Education in Oral Polio Vaccine Program

Abstract

IS THE TERM organization for health one that is understood. and the connotations accepted, by public health personnel as it relates to families with limited education and income? Is it possible for persons with a professional background to accept emotionally as well as intellectually the premise that persons from so-called hard-core areas can contribute substantially to the success of health programs? These questions came up time and time again in the Hillsborough County oral polio vaccine program which was conducted early in 1962 in Florida. (Tampa is the county's principal city.) Other questions were: What is a hard-core group? Do we give them this harsh name because they do not respond to our overtures? A hard-core area by public health definition may not be regarded as such by a life insurance agent, a bolita ticket seller, or an itinerant evangelist. Are we in public health a hard-core group in that we have built our programs and practices around the way we think persons of limited income and education ought to act? A few studies in Florida, encouraged by the Public Health Service's babies and breadwinner program suggestions for increased poliomyelitis immunization, had raised similar questions. The concept of involving local leaders and community organizations is not new (political campaigners have used it for years), but it was found that this deceptively simple method could be outstandingly successful, if the public health staff knew how to identify the true leaders and how to work with them. A poliomyelitis immunization program, using Salk vaccine, in a small rural group had resulted in a 500 percent increase in protected persons; a liaison worker has been used most effectively in an agricultural migrants' project in south Florida; local leaders in a remote rural area, concerned with hookworm, were able to interest persons who had the worms in improving their sanitation practices. An X-ray campaign in another locality resulted in a 500 percent increase when local leaders were brought into the picture. The 1960 Dade County (Miami) community oral polio program had revealed much about acceptance of this type of immunization by those whom county health departments believe to be hardcore families (1). The Hillsborough program provided an opportunity to try out, on a much larger scale, some of the techniques which were being developed by public health personnel in Florida. The objective of the programi, here oversimplified, was to feed oral polio vaccine (trivalent) in a field trial to a potential 250,000 persons under 40 years of age in the county. A public relations program was underway when health educators were invited to participate. The educators' specific charge was to concentrate on children under 6 years old in the lower socioeconomic group. Planning for this phase of the program began less than 2 months before administration of the vaccine began. Discussion of the public information aspect of the program is not essential here. It consisted of the usual proclamations, sound trucks, radio, newspaper, and television coverage, a telephone information center, and announcements to schools and civic and church groups. It was presumed that this approa,ch would reach many of those in the upper and middle class for it would appear that four factorsbasic education, specific information, personalMiss Reed is director, division of health education, Florida State Board of Health.