routine enteric disease surveillance in colorado during
TRANSCRIPT
Routine Enteric Disease
Surveillance in Colorado during
the COVID-19 PandemicPresenters:
Michelle Torok, PhD and Ingrid Hewitson, MPHColorado Integrated Food Safety Center of Excellence
Co-authors: Alice White, MS; Ann Shen, RN, BNS; Natalie Oda, Jordan Queen,
Rachel Jervis, MPH; Elaine Scallan Walter, PhD
Colorado Integrated Food Safety Center of Excellence (CoE)
Image from: https://www.cdc.gov/nndss/
COVID-19 cases in Colorado as of 8/25/20
Image from: https://www.nytimes.com/interactive/2020/us/colorado-coronavirus-cases.html#map
Colorado Student Enteric Disease Interview Team
Colorado Enteric Disease Mobile Health Project
Colorado Student Interview Team: Protocol
● HIPAA training and confidentiality agreements
● CDPHE notifiable disease database
● Virtual phone numbers
● Interview forms
● Lock boxes
Colorado Student Interview Team: Training Curriculum
● Enteric disease surveillance
purposes and goals
● Case interview forms
● Data entry
● Language line
● Protected health information
● Interviewing skills
424 enteric disease cases
105 lost to follow up
319 completed case investigations
2.6 average contact
attempts
2.9 average days to
completion
75%
Evaluation
12 student interviewers
• Brianna Loeck, MPH and Sadie Oppegard, MPH (Nebraska Department of Health and Human Services)
• Tiffany Greenlee, MPH and Courtney Tillman, MPH (Wyoming Department of Health)
Benefits Costs
Support partners at LPHAs
Remote work/logistics
Sustain high-quality enteric disease surveillance
Privacy considerations
Provide real-world public health experience to graduate students
Student turnover
Lessons Learned
Graduate student interview teams:
• Time investment• Sustainable• High-quality work• Benefits both agencies and students
Colorado Enteric Disease Mobile Health (mHealth) Project
0
200
400
600
800
1000
1200
1400
2014 2015 2016 2017 2018
Campylobacter Cases, Colorado, 2014-2018
Interviewed Not interviewed
Giardia PilotPHASE
1
Giardia PilotPHASE
1
Campylobacter PilotPHASE
2
Timeframe of interest
reminder
Educational Messages
External links for
additional information
Videos
Campylobacter case reported in
CEDRS
Campylobacter case assigned to
interviewer
Create a new record in REDCap
Initial contact
with case (phone)
Phone interview
Enter data into
REDCap/CEDRS
CLOSE CASE
Send online survey link
Case completes
online survey
Enter data into CEDRS
*CLOSE CASE
3 attempts 3 emails
Case reports employment or risk factors
of interest
Automatic email generated to
LPHA with information
176 Campylobactercases
25 loss to follow up
151 initial contact
5 phone interviews
136 online surveys
44 loss to follow up
92 online surveys
86%
68%4%
32%
14%
55% Overall response rate
10 refused
176 cases assigned
97 cases completed online
2.5 average number of days for online interview completion
2 average number of contact attempts
Evaluation
Benefits Costs
Interview time Loss to follow up
Transcription
errors
Relies on patients
independent recall
Easily send
educational
materials
Relies on patient’s
commitment
Can do from
anywhere
Requires internet
access
Flexible IT investment
Broader audience Privacy concerns
Lessons Learned• Online surveys can’t replace phone interviews
• Development of online surveys requires coordination and approval (IT, legal, etc.)
• Making online surveys ADA compliant takes time and resources
• Once built they can be adapted and deployed quickly
• Enable more cases to be contacted in a shorter period of time
Conclusions• Routine case interviews are important for
disease control and prevention
• Funding shortfalls and competing priorities (COVID-19) impact routine case interviewing
• Innovative tools and techniques can supplement routine case interviews to save time and resources
• While developed for enterics, these tools could be applied widely
Acknowledgements
• CO CoE Team• Weld, Larimer, El Paso Counties
Questions?
COFoodSafety.org