Post-campaign Survey Research Articles

Integrating Blood Collection within Household Surveys: Lessons Learned from Nesting a Measles and Rubella Serological Survey within a Post-Campaign Coverage Evaluation Survey in Southern Province, Zambia.

.Age-specific population immunity to many vaccine-preventable diseases can be measured using serological surveys. However, stand-alone serological surveys are infrequently conducted in low- and middle-income countries because of costs, operational challenges, and potential high refusal rates for blood collection. Nesting a serosurvey within a household cluster survey may overcome some of these challenges. We share lessons learned from nesting a serosurvey within a measles and rubella vaccination post-campaign coverage evaluation survey (PCES). In 15 of the 26 PCES clusters in Southern Province, Zambia, we collected dried blood spots from 581 participants aged 9 months and older. Household participation rates for the main PCES were higher in the serosurvey clusters (86%) than PCES-only clusters (71%), suggesting that a serosurvey can be successfully integrated without adversely affecting PCES participation. Among households that participated in the PCES, 80% also participated in the serosurvey and 86% of individuals available in the household provided a blood sample for the serosurvey. Substantial planning and coordination, additional staff training, and community mobilization were critical to the success of the serosurvey. Most challenges stemmed from using different data collecting tools and teams for the serosurvey and PCES. A more efficient design would be to fully integrate the serosurvey by adding blood collection and additional questions to the PCES.

Changes in Psychosocial Factors and Physical Activity Among Finnish Working-Age Men in the Adventures of Joe Finn Campaign.

This study evaluated changes in psychosocial factors and self-reported physical activity (PA) among the sample of Finnish men who underwent the fitness tests during the national health campaign. Another aim was to examine whether the fitness test feedback was a meaningful experience for PA change. Baseline data were collected in 2011 by fitness test and questionnaire. Men who had low/moderate fitness along with overweight ( n = 361) were recruited to the postcampaign study in 2014. Data were analyzed with nonparametric tests, logistic regression analysis, and content analysis. The postcampaign survey was completed by 102 men. Positive PA change was associated with high goals, planning skills, and self-efficacy for PA. One fourth of men recalled that they had surprisingly poor fitness at baseline. This experience was not related to positive PA change. A fitness test may awake motivation, but promotion of self-efficacy and self-regulatory skills is needed to support concrete behavior change.

Delivery of Multiple Child and Maternal Health Interventions during Supplementary Immunization Campaign in Rwanda, 2013: Lessons Learnt

This paper assesses and describes the estimated coverage of the Measles Rubella (MR) campaign in each district; the national estimate of coverage for Human Papilloma Virus (HPV) vaccination campaign and Vitamin A supplementation simultaneously implemented in 2013. We applied descriptive statistics and epidemiological tools to the outcomes of the campaigns to assess the coverage achieved on the different child and maternal health interventions. We also assessed the Adverse Events following Immunization (AEFI) where the evaluation was used at the same time to assess the routine immunization performance coverage for children 12-24 months for all childhood antigens, Tetanus Toxoid coverage among mothers of infants, combined with routine immunization performance evaluation, skilled delivery and bed nets use in Rwanda. Results indicated that among the eligible targets, 97.5% received MR vaccine, 91% received HPV doses, and 83% got Vitamin A. The integrated vaccination of MR with HPV did not result in any serious AEFI. Coverage for antigens and doses given early in life was above 95% with card retention of 80%. BCG to measles dropout by card was 8.5%. Main reasons for non-vaccination indicated need for more specific immunization education. About 96.8% of mothers delivered in health institutions and 95% of the mothers slept under bed nets the night before the survey. Rwanda successfully implemented an integrated coverage evaluation survey of the integrated vaccination campaign and routine immunization with statistically valid estimates. We drew lessons that information on routine immunization can be collected during post campaign survey evaluations. The district estimates should guide the programme performance improvement.

Use of the revised World Health Organization cluster survey methodology to classify measles-rubella vaccination campaign coverage in 47 counties in Kenya, 2016.

