, we have to tell whoever is requesting them that we can't do it," Kim explains. That results in a decline of events for the year.

The public education office also saw a 38% decrease in funding for 2010 due to the economy. Kim says that in five years, the department's budget went from $60,000 to $150,000, but this fiscal year it was reduced.

SOURCE & RESOURCE

For more information about the use of health observances for planning community outreach, contact:

• Stephanie Kim, MBA, Associate Director, Community Education Programs, Public Education Office, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 700, Houston, TX 77030. Telephone: (713) 794-1729. E-mail: sfkim@mdanderson.org.

Note: The National Health Observance calendar can be accessed at www.healthfinder.gov/nho/default.aspx.