Oak Ridge Reservation: Communications & Outreach Work Grouop / Health Needs Assessment Work Group
Communications and Outreach Work Group / Health Needs Assessment Work Group
April 12, 2004 - Meeting Minutes
Members attending: James Lewis (Chair), Kowetha Davidson, Karen Galloway, David Johnson, and Donna Mosby
ATSDR Staff attending: Loretta Bush, Marilyn Horton, Libby Howze, Theresa NeSmith, Susan Robinson, Terrie Sterling, and Bill Taylor
Liz Bertelsen (phone)
James Lewis called the meeting to order.
The purpose of the meeting was for ATSDR to provide a status report to the work groups on the Health Education and Health Communication Plan. The report included details on the activities and progress to date, volunteer activities, and geographic information system (GIS) maps.
Meeting Minutes from January 28, 2004
James Lewis asked for a motion to approve the minutes. Kowetha Davidson made a motion to approve the minutes and David Johnson seconded her motion.
ATSDR's Status Report on the Health Education and Health Communication Plan
Terrie Sterling stated that ATSDR had communicated with George Washington University (GWU) and that attempts to attain data from the school were unsuccessful. ATSDR is unable to obtain raw data collected during the study because GWU's law department will not permit a release of the raw data. In particular, ATSDR finds it important to know the interview methods that were used by GWU to collect these data. James Lewis noted that they wanted the aggregate that was used for each question. Ms. Sterling responded that she would call GWU and request the information. Terrie Sterling explained that the Tennessee Department of Health (TDOH) has reports that date to the early 1990s. She said that when they look at reviewing these reports and designing a template, they need to look at the kinds of information (variables) that are available and that they want to include.
David Johnson mentioned a report that was conducted in Knox County. He said it was conducted by a compilation of parties that included the University of Tennessee, Alcoa, Fortune 500 companies, Knoxville Chamber of Commerce, and other entities. Terrie Sterling replied that Mr. Johnson was referring to a document prepared by the University of Tennessee's (UT) Department of Social Work. She said that the problem with this nine-county study was that the counties did not overlap with the Oak Ridge Reservation counties of study. Ms. Sterling added that the study was "quite interesting," and that it included several types of data, such as characteristics of the population, education, employment, and mortality rates by cancer. Bill Taylor asked if the study was finished and Ms. Sterling thought that the report was completed. James Lewis noted that the report contained a section that focuses on environmental issues and health concerns within the nine-county area. He said that the information was collected similarly to focus groups and then put into a table to show each community and issue.
Terrie Sterling explained that another component of the plan was looking at additional reading materials. She said that ATSDR obtained background information and newspaper articles from GWU. ATSDR had reviewed and read all of the materials received and prepared an inventory that included every resource. The documents included memoranda, summaries of studies, and other types of documents. Ms. Sterling noted that minimal information was located through these sources.
Terrie Sterling explained that there are over 300 newspaper articles available. Though, the last article relevant to Oak Ridge was from 2000. The majority of articles found were not relevant to their tasks. She noted that The Tennessean did not seem to have many current articles either. She noted that ATSDR would also go to the US Department of Energy (DOE) to search for newspaper clippings.
Theresa NeSmith explained that DOE had collected hard copies of articles over the past 20 or 30 years. The agency had hundreds of articles; most of the concern-related articles had been printed since the 1990s. DOE is sending ATSDR a sample of articles dating back 5 years. The articles are from different news sources, including The Tennessean, The Oak Ridger, and other publications. Ms. NeSmith asked if it would be beneficial to review articles from The Nashville Tennessean, Knoxville News-Sentinel, Senior Living, and other similar newspapers. James Lewis replied that ATSDR could find articles on non-worker issue concerns and environmental issues "outside of the fence" through these types of resources.
Terrie Sterling mentioned that they had talked about conducting focus groups and interviews. ATSDR is still in the process of investigating these possibilities; the Agency is identifying potential contractors and talking with the Association of Occupational and Environmental Clinics (AOEC).
Libby Howze stated that ATSDR wants to have a better sense of the "mental models" of community members' issues and concerns. They want to evaluate what these assessments are showing and indicating, but they also need to know the different issues and people's feelings about these issues. She questioned the additional actions and interventions that ATSDR would need to consider if people do not believe the scientific-based conclusions. James Lewis added that information about fish kills is something that people will remember, regardless of the scientific conclusions. Ms. Howze said that ATSDR would identify areas where interventions may be necessary.
