Layout 1


ISDS Annual Conference Proceedings 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and
reproduction in any medium, provided the original work is properly cited.

ISDS 2012 Conference Abstracts

Traditional and Mobile Public Health Alert
Communications with Health Care Providers
Debra Revere*, Ian Painter and Janet Baseman

University of Washington, Seattle, WA, USA

Objective
To systematically compare mobile (SMS) and traditional (email,

FAX) communication strategies to identify which modality is most
effective for communication of health alerts and advisories between
public health agencies and health care providers in order to improve
emergency preparedness and response.

Introduction
The effectiveness of emergency preparedness and response sys-

tems depends, in part, on the effectiveness of communication between
agencies and individuals involved in emergency response, including
health care providers who play a significant role in planning, event
detection, response and communication with the public. Although
much attention has been paid to the importance of communicating
clinical data from health care providers to public health agencies for
purposes of early event detection and situational awareness (e.g.,
BioSense) and to the need for alerting health care providers of pub-
lic health events (e.g., Health Alert Networks), no studies to date have
systematically identified the most effective methods of communica-
tion between public health agencies and community health care
providers for purposes of public health emergency preparedness and
response.

The REACH (Rapid Emergency Alert Communication in Health)
study is a 4-year randomized controlled trial to evaluate and compare
the effectiveness of mobile (SMS) and traditional (email, FAX) com-
munication strategies for sending public health messages to health
care providers—physicians, pharmacists, nurse practitioners, physi-
cian’s assistants and veterinarians.

Methods
Providers were recruited from three sites (King County, WA;

Spokane County, WA; and across the state of Montana; N=845) and
randomized to receive time-sensitive public health messages via
email, Fax, short message service (SMS) or to a control group that did
not receive messages. For one year, alerts based on real events of
public health interest were sent quarterly with follow-up telephone
interviews conducted 5-10 days after the delivery date. Interviews
consisted of approximately six questions that elicited information
about message receipt, recall of its content and perceived credibility
and trustworthiness of the message and source. In addition, provider
access to online alert information and delivery success or failure was
collected.

Results
Frequency of receipt, timeliness, content awareness, perceived

credibility and perceived trustworthiness were measured and com-

pared across communication delivery systems. On average 84.0% of
participants were contacted in each follow-up survey following all
alerts and across all three sites. Primary data analysis was designed
to measure differences between the three communication groups
using intent-to-treat methods. A set of secondary analyses examined
the outcomes excluding providers who could not have received mes-
sages (due to incorrect contact information, known technical failures,
or because providers could not receive messages by the assigned de-
livery message—for example, a provider without a Fax number ran-
domized to the Fax group).

We will discuss preliminary results of intent-to-treat analyses re-
garding rate of recall of study alert message content between tradi-
tional and mobile communications and perceived trustworthiness and
credibility of message and message source by providers. In addition,
we will report on frequency of accessing online alert information be-
tween traditional and mobile delivery groups.

Conclusions
There is currently no evidence-based research to guide or improve

the practice of public health communication between public health
agencies and health care providers before, during and after a public
health emergency. Improving this communication via the use of ef-
fective media can enhance disease surveillance, which will aid in
early detection and enhance case finding and situational awareness
for public health emergencies. By systematically evaluating the rel-
ative effectiveness of mobile and traditional message delivery sys-
tems for emergency preparedness and response communications, the
REACH study contributes to building the evidence base for novel
and effective approaches to emergency communications.

Keywords
Emergency Preparedness and Response; Public Health Communica-
tion; Surveillance and Alerting

Acknowledgments

This work was made possible by the CDC Office of Public Health Pre-
paredness and Response Extramural Research Program Preparedness and
Emergency Response Research Centers award, Grant no. 5P01TP000297,
to the University of Washington. The contents are solely the responsibil-
ity of the authors and do not necessarily represent the official views of the
CDC.

*Debra Revere
E-mail: drevere@uw.edu

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e124, 2013