Lessons From Six Years on the Frontlines of Public Health Communications

How Our Asheville Team Became Western NC’s Public Health Marketing Agency

In March 2020, our team sent WNC Health Network a high-stakes proposal: COVID-19: Community Communications Strategy & Management. The initial engagement was a three-month sprint at a moment when nobody knew the true scale or timeline of what was ahead.

Six years later, that twelve-week response has evolved into a long-term partnership. We’ve built a regional public health communications model for western North Carolina that national organizations now look to as a benchmark.

Across 22 counties, through global pandemics, historic floods, and infectious disease outbreaks, we’ve proven that public health messaging never has to be cold or clinical. By grounding rigorous digital strategy in authentic community trust, our work breaks through media noise and pervasive stigmas to drive measurable, real-world behavior change when it matters most.

It Started With COVID and It Never Really Stopped

Our initial 2020 proposal was designed to reach roughly a million residents across 18 counties. We built #MyReasonWNC, a campaign powered not by slick actors or outside authorities, but by more than 150 local leaders and residents sharing why they wore masks, kept their distance, and protected their neighbors.

Every single county in western North Carolina opted in voluntarily. By May 2022, the campaign had reached 1.27 million people at an average cost per click of $0.58. More importantly, it caught the attention of federal health officials: the CDC featured #MyReasonWNC nationally as a model for community-led vaccine engagement.

When the official emergency ended, the work didn’t stop. The relationships we built during the pandemic became the foundation for everything that followed, including mental health initiatives, substance use campaigns, nutrition programs, and disaster response.

Lessons We’ve Learned About Public Health Communications

Commercial marketing is much more straightforward by comparison. When Big Sea increased online bookings for an orthopedic practice by 130%, the conversion was immediate and tangible as we tracked appointments scheduled.

Public health messaging has no product to sell, no checkout counter: its effects take more work to measure. The behaviors we ask for, like checking a vaccine record, downloading a disaster recovery guide, or reaching out to a mental health helpline, happen in private moments of vulnerability. Success shows up months and years later in community health data.

Through public evaluations surveys, WNC Health Network found the campaign produced real results. Among survey participants who saw the campaign ads:

• 53% said they sought more information about COVID-19.
• 30% said they led to vaccination or vaccine consideration.
• 25% said the ads affected their COVID-19-related prevention behaviors.

Over years in the field, two vital lessons have shaped how we operate.

1. Streamlined regional infrastructure powers faster, more effective outreach.

Early on, we spent hundreds of hours managing separate, fragmented campaigns for individual county departments. When a crisis hits, that level of administrative friction slows down life-saving information. After Hurricane Helene in 2024, we shifted strategy: we built a unified regional framework that allowed local health departments to opt in seamlessly. Streamlining the backend operations cut production times from days to hours, freeing up critical resources so we could focus on what actually moves people: carefully crafted messaging that’s deeply inclusive and culturally resonant.

2. Inclusivity must be centered from day one.

In a region as diverse as western North Carolina, messaging only works if it’s non-partisan, and universally readable. Inclusivity is a necessity, not an afterthought. Every resident, across every age, race, religion, and cultural group, needs to see themselves reflected in the messaging without feeling targeted or politically alienated.

For our View From Here mental health initiative, we built our creative on 114 hours of direct community listening conducted with Spanish-speaking families, mothers living on a low income, rural men, and LGBTQIA+ residents. Every ad is framed neutrally, written at an accessible reading level, and designed so that no community is left out of the conversation.

Turning Complicated Science Into Something People Act On

Public health guidance is often written by scientists for scientists. Our job is to translate complex research into clear, digestible copy written for a parent trying to make the best decision for their family on a busy weekday evening.

Take measles guidance, for example. The clinical CDC documentation reads: “Measles can infect 9 out of 10 unvaccinated individuals who are exposed in a shared airspace.” That statement is scientifically accurate, but it doesn’t give a parent scrolling social media in Sylva actionable safety tips.

