Taking public health to the streets works

Going door-to-door with public health messages can be an effective way to educate at-risk populations, suggest the results of such an effort in New Zealand.

Lay educators visited more than 11,000 homes in Auckland, New Zealand to raise awareness of a contagious form of bacterial meningitis known as meningococcal disease--an infection of the fluid surrounding the brain and spinal cord.

"Feedback from individuals, families, and groups contacted through the awareness program was overwhelmingly positive about the house-to-house visiting by lay educators, small group sessions, the resources used, and the key messages," said study author Chris Bullen, a public health physician at Auckland Healthcare Public Health Protection Service.

The door-to-door campaign was initiated in Auckland in 1998 after a sharp rise in subtype B meningococcal disease cases, for which no vaccine is currently available. Most of those affected were children from Pacific Islands and Maori families, which make up about 20 percent of Auckland's population.

In the United States, approximately 3,000 people develop meningococcal disease every year, and 10 to 13 percent of these cases are fatal. Of those who survive, 10 percent suffer mental retardation, hearing loss, and loss of limbs as a result of the disease, according to the U.S. Centers for Disease Control and Prevention.

Under the management of the Auckland Public Health Department, local individuals in the New Zealand study were trained to visit homes and communicate key facts about the disease, including the need for immediate action should parents spot meningococcal disease symptoms in children. Symptoms of this rapidly advancing disease include high fever, headache, stiff neck, nausea, vomiting, and confusion. The disease symptoms are often more difficult to detect in newborns and small infants.

Parent-education sessions were also conducted at early childhood centers, schools, churches, and sports c

Contact: Chris Bullen, MPH, FAFPHM
Center for the Advancement of Health

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