Community Concerns and Communications Work Group

Community Concerns and Communications Work Group

October 27, 2004 - Meeting Minutes

Attendance

ORRHES Members attending:
George Gartseff (Chair), Don Box, Kowetha Davidson, Jeff Hill, David Johnson, and James Lewis

ATSDR Staff attending:
Loretta Bush (phone), Marilyn Palmer (phone), Bill Taylor, and Maria Teran-MacIver (phone)

TDOH Staff attending:
Brenda Vowell

TA Consulting, Inc. (contractor):
Amy Adkins

ERG Contractor:
Liz Bertelsen (phone)

Purpose

George Gartseff called the meeting to order shortly after 5:30 p.m. The purpose of the meeting was to 1) receive an overview of ATSDR's draft communication plan for the Cancer Incidence Assessment, 2) discuss outstanding and current issues for the work group to address, and 3) set up a schedule for regular work group meetings.

ATSDR's Draft Communication Plan for the Cancer Incidence Assessment

Presenter: Loretta Bush, ATSDR

Loretta Bush explained that she had prepared a 17-slide PowerPoint presentation for the group that detailed the draft communication plan. However, because the slides had not been approved by all of the necessary ATSDR staff, she was unable to present the actual materials to the group at this meeting. Once she receives management approval, Ms. Bush will share the plan with the CCCWG to obtain the work group members' feedback.

Loretta Bush stated that ATSDR has been tasked for some time to look at the cancer incidence information and conduct an analysis of the data. Members of the ORRHES and ATSDR staff feel strongly that they need a communication plan already in place when the Cancer Incidence Assessment is released. Ms. Bush discussed the topics of the slides that she had prepared.

Loretta Bush said that the plan will include communication strategies for informing the public about the Cancer Incidence Assessment. It will also identify strategies for communicating the results and time lines to complete the communications. In addition, the plan will include a background section on ATSDR and ORRHES.

Loretta Bush indicated the community will be concerned about whether or not there is an increase of cancer in communities surrounding the Oak Ridge Reservation (ORR). Ms. Bush stated that several actions needed to occur (e.g., an analysis of the data) to answer this question. She said that when they begin to look at communicating this information to the general public, they will need to know who the primary audiences are: lay audiences (public), high school students, elected officials, business owners, grassroots organizers, media representatives, and federal, state, and local officials.

Loretta Bush said that they could use several channels to communicate and disseminate the information to their audiences. These channels will include community groups, churches, schools, businesses, media outlets, grassroots organizations, ORRHES members, and federal, state, and local agencies.

Loretta Bush provided two communication and education goals. First, they want to increase the primary audience's awareness and knowledge of the Cancer Incidence Assessment and its findings. Second, they want to provide reliable, easily accessible, and understandable information related to the findings of the cancer incidence assessment to communities surrounding the ORR. Other goals identified were: 1) effectively communicate the roles of ATSDR and the Tennessee Department of Health (TDOH); 2) identify communication and health education needs; 3) develop appropriate materials to address these needs and obtain feedback on the materials; and 4) evaluate the impact of the program and materials that were implemented.

Loretta Bush stated that ATSDR will "maintain a high degree of consistency in health messages" and materials that are developed. In addition, the plan will help build capacity within the state and local health departments and with health care providers to enable them to respond to public health issues associated with the Cancer Incidence Assessment.

According to Loretta Bush, they will address the following questions:

1. What is a Cancer Incidence Assessment?
2. Why did ATSDR conduct a Cancer Incidence Assessment in the ORR area?
3. What geographical area was included?
4. What cancer information was examined and where was the information obtained?
5. What are the conclusions of the Cancer Incidence Assessment?
6. What are the known risk factors for increases in specific cancers (if there are any)?
7. Where can individuals read and/or obtain a copy of the report?
8. Where do people send their comments regarding the cancer incidence assessment report?

Loretta Bush identified communication channels that they will use. These include newsletters, fact sheets, public availability sessions, media briefings, briefing of elected officials, churches, and other organizations. They will also utilize the following resources: city and county officials, libraries, physicians, churches, and federal, state, and local agencies.

Loretta Bush detailed a time line template that will be included in the plan. It will list each activity and each product. The time line will provide a proposed start and finish date, list the individuals responsible for the work, and detail the time line to effectively disseminate and/or communicate the information.

