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Steve Sparks - "Let's Talk about the Flu": Communicating Health Prevention to Hard-to-Reach, At-Risk Populations

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Presented by Steven W. Sparks, MS, on March 13, 2015 at the fifth Center for Health Literacy Conference: Plain Talk in Complex Times.

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Steve Sparks - "Let's Talk about the Flu": Communicating Health Prevention to Hard-to-Reach, At-Risk Populations

  1. 1. LET’S TALK ABOUT THE FLU Communicating Health Prevention to Hard-to-Reach, At-Risk Populations Steve Sparks Director Wisconsin Health Literacy a division of Wisconsin Literacy, Inc. March 13, 2015 PLAIN TALK in Complex Times
  2. 2. Division of Wisconsin Literacy  73 member literacy agencies 18,000 adult learners; 3300 volunteer tutors Training, Consultation and Interventions on Health Literacy Health Literacy Summit: April 14-15, 2015 WisconsinHealthLiteracy.org Wisconsin Health Literacy
  3. 3. Why focus on Flu? U.S. adults receiving flu shots Wisconsin adults receiving flu shots
  4. 4. IS IT A FLU SHOT? Or an influenza immunization?
  5. 5. The intervention: “Let’s Talk about the Flu” Program Goals: 1. Increase health knowledge 2. Increase flu vaccine rates 3. Collect baseline data about barriers to vaccination 4. Foster relationship with members, communities and funders
  6. 6. Logic Model
  7. 7. The strategy Focus on groups with anticipated lower health literacy and lower immunization rates • Adults with low literacy • Disadvantaged adults • Immigrants/refugees • Homeless adults • Racial/ethnic groups • Seniors
  8. 8. Ethnic minorities & health literacy Below basic health literacy: • 9% - Caucasians • 25% - American Indians and Alaskan Natives • 24% - African Americans • 41% - Latinos NAAL, 2003
  9. 9. The strategy Offer workshops in partnership with trusted organizations, including: • Adult literacy agencies • Neighborhood centers • Homeless shelters • Refugee health programs • Senior centers
  10. 10. Program Elements 1. One-hour workshops 2. Workbook in plain language 3. Voucher or access to free vaccine
  11. 11. Program Elements Flu Prevention Kit as incentive
  12. 12. Program Resources 1. Instructor Guide 2. Myths and misconceptions 3. Partner Stipends 4. Promotional Support
  13. 13. Flu prevention project: 2010 51 workshops conducted 1,128 participants
  14. 14. Flu prevention project: 2010 What we learned: • Need to measure behavior change • Consider flu clinics • Confirm understanding: “I heard you can get immunity from the shot.” • Answer common questions
  15. 15. Flu prevention project: 2010 Common comments and questions: • I know someone who got sick from the shot. • How often do I need the shot? • How long does immunity take? • What is stomach flu? • Does flu cause pneumonia? • Where can I get a free shot?
  16. 16. Flu prevention project: 2011 53 workshops conducted 943 participants
  17. 17. Flu Shot Voucher 17% used
  18. 18. Flu prevention project: 2011 What we learned: • Challenge to measure actual vaccination rates • Need child care • Address cultural myths • PowerPoints optional • Adapt for educational vs. non-educational settings
  19. 19. Flu prevention project: 2013 21 workshops conducted 467 participants
  20. 20. The booklet Tested through literacy partners
  21. 21. Designed with health literacy principles Many photos supporting message
  22. 22. Designed with health literacy principles Lots of white space Larger type, plain language
  23. 23. Designed with health literacy principles Easy-to-follow organization
  24. 24. Designed with health literacy principles Making it personal
  25. 25. Designed with health literacy principles Check for understanding
  26. 26. Types of Evaluation • Needs assessments – What do we need? • Previous workshop experience • Interviews with public and community health authorities • Literature reviews • Process evaluations – How did we do it? • Staff survey • Feedback from community contacts • Outcome evaluations – What happened as a result? • Participant pre-and post-tests • Change in vaccination intention • Change in vaccination behavior • Public relations outcomes
  27. 27. Pre- and post-tests
  28. 28. Outcome Objectives: Know, Think, Do • KNOW (Learning objectives) • Ex. By the end of the workshop, all 750 learners should be able to identify symptoms of the flu, including cough, sore throat and fever • THINK (Belief objectives) • Ex. By the end of the workshop, all 750 learners should be able to discuss personal beliefs about flu vaccines, including whom they trust to make important health care decisions • DO (Behavioral objectives) • Within 3 months of the workshop, 400 learners will obtain a flu vaccine
  29. 29. Results – Outcome objectives KNOW (Learning objectives) • Average pre-test score: 55.7% • Average post-test score: 82.7% THINK (Belief objectives) • Intend to vaccinate before workshop: 73.9% • Intend to vaccinate after workshop: 83.1% • Open-ended responses to reasons why/why not vaccinated in the past DO (Behavior objectives) • Vaccinated before workshop: 12.2% • Used Walgreens voucher: 17.1% • Obtained on-site flu vaccine: 13.1% • Obtained flu vaccine in clinical setting: unknown • Total vaccinated (minimum): 42.4%
  30. 30. Results 33% Hispanic/Latino 30% Caucasian 18% African American 19% Other Outcomes (2011, 2013) Before After Average pre-test score 53.3% 82.5% Planned to get vaccine 798 953 3 years…..125 workshops…..2,516 participants
  31. 31. #1 reason people got a shot: (of those who gave a reason) “I want to protect myself. I don’t want to get sick” Other common reasons: Doctor recommended it In a high risk group (age, health condition) Required (by employer, school, prison)
  32. 32. #1 reason people didn’t get a flu shot: (of those who gave a reason) “I am healthy, never had the flu” Other barriers: Worried about side effects; made me or someone I know get sick Just don’t want it; don’t think it’s necessary Couldn’t afford it; don’t have insurance Hurts; hate needles
  33. 33. What we’d do different in the future • Provide materials translation • More on-the-spot clinics following workshops • Offer program for general audiences
  34. 34. The future of “Let’s Talk about the Flu” Steve Sparks, Health Literacy Director steve@wisconsinliteracy.org

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