IntroductionTo achieve measles elimination, two doses of measles-containing vaccine (MCV) are provided through routine immunization services or vaccination campaigns. In May 2016, Kenya conducted a measles-rubella (MR) vaccination campaign targeting 19 million children aged 9 months–14 years, with a goal of achieving ≥95% coverage. We conducted a post-campaign cluster survey to estimate national coverage and classify coverage in Kenya’s 47 counties.MethodsThe stratified multi-stage cluster survey included data from 20,011 children in 8,253 households sampled using the recently revised World Health Organization coverage survey methodology (2015). Point estimates and 95% confidence intervals (95% CI) of national campaign coverage were calculated, accounting for study design. County vaccination coverage was classified as ‘pass,’ ‘fail,’ or ‘intermediate,’ using one-sided hypothesis tests against a 95% threshold.ResultsEstimated national MR campaign coverage was 95% (95% CI: 94%-96%). Coverage differed significantly (p < 0.05) by child’s school attendance, mother’s education, household wealth, and other factors. In classifying coverage, 20 counties passed (≥95%), two failed (<95%), and 25 were intermediate (unable to classify either way). Reported campaign awareness among caretakers was 92%. After the 2016 MR campaign, an estimated 93% (95% CI: 92%–94%) of children aged 9 months to 14 years had received ≥2 MCV doses; 6% (95% CI: 6%–7%) had 1 MCV dose; and 0.7% (95% CI: 0.6%–0.9%) remained unvaccinated.ConclusionsKenya reached the MR campaign target of 95% vaccination coverage, representing a substantial achievement towards increasing population immunity. High campaign awareness reflected the comprehensive social mobilization strategy implemented in Kenya and supports the importance of including strong communications platforms in future vaccination campaigns. In counties with sub-optimal MR campaign coverage, further efforts are needed to increase MCV coverage to achieve the national goal of measles elimination by 2020.

Public Awareness of Low-Risk Alcohol Use Guidelines.

Objective. To evaluate the effectiveness of a population-based, public education campaign designed to increase awareness of the Canadian Low-Risk Alcohol Drinking Guidelines (LRDG). Method. A province-wide mass media campaign was introduced. To measure campaign effectiveness, we completed a cross-sectional study using pre- and postcampaign surveys. Measurements included awareness of the LRDG, specific knowledge of the LRDG, and beliefs toward drinking and behavior change. Results. Postsurvey respondents were more likely to be aware of the LRDG (19.2% vs. 25.8%). However, increased awareness was largely driven by females being significantly more aware of the guidelines after the campaign (odds ratio = 1.74; 95% confidence interval = [1.38, 2.19]). Men were not found to be more aware postcampaign. The results did not show a significant increase in specific knowledge of the LRDG or change in beliefs toward drinking and behavior change after the campaign. Independent of the survey cycle, males and those aged 19 to 25 years were less likely to be aware of the LRDG, select the correct drink limit or less, and believe that consuming alcohol in excess has short- and long-term health consequences when compared to females and those aged 56 to 70 years. Conclusions. A provincial public health education campaign was effective at increasing awareness of the LRDG, though uptake was lowest among those at highest risk for heavy drinking.

Impact of community-delivered SMS alerts on dog-owner participation during a mass rabies vaccination campaign, Haiti 2017

Haiti has historically vaccinated between 100,000 and 300,000 dogs annually against rabies, however national authorities have not been able to reach and maintain the 70% coverage required to eliminate the canine rabies virus variant. Haiti conducts massive dog vaccination campaigns on an annual basis and utilizes both central point and door-to-door methods. These methods require that dog owners are aware of the dates and locations of the campaign. To improve this awareness among dog owners, 600,000 text messages were sent to phones in two Haitian communes (Gonaives and Saint-Marc) to remind dog owners to attend the campaign. Text messages were delivered on the second day and at the mid-point of the campaign. A post-campaign household survey was conducted to assess dog owner’s perception of the text messages and the impact on their participation in the vaccination campaign. Overall, 147 of 160 (91.9%) text-receiving dog owners indicated the text was helpful, and 162 of 187 (86.6%) responding dog owners said they would like to receive text reminders during future rabies vaccination campaigns. In areas hosting one-day central point campaigns, dog owners who received the text were 2.0 (95% CI 1.1, 3.6) times more likely to have participated in the campaign (73.1% attendance among those who received the text vs 36.4% among those who did not). In areas incorporating door-to-door vaccination over multiple days there was no significant difference in participation between dog owners who did and did not receive a text. Text message reminders were well-received and significantly improved campaign attendance, indicating that short message service (SMS) alerts may be a successful strategy in low resource areas with large free roaming dog populations.

