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Our Research Informs Effective Communications and Supports Positive Health Outcomes

Rigorous research provides the groundwork for all public health communications efforts at IQ Solutions. Our experienced team of researchers use both traditional and digital research approaches to ensure that our work is grounded in the latest data and guided by a firm understanding of a target populations’ cultural and community beliefs, knowledge, and attitudes.

Mixed Methods

Project Title: Youth Tobacco Use Prevention Education Outreach Program


Agency: U.S. Food and Drug Administration (FDA) Center for Tobacco Products (CTP)

Client Objective: Tobacco use remains the single most preventable cause of disease, disability, and death in the United States. Alarmingly, tobacco product use among youth is increasing. The 2020 National Youth Tobacco Survey indicated that among high school students who currently use e-cigarettes, 22.5% use these products every day, and 9.4% of middle school students use these products every day. Early intervention through school-based education is key to shaping youth behaviors around tobacco use by equipping young people with the knowledge to make informed decisions.

Recognizing the invaluable role of school-based interventions in the prevention of tobacco use initiation in youth, FDA CTP seeks to develop new, robust educational offerings for middle and high school educators on the topic of tobacco use prevention that can be implemented in virtual and in-person classroom settings.

Audiences: Primary audience of FDA CTP’s Education Outreach Program: middle and high school educators and students. Secondary audience: parents/guardians, school administrators, school nurses, and counselors—all of whom educate youth in some capacity.

Research Methods: To support the evolving needs of educators and expand the reach of tobacco use prevention messaging for youth, IQ Solutions is working with FDA CTP to lead a mixed methods effort, which includes:

  1. Needs Assessment. A systematic, comprehensive assessment of state-level tobacco policies, health education standards, and current tobacco use prevention curricula available to middle and high schools in all 50 states.
  2. Focus Groups. Recruitment, moderation, and analysis of 18 online focus groups with 91 health educators representing 28 states to inform ways FDA CTP can expand its current collection of tobacco use prevention materials for use by middle and high school educators. We used NVivo to analyze focus group transcripts and received Institutional Review Board and Office of Management and Budget approval.
  3. Survey. Development, recruitment, fielding, and analysis of a survey with 434 middle and high school educators to assess their use of, and experiences with, FDA CTP/Scholastic Vaping Education (The Real Cost of Vaping) resources used during the 2019‒2020 and 2020‒2021 academic years. We used Chi-squared and Fisher’s exact tests to examine differences in results by grade band, geographic type, subject taught, and socioeconomic status. We received Institutional Review Board and Office of Management and Budget approval.

Impact: Through the implementation of our three-pronged mixed methods approach, IQ Solutions gleaned key recommendations and insights to inform FDA CTP’s materials development and promotion strategies—identifying opportunities to improve content development, delivery, and use in schools. Findings from the Needs Assessment on state-level tobacco curriculum policies revealed many critical educational resource needs that can be filled through the development of FDA CTP’s new tobacco use prevention materials. In particular, the assessment identified a need for educational materials addressing the health consequences of vaping, resources focused on decision-making, and materials that involve students in an interactive manner.

Exploratory conversations with middle and high school health educators specific to their needs and challenges with tobacco use prevention education pointed to notable insights that FDA CTP can apply to its materials development strategy. Specifically, health educators do not currently have the support they need to teach a skills-based tobacco use prevention curricula and are eager to access an evidence-based prevention curriculum with hands-on activities that engage students and whose design offers students the ability to understand the relevance of tobacco in their daily lives.


Project Title: The Combat COVID Initiative


Agency: U.S. Department of Health and Human Services (HHS)

Client Objective: Combat COVID is a national outreach and education initiative (developed with HHS) to educate communities about possible treatment options for those with COVID-19. The team promotes Combat COVID through an array of tactics, including social media, web and social advertising, national and regional partnerships, and multicultural outreach to focus on those most affected by the pandemic.

The Combat COVID team wanted to keep abreast of the ongoing success of the Combat COVID initiative by measuring ad recall, brand awareness, and overall knowledge and attitudes toward COVID-19 therapeutic clinical trials. A custom web survey was designed to establish a benchmark and inform enhanced messaging as well as new messaging and strategies.

