35413 Lyme Corps: A Train-the-Trainer Approach to Lyme Disease Prevention & Education

Christina Nelson, MD, MPH1, Anna Perea, MS1 and Dana Perella, MSPH2, 1Division of Vector-Borne Diseases | Bacterial Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, 2Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA

Background: Approximately 30,000 cases of Lyme disease are reported to CDC each year; however, the number of actual infections is estimated to be 300,000 annually. While most patients recover after antibiotic treatment, 10-20% may recover more slowly or experience residual effects from the infection. Rare deaths from Lyme carditis have also been reported. Program background

Program background: DVBD seeks new means of educating health care providers (HCPs) and the public about Lyme disease because: 1) recent surveys indicate that provider practices are often inconsistent with current guidelines and 2) inaccurate information about Lyme disease is disseminated broadly through internet forums, social media, and traditional media. Pairing these needs with the desire for a “hands on” approach, we developed Lyme Corps. Lyme Corps trains students pursuing health care degrees (MD, RN, MS, etc.) to provide Lyme disease education and outreach to both HCPs and the public. Participants’ primary responsibilities include: 1) educating colleagues; 2) educating HCPs via clinic visits and material dissemination; and 3) increasing public knowledge in-person and online. In Year 1 we recruited ten Lyme Corps team members in partnership with Drexel University and the Philadelphia Department of Public Health.  Philadelphia was chosen due to its high incidence of Lyme disease, strong local health department, and interest from various academic centers. Participants attended a 2-day training workshop on clinical and public health management of Lyme disease. Pre- and post-tests to assess knowledge and retention were administered before, during, and after participation. Participants kept detailed logs of activities, participated in monthly conference calls, consulted with CDC organizers regularly, and completed program evaluations to improve future programs. Evaluation Methods and Results

Evaluation Methods and Results: From April-May 2013, participants distributed over 1500 printed materials to schools, clinics, parks, etc. They gave 23 presentations to clinical staff at medical practices (average practice size 1,800 patients). Participants also presented to public health officials and a wide variety of adult and children’s groups from the general public. Total direct reach was 917 persons. Participants answered over 200 Lyme disease-related questions on health forums. These responses benefitted the person who posted the question and also remained online indefinitely as a source of accurate information for others. Participants evaluated their training session and the program positively. Pre- and post-test results indicated that acquisition and retention of Lyme disease knowledge over the course of the program was strong. Conclusions

Conclusions: Lyme Corps is a train-the-trainer program that equips health care students and residents to teach others about Lyme disease while concurrently magnifying CDC’s efforts to disseminate accurate information. By incorporating a wide variety of activities across multiple venues, DVBD has added novel communication strategies to the basic train-the-trainer model.  Regular meetings and engagement of participants helped maintain and build skills over time.  This program was low-cost with broad impact. Implications for research and/or practice

Implications for research and/or practice: High quality outreach to providers and the public can occur through innovative means. Sustainability and expandability of the program requires additional evaluation.