Loretta Bush provided her contact information for people to reach her with additional comments and concerns. Her e-mail address is lsbush@cdc.gov, and her phone number is 404-498-1742 or 1-888-422-8737 (extension 1742).

Discussion

David Johnson asked if the plan would involve the use of collaborations and partnerships throughout the process. Loretta Bush responded that these would be incorporated with the federal, state, and local agencies and other groups that she identified. She added that the plan will provide more information on the channels that they will use and the primary audiences. She said that they will put a core group of individuals together who will give presentations in the Oak Ridge area over a specified period of time (e.g., 1 week, 2 weeks); presentations will be made to various individuals, groups, organizations, and federal, state, and local agencies. She added that ATSDR wants to outreach to individuals who cannot attend meetings due to disabilities and other health concerns, and therefore, ATSDR will give presentations to these individuals at their homes. ATSDR will work with the workgroup and ORRHES in identifying these individuals.

George Gartseff understood the need to emphasize communications related to the Cancer Incidence Assessment because it is a special product. However, he asked if this work group had previously discussed planning how to communicate other products, such as public health assessments (PHAs). He asked if this draft communication plan would be a template for communicating future ATSDR products to the public. Loretta Bush provided her personal thoughts. She said that people indicated that a communication plan was necessary for this Cancer Incidence Assessment. Prior to Ms. Bush's involvement with the ORR, ATSDR staff had prepared an integrated communication strategy plan. She gathered information from this strategy plan, extracted data collected during the needs assessment, and used other sources to develop this draft communication plan. She anticipates this Cancer Incidence Assessment Strategy Plan can be used as a template for communicating the results of the remaining PHA's.

George Gartseff asked about the time line for the draft plan. Loretta Bush stated that Dee Williamson—an epidemiologist with ATSDR's Division of Health Studies—plans to possibly present her material to ORRHES in March or April 2005. Ms. Bush believes that 5 months allows plenty of time to review and comment on the plan. Although areas in the plan are currently incomplete because they do not have the findings, this will still allow enough time for ATSDR to explain its time lines for communicating this information and handling other aspects of the plan.

Jeff Hill noted that the target audience should include current and retired workers. He said that the main three worker groups at the ORR included UT-Battelle, Bechtel Jacobs Company LLC, and Wackenhut Services Inc.

James Lewis said that communication is always a "two-way street." He thought that in addition to looking at various populations, they also needed to consider different races, genders, socio-economic statuses, and cultures. He wanted ATSDR to prepare a detailed abstract that specifies what will be accomplished and the census tracts that will be covered, as well as provide the public with maps of the study areas. He thought that they were focusing on small groups when they should focus on the larger population due to the magnitude and nature of concerns in the community on this issue. He thought that a town meeting rather than a formal presentation would be more suitable. Mr. Lewis was not opposed to small focus groups, but believed that something of this magnitude required reaching more community members. He added that the "approach is lacking" if it does not involve a large formal presentation to the public and advance notification through the press.

George Gartseff wanted to address James Lewis's comment about focus groups. Mr. Gartseff believed that Mr. Lewis had used this term negatively, whereas Mr. Gartseff thought that ATSDR would be focusing on certain groups in order to include everyone. He added that the CCCWG's job is to advise ATSDR who to target within the community.

Loretta Bush responded to James Lewis. She said that media briefings are incorporated in the plan under communication channels. She added that she wants people to "speak freely" about their feelings regarding the presented materials. She stated that they can always look into other suggestions, and make changes as needed. Ms. Bush welcomed the group's feedback; she asked everyone to review the plan once they receive it and provide her with their comments.

James Lewis wanted to see an example of how these types of presentations were advertised at other sites (e.g., press releases). He thought that it was extremely important for community members outside of ORRHES to know about the Cancer Incidence Assessment and understand the geographical areas evaluated. He wanted ATSDR to advertise in advance. Loretta Bush asked if Mr. Lewis wanted ATSDR to advertise prior to the findings of the Cancer Incidence Assessment; he said that Ms. Bush was correct.

James Lewis said that there are more community concerns than the one listed by Loretta Bush in her discussion. Mr. Lewis thought that ATSDR's actions and outreach efforts should correspond with the community's needs and concerns.