Audiences: The general public (consumers) and health care providers (physicians, nurse practitioners, physician assistants, pharmacists, and nurses).

Research Methods: Partnering with The Harris Poll, the Combat COVID team developed and administered a survey among a nationally representative sample of consumers and health care providers—at two time points. Survey questions included knowledge of and trust in clinical trials, intention to seek out clinical trials, and (for those aware of Combat COVID) the impact of seeing messages or visiting the website with the intention to seek out and potentially enroll in a clinical trial for COVID-19 treatments. Additional variables on demographics (age, sex, race and ethnicity, employment, household income, education level, marital status, and household size), geographic targeting (ZIP code), and provider details (specialty, practice setting, and years in practice) allowed us to further segment the two audiences and close gaps in awareness of Combat COVID.

The general population sample was weighted on demographic variables to ensure representativeness. Differences between demographic subgroups of consumers were examined for visits to the website and changes to likelihood of enrolling themselves (or a loved one) in clinical trials. Significant differences (those whose values fell outside the expected 95% confidence interval for that variable) were used to identify areas of stronger performance or potential gaps.

Impact: The survey allowed the team to better understand who has or has not yet become aware of and engaged with Combat COVID. Based on findings from the benchmark survey, we learned that those who were aware of the Combat COVID website were statistically more likely to:

  • Have children in the house.
  • Be people of color.
  • Have higher levels of education (4-year degree or more) and income ($100,000 or more, compared to households with an annual income under $100,000)

Among health care providers, we found more awareness of Combat COVID among those who practiced in inpatient settings, that pharmacists were the specialty group most likely to be knowledgeable about clinical trials, and that most providers learned about Combat COVID from another person. Based on this, the team adjusted marketing strategies. This included broadening reach to all education and income levels, using images of family/children to continue engaging parents and caregivers, and building on “professional word of mouth” for communicating to providers.

The second wave of the survey allowed us to compare changes in the percentage of consumers and providers who are aware of Combat COVID, have visited the website, and express trust in clinical trials for potential COVID-19 treatments. Overall, trust in clinical trials and likelihood of enrolling self or a loved one in a clinical trial was similar at both time points.

Among health care providers, we saw a significant increase in the second wave in the likelihood of referring qualified patients to clinical trials for COVID-19 treatments.

Past research has found that providers with the most experience with clinical trials themselves (conducting them or referring patients to them) were most likely refer patients to future trials. Our survey findings support this trend and show encouraging growth among potential “first time” referrers who can support the National Institutes of Health’s goal of increasing racial and ethnic diversity in clinical trials.


Project Title: Understanding Comprehension and Impact of Latent Tuberculosis Infection Education Messages Among Affected Communities


Agency: Centers for Disease Control and Prevention (CDC) Division of Tuberculosis Elimination (DTBE)

Client Objective: IQ Solutions worked with CDC DTBE to plan, recruit for, conduct, and report on 15 focus groups in five U.S. cities to test 39 unique latent tuberculosis infection education messages with persons disproportionately affected by tuberculosis.

Audiences: People not born in the United States whose countries of origin include those with high tuberculosis case rates, including Vietnam, India, the Philippines, China, Mexico, and Guatemala.

Research Methods: In support of CDC DTBE, IQ Solutions:

  • Developed a comprehensive methodological plan that included a study design informed by the latest epidemiological data.
  • Planned and recruited 126 participants representing six countries of origin to participate in focus groups.
  • Logistically coordinated and conducted 15 total focus groups across five U.S. cities.
  • Systematically analyzed focus group data and developed an actionable summary report that included recommendations for revising education messages and developing audience-tailored communications strategies.

Impact: Focus group findings set the groundwork for developing future communications, education, and outreach efforts with populations disproportionately affected by tuberculosis. Findings reinforced the need for a multidimensional communication and education strategy that addresses the diverse range of cultural nuances, levels of health literacy, and learning styles.

