Program Plan Outline

Title

Community Immunity

Author

Micaiah A. Herndon

Problem/Need statement

The proportion of pediatricians reporting parental vaccine refusals increased from 74.5% in 2006 to 87.0% in 2013.  They perceive that vaccine-refusing parents increasingly believe that immunizations are unnecessary.¹ Unfortunately, parents' decisions to delay or refuse vaccines have been shown to be associated with increased risk of vaccine preventable diseases (VPDs) for both individuals and communities.  Community Immunity will work with pediatricians and parents to increase national immunization rates.

Goals and Objectives

Goal 1: Debunk inaccurate myths about immunization.

Objective: 100% of users will be informed of factual pros and cons of vaccine use and the benefits of immunization.

Goal 2: Increase vaccine (health) literacy.

Objective: Increase health literacy with regards to immunization by 40%.

Goal 3: Empowering parents to take control of their child’s overall health.

Objective: To have 60% of website users engage in educated dialogue and making informed decisions with their pediatrician.

Sponsoring agency/Contact person

Contact person: Micaiah Herndon can be reached via email at micaiah.herndon@communityimmunity.com.

Sponsoring agency: Centers for Disease Control and Prevention (CDC) https://www.cdc.gov/vaccines/index.html

Primary target audience(s)

The primary target audience is expecting parents and parents of children and adolescents whom are using personal belief exemptions to opt of vaccines for their children.  More specifically, mostly white, affluent, suburban parents.

Primary target key strategies (list for each audience)

The goal is to influence behavior change through education.  We will inform the parents of the false information being disseminated throughout their communities and provide valid them with information.  Pediatricians perceive that parents are increasingly refusing vaccinations because parents believe they are unnecessary, discomfort for the child, and concern for immune system burden.¹ Express the risks of vaccine refusal by providing relatable examples of preventable disease outbreaks (Disney Land).  When you start seeing a fraying of herd immunity, you begin to see outbreaks, starting with the most contagious diseases. And that’s exactly what we’ve seen: measles, mumps, and whooping cough outbreaks.² Empower parents to communicate with their health care providers about all vaccine options and the best option for their child. A critical factor shaping parental attitudes to vaccination is the parents’ interactions with health professionals. An effective interaction can address the concerns of vaccine supportive parents and motivate a hesitant parent towards vaccine acceptance.³ Health literacy is a huge barrier for this program.  Most parents are unaware of positive health behaviors.  The largest challenge will be to address parents in ways that they can understand and increase the parents’ health knowledge.  The benefits of the program are overall improvement to community health.  Education is an effective health behavior tool.  The more parents that are educated, the more children will be administered proper vaccinations to prevent the spread of disease.  Social media is the main promotion channel for this initiative.  Advertisements, informationals, and video blogs will be used to inform parents about Community Immunity and the importance of immunizations.

Secondary target audience(s)

The secondary target audience is health care providers.

Secondary target key strategies (list for each audience)

A critical factor shaping parental attitudes to vaccination is the parent’s interactions with health professionals. An effective interaction can address the concerns of vaccine supportive parents and motivate a hesitant parent towards vaccine acceptance. Poor communication can contribute to rejection of vaccinations or dissatisfaction with care. We sought to provide a framework for health professionals when communicating with parents about vaccination. Health professionals have a central role in maintaining public trust in vaccination, including addressing parents’ concerns.³

Encouraging pediatricians to be patient with skeptical parents is the largest barrier of this project. There is an increase in pediatricians dismissing parents due to vaccine refusal—11.7% of pediatricians reported “always dismissing patients for continued vaccine refusal” in 2013².  The major benefit of the program is patient retention and vaccine administration.  Parents will be the channel for information dissemination.  The goal is to assist the parent in creating conversation and creating joint effort to care for the child (ren).

Pretest strategy (trial of primary target message/channel)

We will pretest the program by launching it in California and tracking its use using Alexa and Compete (website statistic tracking tools).  Users will be offered a survey to take addressing effectiveness of the website. Evaluation and outcome reports will be generated based on the responses from the questionnaire after the website has been operational for a year.  Any necessary changes and improvements will be implemented prior to the national release of the website.

