Title: Emergency Risk Communication Principles and Applied Practices
1Emergency Risk Communication Principles and
Applied Practices
- Melinda Frost, MA, MPH
- Health Communications Officer
- US Embassy, Beijing
2Presentation Outline
- Emergency and Risk Communication Definitions
- Emergency Risk Communication Principles
- Emergency Risk Communication in China
- Developing an Emergency Risk Communication Plan
3Definitions
- Risk Communication communication about potential
(uncertain) health risks to support informed
decisions -
- Emergency a health threat in which urgent
response is required
4Why? Emergency Risk Communication
- To provide accurate and timely information as
well as essential coordination during an emergency
5Why? Emergency Risk Communication
- To inform the public of potential risks and steps
being taken during an emergency
6 Why? Emergency Risk Communication
- To aid individuals, stakeholders, or communities
to accept the imperfect nature of choices and to
make best possible decisions during an emergency
7Emergency Communication Challenges
- Uncertainty
- High potential for altered or conflicting
recommendations - People are looking at multiple channels to check
on rumors
8THE CERTAINTIES OF COMMUNICATING UNCERTAINTY
- You will be tempted to suppress your uncertainty
and sound confident its human nature - Things will turn out better if you resist that
temptation
9THE CERTAINTIES OF COMMUNICATING UNCERTAINTY
- Over-confidence rings false, undermining everyone
elses confidence even if you turn out right - Over-confidence provokes acrimony, especially
among your critics - Over-confidence devastates your credibility and
your ability to lead if you turn out wrong -
10- Emergency Risk Communication Principles
11WHO Outbreak Communication (Emergency Risk)
Principles
- Trust
-
- Announce early
-
- Transparency
- Listen to and involve the public
- Planning
12 Accuracy of Information
Speed of Release
Successful Communication
Empathy Openness
13Components of Trust
- The public perception of
- Motives
- Are responders acting to protect my health and
the health of my family? -
- Honesty
- Are the responders holding back information?
- Competence
- Are the responders capable of controlling the
outbreak? -
- Trust must come before the crisis
14Announce Early
- First Announcement
- The most critical of all outbreak communication
messages - Must be early
- Likely to be wrong
-
15Transparency
- Barriers to Transparency
- Real or perceived competing interest (economic
vs. public health) -
- Spokespersons uncomfortable with delivering bad
news
16Transparency
- Barriers to Transparency
- Fear the media will misrepresent bad or uncertain
news - Concern the public cant tolerate uncertainty or
will panic - Official belief that if you say nothing, nothing
will happen
17Listen to and involve the public
- State continued concern before stating updates
- Acknowledge uncertainty
-
- Emphasize a process in place
- Tell people what to expect
- Give people things to do
- Let people choose their own actions
-
- Ask more of people
18Listen to and involve the public
- Dont try to allay panic
- Acknowledge peoples fears
-
- In every message, try to use
- Empathy
- Action
- Respect
19Influenza A H1N1 Communication Response Announce
Early, Transparency Trust
- First cases laboratory confirmed 4/15 - 17
- 4/22 Activation of Emergency Operations Center
(http//www.cdc.gov/h1n1flu/) - 4/23 Daily press briefings (http//www.cdc.gov/h1n
1flu/press/)
20Risk Communication Principles Project Background
- Public Health Emergency Risk Communication Draft
Guidelines and Handbook
21Risk Communication Principles Project Background
March 09 Preliminary Handbook Table Top
Sept 10 Final Handbook Table Top
October 06
November 07 Draft Guidelines
Dalian Workshop
Nov 06-Jan 07
2007-08 Training of Draft Guidelines
Review of Risk Communication Principles
2009-10 Re-draft of Risk Communication Handbook
22Risk Communication Principles
Pilot Training and Testing
January 07 March 08
Fujian Province Guizhou Province Jiangsu Province
23China MoH US CDC Emergency Risk Communication
Activities, 2006 2008
- Pilot Training and Testing
- Provinces
- Fujian
- Guizhou
- Jiangsu
- Training completed in 2007
- Anhui
- Chongqing
- Guanxi
- Hubei
- Liaoning
- Shanghai
- Yunnan
- Training scheduled for 2010-11
- Beijing
- Hebei
- Heilongjiang,
- Zhejiang,
- Sichuan
24Testing and Training of Effective Risk
Communication Principles
- In Fujian Province (Jan 2007), Guizhou and
Jiangsu (Mar 2008) activities in to test -
- Was training on the risk communication principles
effective? -
- Are risk communication principles effective for
Chinese public?