George Gartseff asked the group to refrain from giving specific comments or criticisms until everyone had a chance to look at the draft communication plan. James Lewis thought that it was appropriate to make comments now based on "failed miss-starts" from previous ATSDR efforts. As soon as she knows when the draft plan will be ready, Loretta Bush said that she would have Marilyn Palmer send an e-mail advising everyone when to expect the document.

Jeff Hill noted that committee meetings were not receiving much public attendance. He wondered if they should rollout the product at a public meeting to generate public interest. James Lewis thought that this would be too late because they would already have the study results. Mr. Lewis suggested setting up an e-mail address for community members to send their questions and issues associated with cancer. Then, ATSDR would know the public's issues before preparing presentations, and the agency could develop a communication program that matches the community's needs.

Loretta Bush said that she will share all of their comments from tonight's meeting with her management. She suggested that the CCCWG hold more regular meetings to talk about these issues. She mentioned bringing ATSDR management into their conversations in order to effectively address all of their concerns. Jeff Hill thought that they could make decisions and then inform ATSDR management of their decisions. However, Ms. Bush said that management has to agree upon the work group's decisions.

David Johnson asked if the American Cancer Society (ACS) would be included in the process. Loretta Bush stated that ACS was on the list of names in the communication plan.

David Johnson asked if ATSDR would hold a town hall meeting. Loretta Bush responded that they could consider and discuss this after the work group members have the draft communication plan, however, management would have to agree with this. She has conducted these types of activities at other sites, such as bringing in ACS, American Lung Association (ALA), and other agencies to speak with communities. Ms. Bush noted that these options are presented in the plan, and added that she is "not ruling anything out" for communicating with the public.

Discussion of Outstanding Issues and Current Issues to Address

Facilitator: George Gartseff, Chair

George Gartseff wanted to talk about outstanding and current issues that the CCCWG should explore under the new work group structure, and also discuss what the group hopes to accomplish.

Kowetha Davidson thought that the Web site development would fall within the framework of the CCCWG.

David Johnson thought that ATSDR needed to engage in the communication process so that the agency could "bring trust and credibility to the table."

Jeff Hill discussed a video entitled "Ducktown" that he had watched, and asked if this video would fall within the scope of this work group. Bill Taylor thought that the video probably would correlate with this work group. Dr. Taylor continued that the tape was provided as an example of a video produced for another community. He said that Bob Safay, Jack Hanley, and other ATSDR personnel were discussing creating a similar video for Oak Ridge. Mr. Hill stated that the video was "entertaining" and "well put together," but that it contained no "meat" at the end. He said that the video did not answer important questions that community members, such as himself, would want to know (i.e., Is the water safe to drink?). Mr. Hill thought that the video should detail any past, current, and future hazards.

Bill Taylor said that ATSDR was still in the development process; he was unsure of the stage of production. Jeff Hill asked when the committee would review the dialogue because he did not want someone to prepare a product and then bring it back to them. Instead, he wanted to take ownership of the product and participate in the development process. Mr. Hill asked what they could produce. Dr. Taylor thought that the first video would focus on the Y-12 Uranium PHA and then continue with other PHAs as they are released.

Marilyn Palmer asked Bill Taylor if a video would possibly be produced for each PHA; Dr. Taylor said that Ms. Palmer was correct. Dr. Taylor said that ATSDR may combine some of the PHAs due to time constraints, and added that the video was still in the "discussion stage." He explained that only a video for the Y-12 Uranium PHA could be produced at this time because a product has to precede any outreach efforts. Therefore, he said that since this is the only PHA completed at this time, this is the only PHA that could be incorporated into a video.

Don Box contacted his minister who would like to represent their committee to other ministers in the area. Mr. Box also spoke with a physician (a member of his church) who will disseminate information to other physicians in the workplace. Mr. Box thought that they should brief these individuals on their goals and intended accomplishments, and provide them with information to dole out to other people. George Gartseff asked about the individuals' willingness and availability to attend meetings. Mr. Box said that both people could come to meetings, but that he thought it would be more productive to schedule something specifically for these individuals because of their busy schedules. Kowetha Davidson suggested that they prepare packages of briefing materials to give to these individuals for their own information and also to disseminate. She thought that they could arrange a time to provide the information and discuss the materials with them. Bill Taylor said that ATSDR had developed information packages in the past, and that this could certainly be done.