Theoretical foundation (model or framework and how to use it in this project)

The theoretical foundation used for this program is the Persuasion Theory.  The persuasion theory is a mass communication theory that deals with messages aimed at subtly changing specific behaviors.  Persuasion Theory focuses on framing messages for persuasive communication to change individual behavior.  Message framing is giving it a context or even suggesting a point of view or an interpretation with which it is to be understood—whether consciously or uncounsciously.⁴ the goal is to change the mindset of skeptical parents and persuade them to consider vaccine use for their children. 

Management chart

Program Manager	Overall function of the program	Provide program evaluation to staff and stakeholders	Generate end of year evaluation, generate a plan of action for the following year, disseminate info to staff and stakeholders
Finance Manager	Manage payroll	Provide overview of payroll costs	Release W-2 for all employees
Public Relations	Advertising	Launch new ads	End of year report on effectiveness of ads
Financial Manger	Grant Writing/Soliciting free money	Finance brief/status of finances	File taxes.
IT	Website upkeep	Survey dissemination	Launch end of year survey

           

Budget

Budget: $1,500,000
Initial startup cost	$10,000.00
Advertising	$120,000.00
Payroll	$1,325,000.00
MISC. expenses	$45, 000
SUBTOTAL	1,455,000.00
Revenue	100,000.00
TOTAL	1,355,000.00

• The initial start of the website is estimated to cost $10,000.  This cost includes the cost of website design and the cost to launch the site.
• Advertising will cost an estimated $120,000. Social media (Facebook, twitter, Tumblr, etc.) is the main platform that will be used for advertisement.  Additionally, money is allocated to improve the websites search ability on Google, Bing, and Yahoo.com.  Other advertising will come from healthcare providers and word of mouth from users.
• Individuals included on payroll include public health officials who monitor and answer questions proposed by parents, IT individuals who maintain the website and ensure that the site functions without error, public health officials who conduct research on relevant information to post on the site, and the management team (program manager, financial manager, and public relations manager).
• MISC. expenses is a buffer fund that can be used as needed.
• We anticipate and estimated $100,000 in advertising funds.  We hope that eventually this program is able to function successfully on donated funds and funds collected through digital advertising on the website.

Resources required/needed and available, with sources

Our major resources are CDC and local/state public health officials.  We will rely heavily on them to provide up to date vaccine information and health trends based on location.

Issues of concern/potential problems

Issues of concern include lack of website utilization, delay in information from local/state officials, and minimal behavior effectiveness.  We are weighing heavily on parents seeking information regarding vaccinations and trusting our website to provide them with viable information that can assist in their decision making.  Furthermore, we are anticipating that after parents have learned more about immunization, they will decide to allow their child to receive vaccines.

Evaluation strategies

Formative and process

Formative evaluation will take place before the national launch of the website.  We will use the information collected from the pretest to determine the effectiveness of the website, what information was most effective, and what information created more skepticism among the parents.  This will allow us to assess the necessity of certain information and better engage with the target audience. 

Process evaluation will begin after the national launch of the website. This evaluation will focus more on the utilization of the website using Alexa and Compete.  Furthermore, we will poll healthcare providers in high use areas to analyze immunization trends.       

Summative (outcome and impact)

Semi-annually for the first 5 years and annually every year following we will evaluate our outcome with information attainment surveys.  The surveys will ask basic questions to test the health (vaccine) literacy of users, their opinions of vaccines after visiting the website, and if their decision making process has become easier because of information obtained from the website. This will allow us to understand the effectiveness of the website and ensure that its use influences health behaviors.

References:

1. Hough-Telford C, Kimberlin DW, Aban I, et al. Vaccine Delays, Refusals, and Patient Dismissals: A Survey of Pediatricians.  Pediatrics. Aug 2016. e20162127; doi: 10.1542/peds.2016-2127.  Accessed December 13, 2016.
2. Kollipara P. How the anti-vaccine movement is endangering lives.  The Washington Post. May 4, 2014. https://www.washingtonpost.com/news/wonk/wp/2014/05/05/how-the-anti-vaccine-movement-is-endangering-lives/?utm_term=.318177c1422f.  Accessed December 13, 2016.
3. Leask J, Kinnersley P, Jackson C, et al.  Communicating with parents about vaccination: a framework for health professionals.  BMC Pediatrics. 2012;12:154.  doi: 10.1186/1471-2431-12-154.  Accessed December 13, 2016.
4. Parvanta C, Nelson DE, Parvanta SA, Harner RN. Evaluating a health communication program. In: Essentials of Public Health Communication. Sudbury, MA: Jones and Bartlett Learning; 2011:297-310.