Editor's Note: CIDRAP's Promising Practices: Pandemic Influenza Tools (http://www.cidrap.umn.edu/public-health-practices) online database showcases expert-reviewed practices, including useful tools to help others. This article is one of a series exploring the development of these practices. We hope that describing the process and context of these practices enhances pandemic planning and response.
Jun 30, 2008 (CIDRAP News) – After the Sep 11 terrorist attacks, officials in some of Minnesota's largest public health departments identified a big gap in their communications strategy: They had few options for getting important health and safety information to diverse state residents who speak limited English.
A coalition of communications officials from state, county, and local health and service agencies came together to form the Emergency and Community Health Outreach (ECHO), with the goal of reaching limited–English-proficiency (LEP) groups with vital health and safety information.
"In a crisis, you have to have the media," said Lillian McDonald, executive director of ECHO. McDonald had worked in broadcast media for several years before she signed on in 2003 to convene a group of public information officers to devise ways to bring preparedness information to LEP populations. "But the mainstream media wouldn't touch this."
By September 2004, ECHO had forged a partnership with Minnesota's public television system to produce and air a series of 20-minute programs in languages that reflect Minnesota's unique cultural landscape: Hmong, Khmer, Lao, Somali, Spanish, Vietnamese, and English.
Topics covered in the series, believed to be the first in the nation, range from Lyme disease to severe weather warnings to pandemic influenza. One of the most recent programs, for example, addressed the mass dispensing of medications in the event of an influenza pandemic or terrorist attack.
McDonald said ECHO hopes to someday have the capacity to go on the air live in a disaster situation such as an illness outbreak. During a local emergency, such as a chemical spill, ECHO can use its phone, fax, and Web portals to update residents on how to protect themselves and their families.
She said the program has been able to address some emerging health threats—for example pediatric flu deaths and illness and deaths from poisonous mushrooms—that are specific to some of its audience groups.
Viewership has expanded threefold, to about 9,500 in the Twin Cities metropolitan area, she said. "Word of mouth has been unbelievable," she said. ECHO recently expanded its coverage across Minnesota through additional public television affiliates. Now, nearly all of the state can access the ECHO broadcasts.
One of the keys to ECHO's acceptance in the LEP populations has been customizing each topic for each language by featuring native-speaking on-air personalities and expert guests. "We're giving communities their own voice—we're creating bridges," she said.
Expanding reach with different formats
Realizing that the important public health messages need to have a longer shelf-life and be available in a variety of formats, ECHO also offers programs and materials on the phone and Web and on DVDs.
Phone messages change monthly and, during nonemergency times, feature seasonal advice, for example avoiding foodborne illnesses during summer months. On ECHO's Web site, viewers can access current and past programs. In addition to the array of languages offered on the television programs, the phone messages are also offered in Russian, Arabic, Oromo, and English.
The system also sends fax and e-mail health alerts to community organizations that work with Minnesota's LEP populations.
McDonald said despite little money for advertising, publicizing the various components of ECHO hasn't been difficult, given the involvement of communications officials in the system. "Word of mouth has been unbelievable," she said.
Moving toward greater sustainability
ECHO would like to maintain its momentum and even grow to meet its audience's changing needs, McDonald said, but shrinking grant dollars are a challenge. Some foundations would like to donate to the organization, but they often run into rules that prohibit giving to government organizations. Currently, ECHO's fiscal agent is the Association of Minnesota Counties (AMC), based in St Paul.
"If we're going to be going around door knocking, we need to have a business model—we can't be all government," she said.
McDonald said one promising avenue is for ECHO to become a nonprofit group under the arm of the AMC's nonprofit research foundation. She said ECHO has submitted the proposed arrangement to the Internal Revenue Service and hopes it is approved.
View tools and reviewer's comments from the "Emergency and Community Health Outreach" practice