Kowetha Davidson explained that they needed to identify the types of general information that people want to know. People will want to know about occurrences that take place around them and the relationship between these incidents and other occurrences. She added that ATSDR needed to give people a "primer" and provide reasons why there are fish kills"it is a natural phenomenon." Bill Taylor told the group that he was conducting research on fish kills. He talked to representatives of the Tennessee Valley Authority (TVA) and DOE. Based on his research thus far, there are reasons why these fish kills occur. If chemical contamination occurred in the water systems, then the fish kill patterns would be different. Libby Howze said that ATSDR is finding that contamination is not associated with the ORR facilities. James Lewis cautioned that they needed to consider the casual observer.
Terrie Sterling informed the group that ATSDR had conducted preliminary GIS work, and that she brought a map to show the group. Ms. Sterling presented a map on Roane County; the map depicted the center of Roane County. There was a residential area outlined in red and the ORR facilities were outlined also. She pointed out that the map showed no primary care facilities in the area. The map also showed the locations of private and public schools, childcare facilities, and nursing care facilities. Ms. Sterling explained that based on the map, people could obtain a sense of the different network sectors in the area. She pointed out that the map indicated that health care and medical services were underserved in the ORR area. The map included the population density in the lower left- hand corner and the ethnic and racial groups in the right-hand corner.
Terrie Sterling showed that the map placed similar cluster groups (such as age, socio-economic status, lifestyle patters, recreational activities) into small geographic areas. Ms. Sterling spoke about a marketing database that provides tools for communicating in these different areas. It should be noted that the marketing database uses titles for different groups that ATSDR does not endorse; a private marketing company selected the titles.
Terrie Sterling asked the group for feedback. Karen Galloway said that she would like to see more community-specific information. She asked what types of information ATSDR needs to plot the communities onto the map. Ms. Sterling said that they needed to make sure to put information onto the map that would be useful for the communities. Ms. Sterling read some of the different types of information available through the database; one item included the number of people in the area who read fishing magazines. James Lewis thought it would be a good idea to place information into a fishing magazine to reach people potentially affected by issues related to the ORR (such as fishing in the Clinch River and/or the Lower Watts Bar Reservoir).
Terrie Sterling concluded that she had presented a preliminary map so that ATSDR could change and alter items based on the work groups' opinions. Kowetha Davidson thought that the community wanted these types of maps. Bill Taylor noted that they can put a lot of information onto the map or they can pinpoint specific information to target areas of interest.
Bill Taylor noted that the TDOH's Reports of the Oak Ridge Dose Reconstruction investigated questions regarding major contamination from the ORR site. However, they were finding that there are some concerns among the community members that go beyond the concerns studied in the TDOH reports.
ATSDR had a list of volunteers and the agency would be contacting these people.
Review of Action Items
James Lewis asked to review the action items from the meeting. Terrie Sterling noted the following:
- answer questions related to the nine-county study
- incorporate data for the environmental section
- evaluate location and categorization information
- review the UT reporting methods
- look at environmental issues in The Tennessean
- address issues related to separate agencies (state and federal) releasing different information
- make many changes to the maps, including adding communities to help orient people when looking at the figures
Also, Ms. Sterling noted that as ATSDR moves further along in the focus group process, the agency would request guidance to assist in focus group facilitation. However, this would be planned in the future. James Lewis asked if the groups would be small and how they would be limited. Libby Howze replied that ATSDR had to conduct additional work and discussions before determining the issues. Kowetha Davidson explained that one of the points of a focus group would be to "rank" general health concerns with specific environmental concerns. She said that they could not start out with specific concerns because there might not be any. She suggested that they start with general concerns and then they would be able to obtain specific concerns. Ms. Howze said that they are not exactly sure of their approach yet, but they have talked about beginning with general issues and then moving to environmental or more specific concerns.
On May 11 and 25, 2004, the chairs will meet to set the agendas. The next ORRHES meeting is on June 8, 2004. Kowetha Davidson suggested that the COWG have a meeting about three weeks prior to the ORRHES meeting to accomplish some tasks before the ORRHES convenes. Dr. Davidson was concerned about expediting things and thought that they should "start peddling a little faster." Libby Howze noted that they have a meeting on the fourth Tuesday of every month.
The meeting was officially adjourned at 8:00 pm.