Evaluation of a Social Norms Approach to a Suicide Prevention Campaign

Suicide is a leading cause of death for college-aged youth, and university counseling centers (UCC) strive to educate students about mental health issues and available campus services. The current research evaluates a college campus social norms campaign that used both peer and celebrity sources to promote help seeking among college students as a suicide prevention strategy. Postcampaign surveys of this quasi-experiment (n = 391) revealed that compared to students in the control neighborhood condition, students exposed to the campaign messages in the experimental neighborhood conditions were more likely to perceive students would refer a friend to the UCC and more likely to visit the UCC for a mental health concern. Students living in the intervention neighborhood with a peer message source reported a greater willingness to refer friends to the UCC compared to those who lived in the celebrity and control neighborhoods. Regardless of condition, students who reported seeing UCC messages reported greater effects than those who reported not viewing the messages (e.g., greater intentions to seek help and to talk to others about the UCC). Results of this study are discussed within a social norms framework and support the need for continued exposure to campaign messages to impact health outcomes.

Public Health Campaigns and Medicine Use Awareness: A Systematic Literature Review

This study investigates the medicine awareness, which can be defined as the increase in knowledge and understanding of the general public on appropriate medicine use. Objective: To identify the characteristics of Public Health campaigns that focus on medicine use and/or medicine awareness. Study Design: Systematic review focusing on pre- and post-campaign surveys. Methods: Electronic databases: PubMed, Science Direct, Web of Knowledge, Scopus, Global Health, and Google Scholar were searched. Articles within the last 10 years, with a focus on adults over the age of 18 were used to report findings. Results: A total of 4336 studies were reviewed after which eight were identified, which focused on medicines use and/or awareness. Most campaigns emphasized the knowledge and understanding of patients on the importance of appropriate medicine use and drew a comparison from pre- to post-campaign results. A limited number of Public Health campaigns demonstrated an increase in the level of medicines use awareness of patients. Various tools were used to portray the message across in the campaigns. These included, video, written information, face to face approaches, as well as educational games. Four studies demonstrated a statistically significant increase, in awareness of the public in regards to medication. However, the remaining studies were not successful in portraying a significant impact. Conclusion: Most campaigns demonstrated a limited increase in level of medicine use awareness in their post-campaign surveys. The results support the need for a comprehensive Public Health campaign that focuses on medicine use.

Evaluation of Knowledge and Practices Regarding Cholera, Water Treatment, Hygiene, and Sanitation Before and After an Oral Cholera Vaccination Campaign—Haiti, 2013–2014

In 2013, the Government of Haiti implemented its first oral cholera vaccine (OCV) campaign in Petite Anse, an urban setting, and Cerca Carvajal, a rural commune. We conducted and compared responses to two independent cross-sectional knowledge and practices household surveys pre- (N = 297) and post- (N = 302) OCV campaign in Petite Anse. No significant differences in knowledge about causes, symptoms, and prevention of cholera were noted. Compared with precampaign respondents, fewer postcampaign respondents reported treating (66% versus 27%, P < 0.001) and covering (96% versus 89%, P = 0.02) their drinking water. Compared with precampaign, postcampaign survey household observations showed increased availability of soap (16.2% versus 34.5%, P = 0.001) and handwashing stations (14.7% versus 30.1%, P = 0.01), but no significant changes in handwashing practices were reported. Although there was no change in knowledge, significant decreases in water treatment practices necessary for cholera and other diarrheal diseases prevention were noted in the postcampaign survey. Future OCV campaigns in Haiti should be used as an opportunity to emphasize the importance of maintaining good water, sanitation, and hygiene practices, and include a comprehensive, integrated approach for cholera control.