George Gartseff was concerned about communicating the results of the draft PHAs that may be released prior to the spring release of the Cancer Incidence Assessment. He said that they needed to communicate the results of these PHAs to the public. In addition, Mr. Gartseff wanted to ensure that they respond to the concerns in the community concerns database—either conclusively or on an ongoing basis. He thought that they had many tasks to complete in a short period of time. He was aware that ATSDR had its own constraints, but that they had to communicate effectively to the public.

Jeff Hill asked about the requirements to offer continuing education credits for medical professionals (e.g., physicians) to draw them into meetings. Bill Taylor said that ATSDR had done this in the past, but was unsure of the procedures. Brenda Vowell said that for nursing continuing education units (CEUs), she has to submit an outline with the course goals and objectives and then have the outline approved. Marilyn Palmer said that Maria Teran-MacIver has discussed contacting physicians in the Oak Ridge area to offer them continuing education credits. She said that ATSDR has thought about this, but that she was not in a position to provide more information at this time.

Maria Teran-MacIver asked if they wanted to offer continuing education credits for a particular presentation. Bill Taylor noted that they did not have a specific presentation in mind. Kowetha Davidson suggested possibly presenting the Cancer Incidence Assessment to area physicians for continuing education credits.

Jeff Hill asked if they would be able to take the presentations "on the road," meaning to hospitals and clinics where health personnel work. Marilyn Palmer thought that these courses were normally conducted in medical-type settings (e.g., hospitals). She asked if Mr. Hill was suggesting a venue, such as Methodist Medical Center; he said Ms. Palmer was correct.

David Johnson said that Knoxville Medical Academy should be contacted because it encompasses physicians within several area counties. Mr. Johnson also thought Paul Erwin, a physician, would be a "good reference for Bill Taylor to interface with." Brenda Vowell stated that Dr. Erwin was her boss and that she kept him informed but she was unsure of his extent of involvement in the medical society.

Bill Taylor said that it was definitely possible to go out and talk with members of the medical society, but that ATSDR could not talk to people until staff had a product to discuss. He noted that they had to have a "fairly complete product" before communicating with the public. He said that James Lewis had often mentioned that a lot of interest could be generated if communication strategies were done properly. Dr. Taylor believed that they needed to think broadly in terms of outreach. He thought that Loretta Bush's draft plan indicated that ATSDR would look at various avenues and methods to communicate with larger and broader groups.

George Gartseff asked about the mailing list used to invite people to these meetings. Marilyn Palmer replied that she was only able to send this meeting announcement to ORRHES members, liaisons, and key staff members who were listed on a roster that she had with her when she sent the list. She sent the list from the Oak Ridge field office, and her computer in Atlanta is not compatible with the field office's system. Therefore, she could not send the meeting announcement to the complete distribution list. Bill Taylor elaborated that a new mailing distribution list was recently compiled, which includes all of the ORRHES members, liaisons, and other people who have expressed an interest in work group meetings. He said that all of these people will be included in future work group meeting announcements. Also, he asked that if anyone knew of anyone else who wanted to be included to let him know.

Marilyn Palmer said that Don Box could forward the meeting announcements to his two contacts if he would like. Bill Taylor said he was willing to set up a private meeting for these individuals; however, he would be unable to do this with many people.

George Gartseff asked how often the group wanted to meet and suggested meeting once a month. Jeff Hill thought that the CCCWG should meet twice a month. Mr. Gartseff said that the work group needed "to work in parallel" with products that are released. He thought that they should meet after Loretta Bush had the draft communication plan prepared, and that people could e-mail him if they wanted to discuss issues before that time. Mr. Hill thought that they should set future meeting dates now, and then cancel the meetings if they are deemed unnecessary. Mr. Gartseff suggested meeting the second and fourth Tuesday of each month, with November 9 and 23, 2004, as the next meeting dates.

George Gartseff asked if anyone wanted ownership of specific issues. Jeff Hill said that his biggest interest involved the video, and he recommended that everyone watch the Ducktown video between now and the November 9, 2004, meeting.

Jeff Hill asked if an e-mail could be sent out that summarizes the issues discussed during the meeting. Bill Taylor said that this could be done.

George Gartseff adjourned the meeting at 6:55 pm.