How to Start a Community Screening Project

by Hanover Hospital


After 15 years in practice, it still amazes me how patients can be treated for COPD and asthma without a spirometry test. I'm still surprised that few people have heard the term COPD and fewer people know that COPD is the 4th leading cause of death in the U.S., and that lung cancer is the number one killer! Many primary care physicians are still mystified about spirometry and think that spirometry is an advanced test that only pulmonary specialists do.

About two years ago, I heard about the National Lung Health Education Program and its goal to increase public awareness of lung disease and lung function, and to increase the use of spirometry in the office of the primary care provider. Because I am the only pulmonologist in a small community with a well-supported community hospital, I decided to take action.

We=re still at the beginning of our promotion and educational efforts at Hanover Hospital, and we have a lot of things yet to do. I thought it might be helpful to others to write down what we have tried to do with our program so that other community-based programs could benefit from our experience.

  1. We defined our goals as:

    - Educate the public about COPD (and lung cancer), spirometry, and the benefits of early detection.

    - Educate primary care physicians about early detection of COPD; how and why.

    - Promote greater use of spirometry for early detection of COPD (and for chronic respiratory symptoms and conditions).

  1. I asked for volunteers who are interested in community health and preventive medicine. Our group includes: Respiratory Therapy Supervisor, Pulmonary Rehabilitation Respiratory Therapist, a nurse from the Hospital Wellness Department, a representative from the Hospital Community Relations Department, my pulmonary practice office Nurse, a representative from the local Lung Association, and a liaison from Hospital Administration. This volunteer group was initially not Hospital affiliated. Some of the volunteers worked in the Hospital, but they did this project on their own time.
  1. We called ourselves the Coalition for Lung Health. We discussed a promotion and education strategy for the lay public and primary care physicians in our community and a neighboring community. We brain stormed about how to get funds to support this program.
  1. An initial letter was sent from me to all the local primary care physicians to explain the basics of the NLHEP and the reason for the local Coalition. I introduced them to the goals, and the slogan, ATest Your Lungs - Know Your Numbers@, as well as our promotional plans. I promised frequent follow-up letters to keep them informed of our plans and or progress. I made sure that our promotion to the public would be no surprise to this group of doctors, in case our campaign efforts resulted in public pressure for PCP=s to do spirometry, much like the public insisted on cholesterol measurements last decade.
  1. The Coalition for Lung Health plan was presented to Hanover Hospital=s AQuality Council@ as a community health program they should consider endorsing. Their agreement allowed us to officially use Hospital personnel, Hospital space, and some Hospital services , such as copying and printing. It also allowed the Wellness Department to officially help us promote the Coalition goals and it gave us access to publicity through several Hospital newsletters.
  1. An inexpensive local graphic designer was hired to create a local logo for print advertisement and an 8" x 10" poster. These posters mentioned NLHEP, COPD, the slogan, ATest Your Lungs - Know Your Numbers=, and AContact Your Physician@, so the campaign would not appear to promote Health Fairs or Hospital Screenings.
  1. Informational letters about the Coalition were sent to the Hospital CEO and Director of Development. The Director of Development accounts for all (non-profit) moneys received and disbursed by the Coalition.
  1. I sought funds for the Coalition from several pharmaceutical and local medical supply companies. $1,500 in initial gifts was enough to start the entire project. Some medical companies gave without any strings attached, and some gave when I agreed to talk to their reps for 30 minutes on some educational topic, or in exchange for a staff lecture.
  1. The Coalition=s first public advertisement was an Aad@ for each performance throughout the season at our local performing arts theater.
  1. An informational message about the NLHEP, COPD, and the ATest Your Lungs - Know Your Numbers@ slogan appeared in each Hospital Wellness Schedule of Events and Newsletter. These flyers were sent out monthly and also as announcements to the local newspaper.
  1. An article about the NLHEP and the Coalition for Lung Health was written for the Hospital newsletter, which is widely distributed in the community.
  1. Our first poster was sent out to every business in the community using a list of Chamber of Commerce members. A letter accompanying the poster described the Coalition goals and asked each business to place the poster in a prominent public area.
  1. A Grand Rounds was given on ACOPD@ which discussed the NLHEP, early detection of COPD, and the importance of spirometry and early lung cancer screening.
  1. A brochure for the Coalition was designed outlining 20 frequently asked questions. This brochure was sent to all local physicians with a letter asking them to place these brochures in their clinic waiting areas. These brochures were also sent to other health care organizations, pharmacies, churches, and will be used at future Hospital screening events.
  1. One of the letters to the PCP=s included NLHEP recommendations on office spirometers, who to screen, and what to do with results. This same group of doctors were also sent Dr. Petty=s Book: Spirometry for the Primary Care Physician, donated by a pharmaceutical company.
  1. The Hospital Respiratory Therapy Department notified all local PCP offices that they are willing to help set up office spirometers, calibrate the equipment regularly, and teach their staff how to use the spirometers.
  1. We met with a representative from a neighboring small community Hospital about expanding the Coalition=s public relations campaign to the public in that community.

Future plans include:

  1. Write to local insurance companies, HMO=s, and PPO=s explaining the benefit of early screening spirometry.

  1. Continue to place announcements in the local media, especially newspapers.

  1. Send out new educational posters to local businesses and physicians every several months.

  1. Request funds from medical suppliers, pharmaceuticals, and the Hospital auxiliary. We will write to local politicians to apply for Atobacco funds@.

  1. Continue to update local PCP offices with newsletters about the NLHEP and other COPD and lung cancer screening issues.

  1. Continue to create educational messages to promote the goals and ideals of the NLHEP to the public.

  1. Continue the media presence of the Coalition for at least 2-3 years.

  1. After a year, the public will be polled about their knowledge of COPD and spirometry and results will be compared to a baseline poll completed before the Coalition campaign started. PCP offices will also be polled on the use of spirometry, and the results will be compared to baseline.

If you would like any more information on our Coalition for Lung Health, or have any questions, I would welcome your inquires at:

Michael (Mickey) Ader, M.D., FCCP
Director Hanover Hospital Respiratory Therapy and Pulmonary Rehabilitation