‘Forgotten but not gone’an overview of the Bay of Plenty rheumatic fever awareness raising campaign

Author: Lindsay Lowe,Rheumatic Fever Co-ordinator,

Toi Te Ora – Public Health Service

IntroductionRheumatic fever is a serious preventable disease which may cause permanent heart damage. A 2008 review confirmed: 1

• The annual incidence of acute rheumatic fever in the Bay of Plenty (BOP) is nearly three times the New Zealand rate

• Kawerau, Opotiki and Murupara have some of the world’s highest recently documented age specific rates of acute rheumatic fever in children aged 5-14 years

• Most at risk are Māori tamariki/rangatahi aged 5-14 years - 90% of all cases in the BOP are Māori.

In response a strategic approach was developed which included a four month multi - media awareness campaign. This was launched in March 2010.

Aims of the campaign• General awareness raising: To increase community awareness and knowledge of rheumatic fever across the BOP

• Targeted awareness raising: To increase awareness and understanding of rheumatic fever in high incidence communities • GPs and health professionals: To promote the use of the Heart Foundation Rheumatic Fever Guidelines particularly Algorithm 4 – Guide for sore throat management 2

The underlying premise of the campaign is that early diagnosis and treatment of strep throat will reduce the incidence of acute rheumatic fever.

Multi media campaign• Press releases, advertorials and full page commis-

sioned articles appeared in several local papers.

• Radio adverts promoting the ‘sore throats matter’ and ‘sore throats can break a heart’ messages played on 8 stations across the Bay.

• Rheumatic fever information was shared with school communities and articles featured in ‘Health Promoting Schools’ and school newsletters.

• A rheumatic fever web page was created on the Toi Te Ora website, http://www.toiteorapublichealth.govt.nz/rheumatic_fever-public

Helping to prevent

Acknowledgements:

Design and layout: Lakes DHB Rheumatic Fever Project

Steering Group, Text: Northland District Health Board

Rheumatic

Fever

“Te Ao Hou PHO” acknowledges the work done by Northland District Health Board in producing this material – August 2009

For further details about rheumatic fever

please contact a doctor or

Public Health Nurse in your area

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What can happen if my

child/tamariki does not have

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Your child may get rheumatic fever, which could

lead to permanent heart damage.

What if my child/tamariki

does get Rheumatic Fever?

• They will need to go to hospital for bedrest,

antibiotics, blood tests and heart checks.

• Your child/tamariki could be off school and may

be too tired to play their usual sports and

activities.

• Your child/tamariki will need regular doctors visits

and dental checks.

• Your child/tamariki will need monthly antibiotic

injections for at least 10 years to protect them

from further attacks of rheumatic fever.

April 2010

He korokoro ora

he manawa ora

Mo tatou katoa

A healthy throat

a healthy heart

for all of us

For further information about rheumatic

fever please contact a doctor or nurse in

your area, or visit

www.toiteorapublichealth.govt.nz Sore Throats

Matter!Sore throats matter

Get them

checked!

Resources developedDisplay kits including pamphlets, posters and pull up banners.

A rheumatic fever information booklet.

A large model of the heart was also purchased to help children to understand how rheumatic fever can affect the heart

•

•

•

Awareness raising initiatives for GPs and health professionalsPresentations based on the National Heart Foundation Rheumatic Fever Guidelines were delivered to health professionals: • Continuing Medical Education (CME) sessions in the Eastern and Western BOP • ‘Grand Round’ presentations at Tauranga and Whakatane hospitals

• Rheumatic fever presentations to nursing students, public health and B4 school nurses

• A rheumatic fever web page for health professionals: http://www.toiteorapublichealth.govt.nz/Rheumatic_ Fever_GP

Evaluation of the awareness campaignA total of 498 random face to face surveys were conducted in Tauranga, Kawerau and Whakatane. Surveys were administered before, during and after the awareness campaign.

Western Bay PHO GPs were also surveyed following the CME sessions regarding their use and knowledge of the National Heart Foundation Sore Throat Management Guidelines (53/89 GPs responded to the survey).

Qualitative themes Surprise that rheumatic fever was still an issue: “I thought it was eradicated”

Cost identified as a barrier to GP visits “Can’t always check sore throats, can’t afford it”

The radio advertisements were effective and clearly recalled: “I remember the man from Opotiki talking about sore throats on the radio”

The 55 years and above age group retained knowledge that was lacking in the 15-24 year old age group: “My generation knew people with rheumatic fever”

ConclusionOverall, the campaign increased awareness and knowledge of rheumatic fever. However, a knowledge gap in the 15-24 year old age group was very apparent. The challenge is to develop innovative and creative approaches to reach the younger generation, many of whom will be the parents of ‘tomorrow’s people’.

References 1. Loring, B (2008). Rheumatic Fever in the Bay of Plenty and Lakes District Health Boards: A review of the evidence and recommendations for action. Toi Te Ora – Public Health, Tauranga. Available at: http:/www.toiteorapublichealth.govt.nz/rhuematic_fever_gp 2. New Zealand Rheumatic Fever Writing Group (2006). Algorithm 4 - Guide for sore throat management. Available at: http://www.heartfoundation.org.nz/files/guide%20for%20for%20sore%20%throat%throat%20management.pdf.

AcknowledgementsToi Te Ora - Public Health Service: Dr Phil Shoemack, Dr Jim Miller, Russell Ingram Seal, Clare Dowthwaite. Te Ao Hou PHO/ WISH: Sandra Ball, Nita Walker, Miriam Steadman, Danny Paruru. Waiariki Institute of Technology: Brigid McPherson, Stacey Stent, Shelly Smith, Mare Curle, Kelly Stewart, Karen White, Deborah Stewart

Results Awareness of rheumatic fever, sore throats and potential heart damage all showed an increase in both the mid and post awareness campaign surveys.

GPs found the sore throat management guidelines helpful and most were using them.