When we produced the campaign creative, we put Jennifer Gregory, a local communicable disease nurse at the Jackson County Department of Public Health, directly on camera. She delivered the message in plain terms: “Measles is so contagious that if an infected person enters a room, the virus stays in the air for up to two hours after they leave.” We paired her message with a single, unambiguous instruction: Check your family’s immunization records, and call your local health department if you aren’t sure.

We follow three unyielding rules for every campaign:

• Translate the science directly alongside local health communicators during weekly working sessions.
• Always cut the message down to one single action. An ad that asks for two things weakens community impact.
• Verify clinical accuracy with epidemiologists and medical reviewers before a single asset goes to design.

Earning Trust in Rural Counties Takes Longer Than a Campaign

Public health in small mountain communities runs on hyper-local messengers. The voices that hold weight in Asheville aren’t always the ones people listen to in neighboring Swain, Graham, or Mitchell counties.

Our coverage area spans 18 counties, plus the Qualla Boundary and the Eastern Band of Cherokee Indians. In small communities like Swain County (population 14,000), traditional geo-fencing hits frequency ceilings in days. We build smart, regional audience radii that cluster neighboring mountain counties together, expanding addressable audiences while respecting cultural ties.

When we cast our campaigns, we skip agency spokespeople. The people on screen in our measles and mental health work are local school nurses, EMS responders, county health directors, and trusted clinicians.

That local authenticity drives extraordinary engagement. In our community surveys across WNC:

• 30% of English-speaking respondents reported changing health behavior based on our campaigns.
• 74% of Spanish-speaking respondents reported changing health behavior after seeing our culturally adapted creative.

When Disaster Strikes: The Campaigns That Tested Us

Hurricane Helene and the New Definition of Rapid Response

When Hurricane Helene devastated western North Carolina in September 2024, digital marketing as we knew it vanished overnight. Cell towers were down, roads were washed away, and communities were cut off from power for weeks.

In those first 72 hours, emergency response was more of an infrastructure test than a digital strategy. Fortunately, we had spent four years building our Rapid Response program, an operational framework designed to bypass red tape and push critical advisories live in hours.

Before our formal recovery contracts were even signed, our team launched targeted pushes for emergency DSNAP food assistance. When our regional effort, WNC Ready, officially launched across 22 counties, backed by The Duke Endowment and the Community Foundation of WNC, we stood up four emergency streams: FEMA appeals, mental health support, recovery resources, and vital public health advisories on water safety, debris burning, and mold remediation.

The numbers reflect a region looking for answers:

• 1.9+ million video views
• 1.2 million unique impressions (roughly 36% of the region’s entire population)
• 26,744 clicks driving people straight to emergency aid
• 484 organic shares on FEMA guidance alone

Helene proved that rapid response isn’t about creative agility in the moment. Instead, it’s an operational system you build months before the storm hits.

The Crucial Work Between the Crises

Crisis response makes headlines, but continuous prevention work is what keeps health concerns from turning into emergency room visits.

• Mental Health (View From Here): Funded by The Duke Endowment for WNC Health Network, this region-wide, ongoing campaign provides clinically vetted psychoeducation wrapped in deeply empathetic, non-judgmental language across 19 counties and the EBCI.
• Nutrition (Good Food, Real Life): A Swain County Health Department initiative built with The Uncomplicated Kitchen. We produced inventive, down-to-earth, short cooking videos showing how to feed a family of four for under $10. The permanent asset library helped Swain County secure accreditation and future grant funding.
• Substance Use Disorder: Partnering with the CARE Coalition in Transylvania County, we produce targeted social campaigns designed to dismantle the stigma that prevents people from seeking addiction treatment.

Containing Measles Before the Spark Took Hold

When Polk County confirmed its first measles case on New Year’s Eve, it could have been the spark that lit our entire region on fire. Measles was tearing across the country, hospitalizing hundreds of kids and changing families forever. On paper, a single positive case at the end of the year had all the makings of a major crisis.   

It didn’t turn into an outbreak because WNC’s public health network spent months building an emergency safety net long before the virus reached our doorstep. County health departments, EMS crews, hospitals, and local communicators ran joint tabletop scenarios, locked in containment protocols, and aligned regional messaging so everyone knew how to protect schools and vulnerable neighbors. When that first case hit, teams didn’t scramble; they executed a plan that was already built.   

