Rheumatic fever is a serious but preventable illness, and New Zealand is one of the few developed countries in the world still affected by it.
The illness is so serious it can lead to permanent heart damage and even death.
Children with rheumatic fever often need serious heart operations, and as part of their treatment requir, monthly penicillin injections for at least ten years.
The thing about rheumatic fever is it is entirely preventable. The illness starts with a sore throat, and if Strep A throat infections are left untreated, they can develop into rheumatic fever.
Those affected are more likely to live in over-crowded conditions, often cold and damp, where strep throat germs can more easily spread.
The populations most affected are Maori and Pacific children and young people aged four to 19 years. Many have English as a second language.
These at-risk audiences are aware of rheumatic fever, but less aware of how it occurs or the actions they should take to prevent it from occurring.
The HPA had run a successful campaign around acting on sore throats, but children were still getting sick. Plus it had great success with Pacific families, but slower uptake with Maori. It needed to go further this time.
The HPA knew that if it could educate people about having drier homes and safer sleeping arrangements, more rheumatic fever cases could be prevented. But research showed these messages would be hard to deliver – families wouldn’t accept being told how to live their lives and keep their homes healthy.
Previously, the messaging around rheumatic fever had focused on the sore throat aspect of the illness, and the importance of getting these treated.
This campaign took one step back again, to encourage creating warmer and drier homes to prevent the onset of strep throat in the first place.
However, as a sensitive area – telling people how to keep their homes and put their children to sleep – the campaign had to tread carefully.
It developed flash-cards health providers could use in face-to-face conversations with at-risk families, and made them adaptable for the situation.
Research had shown positive and encouraging messages were more effective than directional ones, so the HPA also adopted a process of ‘real people’ storytelling, where real families modeled good behaviour rather than telling people what to do.
It developed a video featuring three families – one Maori, one Samoan, one Tongan – who had adopted easy and achievable, effective techniques for improving the healthiness of their families.
With a diverse audience, the HPA ensured all three key ethnicities were addressed and materials made in all key languages.
With a greater focus on Maori families, but with half its budget from last year, the HPA used clever editing from an existing video to create two new TVCs in the same vein as previous ones. These were supported with outdoor and online advertising.
The HPA says the campaign has contributed to a massive 45 percent decline in rheumatic fever hospitalisations since 2012.
When assessing the 2015/16 campaign specifically, the HPA found it had achieved 95 percent awareness with the target group of Maori and Pacific families.
And the groups understood the message: 91 percent knew rheumatic fever could damage health, and 81 percent understood a sore throat can cause rheumatic fever.
The health providers also became more engaged. The HPA had 11 District Health Boards and six government agencies liaise with it to personalise materials specifically for their use.
Thanks to these partnerships, 71 percent of Maori and Pacific families had seen the materials at health service providers, with many more seeing them at school, festivals and community centres.
Finally, and crucially, people were taking action thanks to the campaign. Research found that 88 percent of its target audience took some action in response to the campaign, with 80 percent of Maori and Pacific families reporting taking their child to the doctor the last time they had a sore throat.