2012-2013 Flu Season

27 09 2012

PKIDs’ advice nurse, Dr. Mary Beth Koslap-Petraco, discusses the current flu season and what we can expect.

Listen now!

Right-click here to download (6.5 min/3 mb)

Twitter Header How-To

24 09 2012

Heads up, Twitter users! Come November, your twitter profile is going to look a little grey if you don’t do something about it.

They’re changing the look to include a header image of your choice, similar to the timeline cover that is now on Facebook pages.

The fix is simple and here’s how you do it:

First, create an image. Keep in mind that the header image you’re about to create will show along with your existing background image, so make sure they don’t clash.

Open your image editor (Photoshop or Paint or whatever you use) and create a New image with these dimensions: 1252px (width) X 626px (height) and 300 (resolution). I like to set the resolution this high because it makes any text you put on the image look good. This holds true for your Facebook timeline cover, and maybe even more true for that image.

Design your image as you like and keep in mind that your profile picture and some of the text from your profile will automatically show up on the image once you’ve uploaded it and are done with it:

Log onto your Twitter page and click on the Settings wheel at the top of your page on the right side. In the dropdown menu, click on Edit Profile:

On the left side of your page where you see Account, Password, Mobile, and so on, click on Design:

Scroll down a little, and click on the Change Header or Header option. It might say something slightly different if you don’t yet have a header, but look for the “Header” box above the Change Background box on the right side of the page:

Click on the Header box and a box will pop up that is a directory of your computer. Make sure you’ve named your image something obvious and that you remember where you stored it, then click on the “Look in” dropdown at the top of the box and go find your image:

Once you’ve found it, double-click on it and a new box will appear saying “Upload a header image” and it will have a slider bar at the bottom so you can do any final adjustments to the image. You then click Save or Cancel on the box, as you like:

Assuming you clicked save, it will do so and then you scroll to the bottom of the Design page and click “Save changes.” To see your new header, click on “Me” at the top of your page.

And that’s it! Do you have some Twitter headers you’d like to share? We’re all looking for great ideas!

By Trish Parnell

Weekly Flu Update

20 09 2012

In case you couldn’t make the call, here are some notes from the 20 September National Influenza Vaccine Summit call, hosted by Litjen Tan of the AMA:

Scott Epperson from CDC offered this influenza surveillance update

It’s been pretty quiet for seasonal flu, so not much to report. The vaccines we have in the Northern Hemisphere will cover most strains that are circulating, including 2009 H1N1, H3N2, and influenza B.

As for the H3N2v, there have been 305 reported cases so far. The numbers of new cases have dropped dramatically, probably due to the fairs wrapping up around the country, although the strain is still out there, so stay away from the pigs!

New numbers of H3N2v cases are on the CDC website every Friday.

General information on H3N2v can also be found on the CDC website

The Southern Hemisphere is experiencing a more severe flu season than it’s had in several years. The question is, will that hold true for us in the Northern Hemisphere? It’s difficult to say, as H3N2 is circulating more in the South, and they did not have the particular strain in their vaccine this year, although the Northern Hemisphere does have the strain in its current vaccine.

Douglas Shenson reported on his program: Vote & Vax

It’s a fun and impactful program that was initially supported by the Robert Wood Johnson Foundation and is growing each year. It’s easiest to go to the website to get educated about this effort and to find out how you can set up a flu vaccination clinic at or near a polling place.

NFID News Conference

The National Foundation for Infectious Diseases (NFID) is sponsoring a news conference on 27 September at 10am eastern that will serve as the kickoff for the autumn immunization season. The news conference will be live from the National Press Club in Washington, DC, and Dr. Len Novick is the event coordinator.

Dr. Howard Koh, Assistant Secretary for Health at HHS, will announce new data of vaccine coverage from the 2011/2012 season.

Manufacturers’ projections for the coming season and the strains for next season will also be discussed.

Dr. Bill Schaffner, immediate past president of NFID, will moderate the conference, and on the panel will be several physicians representing various professional healthcare associations. Anyone may join the conference on the live feed, although pre-registration is a must. The teleconference number is T: 800-755-1805

Remember to visit the Summit website for the latest on influenza immunization resources! You can find it at: www.preventinfluenza.org.

