Clear Communication: The Check and Report Ebola (CARE) Kit

Background: The Centers for Disease Control and Prevention (CDC) and many partners are responding to the largest Ebola epidemic in history, affecting multiple countries in West Africa. A core component of CDC’s domestic response is protecting the health of U.S. communities through enhanced entry screening of travelers arriving from countries with Ebola outbreaks at five U.S. airports.

Program background:  Since mid-October 2014, all travelers arriving to the United States from countries with Ebola outbreaks are assessed for symptoms and possible exposures, asked to provide their contact information, and given information about Ebola for symptom monitoring and reporting, which altogether, comprise the enhanced entry screening process. A key component of enhanced entry screening was the development of clear, cross-cultural educational materials for these travelers. The CDC Check and Report Ebola (CARE) Kit provides travelers with information and tools that promote early detection, isolation and treatment, in the event Ebola symptoms develop. The CARE Kit serves to educate travelers about how to connect with a state or local health department and how to successfully complete symptom monitoring and reporting until 21 days after their last possible Ebola exposure. The kit is given to each traveler during enhanced entry screening and is available in English, French, and Spanish.

Evaluation Methods and Results:  The decision to implement enhanced entry screening and monitoring in the United States occurred quickly. CDC developed information and tools within a matter of days in order to help travelers understand and comply with government monitoring and reporting requirements. Early drafts of the CARE kit were not pre-tested with travelers. However, the content and layout of the kit were revised several times in response to changes in the U.S. Ebola monitoring program as well as in response to informal feedback from state partners, West African diaspora community members, and internal workgroups at CDC. CDC implemented a major revision of the kit’s content and format using structured feedback compiled from 50 travelers from affected countries who were interviewed both in airports upon arrival and by phone a few days after they began reporting to a health department.

Conclusions:  The CDC CARE Kit evolved over time in response to program changes and to stakeholder and audience feedback. Revisions were made to improve travelers’ understanding of the monitoring program and to increase the likelihood that travelers would correctly complete the program’s requirements. To date, over 11,000 CARE Kits have been distributed.

Implications for research and/or practice: In an emergency response, communication materials must evolve in order to stay relevant to the dynamic nature of the situation. Improvements can be made to incorporate feedback from a variety of sources and are critical for ensuring messages are understood by and helpful to the intended audience.  Even amidst an emergency response, gathering insights from stakeholders, partners, and audience members and adapting materials as needed are vital for ensuring clear communication.