Community Circles and Cells: A method for rapidly engaging communities in risk communication feedback

Public health communication before, during, and after an emergency is critical for reducing poor outcomes. The literature supports community involvement in health promotion, whether related to constructing prevention messages; assisting in the dissemination of emergency communication; or enlisting their help as key informants. This study developed partnerships between community-based organizations and our academic institution in order to evaluate the framework for a message testing platform which allowed rapid dissemination of draft risk communication messages and the subsequent collection of community-level feedback. The project employed novel technologies such as netbooks, bi-modal web and telephone interactive voice response (IVR) systems, flash-based web- and videoconferencing, and live audience polling using text messaging to (1) distribute risk communication messages of varying media to the communities, and (2) gather community-specific information regarding message content, salience, presentation, and dissemination. We tested the platform in four at-risk populations: urban teenagers, rural homebound and/or their caregivers, suburban HIV/AIDS patients, and undocumented Latin American immigrants nationwide. Quantitative and qualitative assessments were made to determine the most efficient and effective feedback methods in these communities. The feedback mechanism was predicated on a multi-level hierarchical system in which each of the four targeted communities was designated a “circle,” headed by a circle coordinator, and within each circle were four “cells” composed of six to ten members led by a peer cell captain. This structure permitted rapid mobilization of all the communities with minimal burden to any organizational level (academic leader, four circle coordinators, 16 cell captains, or 100 cell members).