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U.S. Food and Drug Administration
FDA Consumer magazine
November-December 2002
Table of Contents

Public Affairs Specialists: On the FDA's Front Line

By Linda Bren

Nervous, yet eager to make her appearance, Cynthia Leggett awaited her turn in front of the television cameras. Had she known she would soon be sharing the stage with a 500-pound lion, she might have been a little less eager.

It was 1974 and Leggett, an FDA public affairs specialist, was about to give a live interview on WSB-TV in Atlanta. She knew her colleagues would be watching as she spoke about the FDA's role in regulating cosmetic products.

Once on the stage, Leggett began to confidently answer her interviewer's questions. But soon she said something that neither she nor anyone else in the audience was prepared for: "There's a lion in the back of the studio."

Shortly after Leggett's announcement, the lion walked in front of the camera and slowly laid down just a few feet from her. Leggett remained calm. The interviewer, however, jumped up on his chair and screamed. The show went to a commercial break while the lion, part of a Ringling Bros. and Barnum & Bailey circus promotion, was retrieved by his apologetic trainer.

"I've got to finish this interview," said Leggett. "I've got a message to get out." The interviewer allowed Leggett to proceed, and she finished her talk on cosmetic safety without further interruption.

Not every day is filled with drama for the FDA's public affairs specialists (PASs) located throughout the United States and in Puerto Rico. But, like Leggett, these health educators are dedicated to delivering the FDA's messages to the public--messages to help them make informed and responsible health decisions.

This year marks the 50th anniversary of this elite team of more than 40 professionals. Today's PASs, like their predecessors, serve as key links between consumers and the agency whose mission it is to protect them. Their job is to tell consumers--as well as industry, academia, the health community, and the local media--about FDA-regulated products and related heath issues.

"PASs have to take highly technical, scientific material, figure out what it means, and then explain it to the outside world," says Leggett, now a PAS at the FDA's headquarters in Rockville, Md.

Last year, FDA PASs reached more than 1 million people through 2,300 outreach and educational programs and 450 workshops, conferences, and meetings. All told, the team responded to over 10,000 inquiries in 2001.

Along with educating consumers, the PASs take the pulse of the public, reporting consumer concerns to agency management. Through this feedback, future FDA programs and messages can be better targeted and agency decisions can be responsive to shifting public health needs.

Breaking New Ground

On Nov. 9, 1952, FDA Commissioner Charles Crawford announced the appointment of the first 16 part-time public affairs specialists, then called "consumer consultants." Ironically, a controversy over white bread was a catalyst for hiring these consultants, says Suzanne White Junod, Ph.D., an FDA historian. Following World War II, the FDA held open hearings to establish standards for white bread. A vocal coalition of consumers and academics alike criticized the FDA's proposal that white bread should be made with wheat flour, arguing that soy flour was more nutritious and should be America's standard bread ingredient.

"FDA officials came to realize that the agency needed a means both of keeping abreast of the newest consumer concerns and of explaining the agency's position to consumers directly," says Junod. The consumer consultants became that means. These 16 pioneers, all women, were highly regarded as home economists, dieticians, or nutritionists. Some held high positions in the educational field; others were homemakers who were active in civic affairs and had wide responsibilities in women's organizations.

Paid $20 per day, the consumer consultants worked part time up to four days per month. They were expected to forge relationships with key consumer and community groups to determine public attitudes and concerns. Their first task was to circulate 400 questionnaires at meetings of different organizations to determine consumer preferences in the canning and labeling of tuna. These preferences, along with accounts of food poisoning, misleading labels, deceptive packaging, and other product complaints, were reported back to FDA headquarters. Some of the consultants were brought to Washington, D.C., to testify on consumer needs at food standards hearings.

Based on the FDA philosophy that informed consumers need less protection by the government, a two-way communication soon evolved. In addition to reporting consumer views, the consultants educated the public on FDA-regulated products.

Lorena Meyers of Kansas City, Mo., one of the original 16 part-time consultants, frequently gave speeches on seized and fraudulent products to community organizations. "I was given a few seized products for show-and-tell," says Meyers. One such product was a foam rubber mask that was worn after dipping in buttermilk, cucumber juice, or rainwater, supposedly to make wrinkles vanish.

The consumer consultants enjoyed a reputation in their communities for providing good, solid facts. "The job was exciting and I loved it," says Meyers, adding that a consumer approached her after one of her speeches and said, "I didn't know anybody in the government knew as much as you did!"

Spreading Public Health Messages

Public affairs specialists must continually adapt to the ever-changing world of food and health and must stay current on the many kinds of products regulated by the FDA. Today, these include foods, drugs, cosmetics, radiation-emitting products, medical devices, biologics, and veterinary products.

