Increasing opportunities for prevention of infectious diseases by new, effective vaccines and the expansion of global immunization programs across the life course highlight the importance and value of evidence-informed decision-making (EIDM) by National Immunization Technical Advisory Groups (NITAGs). The U.S. Centers for Disease Control and Prevention (CDC) and Task Force for Global Health (TFGH) have developed and made available new tools to support NITAGs in EIDM. These include a toolkit for conducting facilitated training of NITAGs, Secretariats, or work groups on the use of the Evidence to Recommendations (EtR) approach to advise Ministries of Health (MoH) on specific vaccine policies, and an eLearning module on the EtR approach for NITAG members, Secretariat and others. The CDC and TFGH have also supported final development and implementation of the NITAG Maturity Assessment Tool (NMAT) for assessing maturity of NITAG capabilities in seven functional domains. The EtR toolkit and eLearning have been widely promoted in collaboration with the World Health Organization (WHO) Headquarters and Regional Offices through workshops engaging over 30 countries to date, and the NMAT assessment tool used in most countries in 3 WHO regions (Americas, Eastern Mediterranean, African). Important lessons have been learned regarding planning and conducting trainings for multiple countries and additional ways to support countries in applying the EtR approach to complete vaccine recommendations. Priorities for future work include the need to evaluate the impact of EtR training and NMAT assessments, working with partners to expand and adapt these tools for wider use, synergizing with other approaches for NITAG strengthening, and developing the best approaches to empower NITAGs to use the EtR approach.

Narrative approaches and storytelling are emerging as powerful health promotion tools that can spark interest, increase understanding of determinants of health, and translate complex science. A Story of Health, a multimedia e-book with continuing education credits was designed to harness the power of storytelling to increase environmental health literacy. Health professionals are a key audience. They recognize that patients may be suffering from preventable illnesses of environmental origin but often feel ill-equipped to educate individuals and families about risks associated with common exposures. A Story of Health seeks to fill this gap and help readers develop the competencies they need in order to help patients make informed choices, reduce health risks, improve quality of life, and protect the environment. Americans rate nurses and medical doctors as having the highest honesty and ethical standards of all professions. These medical professionals can play a key role in changing patterns of patient behavior and influencing public policies. The e-book provides an easily accessible method of developing environmental health competency. The multimedia format with graphical interpretations allows for quick reviews of topics or for more in-depth analysis via links to additional resources. The CE evaluations have been overwhelmingly positive.

The U.S. Environmental Protection Agency (U.S. EPA) estimates approximately 21,000 lung cancer deaths are attributable to radon exposure (U.S. EPA, 2003). This number is approximately seven times greater than the number of lung cancer deaths due to secondhand smoke exposure and about twice as many deaths caused by drunk drivers (Centers for Disease Control and Prevention, 2015; Foundation for Advancing Alcohol Responsibility, 2013; National Cancer Institute, 2012). Despite these startling statistics, very few programs are in place to monitor or evaluate indoor radon levels in homes and public buildings in the U.S. Since radon gas is colorless, odorless, and tasteless, testing is the only way to determine its presence (Agency for Toxic Substances and Disease Registry [ATSDR], 2012; U.S. EPA, 2003; U.S. Geological Survey, 1993). When testing reveals levels greater than 4 picocuries per liter (pCi/L), mitigation is recommended by U.S. EPA and several effective strategies for reducing indoor radon levels exist (American Association of Radon Scientists and Technologists, 2014; U.S. EPA, 2010). Given the absence of a national program for radon surveillance and the ubiquitous nature of radon gas, we have undertaken a series of activities to understand the extent to which indoor radon may be a risk for Americans, specifically for children attending public schools, in hopes of increasing awareness about the importance of radon testing. | In 2013, we began a study of the scope and extent of regular and standard radon testing programs in schools across the nation. We learned that many states have active radon testing and mitigation programs. For example, in the last eight years New Jersey has tested 1,705 (51%) public schools (New Jersey Department of Environmental Protection, 2014). We also learned, however, that laws and regulations for reducing radon in schools were scarce (Bernstein, 2013). Additionally, we were surprised to uncover the variations in requirements among different laws. Since our original inquiries, some states have lost funding to support their legislation. Other states have added language in support of testing or radon-resistant new construction practices (Environmental Law Institute, 2014). Policies for radon testing in schools and radon-resistant new construction continue to be uncommon and moving targets.