Gastro Bugs

17 09 2012

There is no such thing as “stomach flu,” despite the cavalier use of the phrase in some circles. What’s really going on is usually viral gastroenteritis.

Viral gastroenteritis isn’t caused by just one thing—it can be the result of any one of many different viruses, such as norovirus or rotavirus.

A gastro bug, as I like to call it, can be in the food or water we consume and will most commonly cause diarrhea, nausea and vomiting, and/or abdominal pain or discomfort.

Sometimes, it can also cause you to have a fever or chills, clammy skin, muscle or joint pain, and may put you off your feed. (That’s a “duh,” isn’t it!)

With liquids of various sorts pouring out of you, dehydration is a concern. Here are the signs, symptoms, and potential treatments to consider, as specified by NIH:

Signs and tests

The healthcare provider will look for signs of dehydration, including:

  • Dry or sticky mouth
  • Lethargy or coma (severe dehydration)
  • Low blood pressure
  • Low or no urine output; concentrated urine that looks dark yellow
  • Markedly sunken soft spots (fontanelles) on the top of an infant’s head
  • No tears
  • Sunken eyes

Tests that examine stool samples may be used to identify which virus is causing the sickness. This is usually not needed for viral gastroenteritis. A stool culture may be done to find out whether diarrhea are causing the problem.


The goal of treatment is to prevent dehydration by making sure the body has enough water and fluids. Fluids and electrolytes (salt and minerals) that are lost through diarrhea or vomiting must be replaced by drinking extra fluids. Even if you are able to eat, you should still drink extra fluids between meals.

  • Older children and adults can drink sports beverages such as Gatorade, but these should not be used for younger children. Instead, use the electrolyte and fluid replacement solutions or freezer pops available in food and drug stores.
  • Do NOT use fruit juice (including apple juice), sodas or cola (flat or bubbly), Jell-O, or broth. All of these have a lot of sugar, which makes diarrhea worse, and they don’t replace lost minerals.
  • Drink small amounts of fluid (2-4 oz.) every 30-60 minutes. Do not try to force large amounts of fluid at one time, which can cause vomiting. Use a teaspoon or syringe for an infant or small child.
  • Breast milk or formula can be continued along with extra fluids. You do NOT need to switch to a soy formula.

Food may be offered often in small amounts. Suggested foods include:

  • Cereals, bread, potatoes, lean meats
  • Plain yogurt, bananas, fresh apples
  • Vegetables

People with diarrhea who are unable to drink fluids because of nausea may need intravenous (directly into a vein) fluids. This is especially true in small children.

Antibiotics do not work for viruses.

Drugs to slow down the amount of diarrhea (anti-diarrheal medications) should not be given without first talking with your healthcare provider. DO NOT give these anti-diarrheal medications to children unless directed to do so by a healthcare provider.

People taking water pills (diuretics) who develop diarrhea may be told by their healthcare provider to stop taking the diuretic during the acute episode. However, DO NOT stop taking any prescription medicine without first talking to your healthcare provider.

The risk of dehydration is greatest in infants and young children, so parents should closely monitor the number of wet diapers changed per day when their child is sick.

You can buy medicines at the drugstore that can help stop or slow diarrhea.

  • Do not use these medicines without talking to your healthcare provider if you have bloody diarrhea, a fever, or if the diarrhea is severe.
  • Do not give these medicines to children.

Viral gastroenteritis can become a serious illness, so watch for the symptoms and alert your healthcare provider if symptoms worsen.

Washing hands is the best prevention, along with vaccination when available (babies can be vaccinated against rotavirus).

Visit these websites for more information on gastro bugs

By Trish Parnell (really by the NIH with a few asides from me)

Image courtesy of Examiner

School’s Here!

13 09 2012

School is here. So, new clothes, cell phone, new haircut, make-up, sweet-smelling body spray . . . what else could you possibly need?

Sports physicals―Want to play a sport this year? Gotta get a physical. Check your school website for the forms. Lots of places offer free physicals. Check that out on the website or call the health department.

Shots―Nobody wants them, everybody gets them. And don’t forget your flu shot. Local health clinics or your doc’s office will know what shots you need for your grade/school.

More Must-Haves, Must-Dos

It’s all about the numbers―Write down phone numbers of people who can help you in an emergency. Stash the list in your backpack or locker. These numbers might be in your cell phone, but if you lose your phone or the battery dies, you’ll still have the list.