Measuring populations to improve vaccination coverage.

In low-income settings, vaccination campaigns supplement routine immunization but often fail to achieve coverage goals due to uncertainty about target population size and distribution. Accurate, updated estimates of target populations are rare but critical; short-term fluctuations can greatly impact population size and susceptibility. We use satellite imagery to quantify population fluctuations and the coverage achieved by a measles outbreak response vaccination campaign in urban Niger and compare campaign estimates to measurements from a post-campaign survey. Vaccine coverage was overestimated because the campaign underestimated resident numbers and seasonal migration further increased the target population. We combine satellite-derived measurements of fluctuations in population distribution with high-resolution measles case reports to develop a dynamic model that illustrates the potential improvement in vaccination campaign coverage if planners account for predictable population fluctuations. Satellite imagery can improve retrospective estimates of vaccination campaign impact and future campaign planning by synchronizing interventions with predictable population fluxes.

The impact of behaviour change communication on the use of insecticide treated nets: a secondary analysis of ten post-campaign surveys from Nigeria.

BackgroundMass distribution campaigns of insecticide-treated nets for malaria prevention are usually accompanied by intensive behaviour change communication (BCC) to encourage hanging and use of nets. However, data on the effectiveness of these communication efforts are scarce. In preparation for the next round of mass campaigns in Nigeria, a secondary analysis of existing data from post-campaign surveys was undertaken to investigate the influence of BCC on net hanging and use.MethodsSurveys were undertaken between 2009 and 2012 in ten states in Nigeria using standardized questionnaires. Two-stage cluster sampling was used to select households in each study site. Outcomes were defined as the effects of BCC message exposure and recall on knowledge, attitudes, perception as well as intentions and actual use. From the univariable analysis, potential confounders and explanatory variables were identified and key effects explored in multivariable linear or logistic regression models; terms in the models were kept if they had a marginal significance with p < 0.2. To quantify the effects from BCC, a treatment effect model was used with an inverse-probability weight regression adjustment.ResultsMore than half of the respondents (58.4 %; 95 % CI 56.0, 60.7) had heard a message about net use or hanging during or after the distribution campaign, with media cited as the most common source of information. Attitude towards net use was positively linked to the number of messages recalled and was overall better in the northern study sites. The number of messages recalled was also the strongest predictor of knowledge (p < 0.001). All BCC outcomes showed a significant increase in net use, which was strongest for the confidence to take action regarding nets with an overall effect of 17 %-point increase of net use comparing poor and excellent confidence levels. Intention to use every night increased net use by 15 %-points and discussing net use in the family by 8 % points. All these effects were statistically significant (p < 0.001).ConclusionsMultichannel BCC campaigns as well as other media were effective in contributing to an increase in net culture, hanging and use, particularly by vulnerable groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1463-7) contains supplementary material, which is available to authorized users.

