Community programs that teach English for Speakers of Other Languages (ESOL) are great partners. These educational programs are often eager to add new and useful curriculum topics, such as health and wellness. Help them develop a module on flu, using the MDPH Flu Facts materials in the Toolbox.
The Office of Public Health Strategy and Communications (OPHSC) at the Massachusetts Department of Public Health has produced a very useful translation toolkit, which can be found in the Resources section at the back of this guide.
As in English, it is important to pay attention to the literacy level of the target population when copying or posting material in other languages. If a translated document is above the literacy levels of the group you are trying to reach, or contains technical language, it will not be useful. As you learn about the population, find out what grade levels they have completed, on average, and what sort of materials they are likely to use. In these situations, oral communication through radio spots, informal educational talks, or outreach may be the most effective way to get your message out. Again, partnerships are critical. Locate the programs that work with community groups in their own languages.
(Translation resources are listed on page 46.)
Toolbox Section Eleven: Toolbox
Flu Vaccination Reimbursement Projects for Massachusetts Public Health and School Flu Clinics 32
How to Conduct a Discussion Group 33
Sample Flu Education Outline 34
Flu Education PowerPoint Presentation Link 34
Telephone Survey Template 35
Community Partners and Collaborators Database Template 36
Massachusetts Ethnic Community Organizations and Advocacy Groups 37
Ethnic Media in Massachusetts 39
Press Release Template 40
Resources by Section 41
Planning Your Outreach Campaign 41
Faith-Based Organizations 42
Homeless Populations 43
Community Organizations and Ethnic Groups 43
Flu Education 44
Publicize Your Message 45
Language and Translation 46
Flu Vaccination Reimbursement Projects for
Massachusetts Public Health and School Flu Clinics
Medicare Roster Billing
For Medicare beneficiaries, usually 65 years of age and older; some younger disabled individuals can also have Medicare.
Will reimburse for the cost of flu and pneumococcal vaccines, as well as for the cost of administering the vaccine.
For questions: Call Commonwealth Medicine, (800) 890-2986, or send e-mail to email@example.com.
To contract for billing assistance: Call Public Sector Partners, 508-421-5938, or visit http://www.publicsectorpartners.com.
Health Plan Reimbursement Program
For children and adults younger than 65 years of age.
Will reimburse for the cost of administering flu vaccine at public clinics. The list of Health Plans participating each year changes, so you must get the current list each fall.
For assistance: Call University of Massachusetts Medical Center at 617-886-8161.
Information and forms are available at http://www.umassmed.edu/commed/flu-reimb/index.aspx.
Photo courtesy of Cambridge Public Health Department
A discussion group can be a powerful means to test new ideas for flu outreach. By gathering a group of people from the community you wish to educate and vaccinate, you can get a great deal of information and also develop trusted connections to help with your outreach effort.
Preparing for the session
Identify the major objective of the meeting. What is the key thing you hope to learn about?
Recruit for your group. Invite individuals or groups who are knowledgeable about their community. These can include clergy, parents, educators, employers, civic leaders and youth workers. Although it’s ideal if participants don’t know one another, you can also consider groups that have already met (such as parent groups, community health workers, and agency staff). Incentives really help in recruiting; consider a small gift card, and make sure to provide refreshments for community groups!
Make reminder calls. About three days before the session, call each member to remind him or her to attend.
Make special accommodations needed (e.g., dietary restrictions, access for people with disabilities).
Keep it brief. Develop no more than four or five questions.
Plan your session
Scheduling: Plan meetings to be 1 to 1.5 hours long. Lunch seems to be a very good time for others to find time to attend.
Setting and Refreshments: Hold sessions in a conference room, or other setting with adequate air flow and lighting. Configure chairs so that all members can see each other. Provide name tags for members. Be certain to make accommodations for people with disabilities.
Ground Rules: You want all members to participate as much as possible, but keep the session moving along while generating useful information. Because the session is often a one-time occurrence, it is useful to have a few short ground rules that sustain participation, yet do so with focus. Consider the following three ground rules: keep focused, maintain momentum, and allow for everyone to speak.
Recording: Plan to record the session with either an audio or audio-video recorder. Don’t count on your memory. If recording isn’t practical, involve a co-facilitator who will take notes. (If audio-video recording, get prior written permission from each participant, this could be done with a single master release form with multiple signature lines.)
Facilitating the session
Introduce yourself and the co-facilitator, if any.
Review the agenda. Consider the following agenda: welcome, review of agenda, review of goal of the meeting, review of ground rules, introductions, questions and answers, and wrap-up.
Explain the means to record the session.
Word each question carefully before presenting to the group. Allow a few minutes for each member to think about answers. Then, facilitate discussion around the answers to each question, one at a time.