Social Listening

Project Title: COVID-19 and Tobacco: Using Online Discussions to Determine Influence and Strategy


Agency: U.S. Food and Drug Administration (FDA) Center for Tobacco Products (CTP)

Client Objective: FDA CTP wanted to identify the influence of stakeholders in the conversation around the possible correlation between smoking and the severity of COVID-19 symptoms and subsequently develop resonant messaging and possible outreach tactics.

Audience: Internal stakeholders for CTP’s Office of Health Communication and Education and FDA’s Joint Information Center.

Research Methods: To inform CTP’s stakeholder outreach and communications strategy regarding the correlation between smoking and the severity of COVID-19 symptoms, IQ Solutions:

  • Used social listening to determine how engaged identified stakeholders were in the conversation around the correlation of COVID-19 and tobacco use. This list of stakeholders was a carefully curated, data-driven list of tobacco advocacy and public health organizations.
  • Used a proprietary methodology to quantify each stakeholder’s relative traditional, social, and broadcast media influence. This “influencer score” was converted to an index with 100 indicating the most influential organization.
  • Developed a series of visual, data-driven “influencer maps” that compare the influencer scores of these stakeholders.
  • Analyzed prominent message themes across media channels and stakeholder organizations/individuals.
  • Used the results to generate recommendations to support stakeholder outreach and public education efforts.

Impact: IQ Solutions presented the findings from the influencer mapping project to internal FDA staff to aid in the development of strategic communications around COVID-19 and its relation to tobacco use.

Usability Testing

Project Title: Informing the Development of the NIAAA Treatment Navigator Tool


Agency: National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Client Objective: To understand audience behaviors and perspectives in order to ensure that the forthcoming NIAAA Treatment Navigator tool will appropriately meet the needs of those seeking treatment for alcohol use disorder.

Audiences: Individuals seeking treatment for alcohol use disorder and family members who assist individuals in seeking treatment.

Research Methods: IQ Solutions planned, recruited for, and implemented a series of usability testing methods for this effort that included: card sorting, first-click testing, and virtual qualitative discussions with potential tool end-users.

Impact: Based on the findings, we were able to recommend both user experience and content changes that could enhance the usability of the NIAAA Treatment Navigator tool, as well as support search engine optimization. Findings highlighted the value of maintaining the right balance between scientific information and educational substance, mixed with an authentic, compassionate voice of authority to empower users in finding their way to treatment for alcohol use disorder.

Data Analytics

Project Title: Website Optimizations to Promote Clinical Trial Conversions


Agency: U.S. Department of Health and Human Services (HHS), Federal COVID Response

Client Objective: Through the Combat COVID website, HHS wanted to help individuals get into clinical trials for COVID-19 treatment.

Audiences: People with COVID-19, intermediaries.

Actions: The Combat COVID website was established as a hub for individuals to seek information about COVID-19 treatment options, including treatments through clinical trials. As a part of IQ Solutions’ measurement strategy for the site, and using Google Analytics, we developed several goals that we wanted website users to take. One key goal was to get visitors to actually “click” to learn more about a clinical trial—either by clicking off to a clinical trial website, clicking a link that would allow users to email/call a trial site, or opening the clinical trials chat feature. In line with this goal, we proposed—and ultimately implemented—several site changes, including:

  • Prioritizing clinical trials information in the site’s navigation.
  • Cross-promoting clinical trials prominently on other pages of the site.
  • Utilizing call-to-action buttons to help users along the journey and providing a simplified path for users to find the clinical trials information they were seeking.

Impact: The conversion rates associated with our clinical trial-related goals increased over time as the aforementioned updates to the site were implemented. Most notably, we saw a four-fold increase in conversation rates over 18 weeks.

Outcome Evaluation

Project Title: CDCF Data to Policy (D2P) Initiative

Agency: Centers for Disease Control and Prevention Foundation (CDCF)

Client Objective: CDCF asked IQ Solutions to evaluate the effectiveness of training methods in policy brief writing classes.

Audiences: CDC and Vital Strategies trainers and Ministries of Health trainees.