Meds and health stuff―If you take medicine regularly, or have any health problems like allergies or asthma, make a list of these things, including doses of the meds. Include your doc’s phone number so that if you lose your meds or are having health-related problems, you can give this info to the school nurse and not have to remember everything.

Lighten up―If the school gives you lots of books to take back and forth every day, carrying them can make you sore. See if you can get two of each book and keep one at home and one at school.

Eat breakfast―The commercials are right: it’s the most important meal of the day. And don’t load it up with sugar. Try eating healthy stuff like fruits, proteins (not too fatty though) and whole grains every morning for a week and see how you feel. If you like it, keep it up.

Eyes and ears―If you’re having trouble hearing or seeing, tell your parents. If that doesn’t help, tell the school nurse. There are things that can be done to help! After all, why make life any harder than it needs to be?

What else do you need to get the year going right?

NIVS Weekly Call

10 09 2012

The National Influenza Vaccine Summit was created about a dozen years ago to address and resolve “influenza and influenza vaccine issues.” The CDC, the AMA, and 400+ other partners work together in this year-round effort.

During the flu season, there are weekly calls to keep all of the partners updated on the ups and downs of influenza in the US. And, just last spring in May 2011, there was held in Brussels, Belgium, the first European Influenza Summit. The two groups are now working collaboratively to reduce influenza infections.

The calls are brief and to the point. We thought you might find use for these few notes from the 6 September US call:

  • Scott Epperson from the CDC reported on flu surveillance. He said that there are low numbers of seasonal flu and most of those are H3N2 and influenza B viruses. However, there are 288 confirmed cases of the H3N2v (variant) virus, which is a swine flu strain. (New numbers are posted every Friday, so this figure may change by the time this post runs.) Sixteen of those infected were hospitalized and there was a death—an older individual with multiple, high-risk medical conditions which led to complications of influenza infection. Ninety-three of those infected were under the age of 18, with an average age of six years. Fifty-two percent were female and 48% were male, and of those with a known antiviral treatment status, 60% had been treated, and of those with a known vaccination status, 53% reported being vaccinated within the last year.
  • Harvard has now taken over the Flu Shot Finder started by Google, and they’ve done an excellent job expanding its capabilities. John Brownstein provided slides on the new features and the new site can be found at http://flushot.healthmap.org. There’s a widget available for use on your own websites that will allow people to put in their zip codes to find flu vaccine near them.
  • Christine Harding from the National Council on Aging’s Flu + You campaign presented on their program and the many free resources available to flu educators and healthcare providers. Stop by their site and take a look—there’s bound to be something you can use.

That’s it for this week. We didn’t cover everything, but what’s left out has been covered extensively elsewhere.

Do you have any flu educational resources you’d like to share? Let folks know about them in the comments, and thanks!

By Trish Parnell
Image courtesy of NIVS

Social Marketing 101

6 09 2012

What Is Social Marketing?

Social marketing is the same as commercial marketing—the marketing that sells a certain brand of car or shoe. It’s the goals we hope to achieve that are different. As social marketers, we want to influence social behavior that benefits the individual, the target audience, and society—not just behavior that benefits us as marketers. We don’t want to sell vaccines; we want to sell the idea of health benefits associated with immunizing and health risks associated with not immunizing. We want to sell the attitude that protecting the community is as important as protecting oneself. We want to sell the behavior of timely immunization for oneself and loved ones.

What Is The Approach?

Nedra Kline Weinreich of Weinreich Communications talks about “the four Ps of marketing” and that social marketing “adds a few more Ps.” She says that one has to plan out a “marketing mix” that is consumer-focused:

  • Product. Disease prevention through immunization—that’s the product we’re marketing.
  • Price. What’s the price to the public to prevent disease through immunization? There are several costs, but the bottom line is that the public has to believe that there’s more value to vaccinating than not vaccinating.
  • Place. Where can the public get immunizations? Vaccines must be easy to get so that the public feels satisfied with the experience.
  • Promotion. Promoting disease prevention through vaccination can be done through many avenues including PSAs, blog articles, online networking, and sharing the personal stories of those affected by preventable disease.