Ensure even participation. If one or two people are dominating the meeting, call on others. Consider using a round-table approach, going in one direction around the table and giving each person a minute to answer the question. If the domination persists, note it to the group and ask for ideas about how the participation can be increased.
Close the session. Tell members that they will receive a copy of the report generated from their answers, thank them for coming, and adjourn the meeting.
Immediately after the session
Verify that the tape recorder, if used, worked throughout the session.
Check your notes. Clean up unclear handwriting, ensure pages are numbered, and clarify any notes that don’t make sense.
Write down any observations made during the session. For example, where did the session occur and when? What was the nature of participation? Were there any surprises during the session? Did the tape recorder break?
Fever, chills, weakness, loss of appetite, or aches and pains all over.
Sore throat and cough.
Possible complications: dehydration, pneumonia, and worsening of other health problems such as asthma, bronchitis, heart disease, and diabetes.
How is it different from a cold?
Colds usually don’t have high fever, or the fever doesn’t last long.
Flu causes aches, pains and extreme tiredness (lethargy).
Colds and flu both have upper respiratory symptoms, but flu feels much worse than a cold. People with flu feel so badly that they have to stay in bed.
Each year, between 4,000 and 49,000 people in the U.S. die from flu.
Impact of flu
While some are elderly or have chronic health conditions, some were completely healthy before they got the flu.
Half of the children hospitalized with flu in 2010–11 season had no prior health conditions.
Flu has a huge impact on daily life: it causes workers to miss work, children to miss school, and seniors to be hospitalized.
Flu prevention: Spreading flu is best prevented by:
Staying home when sick.
Covering coughs and sneezes.
Frequent hand washing.
Flu vaccine basics
The vaccine is now recommended for everyone over 6 months, so that more vulnerable people can be protected.
There are two kinds of flu vaccine, the shot and the nasal mist.
Both protect against the three most likely strains of flu that may be encountered during flu season.
Flu shot is made from inactivated viruses.
Nasal spray is made from live virus that has been changed (“attenuated”) so that it cannot cause illness. It can only be given to healthy people between age 2 and 49.
People who are allergic to eggs cannot get flu vaccine because it is grown in eggs.
The vaccine can’t cause flu, but does have side effects.
A sore arm where the shot was given. This goes away after a day or two.
In some cases, a person may feel a little sick 12–48 hours after the shot.
Vaccine protection occurs within two weeks.
Flu vaccine is NOT experimental. It has been successfully given to hundreds of millions of people from countries and cultures all over the world for decades.
Flu Education PowerPoint presentation
The MDPH Health Equity Immunization Work Group has developed a brief PowerPoint presentation that can be adapted for use in flu education settings. To request an electronic version, send an e-mail to DPH-HealthEquity@state.ma.us.
Telephone Survey Template
This script can be used to contact and develop partnerships with local organizations in your community. If you are reaching out to organizations that work with racially, ethnically and linguistically diverse (REL) communities, you may want to work with an interpreter.
Name of Organization:
Name of contact person you are speaking with:
Thank you for speaking with me today. We are collecting information to learn about the perception of flu in racial and ethnic populations, and I think your knowledge and experience will be helpful. Are you ready to begin?
What populations are served by your agency/organization?
What are the primary language(s) spoken in the community?
Who are the leaders, spokespersons, trusted sources, and key informants in the community?
What are the formal and informal ways people get their information?
What is the biggest gap in communication with your community?
Who most influences the health decisions for people in your community?
Where do most community members get their health care?
Is there anything else you would like to share?
Would you be willing to help us get the word out about flu this season?
What’s the best way to reach you?
Is there someone else I should speak with?
Thank you so much for your time.
Community Partners and Potential Collaborators Database Template
Massachusetts Ethnic Community Organizations and Advocacy Groups
When contacting these organizations, consider asking:
What racial or ethnic groups does your organization serve/represent?
The Epoch Times (multiple languages) Vocero Hispano
WCUW 91.3 FM (Irish, Scottish, French, Polish,
Latino, Indian, Jewish, Albanian, Chinese)
WJFD/Radio Globo (Portuguese)
WJUL/Salsa 91 (Hispanic)
WMBR 88.1 FM (multicultural)
WSPR (Western Mass Spanish Language Radio)
WUNI-TV, Channel 27/Univision (Hispanic)
WUNR 1600 AM (eight languages)
WTCC Radio – Springfield Technical College Radio
Press Release Template
A press release is a one-page description of your news or event designed to inform media of high-level information—the “who,” “what,” where,” “when,” “why” and “how.” A press release should include the partner’s contact information, a descriptive headline, and a quote from your organization’s president or spokesperson and should only include essential information about your issue or event. Keep your press release to one page.
FOR IMMEDIATE RELEASE: (this goes directly under your letterhead)
DATELINE: e.g., Springfield, Massachusetts, June 1, 2011
Paragraph one—Two to three sentences describing what happened or will happen—the most important facts of the release.
