National Education Campaign about Ulcers - United States

Key strategies included:

• Addressing the public's misconceptions about the cause of ulcers through a mass media strategy that combined media relations, public service announcements (PSAs), and education through entertainment;
• supplying health care professionals with information about diagnosis and treatment of H. pylori, and materials to help them talk to their patients about the new cure for ulcers; and
• delivering information to ulcer sufferers through the pharmacy where they purchase over-the-counter medications to self-treat their ulcers.

First, to educate national media that ulcers are caused by an infection, a media briefing was held at the National Press Club in October, 1997. To increase the news value of the story, CDC issued a special report on H. pylori, followed by a nationwide media kit mailing to English- and Spanish-language media. State public information officers received implementation kits to enlist their support in local media relations efforts. To further target the Hispanic audience, a week-long radio series on H. pylori was produced for "Cuidando su Salud," syndicated by the nation's leading Spanish language stations. In addition, television, radio, and print public service advertisements were distributed nationwide.

The first wave of advertising focused on the good news that ulcers are a curable infection, with a humorous "Happy Ulcer Sufferers" approach. This tone carried through all PSA materials, including the teaser packaging. The second wave focused on ulcer sufferers hearing about this good news "Over and Over" from their doctors. To address higher infection rates in African Americans and Hispanics, materials were multi-ethnic, and produced in English and Spanish. CDC's toll-free line (1-888-My-Ulcer) and web site were referenced in materials. In addition, H. pylori and ulcer information was delivered to soap opera producers and writers in Hollywood, with the objective of embedding messages about H. pylori into set designs and/or storylines.

Second, to improve communication between ulcer sufferers and physicians, special information kits were created, including a physician fact sheet, waiting room poster, and consumer brochure. The kits were mailed to more than 780,000 English-speaking and Spanish-speaking health professionals. Finally, several pharmaceutical partners distributed materials through their sales representatives. Because many ulcer sufferers self-medicate with over-the-counter products, pharmacists were determined to be a primary information source for consumers. A pilot programme was created with 236 pharmacies in the Washington, D.C., area to test the effectiveness of reaching patients through this key point of contact for information and products. Participating stores received kits including consumer brochures, a pharmacist fact sheet, a list of counseling tips and commonly-asked questions, a brochure holder, and a shelf-talker.

Health.

A National Institutes of Health Consensus Conference in 1994 concluded that 90 percent of stomach ulcers are caused by the bacterium Helicobacter pylori (H. pylori) and can be cured with antibiotics. More than two years later, a national consumer study revealed that most consumers were still unaware that an infection - not stress (as 60% believe) or spicy foods (as 17% believe) - was the real cause of ulcers, and many doctors were not treating ulcers as an infectious disease. Only 27 percent of respondents correctly blamed a bacterial infection. Many self-diagnosed and self-medicated with over-the-counter antacid medication, and were resigned to a life of pain and a cycle of flare-ups, treatment, and relief. National surveys conducted in 1994 and 1996 by the Baylor College of Medicine indicated that primary care physicians were treating approximately half of patients who had first-time ulcer symptoms with antisecretory agents without testing for H. pylori.

Ulcers affect 25 million Americans and represent $6 billion annually in health care costs.