An analysis of state health department COVID-19 information for the public (Preprint)

2020 ◽  
Author(s):  
Nandita S. Mani ◽  
Terri Ottosen ◽  
Megan Fratta ◽  
Fei Yu

BACKGROUND In response to the current COVID-19 crisis, public health departments across the U.S. have created, distributed, and shared COVID-19 health information. The extent to which information is understandable and actionable can be examined by use of validated health literacy and readability tools. Health information must be actionable, simple, and straightforward, particularly for health messages in times of urgency or during a health crisis. OBJECTIVE This study aimed (1) to use three validated health literacy tools to assess the understandability, actionability, clarity, and readability of COVID-19 health information created for the public by U.S. state public health departments; (2) to examine the correlations between understandability, actionability, clarity, readability, and material types; (3) to propose potential strategies to improve public health messaging. METHODS Based on CDC statistics on June 30, 2020, we identified the top 10 U.S. states with the highest number of COVID-19 cases. We visited the 10 state public health department websites and selected materials related to COVID-19 prevention according to a pre-defined eligibility criteria. Two raters independently assessed the materials by Patient Education and Materials Assessment Tool (PEMAT) and Clear Communication Index (Index). One rater generated the Flesch-Kincaid Grade Level (FKGL) score. Statistical analyses included (1) interrater reliability (IRR) by Cohen’s kappa; (2) the mean, median, standard deviation, range, minimum, maximum, and frequency scores associated with PEMAT, Index, and FKGL; (3) statistical significance of the correlation between PEMAT, Index, FKGL, and Material Type. RESULTS Of 42 materials in this study, (1) inter-rater reliability was 0.94. (2) The mean PEMAT (n=42) understandability was 88.67% (SD±17.69%), with a media of 94% and a range between 21% and 100%; the mean of PEMAT actionability was 88.48% (SD±14.3%), with a media of 100% and a range between 40% and 100%; the mean Index scores was 78.32 (SD±13.03), with a media of 78.35 and a range between 50 and 100. The mean of FKGL of the materials (n=34) was 7.11 (SD±2.60), with a media of 7.3 and a range between 1.7 and 12.5. (3) Correlations were significant (P<0.01) and positive between PEMAT understandability and actionability, PEMAT understandability and Index scores, PEMAT actionability and Index scores, PEMAT understandability and Material Type, PEMAT actionability and Material type. Correlations were significant (P<0.01) and negative between PEMAT understandability and FKGL scores, PEMAT actionability and FKGL scores, Index and FKGL scores, and FKGL and Material Types. No correlation was detected between Index scores and Material types (P>0.05). CONCLUSIONS COVID-19 health information provided by states for the public were easy to understand and act upon but could be improved in terms of readability and clear communication. The positive correlation identified between material types and PEMAT understandability/PEMAT actionability/Index scores respectively led to our recommendation on using more infographics and video format for public health messaging. CLINICALTRIAL N/A

2021 ◽  
Vol 109 (3) ◽  
Author(s):  
Nandita S. Mani ◽  
Terri Ottosen ◽  
Megan Fratta ◽  
Fei Yu

Objective: The COVID-19 pandemic highlights the public’s need for quality health information that is understandable. This study aimed to identify (1) the extent to which COVID-19 messaging by state public health departments is understandable, actionable, and clear; (2) whether materials produced by public health departments are easily readable; (3) relationships between material type and understandability, actionability, clarity, and reading grade level; and (4) potential strategies to improve public health messaging around COVID-19. Methods: Based on US Centers for Disease Control and Prevention statistics from June 30, 2020, we identified the ten states with the most COVID-19 cases and selected forty-two materials (i.e., webpages, infographics, and videos) related to COVID-19 prevention according to predefined eligibility criteria. We applied three validated health literacy tools (i.e., Patient Education Materials Assessment Tool, CDC Clear Communication Index, and Flesch-Kincaid Grade Level) to assess material understandability, actionability, clarity, and readability. We also analyzed correlations between scores on the three health literacy tools and material types.Results: Overall, COVID-19 materials had high understandability and actionability but could be improved in terms of clarity and readability. Material type was significantly correlated with understandability, actionability, and clarity. Infographics and videos received higher scores on all tools.Conclusions: Based on our findings, we recommend public health entities apply a combination of these tools when developing health information materials to improve their understandability, actionability, and clarity. We also recommend using infographics and videos when possible, taking a human-centered approach to information design, and providing multiple modes and platforms for information delivery.


2021 ◽  
Vol 12 ◽  
pp. 215013272199545
Author(s):  
Areej Khokhar ◽  
Aaron Spaulding ◽  
Zuhair Niazi ◽  
Sikander Ailawadhi ◽  
Rami Manochakian ◽  
...  