BODY: Paragraph two—Include essential background material, names of key characters, the number of people expected in attendance, sources for data cited. Also, include supportive quotes.
Paragraph three—Elaborate the material in the first two paragraphs, including background material, and attribution. Include supportive quotes from community members, if possible.
Always end the press release with three number signs, centered, at the end of your release.
Resources (by Section)
Resources for Section Two: Planning Your Outreach Campaign
U.S. Census Bureau
Offers extensive data on national, state, county, and city populations. In addition, The American Community Survey (ACS) is an ongoing survey that provides data every year—giving communities the current information they need to plan investments and services.
U.S. Census American Fact Finder
Includes data on racial and ethnic characteristics of populations at the sub-county and census tract level.
American Community Survey
Provides data every year, giving communities the current information they need to plan investments and services.
Office of Refugees and Immigrants (ORI)
Tel: (617) 727-7888
Fax: (617) 727-1822
TTY: (617) 727-8147
Promotes the full participation of refugees and immigrants as self-sufficient individuals and families in the economic, social, and civic life of Massachusetts. ORI sponsors a variety of programs geared to immigrant populations and keeps important data on new populations in Massachusetts.
Enter Department of Housing and Community Development in the SEARCH field.
Massachusetts Association of Community Health
A statewide network of community health workers
(CHWs) from all disciplines.
The Massachusetts Regional Center for Healthy
Provides assistance and support for health and safety related initiatives in communities across the Commonwealth. Each center maintains a resource library that provides free loans of current and culturally appropriate prevention resources including videos, curricula, books, and health data. Many materials are available in languages other than English.
Western Massachusetts Center for Healthy
Central Massachusetts Center for Healthy
Northeast Center for Healthy Communities
Regional Center for Healthy Communities (serving
suburban Boston and Metrowest)
Southeast Center for Healthy Communities
508-583-2350 / 1-800-530-2770 (phone)
Greater Boston Center for Healthy Communities http://www.hria.org/services/healthy-communities.html
National Institute for Occupational Safety and Health Guidance For Preventing Seasonal Flu in the Workplace
Companies that want to implement site-based flu clinics, and are willing to pay for them can contact the local VNA, or a number of businesses that offer onsite flu clinics.
Locate your local Visiting Nurse Association by visiting http://www.vnaa.org and clicking “Find a VNA.”
Maxim Health Care: http://www.maximhealthcare.com/services/flu-wellness.aspx
The Wellness Company: http://www.thewellcomp.com/
Resources for Section Six: Homeless Populations
The Health Care of Homeless Persons: A Guide of
Communicable Diseases and Common Problems in
Shelters and on the Streets http://www.bhchp.org/BHCHP%20Manual/pages/chapters.html
A 384-page guide that describes health problems commonly afflicting homeless persons and discusses appropriate responses and treatment. The guide addresses communicable disease control and food handling in shelter settings, and current approaches to the management of chronic diseases.
It includes convenient patient education materials in English and Spanish that can be easily reproduced and given to shelter guests and staff. The Guide is no longer available in print, but some chapters are downloadable at the website above.
National Health Care for the Homeless Flu Guide
Written to assist shelters and other congregate facility manage the potential spread of H1N1, but is equally useful for preventing and managing seasonal flu in homelessness programs.
Resources for Section Seven: Community Organizations and Ethnic Groups
Massachusetts Office for Refugees and Immigrants
(ORI) Provider List – see Section 11, Toolbox
Massachusetts Department of Public Health Refugee and Immigrant Health Program
State Laboratory Institute
305 South Street
Jamaica Plain, MA 02130
Greater Boston Regional Office (Area includes
Metropolitan Boston, North Shore and South Shore)
State Laboratory Institute
305 South Street
Jamaica Plain, MA 02130
Tel: 617-983-6594 or 617-983-6587
Northeast/Central Regional Office (Area includes
Merrimack Valley and Worcester County)
365 East Street
Tewksbury, MA 01876
Tel: 978-851-7261 x4033
Western Regional Office (Area includes Hampden, Hampshire, Franklin and Berkshire Counties)
23 Service Center
Northampton, MA 01060
Tel: 413-586-7525 x1141
Massachusetts Department of Public Health, Office of Health Equity
250 Washington Street, 5th Floor
Boston, MA 02108
The Cross Cultural Health Care Program
Provides information, research and resources to help ensure underserved communities have full access to quality health care that is culturally and linguistically appropriate. This site includes cultural competency training materials, links to national sites, and a resource library, including many resources about specific ethnic communities.
A website for health care providers who see patients from different ethnic groups. It contains resources and information about culture, language, health, illness and community resources.
(Also, see List of Ethnic Community Based Organizations on page 37.)