Parent Attitudes Toward Meatless Meals at School

ObjectiveStudies show health benefits of plant-based diets. Building meatless meals into school lunches should help build positive habits in the children. The objective of this study was to assess the attitudes of parents toward meatless meals at school.Design, Setting, Participants, and InterventionA two-part campaign to raise awareness of the benefits of occasional meatless meals was conducted at an elementary school and a middle school. Students were sent home with an information sheet on benefits of plant based diets and short age-appropriate promotions were conducted during lunch times.Outcome Measures and AnalysisParents in both schools were invited to participate in a 10-question web-based survey after the campaign. Data were analyzed using descriptive statistics and chi square tests.ResultsThe post-campaign survey was completed by 185 parents (16.8% response rate). Most were female (63.8%) and 35-54 years old (91%). Most reported that they try to eat healthy (85.9%) and recognized beans as a good substitute for meat. 73% of parents reported hearing of “Meatless Monday” while only 56.8% agreed that going meatless once a week would be good for their child’s health. There was no significant gender difference in the responses of parents. Only 36.2% of parents reported that their child discussed their school’s campaign with them.Conclusions and ImplicationsParents have some appreciation for the value of plant-based meals, but room for progress remains. Most students did not share meatless meal information with their parents, which was a missed opportunity for education.FundingNone ObjectiveStudies show health benefits of plant-based diets. Building meatless meals into school lunches should help build positive habits in the children. The objective of this study was to assess the attitudes of parents toward meatless meals at school. Studies show health benefits of plant-based diets. Building meatless meals into school lunches should help build positive habits in the children. The objective of this study was to assess the attitudes of parents toward meatless meals at school. Design, Setting, Participants, and InterventionA two-part campaign to raise awareness of the benefits of occasional meatless meals was conducted at an elementary school and a middle school. Students were sent home with an information sheet on benefits of plant based diets and short age-appropriate promotions were conducted during lunch times. A two-part campaign to raise awareness of the benefits of occasional meatless meals was conducted at an elementary school and a middle school. Students were sent home with an information sheet on benefits of plant based diets and short age-appropriate promotions were conducted during lunch times. Outcome Measures and AnalysisParents in both schools were invited to participate in a 10-question web-based survey after the campaign. Data were analyzed using descriptive statistics and chi square tests. Parents in both schools were invited to participate in a 10-question web-based survey after the campaign. Data were analyzed using descriptive statistics and chi square tests. ResultsThe post-campaign survey was completed by 185 parents (16.8% response rate). Most were female (63.8%) and 35-54 years old (91%). Most reported that they try to eat healthy (85.9%) and recognized beans as a good substitute for meat. 73% of parents reported hearing of “Meatless Monday” while only 56.8% agreed that going meatless once a week would be good for their child’s health. There was no significant gender difference in the responses of parents. Only 36.2% of parents reported that their child discussed their school’s campaign with them. The post-campaign survey was completed by 185 parents (16.8% response rate). Most were female (63.8%) and 35-54 years old (91%). Most reported that they try to eat healthy (85.9%) and recognized beans as a good substitute for meat. 73% of parents reported hearing of “Meatless Monday” while only 56.8% agreed that going meatless once a week would be good for their child’s health. There was no significant gender difference in the responses of parents. Only 36.2% of parents reported that their child discussed their school’s campaign with them. Conclusions and ImplicationsParents have some appreciation for the value of plant-based meals, but room for progress remains. Most students did not share meatless meal information with their parents, which was a missed opportunity for education. Parents have some appreciation for the value of plant-based meals, but room for progress remains. Most students did not share meatless meal information with their parents, which was a missed opportunity for education.

Hepatitis B knowledge among key stakeholders in Haimen City, China: Implications for addressing chronic HBV infection.

BackgroundThis article describes hepatitis B-related knowledge, attitudes and practices after completion of the Gateway to Care campaign, a citywide public health education program that targeted city residents, health care providers and individuals chronically infected with hepatitis B virus in Haimen City, China.MethodsPre/post questionnaires assessed hepatitis B knowledge change among health care providers and post-campaign surveys evaluated hepatitis B knowledge, attitudes and behaviors (including stigma-related beliefs and practices) among health care providers, city residents and chronically infected individuals. Focus groups were conducted to gain a more in-depth understanding of the needs of the target communities, and to identify future intervention strategies to improve hepatitis B testing and linkage to care and treatment.ResultsResults indicate high levels of hepatitis B knowledge among multiple stakeholders in Haimen City, with significant knowledge improvement among health care providers. Stigma-related beliefs and myths regarding separation of infected individuals from certain aspects of family life were common among all stakeholder groups, despite high levels of accurate knowledge about hepatitis B transmission and prevention. Self-report of hepatitis B screening was low among city residents, as was awareness of hepatitis B treatment.ConclusionsMore efforts are needed to improve awareness of HBV treatment, decrease HBV-related stigma, improve screening rates, and reduce cost of antiviral treatment. Future interventions in Haimen City should be driven by behavioral change theory, to not only improve knowledge, but to improve screening behaviors and address hepatitis B-related stigma and discrimination.Electronic supplementary materialThe online version of this article (doi:10.1186/s41124-016-0004-x) contains supplementary material, which is available to authorized users.

Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best?

BackgroundThe use of insecticide-treated nets (ITNs) is widely recognized as one of the main interventions to prevent malaria. High ITN coverage is needed to reduce transmission. Mass distribution campaigns are the fastest way to rapidly scale up ITN coverage. However, the best strategy to distribute ITNs to ensure household coverage targets are met is still under debate. This paper presents results from 14 post-campaign surveys in five African countries to assess whether the campaign strategy used had any effect on distribution outcome.MethodsData from 13,901 households and 14 campaigns from Ghana, Nigeria, Senegal, South Sudan and Uganda, were obtained through representative cross-sectional questionnaire surveys, conducted three to 16 months after ITN distribution. All evaluations used a multi-stage sampling approach and similar methods for data collection. Key outcomes examined were the proportion of households having received a net from the campaign and the proportion of households with one net for every two people.ResultsHousehold registration rates proved to be the most important determinant of a household receiving any net from the campaign (adjusted odds ratio [OR] 74.8; 95 % confidence interval [CI]: 55.3–101.1) or had enough ITNs for all household members (adjusted OR 19.1; 95 % CI: 55.34–101.05). Factors that positively influenced registration were larger household size (adjusted OR 1.7; 95 % CI: 1.5–2.1) and families with children under five (adjusted OR 1.4; 95 % CI: 1.2–1.6). Urban residence was negatively associated with receipt of a net from the campaign (adjusted OR 0.73; 95 % CI: 0.58–0.92). Registration was equitable in most campaigns except for Uganda and South Sudan, where the poorest wealth quintiles were less likely to have been reached. After adjusting for other factors, delivery strategy (house-to-house vs. fixed point) and distribution approach (integrated versus stand-alone) did not show a systematic impact on registration or owning any ITN. Campaigns that used a universal coverage allocation strategy were more effective in increasing the proportion of households with enough ITNs than campaigns that used a fixed number of ITNs. Registering based on counting usual sleeping spaces resulted in higher levels of households with one net per two people among those receiving any campaign net (adjusted OR 1.6; 95 % CI: 1.07–2.48) than campaigns that registered based on the number of household members.ConclusionAll of the campaigns, irrespective of strategy, successfully increased ownership of at least one ITN. Delivery method and distribution approach were not associated with receipt of at least one ITN from the campaign. Rather, the key determining factor for receipt of at least one ITN from the campaign was a successful registration process, which depends on the ability of community volunteers to reach households during the exercise. Universal coverage campaigns, especially those that used a sleeping space allocation strategy, were more effective in increasing the proportion of households with enough ITNs. Maximizing registration completeness and using a universal coverage allocation strategy are therefore likely to improve campaign outcomes.

O19.4 Awareness and interpretation of theending hivcampaign and changing attitudes about treatment as prevention in an online cohort of msm