Social marketing “Ps” that pertain to our field include:

  • Publics. Publics is made of two broad groups: the people in your organization who have a say in the establishment of your program and those who will receive your message. For maximum effectiveness, you may need to adapt your message to each target audience. For example, if you are promoting the importance of the HPV vaccine for girls as your basic message, you’ll need to adapt it for different groups who perform different functions, including legislators, school districts, parents, girls, and insurers.
  • Partnership. Partnering with other groups is an efficient way to stretch the budget a bit further. Sharing resources and connections can make a good program great. Health departments and immunization coalitions already do this, so you’re a step ahead!
  • Policy. If you’re promoting HPV vaccination as a healthy choice for girls and young women, and you are successful in getting buy-in from those girls and young women, the program will need policy makers to also buy-in for sustainability. If policy makers are not financially and fundamentally supporting HPV vaccination for girls and young women, the vaccine will not be readily available, it will be too expensive for end-users, and it will not become a widespread practice.
  • Purse Strings. Every health department and immunization coalition knows that, without funding, their programs cannot be developed. Acquiring funds is an ongoing challenge for social marketers.

Putting It Together

A social marketing campaign is fun and challenging. We return to Nedra Kline Weinreich for instructions on how to integrate social marketing into your programs. She offers 10 tips for implementation which have been illustrated with a sample program: Raising awareness of HPV infection and vaccination among teen girls.

1. Talk with your “customers,” your target audiences.

Your program will be more successful if you take time to talk with your target audience and find out what they want and need before constructing your program.

If you are targeting teen girls to raise awareness of HPV infection and the HPV vaccine, go to where teen girls are and talk with them. Listen to them. Ask them what they know about HPV, who do they go to for sexual health information, what’s important to them, how they feel about getting immunizations, and what would improve their experience. There will be many questions to ask and answer, but these are good for starting a conversation.

Don’t forget to sit down with the parents of teen girls, as they might be the ones to make the appointment and take the teen to the clinic for the vaccination. The parents constitute a different target group, so the conversation will be different. However, it’s important to recognize all target groups for the program and that each may require a slightly different marketing message.

Ways to “listen” to the audience include:

  • Surveys – paper or online
  • Focus groups – in person or online
  • Social media – ask and get comments back
  • Research – see what survey results or opinion summaries have already been written.

2. Segment your audience.

Each target group will be different and will have different viewpoints of the same issue. As mentioned previously, the parents of a teen girl will be concerned with different things than a teen girl. For example, parents may be concerned with vaccination costs while their daughter might be more concerned with the pain of getting a shot.

Knowing each of your audiences and talking with each will help define and refine your messages. For this program, you might break your audience up by age range (11–14, 15–17, 18–19), by cultural, racial, or religious backgrounds (Asian, African American, Islamic), by geographic location (Southwest, Northeast), or by another common factor.

How many segments you target will depend on your budget and goals. Each segment will require messages that resonate with that group.

3. Position your product.

In social marketing, your product is going to be the end result—perhaps a change in behavior or attitude. Ms. Weinreich points out that this is more difficult than when marketing tangible goods:

Products like behaviors and attitudes require long-term commitments and do not sell as easily as a bar of soap or a car. The cost of a social marketing product often includes a person’s time and effort (to attend a class or use services), giving up things he likes (high fat food), embarrassment or inconvenience (buying and using condoms), or social disapproval (resisting peer pressure to smoke).

Positioning the product––getting teen girls to get vaccinated against HPV––means listening to your target audiences and finding out “…the benefits they value most and the barriers they foresee.”

For example, if parents feel that the cost of vaccination trumps any benefit that could be gained by vaccinating, that’s a perceived barrier. In return, you position your product (getting vaccinated) and show how parents can save money (insurance, free clinics) and how the money spent at this time may save health, heartache, and money down the road should someone grow ill as a consequence of not being vaccinated.

4. Know your competition.

Most health educators don’t think in terms of competition because they’re not trying to win anything. The bigger purpose is to make change happen, not make a profit.

While this is true, it’s also true that other health education programs, commercial marketing efforts, and even world events compete for the attention of your target audiences. Or, you may simply be competing against the inertia of your audience—a formidable competitor.

To win the competition, says Ms. Weinreich, “Your product must be more attractive than the alternatives to be accepted.”

It sounds simple, but this is where the creativity of your group will be put to the test.

