Karna has several projects that demonstrate our breadth of services:
Karna Health Communications Fights Global HIV and TB
HIV and TB are globally interconnected, as TB is the leading cause of death for those living with HIV.
CDC’s Center for Global Health, Division of HIV & TB (DGHT) has set progressive goals for the reduction of morbidity and mortality due to HIV/AIDS and TB to achieve greatest worldwide impact, especially among the poorest and most marginalized groups that carry the greatest disease burden. Achieving these goals requires coordinated deployment of resources combined with comprehensive communication strategies targeting public health personnel, health care providers, and the general public. DGHT tasked Karna to provide high-quality communications support, including the strategic use of communications platforms and channels to optimize reach in promoting program contributions to the fight against global HIV/AIDS.
In response, Karna executed an integrated strategic communication plan providing project management support, key messaging development, graphic design, and formal evaluation to build awareness and understanding of DGHT’s role, contributions, programs, and policies. The strategic communication plan clearly defined objectives, key audiences, messages, relevant activities and tailored materials for each audience, and a timeline for implementation. To inform the overarching communication strategy, Karna conducted environmental scans and monitoring to determine emerging issues and trends that were applicable to DGHT. Using this analysis, we developed data-driven strategies, messaging, and products that were relevant and responsive. Key messages were incorporated in products such as; factsheets, success stories, and social media cards and were distributed according to the most effective tactics. Karna monitored and evaluated all communication efforts for effectiveness and reach.
Karna has been instrumental in DGHT’s fight against HIV and TB through communication and dissemination of findings and research. This is evidenced by increased activity on websites and social-media, downloads of newsletters, products, and materials and national and international media coverage on targeted messages and information that produced expected outcomes and addressed stakeholders’ needs.
CDC’s Morbidity and Mortality Weekly Report (MMWR) is CDC’s premier publication for the reporting of scientific information for disease prevention and control, environmental health, and health promotion and health education activities. It is relied on by scientists, public health and healthcare professionals, and government officials for dependable, current and breaking public health information.
Several publications come out of the MMWR office: the Weekly, Reports and Recommendations, Surveillance Summaries, and Supplements. To meet the requirement of influential, accurate, objective, and well-written information in a timely (and sometimes expedited) manner, CDC requires technical and program support services. Specifically we provide skillsets ranging from technical writer/editors, desktop publishing, web development, maintenance and support, and health communication specialists.
Karna’s team supports the review, and publication dissemination of weekly and serial reports as well as additional resources such as those addressing public health emergency responses, depending on the urgency of the event such as Ebola, Zika, or Opioids. First, writer-editors start once a report is reviewed. They help resolve reviewers’ comments by liaising between reviewers and report authors (which include CDC subject matter experts, as well as external subject matter experts from health departments, academic institutions, and other affiliations). They must ensure the reports are written clearly (Federal Plain Language guidelines) and concisely while maintaining the accuracy of scientific content. Once report content is finalized, Karna’s desktop publishers create and edit graphics and prepare the report layout for print and web publication. Our health communication specialists support the planning, implementation, and assessment of MMWR health communication and promotion activities. In addition, they help create, coordinate, and disseminate social media for MMWR publication promotion, support the MMWR podcast series and also develop content for the MMWR website. Karna’s web team is responsible for the development, implementation, and maintenance of the programs website. Our web managers post the finalized reports to the web, design and maintain web layout and provide web analytics to the MMWR Office for evaluation purposes. In addition, Karna uses a web-based platform to disseminate CDC information to decision makers, public health practitioners, and the public while adhering to CDC web standards and Section 508 requirements.
CDC’s MMWR Weekly ranked 2nd in 2018 among the 180 journals in the category of Public, Environmental and Occupational Health in the Science Citation Index Expanded edition of Journal Citations Reports. Through the contributions of CDC authors and the support work done by Karna LLC and Tanaq Corporation, “the voice of CDC” influences and enhances public health by providing timely, authoritative, and useful science and recommendations for public health action.
Managing Foreign Grant Audit Resolutions
The convergence of changes to workflow resulting from OMB’s 2 CFR 200 (“The Uniform Guidance”), and HHS 45 CFR 75, and the increase in number of Foreign Audits required by Ebola and Zika events created a need for an automated solution to manage the tracking and resolution of these audit.
Meeting Business Needs
CDC needed a solution for tracking the receipt and review of required independent audits submitted by foreign-based grantees. Karna developed the Foreign Audit Tracking System (FATS) to support workflow management, communications, and periodic and ad hoc reporting of information about audit submissions, delinquent audits and letter status, resolution of findings status, country-specific data, suspense dates, Management Decision Letter (MDL) status and approvals, work backlogs, noncompliant audits and letter status, appeals, grantee risk status, repeat/systemic findings, and possible trends.
In addition to the FATS software, Karna developed an audit report forecasting methodology based on linking select data from multiple sources, including GrantSolutions, IMPAC II, and SAM.
FATS is a functional web-based information system including access to CDC’s Foreign Audit artifacts. User groups from audit resolution, grants management, and programs can access their own role-specific dashboard displays and execute drill-downs from quick look views to details. As part of the effort, Karna developed a Training Plan, course materials, and release updates, and delivered classroom and webinar training for 162 potential users in Atlanta and at global locations. Karna established Help Line support and provided Tier 2 and 3 product support for users for one year after the initial Go-Live date.