Introduction Treatment as prevention (TAP) has become a key part of HIV control strategies in Australia. Ending HIV was launched in September 2013 as a combination prevention campaign with three messages: HIV testing, HIV treatment, and condom-reinforcement. The Burnet Institute has maintained a HIV prevention evaluation online cohort of men who have sex with men. We compare pre- and post-campaign evaluation surveys to assess Ending HIV campaign awareness and changes in campaign-related attitudes and beliefs. Methods Participants were surveyed in August 2013 (S1, pre- Ending HIV implementation) and July 2014 (S2, post- Ending HIV implementation). Campaign recall and message recognition were assessed at S2, alongside S1 to S2 changes in attitudes and beliefs regarding a range of prevention topics, including TaP. Results There were 353 respondents at S1 and 328 at S2; 193 completed both surveys. 158 respondents (48%) were aware of Ending HIV at S2, of who 87 (55%) correctly recalled at least one campaign message. Most commonly recalled messages referenced HIV testing (58%), followed by HIV treatment (37%) and condom-reinforcement (29%). Significant increases were seen in the proportion of HIV-negative men reporting positive changes in attitudes/beliefs in 7 out of 9 statements about TaP (p < 0.05). Proportional increases ranged from 5.0–17.0%, and highest for agreeing that PrEP is effective for HIV prevention (17%) and disagreeing that people should delay treatment until absolutely necessary (12%). Changes in attitudes and beliefs did not differ significantly by campaign awareness at S2. Conclusion While awareness of Ending HIV is encouraging, comprehension of different combination prevention messages was inconsistent and modest for some messages. Predominant shifts in beliefs about TAP are likely to be driven by influences beyond campaign exposure. Future implementation of Ending HIV and associated prevention campaigns should ensure sufficient emphasis on primary prevention and early treatment messages as a part of combination prevention. Disclosure of interest statement All authors have no conflicts to declare. The Victorian Department of Health funds the implementation of the Ending HIV campaign by the Victorian AIDS Council, and the evaluation of HIV prevention campaigns by the Burnet Institute. The authors would like to acknowledge the NHMRC who provide funding to Margaret Hellard as a Senior Research Fellow, Anna Wilkinson as a public health scholarship recipient, Alisa Pedrana through the Sidney Sax Post-Doctoral Fellowship and Mark Stoove through a Career Development Fellowship. The authors gratefully acknowledge the contribution to this work of Victorian Operational Infrastructure Support Program received by the Burnet Institute.

An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand.

To examine whether being an organizer in a community organizing program improves personal agency and self-reported mental health outcomes among low-income Pacific Island youth in Auckland, New Zealand. Counties Manukau Health initiated a community organizing campaign led and run by Pacific Island youth. We used interviews, focus groups and pre- and post-campaign surveys to examine changes among 30 youths as a result of the campaign. Ten youths completed both pre- and post-campaign surveys. Eleven youths participated in focus groups, and four in interviews. Overall, youths reported an increased sense of agency and improvements to their mental health. Community organizing has potential as a preventive approach to improving mental health and developing agency over health among disempowered populations.

Cluster survey evaluation of a measles vaccination campaign in Jharkhand, India, 2012.

IntroductionIndia was the last country in the world to implement a two-dose strategy for measles-containing vaccine (MCV) in 2010. As part of measles second-dose introduction, phased measles vaccination campaigns were conducted during 2010–2013, targeting 131 million children 9 months to <10 years of age. We performed a post-campaign coverage survey to estimate measles vaccination coverage in Jharkhand state.MethodsA multi-stage cluster survey was conducted 2 months after the phase 2 measles campaign occurred in 19 of 24 districts of Jharkhand during November 2011–March 2012. Vaccination status of children 9 months to <10 years of age was documented based on vaccination card or mother’s recall. Coverage estimates and 95% confidence intervals (95% CI) for 1,018 children were calculated using survey methods.ResultsIn the Jharkhand phase 2 campaign, MCV coverage among children aged 9 months to <10 years was 61.0% (95% CI: 54.4–67.7%). Significant differences in coverage were observed between rural (65.0%; 95% CI: 56.8–73.2%) and urban areas (45.6%; 95% CI: 37.3–53.9%). Campaign awareness among mothers was low (51.5%), and the most commonly reported reason for non-vaccination was being unaware of the campaign (69.4%). At the end of the campaign, 53.7% (95% CI: 46.5–60.9%) of children 12 months to <10 years of age received ≥2 MCV doses, while a large proportion of children remained under-vaccinated (34.0%, 95% CI: 28.0–40.0%) or unvaccinated (12.3%, 95% CI: 9.3–16.2%).ConclusionsImplementation of the national measles campaign was a significant achievement towards measles elimination in India. In Jharkhand, campaign performance was below the target coverage of ≥90% set by the Government of India, and challenges in disseminating campaign messages were identified. Efforts towards increasing two-dose MCV coverage are needed to achieve the recently adopted measles elimination goal in India and the South-East Asia region.

