Children's Health after the Storms (CHATS) CBO & Media Campaign

Background: On August 29, 2005, the Gulf Coast was struck by Katrina, a category 5 hurricane, that brought massive flooding and heavy winds, resulting in loss of life and enormous environmental and structural damage.  One month later, hurricane Rita arrived.  These storms left a housing crisis unlike any witnessed before in the United States.  While FEMA-supplied temporary housing units (THUs) provided immediate shelter, an unintended consequence was first reported by physicians concerned that health problems observed in children might be related to residence in the THUs and possible exposure to formaldehyde.

Program background: The Children’s Health after the Storms (CHATS) study was developed to look at how children’s exposures to the THUs and pollutants may have harmed their health since the storms.  However, residents were "study weary" and resentment and mistrust due to concerns about the THUs and perceptions of the Federal response after the Storms remained.  To address these challenges, and encourage support and participation of Gulf Coast families, RTI planned and implemented a robust community-based outreach (CBO) effort and modest regional media campaign.

Evaluation Methods and Results:  Engaged Grassroots Community Leaders as Study Collaborators – RTI first established a Community Advisory Panel (CAP), comprised of leaders from trusted CBOs serving the needs of residents since the Storms.  We engaged them on nearly every aspect of the study, from its name to differences in field teams’ approach to scheduling appointments with families in Louisiana vs. Mississippi.  CAP members engaged their professional networks in actively promoting the campaign and disseminating materials, helping build awareness and support, and significantly expanding campaign capacity. Built Partnerships in Advance of the Media Effort - The team developed numerous partnerships and more than 900 community contacts on behalf of CHATS.  Partners began spreading the word in advance of the media effort at community events, e-mail networks, and word of mouth, which helped participants positively connect the outreach effort with the media campaign once launched.  Media Campaign Buy-in and Support – The campaign featured billboard, radio, and Facebook placements in both states.  Our active engagement of the CAP ensured the campaign’s resonance with the population.  Partners promoted the campaign, and airtime donated by local radio stations yielded a 150% return on the radio ad spend.

Conclusions: Building positive relationships within hard-to-reach populations through CBO can create a sense of community ownership and empowerment that eases receptivity of a study, bolsters awareness and participation, and builds trust in ways that may not be achievable with a media campaign alone.  This was critical for CHATS communities and may be particularly meaningful when the population has experienced a devastating event in which restoration to a state and sense of “normalcy” was not rapidly or easily achieved.

Implications for research and/or practice: CHATS suggests there may be important benefits to engaging hard-to-reach communities through grassroots CBO in advance of a media campaign.  Taking time to build relationships provides oft-needed human interaction, context, and understanding that can be essential in advance of recruitment efforts.  This may be particularly helpful where Government mistrust exists and media budgets are limited.