Since FATS received its authorization to go operational, it has become a viable enterprise-wide system for integrating and managing the disparate pieces of the Foreign Audit resolution workflow into a smoothly-operating standard process.
The current FATS provides the capability to share a more common and accurate view of Foreign Audits in the resolution process and to reduce the time needed for resolution workflow activities from days and weeks to hours and minutes.
The National Center for Health Statistics conducts the National Health Care Surveys. Each survey targets a specific care setting. The data from these surveys must be weighted, sampled, and analyzed in order to provide information to support health care policy makers, public health professionals, and researchers.
Karna provides senior statistical programming support to NCHS including weighting survey data, sampling and producing national estimates and variances. This requires expert knowledge in the underlying coding standards, including HL7, SNOMED, LOINC, CPT, ICD-9, ICD-10, CDA, CDA IG, and RX NORM. Our team uses SAS, SQL, Java, XML, and Schematron tools to accomplish the work.
The result of this effort are data files and specification documents that allow the survey data to be available including the NCHS Data Online Query System (DOQS), Healthy People 2020 (HP2020), the Health Indicators Warehouse (HIW), the Web-Based Injury Statistics Query and Reporting System (WISQARS), and the Wide-ranging Online Data for Epidemiologic Research (CDC WONDER).
Evaluating an Evidence-Based Program
The National Diabetes Prevention Program (National DPP) and Diabetes Self-Management Education and Support (DSMES) programs are two evidence-based interventions for preventing and managing diabetes that are implemented in many locations in the United States. To support the programs’ ability to do performance monitoring and evaluation reporting, CDC requested an evaluation capability assessment to be followed by the development and provision of training and technical assistance in those areas needing improvement.
Karna analyzed CDC DDT grantee information for all awardees under the State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (SPHA1305) and 1422 Funding Opportunity Announcements (FOA)s. The assessment included each State’s evaluation plan, awardee work plans, logic models and Annual Performance Reports as well as in-person feedback gathering sessions. The result was a capacity-assessment rubric that was applied to all 51 grantees’ reports to identify their evaluation capacity.
Karna delivered a number of performance monitoring, evaluation and capacity-building tool resources that will be usable for current and future activities including a:
- Detailed logic models for both DPP and DSMES (in collaboration with CDC)
- Access to sustainable diabetes-related data sources, including data sharing agreements with the national diabetes advocacy organizations
- Ten evaluation capacity building webinars to improve awardees’ performance monitoring, evaluation reporting, program implementation and planning activities
Immunization Information Systems
60+ jurisdictions – including states, large cities and U.S. territories- received funding from the CDC to develop and maintain an Immunization Information System (IIS) that consolidates immunization information into one reliable source for providers and families. The challenge facing CDC are that each jurisdiction has unique laws and workflows impacting the manner in which immunization data is reported and tracked. In addition the awardees vary in their ability to implement tracking systems, resulting from a number of factors.
The National Center for Immunization and Respiratory Diseases (NCIRD) requested an analysis of the effectiveness of the current approach to funding IIS activities and the possible ways to increase the sustainability of the national IIS system maintenance and enhancement.
Karna conducted surveys, facilitated discussions and interviewed stakeholders to evaluate awardees’ maturity in accepting, transmitting, and analyzing immunization data. We developed profiles of the current state and created a consolidated view of the awardee cohort. Karna collaborated with the American Immunization Registry Association (AIRA) and Public Health Informatics Institute (PHII) as well as the awardees and government stakeholders.
In the second phase of the project, we worked with CDC to develop a future state funding model, future state tools and a roadmap for creating those tools. This included development of a Shared Services Catalog and approaches to actualizing Service Centers. We reviewed private and governmental sectors to discover and evaluate models for creating a sustainable environment which could manage, support, and deploy shared software services across the awardee community. Karna also performed an alternate IIS funding implementation assessment, to develop new approaches to funding the IIS’s. The objective was to create sustainable funding and infrastructure to assure the future of state based immunization services.
The final work product was an implementation road-map, a step-by-step how-to for achieving a future state of higher performing, inter-active and sustainably funded IIS’s.
CDC DGHP Global Health Security Communications Engagement
CDC’s Global Health Security Agenda (GHSA) is designed to address the increasing risk of global health threats. The success of its implementation requires systematic and consistent communication between the CDC Division of Global Health Protection (DGHP) and CGH country offices and communications that are economically effective.
Karna supported the development of a robust partner engagement process and a method for evaluating the effectiveness and value through economic analyses. We started by inventorying the events and observances related to global health security and the coordinated that with partner visits to CDC for which we developed talking points and policy briefs. We developed materials for the annual meeting, social media, campaign events, and DGHP publications. We developed a landscape analysis intended for publication for CGH of economic/cost studies and reports outlining the economic impacts of CGH’s investments in various programs since inception.
The linkage of consistent communications to economic value allows DGHP to focus on those actions which increase GHSA. Our approach to cost-benefit, cost-effectiveness, and cost-utility analysis was used to evaluate global health interventions from the impact of immunization funding on data collection/quality in sub-Saharan African countries to the economic cost of the Nigeria Malaria Frontline Project.