Educational Outreach in a Large Retail Chain: Opportunities, Challenges, and Suggested Approaches

Situation

In the process of outreach education, it is harder and harder to bring our audiences to traditional evening meetings. One alternative is to bring the program to the audience.

While the dangers of low-level lead poisoning have been known for more than a decade now, (Lanphear, 1998) the level of public awareness of and attention to the dangers of "small" exposures to lead paint debris is less than it should be. It has been our consistent observation that most people whom we speak with envision lead poisoning as involving a child in a low-income household eating paint chips. It is well established that the prevalent exposure scenario for young children, who are most vulnerable to lead poisoning's effects, involves the repeated ingestion of small amounts of lead contaminated dust during hand-to-mouth activity (Lanphear, 1998).

We believe that a continuing, long-term educational campaign is needed to raise public awareness to the dangers of low-level lead poisoning from the sort of lead releases and subsequent contamination resulting from commonplace home repair, remodeling, and repainting projects undertaken in older homes. This is an extraordinary need in regions of the country having an older housing stock. Survey data of the US Department of Housing and Urban Development (HUD) indicate that in the northeastern United States, 93% of occupied housing units built before 1980 have some lead-based paint (US Department of Housing and Urban Development, 1990).

It seemed obvious to us that a likely place for outreach would be home centers catering to customers doing the sorts of tasks that could create hazards from lead debris. This article describes our experiences with this type of outreach. There are likely many other issues in Extension that could benefit from an outreach based on retail outlets.

Methods

Two outreach methodologies were employed. An initial outreach consisted of distribution of literature in a point-of-purchase poster display. This effort was confined to a single county in New Jersey, predominantly rural, and was conducted in small paint and hardware stores with the collaboration of the county health department. The posters were specially designed to fit a countertop and hold two brochures about lead paint remodeling hazards, targeted to occupants (Homeowner brochure) and to contractors (Contractor brochure).

The field worker also visited the stores at 1-to-2 week intervals to replenish brochures--and sometimes see to the replacement of posters that had been pushed out of sight. Upon her first visit, the field worker provided some initial education to store personnel about lead paint. More often than not, there was additional education on the return visits, sometimes prompted by questions relayed from customers who had seen the brochures.

The second project involved a statewide, active outreach to those engaged in home remodeling, repair, or repainting projects. The Home Depot chain is a dominant presence in this state for home repair and remodeling supplies and materials. Moreover, their corporate strategy is to staff the stores with knowledgeable tradespersons to whom consumers look for expert advice. In addition, this chain offers classes on home repairs techniques to customers.

Thus, this chain seemed to be an excellent venue for educational outreach on lead poisoning hazards in remodeling and painting projects. Our initial plan was to offer classes in Home Depot stores, promoting recommended work practices. This proved not to be feasible. Instead, we posted health educators in stores, where they provided information to consumers. In addition, training sessions were conducted for store personnel (particularly paint department staff.)

Observations and Results

Point of Purchase Display

Over the course of 2 years, we distributed a total of 1,391 Homeowner and Contractor brochures. (This particular county is rural in character, with a 1998 population of 122,389 persons according to the US Census Bureau (US Census Bureau, 1999).

While we did not attempt an impact evaluation, store personnel told us of requests for lead test kits as a result of our brochure program. Also, store personnel reported a flow of questions from customers and painting contractors, in response to the poster and brochures. As a result, we provided a question-and-answer session targeted to painters and to store personnel. (Attendance was modest, partly because this was an "after hours" activity for store personnel.)

Another important but not totally unexpected finding of this outreach was the development of a rapport between the store personnel and the outreach worker. On each visit, while replenishing brochures, conversations usually centered on the topic of lead-based paint. Initially, some store personnel made statements such as: "Why are you doing this? We don't sell lead paint anymore." After multiple visits, it became evident that the outreach worker became a trusted expert in the eyes of store personnel. It was also evident that their understanding and attitudes regarding the lead paint problem were enhanced. It is hoped that this updated information was conveyed to customers.

Home Depot Outreach

Our initial plan was to get endorsement of our outreach project from the national headquarters of Home Depot. We reasoned that such endorsement would enhance our chances of success as we approached local stores. Over the course of several weeks we attempted to establish contact with the environmental affairs representative at Home Depot. When we finally did make contact, we described our project and were asked to send an outline of our proposed presentation. This was done, but after a few more weeks of unsuccessful efforts to again communicate, we decided to proceed with individual store contacts without official endorsement.