Our role was turning that behind-the-scenes readiness into Health on the Horizon, a regional campaign anchored by local leaders. Instead of spreading top-down panic, we told the story of a region standing together to protect its own.   

That local trust drove massive engagement across 22 counties:   

• Over 390,000 combined impressions across regional target zones.   
• 15% to 15.5% engagement rates by impressions, blowing past standard Meta healthcare benchmarks of 0.5% to 2%.   
• A 35% engagement rate by reach in primary markets, proving people pay attention when health messaging leads with local preparedness and authentic trust.   

Decoding How Communities Consume Media

National marketing playbooks fall short when agencies treat every market the same. Whether we’re launching campaigns in the Pacific Northwest, the Midwest, Florida, or the Appalachian mountains, Big Sea team members are distributed across the country, and we start with the same core practice: analyzing local media habits to uncover how specific communities actually process critical information.

During our Helene disaster recovery work in western NC, that deep audience research revealed a pattern most digital agencies miss. Our video, Getting Back to Life After Disaster, generated over 31,000 views and 500+ watch hours with a 78% completion rate. But 84% of those views happened on connected television sets. 

In communities navigating severe connectivity outages, families gathered around the few connected screens available, watching long-form health guidance together in their living rooms, rather than scrolling individually on their smartphones. Grounding our media architecture in real-world habits instead of standard digital templates, we achieved an $0.18 cost per click and a 2.62% click-through rate, nearly triple the national healthcare benchmark.

To truly meet a community where it lives, we also have to know when digital isn’t enough. In areas with spotty broadband or under-resourced neighborhoods, every digital campaign we build includes print-ready assets designed for local health clinics, community boards, and regional relief networks.

We bring remote agency talent from coast to coast together with hyper-local insight, giving public health departments anywhere in the country the exact strategy needed to reach their neighbors.

Strategy, Creative, and Measurable Impact

We handle brand strategy, campaign creative, bilingual production, media buying, and analytics. But we build our systems so local health departments stay in full control:

• We write so everyone can read. Clinical phrasing like “Maternal burnout presents as emotional exhaustion” is translated into copy that resonates with everyday people.
• We measure action, not just impressions or clicks. Following our WNC Ready campaign, post-exposure surveys revealed that 77% of viewers found the info helpful, 61% learned something new, and 50% took a direct, post-exposure action. 
• We leave local trust where it belongs. Communities don’t want to hear from distant agency spokespeople or generic ad talent; they listen to neighbors and local authorities they already know. Our process is built around embedding authentic, on-the-ground voices who navigate the exact same challenges as the people watching the screen. When a local nurse, EMS responder, or community leader shares a health message, it transforms an ad into a neighbor-to-neighbor conversation.

As Brandon Romstadt, Director of Health Communications at WNC Health Network, notes:

“Having an agency team that understands both the clinical nuances of public health and the geographic reality of our counties allows us to move from crisis response to long-term strategy without losing momentum.”

Tested in the Field (and the Mountains), Built for Public Health Everywhere

Our core philosophy is simple: Public health messaging only works when it treats target audiences like neighbors, not numbers.

Our experience in managing high-stakes campaigns through pandemics, natural disasters, and health advisories in western North Carolina gave our agency immeasurable, real-world insight into what it actually takes to earn trust in complex communities. But our capability doesn’t stop at a single geographic border.

We combine those battle-tested public health lessons with our nationwide team’s expertise across commercial healthcare, higher education, and mission-driven sectors to build relationship-first campaign models that scale anywhere.

We embed ourselves in the distinct culture, media consumption habits, and trusted networks of every region we serve. Western North Carolina is where we refined our public health communications methodology; today, we bring that flexible, nationally recognized framework to health departments and public health coalitions across the country.

Let’s Talk About Your Next Public Health Campaign

Whether you direct communications for a county health department, a regional health network, or a national public health nonprofit, our team brings six years of proven, award-winning experience to your mission. Get in touch to start building momentum in your region.