5. Go to where your audience is.

Where do your target audiences get their news? Where do they spend their time? Online? At church? In school? At the mall? Wherever it is, that’s where you want to place your messages. You want to make sure they see and hear what you have to say, so put the advertising (posters, PSAs, stories) where you know they will be looking.

6. Utilize a variety of approaches.

Take your messages: “It’s your body, protect it” or “Protect your daughter’s future today”, for example, and present them in multiple outlets and in multiple forms.

Other ideas include:

  • Making up bumper stickers and distribute them through the PTA;
  • Designing posters and place them in malls and free clinics;
  • Recording PSAs and place them on local radio stations and school radio;
  • Placing ads in newspapers;
  • Providing free stickers in fast food bags

Be creative and make sure the venue choices are appropriate for each target audience.

Your budget will help determine the activities and the number of ways you can get your message out. Make sure the message is branded, so that audiences will recognize it when they see it. For each target audience, make sure their main message and design remains the same on posters, stickers, PSAs and other approaches.

7. Use models that work.

Social marketing usually seeks to change behavior in some way. The CDC provides a description of several behavior change models that could be adapted as you design your own program. We’ve included a couple of models here:

Health Belief Model

Premise: Health behavior is a function of specific health beliefs. All must be operating for a risk reducing/health promoting behavior to occur.

I. Threat

* Perceived susceptibility
” I could get it.”
* Perceived severity
“The consequences of getting it would be serious.”

II. Outcome expectations

* Perceived benefits of performing a behavior
” If I use condoms/bleach, I can prevent HIV infection.”
* Perceived barriers of performing the behavior
“Cleaning my works is a real drag.”
* Belief that the benefits of performing a behavior outweigh the consequences of not performing it before behavior change will occur
“I’d rather use clean needles than get HIV.”

III. Self efficacy (later addition)

* Belief that one can perform a behavior, even under difficult circumstances
“I know I can do this.”

Transtheoretical Model (Stages of Change)

Premise: Behavior occurs in a series of stages, independent of specific theoretical factors. Movement through the stages varies from person to person and group to group. There are 5 stages of change, as well as various processes and levels of change.

Five Stages of Change

* Precontemplation—no intention to change behavior; not aware of risk, or believe behaviors don’t place them at risk.
“I know I have a lot of sexual partners, but I don’t need to use condoms because my partners aren’t at risk for HIV.”
* Contemplation—recognizes behavior puts them at risk and is thinking of changing, but not committed to making that change.
“I know that not using a condom puts me at risk for HIV, but sex isn’t the same when I wear a condom.”
* Preparation—person intends to change risky behavior sometime soon and is actively preparing.
“I just bought some condoms and am going to talk to my partner about using them the next time we have sex.”
* Action—person has changed risky behavior recently, with change having occurred in a relatively recent time period (i.e., 6 months)
“My partner and I used a condom for the first time and it wasn’t as bad as I thought.”
* Maintenance—person has maintained behavior change for a long period of time (> 6 months), and has adapted to the change.
“Using condoms is no big deal anymore; my partner and I have our routine down and always use them when we have sex.”
* Relapse is a normal process in one’s attempt to change behaviors.

8. Test, test, test.

Test your messages and materials for each target group with each target group. Use focus groups and surveys and any other evaluative tool that works and test throughout the development process. Test again after your messages and materials have been in use for a short time and adapt your messages and materials if necessary. Testing will make your program more successful.

9. Build partnerships with key allies.

Working with other groups whose missions are similar to yours will extend the reach of your program, stretch your budget dollars, and increase exposure for all allies. Key allies might be other health educators, or they might be those outside of health education who have an interest or connection to your target audience(s). These include youth ministers, coaches, retailers, members of the media, and other service groups who share your target audiences. Think beyond health education and consider any group or individual with a connection to your target audiences.

10. See what you can do better next time.

Evaluating your program is what will give it and future programs more substance. Some evaluation occurs in the testing phase mentioned earlier. Evaluations performed at the beginning and end of the program can help you understand what changes did and did not take place in your target audience. Getting both qualitative and quantitative feedback from your target audiences throughout the program can help you improve your approaches as you proceed. Tracking your progress as you implement the program can help you find ways to be more efficient.

It’s important to do the evaluations so that you can cut a little bit off of the learning curve and start out with a stronger program next time.

The following are samples of social marketing programs

CDC case studies

Turning Point case studies

From: Communications Made Easy