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Mobilizing Community Partners to Action: How a Small Vector Control Program Tackled Zika

Date: 10/11/2016 4:32 PM

Related Categories: Performance Management, Quality Improvement

Topic: Performance Management and Quality Improvement

Tag: Centers for Disease Control and Prevention (CDC), Driver Diagram, Environmental Health, Partnerships, Quality Improvement, Vector Control

Cheryl Clay is the Public Health Senior Environmentalist for the Madison County Health Department, where her core responsibility is managing the vector control program for the City of Huntsville. Her vector control program emphasizes public education and source reduction as the most effective means to prevent mosquito-borne disease.She has been an environmentalist for the Alabama Department of Public Health for over 10 years.


When I transferred to vector control at Madison County in 2012, I learned from the veteran employees that program staff had been dwindling for a number of years and even the arrival of West Nile couldn’t stop the trend. I began to read about the emergence of Chikungunya and knew I had to do more to educate and convince residents to address mosquito-breeding grounds, but I did not know how to move beyond our current activities. Luckily around that time, Justin Gerding with the National Center for Environmental Health at the Centers for Disease Control and Prevention (CDC) called and said my program was suggested as a potential participant in an upcoming collaboration with the Public Health Foundation (PHF). The purpose was to assist vector control programs in improving effectiveness and capacity, starting with the Environmental Public Health Performance Standards. At the time, I was not familiar with the performance standards, but was very eager to learn more and adamantly agreed to participate.

Based on our organization’s self-assessment, an identified area of need was Service #4 of the 10 Essential Environmental Public Health Services – mobilize community partners and actions to identify and solve environmental health problems. With the assistance of PHF’s quality improvement expert, Jack Moran, we narrowed our focus to educating homeowners on the removal of mosquito breeding environments. Because we are a very small department, we needed the assistance of community partners to help disseminate information throughout the city. Our goal was to create partnerships among community groups that would invite us to speak at their meetings and distribute information for us. The message was simple: we all need to work together as a community to minimize the number of mosquitoes in the environment. After soliciting the help of local government officials, the media, and neighborhood associations, we started to build our network. Our partners hung flyers in local businesses; distributed information door-to-door; and shared information through email, social media, and community newsletters. We were invited to public events, such as the city’s Earth Day event and community health fairs and meetings, where we could educate and interact with numerous residents in a short period of time.


"We all need to work together as a community to minimize the number of mosquitoes in the environment"
In the middle of this, along came Zika. As one of only three active health department vector control programs in Alabama, our bureau director requested assistance on what our environmentalists could do to prevent and prepare for Zika virus in our state. Immediately, I knew that educating residents on mosquito bite prevention, particularly through the removal of mosquito breeding environments, was going to be the best way to protect the public. The focus on education resulted in the creation of the Zika Skeeter Beaters Coloring Book (also in Spanish) for kids; A Guide to Zika Virus for Environmentalists, Municipalities, and County Commissions; and property inspection checklists that could be used by environmentalists checking areas around a Zika positive patient or a resident who wants to ensure nothing was overlooked on his or her property. An established community partnership network in the Huntsville area was invaluable for distributing timely and accurate information to our local residents regarding protective measures and the potential for Zika virus transmission in our area. We never could have reached as many residents with our important message without the help of our partners.


We now have 80 community partners and through our outreach, we have completed 135 property inspections; distributed over 5,000 door hangers; and have given 24 news interviews and 13 presentations so far in 2016. I would never have been able to adequately assist my state with Zika virus prevention had I not participated in the improvement project with PHF. Our work with them broadened my thinking and helped me realize that even a very small program can have a huge and everlasting impact on the health of our community. We have grown from a program of three employees to a whole community working together to ensure conditions in which we can be healthy. I am forever grateful to Jack Moran and Vanessa Lamers of PHF for their constant support, indispensable feedback, and encouragement for our endeavors to improve public health.

As we’re reaching the end of this project, we’re moving on to quantifying our educational reach, communicating our successes and lessons learned, and beginning the process of increasing our surveillance capabilities, including a focus on resistance testing and reporting. Education remains our focus – but has grown through our new community partnerships. When I first started this project, I targeted one elementary school, and hoped to get into more. Now with our new partners at the City of Huntsville Earthscope Program, we’ll work to incorporate mosquito, rat, and tick information into their curricula for 15,000 students, citywide, kindergarten through 6th grade.


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The PHF Pulse Blog welcomes conversations and commentary from contributors. Posts may not necessarily reflect the views of the Public Health Foundation.


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Marc Parnell


It has been a real pleasure working with such a hardworking women as Cheryl Clay or "BOSS MAAM" as we like to call her. She is always hard at work from the beginning of the shift to the end. It's inspiring to witness how committed she is to her work. You can't get them all; but she will try!

Sandra Fry


Awesome work! Another great example of how a small number of individuals can bring about social and environmental change through collaborating and developing partnerships with community stakeholders.

Annie Vosel


Going from 1 elementary school to sharing your message with over 15,000 students is very impressive. Congratulations to you and your community partners!

Phyllis Mardis


Very good article (blog) Cheryl. It is impressive to see how your program's outreach has grown. I hope to hear more about your mosquito, rat, and tick programs as they progress.

Sonja Armbruster


Thank you Cheryl Clay for sharing your success story! It's exciting to see improvement processes leading to action. Imagine how health would be impacted if every program could say as you did: "We have grown from a program of three employees to a whole community working together to ensure conditions in which we can be healthy." Kudos to you and thanks for sharing your PHF story.

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