Importance: Social media is widely used by various segments of society. Its role as a tool of communication by the Public Health Departments in the U.S. remains unknown. Objective: To determine the impact of the COVID-19 pandemic on social media following of the Public Health Departments of the 50 States of the U.S. Design, Setting, and Participants: Data were collected by visiting the Public Health Department web page for each social media platform. State-level demographics were collected from the U.S. Census Bureau. The Center for Disease Control and Prevention was utilized to collect information regarding the Governance of each State’s Public Health Department. Health rankings were collected from “America’s Health Rankings” 2019 Annual report from the United Health Foundation. The U.S. News and World Report Education Rankings were utilized to provide information regarding the public education of each State. Exposure: Data were pulled on 3 separate dates: first on March 5th (baseline and pre-national emergency declaration (NED) for COVID-19), March 18th (week following NED), and March 25th (2 weeks after NED). In addition, a variable identifying the total change across platforms was also created. All data were collected at the State level. Main Outcome: Overall, the social media following of the state Public Health Departments was very low. There was a significant increase in the public interest in following the Public Health Departments during the early phase of the COVID-19 pandemic. Results: With the declaration of National Emergency, there was a 150% increase in overall public following of the State Public Health Departments in the U.S. The increase was most noted in the Midwest and South regions of the U.S. The overall following in the pandemic “hotspots,” such as New York, California, and Florida, was significantly lower. Interesting correlations were noted between various demographic variables, health, and education ranking of the States and the social media following of their Health Departments. Conclusion and Relevance: Social media following of Public Health Departments across all States of the U.S. was very low. Though, the social media following significantly increased during the early course of the COVID-19 pandemic, but it still remains low. Significant opportunity exists for Public Health Departments to improve social media use to engage the public better.


2019 ◽  
Vol 134 (4) ◽  
pp. 395-403
Author(s):  
Brandon Grimm ◽  
Christine Arcari ◽  
Athena Ramos ◽  
Tricia LeVan ◽  
Kathleen Brandert ◽  
...  

Objectives: The objectives of our study were to (1) illustrate a public health workforce assessment process in a medium-sized city or county health department and (2) demonstrate the insights gained by moving from the use of aggregate department-level and competency domain-level training needs results to more granular division-level and skills-level results when creating a workforce development plan. Methods: We used a 130-question needs assessment to guide the creation of a workforce development plan for the Lincoln Lancaster County Health Department (LLCHD) in Nebraska and its 7 divisions. Using SurveyMonkey, we administered the survey to 128 (of the 129) LLCHD public health staff members in June 2015. Using a Likert scale, respondents indicated (1) the importance of the skill to their work and (2) their capacity to carry out 57 skills in 8 domains of the core competencies for public health professionals. We identified training needs as those for which the percentage of respondents who perceived moderate-to-high importance was at least 15 percentage points higher than the percentage of respondents who perceived moderate-to-high capacity. Results: LLCHD as a department had training needs in only 2 competency domains: financial planning and management (importance-capacity difference, 15 percentage points) and policy development and program planning (importance-capacity difference, 19 percentage points). The Health Promotion and Outreach division had training needs in all 8 domains (importance-capacity difference range, 15-45 percentage points). Of the 57 skills, 41 were identified by at least 1 of the LLCHD divisions as having training needs. In 24 instances, a division did not qualify as having training needs in the overall domain yet did have training needs for specific skills within a domain. Conclusions: When performing public health workforce assessments, medium-to-large public health departments can obtain detailed workforce training needs results that pertain to individual skills and that are tailored to each of their divisions. These results may help customize and improve workforce development plans, ensuring that the workforce has the necessary skills to do its job.


10.2196/22331 ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e22331 ◽  
Author(s):  
David R Sayers ◽  
Scott T Hulse ◽  
Bryant J Webber ◽  
Timothy A Burns ◽  
Anne L Denicoff

Epidemiologic and syndromic surveillance metrics traditionally used by public health departments can be enhanced to better predict hospitalization for coronavirus disease (COVID-19). In Montgomery County, Maryland, measurements of oxygen saturation (SpO2) by pulse oximetry obtained by the emergency medical service (EMS) were added to these traditional metrics to enhance the public health picture for decision makers. During a 78-day period, the rolling 7-day average of the percentage of EMS patients with SpO2 <94% had a stronger correlation with next-day hospital bed occupancy (Spearman ρ=0.58, 95% CI 0.40-0.71) than either the rolling 7-day average of the percentage of positive tests (ρ=0.55, 95% CI: 0.37-0.69) or the rolling 7-day average of the percentage of emergency department visits for COVID-19–like illness (ρ=0.49, 95% CI: 0.30-0.64). Health departments should consider adding EMS data to augment COVID-19 surveillance and thus improve resource allocation.