25Risk Communication Principles Project Protocol
- Step 1 Health officials wrote public health
messages based on a hypothetical case study
involving a 3-stage H5N1 scenario. - Step 2 Trained on Risk Communication Principles
and Practice - Step 3 Message revision based on principles and
training - Step 4 Message testing with citizen groups
26The risk communication training was effective
- Post-training messages
- More risk communication principles
- More types of principles to address psychological
functions of risk communication - Decrease feelings of uncertainty and fear
- Increase feelings of control
- Increased trust in health authority
- Address publics cognitive needs
27Guizhou health care workers wrote messages that
included this many Risk Communication principles
28Jiangsu health care workers wrote messages that
included this many Risk Communication principles
29Combined provincial health care workers wrote
messages including this many Risk Communication
principles
30Risk Communication Principles Message Testing
Results
184 Citizens
31Risk Communication Principles Message Testing
Results
32What the Public Wants to Know
- Feedback from Fujian Province Audiences
- How can I prevent getting the disease?
- How is the disease transmitted?
- Is what Im hearing about the disease true?
- What is the disease? And how serious?
- What is the government doing to prevent the
spread of disease? - Where can we go for more information?
- Is there a vaccine available?
- Topics from US Audiences
- What is the health threat?
- How does it harm people?
- How will I know if Ive been exposed?
- Signs and symptoms (long/short term)
- How can I protect myself/my family
- How is it treated?
- Where can I get more information?
-
33Where are People Going for Information?
- Television news
- CCTV
- Newspapers
- Website
- Health bureau, News Website, Sina.com,
Xinhua.com, MSNBC.com, Baidu search engine - Local health bureau
- Community residents committee
- Telephone line for public inquiries (hotline)
- Local health department, national hotline
- CDC
- Local hospital
- Emergency Center
- Neighbors
34Channels Used by The Public to Seek Emergency
Information
- Distant threat passive channels
- TV news, newspaper
- Threat is close by, but not in our community
more active information seeking, but impersonal
channels - Internet, Website, Search engines
- Threat is here pro-active search through
interpersonal channels - Hotlines
- Visit local health bureau
- Call hospital
- Visit or call local community residents center
and committee - Call CDC
35Emergency Risk Communication Lifecycle
Pre-crisis
Initial
Maintenance
Resolution
Evaluation
- To facilitate and anticipate the needs of the
public, the media, and partners at different
stages - Each stage has unique communications and
information requirements
36Pre-Crisis Communication
- Be prepared
- Foster alliances
- Develop recommendations through consensus
- Test audience messages
Pre-crisis
37Planning
- Communicators
- Technical staff
- Policy makers
Communicators
Tech staff
Policy makers
38Nine Steps of Communication Response
4
3
5
2
6
1
7
8
9
39Public Information Release
- Select the appropriate channels of communication
and apply them - Simply
- Timely
- Accurately
- Repeatedly
- Credibly
- Consistently
40Trust Case Study
- Measles, Mumps Rubella Vaccine (MMR)
- United Kingdom, 2008
Raithatha N, Holland R, Gerrard S, Harvey I, A
qualitative investigation of vaccine risk
perception amongst parents who immunize their
children a matter of public health concern. J.
of Public Health Medicine. 25 (2) 2003
41MMR Vaccination in the UK What happened?
- In 1998, a researcher suggested that the MMR
vaccine may cause autism - In 2001, the same researcher developed another
paper questioning the safety of MMR
42MMR Vaccination in the UK What happened?
- The media reported the paper out of proportion
- Subsequent papers and studies have disproved the
link between MMR and autism
43Context in the United Kingdom in early 2000s
- Parents understood true benefits of vaccination
but still felt dread at thoughts of long-term
disability - Lack of trust in recent government
- reaction to BSE crisis
- Slight lack of trust in motives, and knowledge
base of doctors
44MMR Vaccination in the UKThe Results
- MMR Vaccination rates dropped from 91 to 80
between 1998 and 2004 - 1,049 cases of measles between Jan Oct, 2008
(the worst year since 1995) - 55,000 cases of mumps between 2004-06
-
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47Audience Perceptions and Rumors
- A rumor is a specific (or topical) proposition
for belief, passed along from person to person,
without secure standards or evidence being
present.
48Rumor sources
- Blogosphere
- SMS text messaging
- Internet
- Word of mouth
- Where else?
49Audience Perceptions Sources of Insight
- Monitoring for rumors (listening to your
audience) - Social media websites,
- blogospheres
- Hotlines (12320, hospitals, etc.)
- Print/broadcast media
50Audience Perceptions Sources of Insight
- Listening to your audience
- Focus groups
- Intercept interviews
- What else?
51Rumor found to react or ignore?
- The two factors that influence a rumor are its
importance to the listener and its ambiguity. - Rumors travel when events have importance in the
lives of individuals, and when the news received
about them is either lacking or subjectivity
ambiguous. The ambiguity may arise from the fact
that the news is not clearly reported, or from
the fact the conflicting versions of the news
have reached the individual, or from his
incapacity to comprehend the news he receives.
52How do we address misinformation?Risk
Communication Principles
- Rumors fly in the absence of news. Therefore, we
must give the people the most accurate possible
news, promptly and completely. - Announce early
- Be transparent
- Listen to the public
- Show empathy
53How do we address a rumor?Messaging
- Simply denying a rumor does not eliminate
ambiguity it may even increase it. - No comment increases
- ambiguity.
-
- Silence REALLY increases ambiguity.
-
54Thank you!Questions?