Resources for Section Eight: Flu Education
Massachusetts Department of Public Health flu education materials
Complete information on how to write a press release and a public service announcement, as well as specific annual information and key messages on flu for specific target audiences.
CDC Gateway to Health Communication & Social
Links to tools and templates that make preparing a social marketing or health communication plan much easier for you.
Free broadcast-quality media
http://www.cdcmediaresources.com Social Media Toolkit—The Social Media Toolkit has been designed to provide guidance and to the share lessons learned in more than three years of integrating social media into CDC health communication campaigns, activities, and emergency response efforts. In this guide, you will find information to help you get started using social media—from developing governance to determining which channels best meet your communication objectives to creating a social media strategy. You will also learn about popular channels you can incorporate into your plan—like blogs, video-sharing sites, mobile applications, and RSS feeds.
Federal Government Flu Site
CDC Seasonal Flu Website
Includes a wide range of ethnic and linguistic-specific materials.
In 2014-2015, the Massachusetts Department of Public Health’s (MDPH) Office of Health Equity (OHE), in partnership with the Bureau of Infectious Disease Immunization Program, collaborated with the Office of Health Communications, Emergency Preparedness Bureau (EPB), Bureau of Health Care Quality and Safety, local boards of health (LBoH) and community-based organizations in an initiative to increase community awareness and immunization against influenza.
Through this initiative, OHE supported and facilitated outreach, education and flu immunization activities targeted at the most vulnerable and isolated racial, ethnic and linguistic (REL) populations hardest hit by the H1N1 flu. OHE produced flu education materials, provided technical assistance (TA) to 8 grantees in 2014 and 10 grantees in 2015, and collected outreach, education and vaccination data by age, race, ethnicity and language. An overview of the measures and process of this initiative, as well as a summary of outcomes from each grantee, is included in the following pages.
Proposed Plan: Starting in September 2013, the Immunization Equity Collaborative will build upon and support the work that EPB and other immunization initiatives do by contracting a consultant (0.25 FTE) to offer immunization equity TA for LBoH across the state. The goal of this TA is to build capacity and facilitate systems change through a Plan / Do / Study / Act approach, to ensure sustainability of immunization equity work for years to come.
CLAS Objective: Coordinate the Immunization Equity Collaborative TA to create systems change in immunization practices in minority communities by bringing together stakeholders and providing monitoring support through regular meetings, conference calls, correspondence and reports.
Appoint staff-person (0.25 FTE) to coordinate collaborative membership
Outreach and recruitment of stakeholders
Collaborate with MDPH Bureau of Infectious Disease to build upon past Immunization Equity Initiative efforts
Periodic technical assistance meetings and conference calls
Periodic reports, guidance materials and resources
Number of IEC meetings and calls
Number and role/description of IEC membership
Number of resources produced by IEC
Documented changes in practice and protocols by Local Boards of Health (LBH)
Plan - Do - Study - Act (PDSA) Model
The Immunization Equity Team operates under the Plan-Do–Study–Act (PDSA) model to ensure continuous quality improvement both at the state and local level. Grantees receiving Immunization Collaborative Technical Assistance are asked to apply the PDSA model to their vaccination initiatives.
This process incorporates lessons on immunization learned from the H1N1 pandemic. Initial learning from the H1N1 pandemic flu revealed that aggressive preparation including: identification of priority populations; securing funding to facilitate community outreach and education activities; and making vaccines available and easily accessible for at-risk populations was critical to reducing adverse effects from the flu.
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH Immunization Equity Team Report
Plan, Do, Study, Act (PDSA)
PLAN(the “idea,” a specific goal to address a specific issue/challenge. Think of a SMART* Objective: Specific, Measurable, Attainable, Relevant, Time-specific)
Identified priority populations: Black, Hispanic & Asian communities showing increased Flu morbidity, mortality, and low immunization.
Developed goals and objectives, based on Healthy People 2020 Immunization objectives.
Identified and allocated resources:
Secured Bureau of Emergency Preparedness funding.
Distributed funding among Health Disparities Reduction (HDR) grantees.
Developed educational materials (print and online).
Offered technical assistance to grantees (group and conference calls).
Identified key partners.
DO (list a specific activity "For 3 weeks we will…" – think of a “change,” something you will do differently)
Outreach, dissemination and immunization:
Advertising in local media
Free vaccinations to uninsured/underinsured
STUDY(analyze/measure what happened as a result of the "do" – what improved as a result of the change, and by how much?)
Data collection and analysis:
OHE data collection tool
MDPH staff, HDR grantees, others met to share immunization data, challenges and successes.
Developed recommendations for subsequent flu efforts.
ACT(what will you adopt, adapt or abandon as a result of the “study?” Look at what worked, what didn’t and why, to inform the next cycle)