Before the creation of the Environmental Protection Agency and the Consumer Product Safety Commission in the 1970s, the early consumer consultants had to be well-versed in other areas, such as water and air, baby cribs, flammable products, and even toys, says Lois Meyer of Buffalo, N.Y. Meyer was one of the FDA's first full-time consultants hired when, in 1964, the FDA recognized the tremendous impact made by the part-time consultants and began a full-time program.

In the 1960s, the FDA tried a new approach to consumer protection with its toy safety program. It trained and "deputized" consumers, who then went to retail stores to make sure that dangerous toys on the FDA's Banned Toy List had been removed from shelves. The program, which was supervised by the consumer consultants, had mixed results, and was eventually discontinued.

Although today's public affairs specialists don't deputize consumers, they do train and rely on them to help spread the FDA's public health messages. Many of these training programs are supported by grants from the FDA's Center for Food Safety and Applied Nutrition, the FDA's Office of Women's Health, and other organizations.

Lynne Isaacs in Orlando, Fla., teaches senior citizens to educate other seniors about nutrition, food safety, and health fraud. Armed with their new knowledge, handouts, videos, and a food safety teaching kit (food thermometers, chopping mats, cleaning products, and other kitchen aids), the seniors go out to educate others at senior centers, county fairs, libraries, Meals-on-Wheels programs, and other sites.

Isaacs' elder education program, conducted in partnership with the University of Florida Extension Service, was pilot tested in Brevard County, Fla., where nearly one-third of the population is over 55. "The kitchen food safety teaching kits were ultimately distributed to all 67 county extension offices statewide and used by agents and volunteers in hundreds of training programs, reaching millions of consumers," says Isaacs.

Programs like this have been put into practice by the PASs over time, and are one of their most successful means of getting information to the public, says Meyer.

Cultural Considerations

As consumer audiences broadened over the years, outreach efforts changed to keep pace. Target audiences in the 1950s consisted of older people, schoolteachers, and union workers. During the 1960s, they expanded to include youth, low-income families, and Hispanics. By the end of the decade, 20 full-time and 10 part-time consumer consultants had participated in over 400 FDA-sponsored conferences for these audiences.

In the 1970s, consumer consultants got a new name--"consumer affairs officers"--and continued to broaden their outreach efforts. They were given cultural sensitivity training and, for the first time, targeted other minority groups in their outreach programs.

Today's public affairs specialists continue to focus much of their outreach on minority or under-served populations. PAS Laurel Eu of Los Angeles often works with Asians and Pacific Islanders, including Native Hawaiians and people from Japan, China, the Philippines, Vietnam, Samoa, Tonga, and the Marshall Islands.

Community leaders are very concerned about the increasing rates of diabetes, obesity, and cancer in these groups, says Eu. "Many health professionals are not familiar with these individuals and their culture. That is why it is so important to partner with community organizations that work closely with these groups. Teaching people how to read the food label, how to use medicines safely, and becoming aware of diabetes and diabetes management can have a big impact on these communities."

Eu relies on certified translation services, when available, and field tests materials to ensure that these consumers get accurate and culturally appropriate health education materials. "In some cases, it takes many words in the Asian or Pacific Islander language to say one word in English," says Eu. "There may be no native equivalent for certain words like 'cholesterol.'"

Evelyn DeNike, the PAS in Detroit, trains bilingual Arab women to teach other women in the Dearborn, Mich., area, home to the largest Arab community outside of the Middle East. "In their culture, a woman doesn't go to a doctor without her husband or brother," says DeNike. "There is a certain trust factor involved, so it's important to have another Arab woman speaking to them in their native tongue."

Training in food safety is particularly important for this community, says DeNike. "The processed foods here are very different from native Arab foods. They need information about the proper preparation and storage of food."

Hispanics in New York City are benefiting from the work of PAS Dilcia Granville. After discovering a high incidence of emergency room visits for children with foodborne illness in Manhattan, Granville partnered with a local nonprofit organization, the Dominican Women's Development Center, to train childcare providers in food safety. After being trained, the providers then taught others throughout the community.

"They were highly motivated," says Granville, adding that the women showed up faithfully for Friday night training sessions for eight weeks. An unexpected but gratifying result of the program was the involvement of apartment building superintendents. "I gave every woman a thermometer so she could take the temperature of her refrigerator and report back to me," says Granville. "Several refrigerators were not working at all and the food was spoiling quickly." After Granville explained the problem to the superintendents, they fixed or replaced the faulty units.

Making a Difference

Reaching out to the public sometimes means staying in the office to field phone calls and answer letters and e-mail. PASs often deal with the anger, frustration, and even despair of individual consumers. But they know they make a difference. Sometimes people call to tell them so.

When he became a PAS 22 years ago, Don Aird of St. Louis got his first consumer call from a young woman who was having problems with her medication for manic depression. "Her doctor had given her a prescription and sent her home," says Aird. "The physician should have been helping her adjust the dosage for her lithium, something that could take several weeks." Relying on his training as a microbiologist and a discussion with a physician in his office, Aird was able to provide further information to the woman, who then sought the opinion of a second physician. Two months later, she called Aird to thank him "for giving me back my life."