Program Evaluation of a Sanitation Marketing Campaign Among the Bai in China

This social marketing campaign among the Bai ethnic minority group in Eryuan County, Yunnan, China, documents a community-based intervention to increase household toilet building and use in an effort to reduce cysticercosis. The formative research for the development of the social marketing campaign included the use of door-to-door surveys, a rural participatory assessment tool called the “ten-seed technique,” a baseline human neurocysticercosis study, and focus group discussions. Based on the formative research, a toilet-building campaign was implemented in two intervention villages. The results of this social marketing intervention are contrasted with the results of a traditional “outside-expert” approach conducted by a government agency in the two comparison villages. Although marginally fewer toilets were built in the intervention villages, a post-campaign consumer satisfaction survey revealed that satisfaction with and use of the toilets built using the social marketing approach were much greater. This study is the first to report the use of the social marketing of toilets in China and the first to report the use of the social marketing of household toilets as an intervention to reduce cysticercosis.

Peeling lead paint turns into poisonous dust. Guess where it ends up? A media campaign to prevent childhood lead poisoning in New York City.

Successful public health media campaigns promote messages, increase awareness, engage the public, and encourage behavior change. Between 2004 and 2006, the Lead Poisoning Prevention Program of the New York City Department of Health and Mental Hygiene conducted a media campaign grounded in social learning theory and the social marketing model to increase parents' awareness of childhood lead poisoning, ways to protect their children, and property owners' legal responsibility to fix peeling lead paint safely, and increase awareness of regulatory changes and encourage enforcement of New York City's Local Law 1 of 2004. Campaign materials were focus group tested and the campaign was refined annually. The campaign ran city-wide and in targeted high-risk neighborhoods. Neighborhoods and media venue (bus, train, kiosk, and store) changed annually, based on population risk factors and venue availability. Exposure to the campaign, campaign-related knowledge, and behavior were assessed using pre- and postcampaign street intercept surveys. Results showed that campaign reached the targeted population, and had an impact on knowledge of lead poisoning prevention measures as evidenced by increased knowledge of lead paint exposures sources in one year and increased knowledge of preventive behaviors in another year; these improvements were observed for both genders and most ethnic, primary language, educational attainment, and age groups in each year. Lessons learned indicate that well-targeted media campaigns, designed with audience participation, can reach parents through various venues, and improve key knowledge areas. Evaluation challenges faced include high levels of knowledge at baseline, competing media messages, and balancing between program needs and evaluation design.

Oklahoma's youth-driven tobacco policy campaigns: assessment of impacts and lessons learned.

Youth engagement is an important component of comprehensive tobacco control programs. Oklahoma has dozens of Students Working Against Tobacco (SWAT) teams throughout the state. Traditionally, SWAT has focused more on community and peer education than policy initiatives. To systematically engage SWAT members in high-impact policy work, Oklahoma launched new training materials and policy-focused campaigns in October 2011. To examine initial campaign implementation and impact, including outcomes and lessons learned. Youth baseline and post-campaign survey data and program coordinator post-campaign survey data were collected in 2011-2012 and analyzed in 2013. Chi-square analyses and t tests were used to identify differences in youths' attitudes, self-efficacy, and activism behavior. Descriptive statistics and thematic analysis of coordinator survey data were used to identify barriers to campaign implementation. Copies of passed policies were collected. Youths' tobacco-related attitudes (p<0.001) and confidence to implement local policy campaigns (p=0.011) and discuss Big Tobacco's lies (p=0.048) were higher at follow-up. Excepting survey collection (p=0.019), youth did not engage in new advocacy behaviors during the study period. Seven policies were partly attributed to the campaigns. Timing, lack of training, and material format were identified as barriers to implementation. When implementing similar programs, significant planning must go into the timing of the launch. Instruction must be provided to local staff before materials are disseminated. Developed materials must account for short meetings and limited access to technology. With some adjustments, campaigns like these could prove valuable tools for engaging youth in high-impact local tobacco control efforts.