2020 ◽  
Author(s):  
David R Sayers ◽  
Scott T Hulse ◽  
Bryant J Webber ◽  
Timothy A Burns ◽  
Anne L Denicoff

UNSTRUCTURED Epidemiologic and syndromic surveillance metrics traditionally used by public health departments can be enhanced to better predict hospitalization for coronavirus disease (COVID-19). In Montgomery County, Maryland, measurements of oxygen saturation (SpO<sub>2</sub>) by pulse oximetry obtained by the emergency medical service (EMS) were added to these traditional metrics to enhance the public health picture for decision makers. During a 78-day period, the rolling 7-day average of the percentage of EMS patients with SpO<sub>2</sub> &lt;94% had a stronger correlation with next-day hospital bed occupancy (Spearman ρ=0.58, 95% CI 0.40-0.71) than either the rolling 7-day average of the percentage of positive tests (ρ=0.55, 95% CI: 0.37-0.69) or the rolling 7-day average of the percentage of emergency department visits for COVID-19–like illness (ρ=0.49, 95% CI: 0.30-0.64). Health departments should consider adding EMS data to augment COVID-19 surveillance and thus improve resource allocation.


2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Ian Painter ◽  
Debra Revere ◽  
P. Joseph Gibson ◽  
Janet Baseman

Background: Infectious diseases can appear and spread rapidly. Timely information about disease patterns and trends allows public health agencies to quickly investigate and efficiently contain those diseases. But disease case reporting to public health has traditionally been paper-based, resulting in somewhat slow, burdensome processes. Fortunately, the expanding use of electronic health records and health information exchanges has created opportunities for more rapid, complete, and easily managed case reporting and investigation. To assess how this new service might impact the efficiency and quality of a public health agency's case investigations, we compared the timeliness of usual case investigation to that of case investigations based on case report forms that were partially pre-populated with electronic data. Intervention: Between September 2013-March 2014, chlamydia disease report forms for certain clinics in Indianapolis were electronically pre-populated with clinical, lab and patient data available through the Indiana Health Information Exchange, then provided to the patient’s doctor. Doctors could then sign the form and deliver it to public health for investigation and population-level disease tracking. Methods: We utilized a novel matched case analysis of timeliness changes in receipt and processing of communicable disease report forms. Each Chlamydia cases reported with the pre-populated form were matched to cases reported in usual ways. We assessed the time from receipt of the case at the public health agency: 1) inclusion of the case into the public health surveillance system and 2) to close to case. A hierarchical random effects model was used to compare mean difference in each outcome between the target cases and the matched cases, with random intercepts for case. Results: Twenty-one Chlamydia cases were reported to the public health agency using the pre-populated form. Sixteen of these pre-populated form cases were matched to at least one other case, with a mean of 23 matches per case. The mean Reporting Lag for the pre-populated form cases was 2.5 days, which was 2.7 days shorter than the mean Reporting Lag for the matched controls (p = <0.001). The mean time to close a pre-populated form case was 4.7 days, which was 0.2 days shorter than time to close for the matched controls (p = 0.792). Conclusions: Use of pre-populated forms significantly decreased the time it took for the local public health agency to begin documenting and closing chlamydia case investigations. Thoughtful use of electronic health data for case reporting may decrease the per-case workload of public health agencies, and improve the timeliness of information about the pattern and spread of disease.


2020 ◽  
Vol 110 (8) ◽  
pp. 1184-1190 ◽  
Author(s):  
Karen Albright ◽  
Pari Shah ◽  
Melodie Santodomingo ◽  
Jean Scandlyn

Objectives. To determine if and how state and local public health departments present information about climate change on their Web sites, their most public-facing platform. Methods. We collected data from every functioning state (n = 50), county (n = 2090), and city (n = 585) public health department Web site in the United States in 2019 and 2020. We analyzed data for presence and type of climate-related content and to determine whether there existed clear ways to find climate change information. We analyzed Web sites providing original content about climate change for explanatory or attributional language. Results. Fewer than half (40%) of state health department Web sites, and only 1.6% of county and 3.9% of city Web sites, provided clear ways to find climate change information, whether through provision of original content or links to external agencies’ Web sites. Among Web sites providing original content, 48% provided no explanation of climate change causes. Conclusions. National and global public health associations have identified climate change as a public health emergency, but most state and local public health departments are not delivering that message. These departments must be better supported to facilitate dissemination of reliable, scientific information about climate change and its effects on health.


Sign in / Sign up

Export Citation Format

Share Document