We would work directly with individual stores. A letter describing the project was composed. We felt strongly that an introductory letter to busy store managers had to be brief and to the point. Our letter was less than one page. Essential background information about the problem and further details of our proposal were presented in a two-page background piece appended to the letter. But all essential information was contained in the letter. We also believe that university letterhead served to capture attention and add credibility to our proposal.

The first contact with our first store manager was a brief but encouraging meeting. We described the project, the significance of the lead problem for projects in older homes, and the need for public education. The manager agreed to our request to conduct classes in the store. The following Saturday was established as the time for our class on lead paint hazards and remodeling. The manager agreed to post signage in the store to advertise these classes; we provided signs we had made.

When we arrived at the appointed time, we found no signs, no manager (day off), and no one who knew anything about our proposed class. After some discussions with an assistant manager, we were given a space in which to conduct a class, and announcements were made on the store's PA system. On a busy Saturday morning, this was simply not effective. No one came.

After similar experiences in a few other stores, we quickly decided that presenting classes in stores was not a viable approach. We decided to resort to the traditional public health education approach of setting up a table and offering one-on-one outreach. An important element in this approach was to distinguish ourselves from sales displays. This was accomplished through the use of signage that prominently displayed the university name and the words "Lead Poisoning Awareness Project." We felt that this attracted attention and, at the same time, reassured people who would have avoided a sales pitch.

The pattern of unreliable manager contacts, however, continued. Our approach was to make a follow-up call to the manager several days after sending our introductory letter. In this call, we would set up an appointment to meet the manager and get approval to set up a table & conduct our outreach. It was not unusual for us to appear at the store at the agreed-upon time, only to learn that the manager was not on duty (or on vacation).

Nevertheless, our initial conversations seemed to indicate sincerity and sometimes enthusiasm in the part of the managers, so we persisted. Our judgments about manager sincerity were validated. Almost invariably, once we met with managers, they supported our project and allowed us to conduct outreach in the stores.

Of 22 stores that we approached, only one denied us permission to offer our program. It was not unusual for the manager to appoint another staff member to work directly with us. Typically, this would be the store's environmental coordinator or customer service manager. We felt that these linkages worked especially well. The manager had assigned the task, and the designee was usually less harried than the manager was. We began to ask: "Shall we contact you to set up future sessions, or would you designate someone else on your staff to be our contact?" Or "Is there another person we should contact when you are not available?"

Once the initial contact and presentation had been established, the scheduling of subsequent sessions became much easier. Usually, we needed only to make a phone call to tell the contact when we were coming.

After the initial sessions in this project, community educators who had knowledge of lead paint issues conducted the bulk of the outreach. In addition to our standard pamphlets on lead paint and remodeling hazards, we also developed a "support library" of handouts on highly specific topics. Thus, when someone asked, "How can I safely sand lead-based paint?" we offered a handout on dust and debris collectors for sanders.

At one point early in the project, a manager suggested to us that we might offer a "PK" session for the store staff. These are "Product Knowledge" sessions. They are part of an ongoing training program for Home Depot employees and are usually conducted by manufacturer representatives for updates on new products. The stores maintain records of employee participation in these sessions, so there is an incentive for employees to attend.

In some cases, a major training is held for all employees that may involve a round robin in which small groups cycle through multiple training stations. These sessions are usually held before or after store hours. (10:00 PM on a weekday or 6:00 AM on a Sunday is not unusual.) Typically, these sessions run about 20 minutes. Thus, we scheduled five minutes to make as convincing a case as possible about the importance of low level lead poisoning. We feel that for this issue, nothing can happen until people become aware of and believe in the new information regarding low level lead poisoning, so this portion of the presentation was planned very carefully.

Unfortunately, these sessions are sometimes cancelled on short notice, so we have learned to make confirmatory phone calls on the day preceding the session. In this project, formal PK sessions have been presented to 765 employees.

Another important lesson learned involved the timing of our sessions in the stores. Store traffic varies considerably over time. Peaks in customer traffic usually occur on weekends, and we generally found these to be productive times to set up our table. On holiday weekends and on weekends from late November to early January, however, stores were extremely busy, people were in a great hurry, and we quickly learned that these were not productive time for us. Periods of very low traffic were also not very productive for us, so we tried to avoid these times as well. We relied on our outreach educators' judgement of when to leave early on an unproductive outing. Managers, too, were sometimes helpful in advising us about good times of "medium" store traffic.

