Performance Improvement 1995. Evaluation of the Morbidity and Mortality Weekly Report Series



Readers from diverse professional backgrounds were found to value the Morbidity and Mortality Weekly Report (MMWR) for its accuracy, relevance, and concise reporting format. The number of readers is likely double the 450,000 on mailing lists. Recommendations may result in some refinements to content and format.

Purpose The Morbidity and Mortality Weekly Report, published every week by CDC, is the agency's major vehicle for communicating timely public health information. As the mission of CDC has expanded beyond concern for infectious diseases to chronic disease and environmental health, this study sought to evaluate the utility of the MMWR in meeting the needs of all of its public health constituencies.

Background The MMWR has been published weekly since 1961 as an extension of CDC's surveillance activity. More recently, the MMWR has been the first source of information on such public health issues as outbreaks and etiology of AIDS, legionella, and hantavirus, as well as studies of toxic shock syndrome. The MMWR's goal is to document events of public health interest, to disseminate information to those who need it, and to communicate with CDC constituents. MMWR articles have the potential not only of informing, but also of directly helping to prevent disease.

In recent years, the scope of the MMWR has broadened--as the mission of CDC has expanded--to include chronic diseases, environmental and occupational health, and injuries. Having dedicated several staff positions to the publication and recognizing its high visibility, CDC was eager to understand the evolving readership needs of the MMWR.

The MMWR is distributed to more than 450,000 people. Primary distribution (17,000) is through the CDC mailing list; distribution also is through reprinting in the Journal of the American Medical Association (JAMA) and subscriptions to the Massachusetts Medical Society.

Methods Battelle conducted a mail/telephone readership survey with 375 individuals on the MMWR mailing list, 375 subscribers to the MMWR through the Massachusetts Medical Society, and 250 primary care physicians who subscribe to JAMA, which publishes MMWR excerpts in a section called "Notes from CDC: Leads from the MMWR." The survey sought to identify reading habits, readership characteristics, use of MMWR information, feedback on publication content and format, and interest in electronic access.

Findings The MMWR is read with great regularity: two-thirds of respondents had read three or more MMWR issues in the months prior to the survey, and most readers had read the MMWR for 5 years or more. Because the MMWR is often distributed to institutions, it is frequently passed along to additional readers. The actual readership is estimated at more than twice the number of issues distributed. The professional backgrounds of MMWR readers are diverse, and the two dissemination modes evaluated (the CDC mailing list and those who subscribe through the Massachusetts Medical Society) complement each other in terms of professional distribution.

Primary care providers most frequently use information in the MMWR to update their information about diagnosis, treatment, and disease outbreaks. The MMWR is also widely used in teaching, public education, planning, and advocacy. The rate of MMWR citations in the scientific research literature is rising. The number of citations of MMWR articles in scientific journals increased more than threefold from 1981 to 1983 and from 1987 to 1989.

Readers value the content of the MMWR and cite its accuracy, relevance, and concise reporting format, but they have suggestions for changes. Some readers would like a larger page size and others are interested in greater electronic access to the MMWR. Currently, they can access the MMWR if they are connected to the Public Health Network. A majority of the respondents, however, were not equipped with the necessary computer hardware and software at the time of the survey.

The MMWR is generally achieving its major objectives to provide for the information needs of CDC's constituents: it is publishing news of public health importance; distributing time--critical health information to those who need to know; publishing quickly and accurately; assisting and strengthening public health surveillance; and promoting efforts of State and local health agencies.

Use of Results The study recommended that the MMWR maintain the breadth of its coverage, possibly enlarge the format, increase outreach efforts, and improve electronic access.

CDC found this study highly useful in shaping the future of the MMWR. It plans to form an internal ad hoc group, consisting of CDC program managers and independent public health officials, that will make recommendations about the MMWR's content and format.

Publication Not yet published. Final report is available through the CDC Policy Information Center.

Agency sponsor: Centers for Disease Control and Prevention

Federal contact: Richard A. Goodman, M.D., M.P.H.
Epidemiology Program Office
Centers for Disease Control and Prevention
Building 1, Room 5104
1600 Clifton Road NE
Atlanta, GA 30333
(404) 639-3636 Fax: (404) 639-3950

Principal investigator: James Hersey
Battelle, Arlington, VA

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