In addition to being educators, PASs must be networkers, recruiters, trainers, and salespeople. "We invented networking and partnerships before they became popular out of a sheer sense of survival," says Isaacs, who has been a PAS for 25 years. Like other PASs, Isaacs maximizes her public outreach by developing "train the trainer" programs, participating in media events, and partnering with grassroots organizations to get information to a larger audience.

One important audience is people with HIV/AIDS. In 1989, the FDA initiated an AIDS Health Fraud Task Force Network to monitor and counter the promotion of suspected fraudulent AIDS products, such as "energized" water and "ozone therapy." The task forces, established in 21 states, Puerto Rico, and the U.S. Virgin Islands, have built coalitions to educate consumers through telephone hot lines, newsletters, public service announcements, exhibits, and videos.

"It involves a lot of time and work, but it's well worth it," says Isaacs, who remembers speaking at conferences where she required a guard to protect her from angry AIDS activists. Now, as a member of Florida's AIDS Health Fraud Task Force, Isaacs collaborates with the activists, the medical community, and other government organizations to develop educational materials used nationally on good nutrition, food safety, AIDS health fraud, and HIV infection. "It's one of the most rewarding groups that has ultimately reached millions of people," she says.

Long Hours, But Never Dull

To reach their many constituents, PASs often work long hours and travel many miles. Alan Bennett, a PAS for 11 years in Portland, Ore., covered three events and more than 1,700 miles in a three-day period in May 2002. On a Thursday, he attended a food safety conference in Idaho. The following day, he spoke at a meeting in Montana on bioterrorism. Saturday evening found him in Oregon playing a bacterium in Portland's famous Starlight parade. Bennett marched the entire two-mile parade route in a green, cumbersome FDA "Fight BAC" costume, much to the delight of the children in the audience. "I was covered in sweat, but I made it without lagging too far behind the other microbes," he says.

PASs Virlie Walker and Devin Koontz of Denver scramble to cover their 404,000-square-mile territory that includes four states (Utah, Colorado, Wyoming, and New Mexico) and 9 million customers. "There's never a dull moment," says Walker, a PAS veteran of 16 years. "You pray for dull moments."

Far from dull was Walker's "once-in-a-lifetime experience" as a PAS: working at the 2002 Winter Olympic Games in Salt Lake City.

"It was a long, cold and busy month," says Walker, who worked seven days a week during the games. For a year and a half prior to the Olympics, Walker traveled to Salt Lake City monthly to prepare for her role as a public information officer representing the U.S. Department of Health and Human Services (HHS) and the FDA. During the games, she responded to health-related requests from the public and worked with the media to tell the story of the HHS Emergency Response Teams. These five-person teams of medical volunteers from 17 states were poised for action in the event of a disaster or other incident that could pose a threat to the several thousand athletes and 70,000 visitors per day.

"Every day we had four conference calls and at the end of the day we filed a situation report," says Walker. Military personnel armed with M-16's were stationed every few feet, she adds. "It was the safest place in America."

Changing Times

Fifty years ago, consumer consultants fielded questions--mostly from women--about food, nutrition, and drugs. They are still the main areas of concern today, says Leggett. "Not much goes away--we just add to it. The information and products become more technical, more complicated, and there are more gray areas."

Although the majority of callers today still are women, men increasingly are contacting PASs. "The minute FDA approved Viagra, I had more men call me in the one week that followed than in the 38 years I've worked here," says PAS Darlene Bailey of Chicago. "One man asked, 'If I take two Viagra pills instead of the one daily as recommended, will I have double the action?'" says Bailey, who recommended to the caller that he follow the instructions on the label.

"Probably the greatest change that happened in the way the job was done is in communications," says Mary-Margaret Richardson, who retired in 2000 after nearly 30 years as a PAS. Before the Internet and other sophisticated technology, it took a few days to get information out to the public. "Now, you can't hide," says Richardson. "The information needs to be immediate."

Bailey learned the importance of immediate information in 1982, when seven people died from poisoning after swallowing Tylenol that had been tampered with. "Because it involved so many agencies and FDA was the lead agency, we had to keep everyone informed by the minute and we were on the phones constantly (there were no computers at the time) with headquarters, the laboratory, media, state and local health departments, and other authorities," says Bailey. "We had meetings in our offices approximately four to five times a day and we really worked as a team to make sure everybody was speaking with one voice."

The Internet has been both a blessing and a curse in their jobs, according to today's PASs. "It makes more information accessible to the public, but with the facts they also get the frauds and the urban legends," says Bennett, who has had to assure people that bananas don't contain flesh-eating bacteria, a rumor widely circulated on the Internet. With the advent of the Internet, Bennett was worried at first that the public wouldn't need him anymore. "Now they need me as a guide to find the right information on the Web," he says. "But that's what we're all about--getting good information to the public."

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