In addition to timing, location within the stores is also important. Because of the connection between lead-painted surfaces and home contamination, we usually located our table at the paint department. Besides targeting customers doing paint projects, this also built some rapport with the counter staff in that department. Information about the issue of lead paint problems was thus informally provided to staff. Over the course of multiple visits, we believe our familiarity with the staff enhanced the educational message to them. In this project, 2,143 Home Depot customers received individualized information about lead safe practices in home repair/repainting projects. Also, some 8,112 brochures on safe practices were distributed.

Because some stores were located in Spanish-speaking communities, we provided some Spanish language publications. In addition, we were able to obtain the services of an interpreter and reach non-English speaking customers.

Evaluation

Throughout this project, evaluation has been difficult. The ultimate objective has been to change awareness and attitudes about lead paint and to change behaviors of those doing repair, remodeling, and repainting projects.

In the point-of-purchase project, pamphlet distribution served as a marker of sorts of enhanced awareness of lead poisoning issues among customers in small stores. Beyond this, anecdotal observations of store personnel indicated an increased awareness of the issue. As a further indicator of increased awareness, some stores reported customer requests for lead test kits, which they started to stock.

The Home Depot project is mainly a one-on-one education project. Evaluation in this case is based on follow-up mailings of a postcard questionnaire. This consisted of questions regarding adoption of improved work practices in older homes. The difficulty we encountered is that people were reluctant to give their names and addresses. As an incentive, we offered an EPA booklet to those who provided contact information. (Of 300 cards mailed, we had a return rate of 12%). Of those who responded, 95% said they would incorporate what they had learned into current projects.

Summary and Conclusions

An attractive countertop display is an effective means of distributing brochures in a retail outlet, although counter space is a valuable commodity. While we did not develop a direct means of evaluating this project, indirect indicators suggested an increased awareness of the lead paint problem among some customers. An important side effect of this outreach was the informal education provided to store staff as our outreach worker replenished brochures. Here, some significant misperceptions among store personnel were put to rest.

For our work in a large chain, we proceeded to work in individual stores without endorsement from national headquarters. This did not seem to present a problem. In these large stores, a staffed information table is a useful method for public outreach. By its very nature, this effort provides highly personalized, specific information to a very small (but highly motivated) audience. Nevertheless, total impact numbers will be small. The optimum time for this outreach was a time of medium traffic--neither very slow nor very busy. As an incidental impact, a large number of brochures was distributed. An unexpected outcome was the opportunity to conduct staff trainings. It is hoped that increased awareness among store staff will be conveyed to consumers.

The most significant observation, however, concerned store managers. Working with these harried individuals takes persistence, at least for the initial contact. Managers regularly failed to be available for prearranged meetings. We came to realize that this was due to the harried nature of their work situation and not to their disinterest. A key realization developed during our meetings with managers. Meetings usually took place in the store aisles and were regularly interrupted by cell phone calls and other distractions. To the extent that our phone appointments were made under these circumstances, it is easy to see how appointments could be missed in spite of genuine interest on the part of the manager.

Ultimately, our persistence enabled us to meet, but a better strategy would be to ask, in the initial phone call, if there would be a convenient time to meet "today." Once we had conducted initial programs in a store, subsequent arrangements became easier as store personnel got to know us. Also, making arrangements became easier when the manager had assigned a subordinate as our contact.

Evaluation of these programs was difficult. The best method we could devise was a follow-up postcard. Many of the individuals with whom we spoke were reluctant to provide their names and addresses. Currently, an evaluation of the knowledge of Home Depot paint department staff is under way.

Acknowledgements

This work was supported in part by the New Jersey Department of Human Services, Office of Prevention of Mental Retardation and Developmental Disabilities. Also, we would like to thank outreach workers Jenn McGuire, Steve Poset, and John Weber, and the Hunterdon County Department of Health for their expertise and invaluable assistance.

References

Lanphear, B. (1998). The paradox of lead poisoning. Science, 281, 1617-1618.

United States Census Bureau (1999). Population Estimates Program, Population Division; County Population Estimates. Washington, DC. Available at:
http://www.census.gov/population/estimates/county/co-99-1/99C1_34.txt

United States Department of Housing and Urban Development (1990). Comprehensive and Workable Plan for the Abatement of Lead-Based Paint in Privately Owned Housing. Washington, DC.