Actions: IQ Solutions developed and employed a mixed-methods evaluation to assess the organization’s D2P Program. This program trains Ministries of Health staff in selected countries on how to develop and write effective health policy briefs that work to reduce morbidity and mortality from the respective countries’ top health conditions. In conjunction with the development of seven e-learning modules, IQ Solutions developed pre- and post-evaluation instruments to assess trainees’ knowledge and retainment of course learning objectives, from teaching methods that included cultural competency. In addition, IQ Solutions conducted qualitative discussions with D2P alumni to explore possible program improvements and barriers to implementing what they learned via the program.

Impact: Evaluation methods informed sustainability measures for the training programs to ensure the flexibility to adapt to the cultural norms of teaching and learning within the various countries where the program was occurring.

Sustainability of the training programs was achieved by training in-country staff from Ministries of Health to train their colleagues and peers in the course material, thereby continuously expanding the group who can advance health policy in their country. To accelerate and standardize this “training of trainers” (ToT), IQ Solutions created an extensive, culturally-competent ToT manual for the course, including chapters on integrating adult learning principles into the course; best practices for training, facilitating, and mentoring; and a suggested curriculum for training others in these practices. We conducted an in-person training session on ToT practices for 20 D2P trainers at CDC Foundation headquarters, and produced a ToT e-learning module to facilitate onboarding the new D2P trainers.

IQ Solutions collected and analyzed qualitative data about the D2P course from the D2P alumni. This was comprehensive feedback illuminated the most effective aspects of, and possible improvements to, the current iteration of the course, including: barriers to participants’ next steps with policy briefs after the course, and country-specific recommendations for the program and future cohorts. Applying this knowledge and the tools that we helped develop, D2P reduced the 3-week classroom phase of the course to 2 weeks while delivering the same curriculum and preparing new D2P trainers to conduct the course on their own.

IQ Solutions developed a detailed strategic and implementation plan for a D2P Networking Forum, an online community where course participants and trainers can share experiences, troubleshoot, and access course resources and tools—an efficient venue for sustaining the course’s effectiveness and impact. We also developed standard operating procedures for organizing, operating, and maintaining a D2P document-sharing platform on SharePoint. This platform facilitates access and updating of all course materials by displaying folders and documents in a user-friendly way, and tracking access and modifications within files.


  1. Tatum K, Parmer J, Browne I, Hennink M, Macario E, Brackett A, Allen L, DeLuca N. Defensive processing of health risk messages: the case of tuberculosis (TB) risk among U.S. immigrants. Social Science & Medicine. In progress March 2021.
  2. Parmer J, Macario E, Tatum K, Brackett A, Allen L, Picard R, DeLuca N, Dowling M. Latent Tuberculosis Infection (LTBI): misperceptions among non-U.S.-born populations from countries where tuberculosis is common. Global Public Health. Accepted for publication June 7, 2021./li>
  3. Beckie TM, Campbell SM, Schneider YT, Macario E. Self-care activation, social support and self-care behaviors among women living with heart failure. American Journal of Health Education. 2017;48(6):355-65.
  4. Macario E, Montague HZ, Campbell SM, Schneider YT, Mieres JH. Understanding the support needs of minority women with heart disease. Journal of Health Disparities Research and Practice 2017;10(1):97-110.
  5. Macario E, Schneider YT, Campbell SM, Volgman AS. Quality of life experiences among women with atrial fibrillation: findings from an online survey. Women’s Health Issues 2016:26(3):288-297.
  6. Macario E, Krause C, Elcano J, Caplan S, Payes RS, Bornkessel A. NIDA engages teens through its blog: lessons learned. Journal of Social Marketing 2013;3(1):41-55.
  7. Macario E, Isenberg JA, Quintas I. Drugs+HIV: Learn the Link Campaign: How IQ Solutions and the National Institute on Drug Abuse (NIDA) adapted a television PSA for Hispanic teens. Cases in Public Health Communication & Marketing. June 2007.
  8. Silver K, Williams M, Macario E. The National Eye Health Education Program: increasing awareness of diabetic eye disease among American Indians and Alaska Natives. Ethnicity & Disease 2006(Autumn);16:920-925.