Risk Communication for Public Health

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Information about Risk Communication for Public Health
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Published on June 15, 2007

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Essentials of Risk Communication for Public Health Practice Linda Neuhauser, DrPHClinical Professor, UC Berkeley School of Public HealthRochelle, Ereman, MS, MPHEpidemiology Program Chief, Marin County Department of Health UC Berkeley Center for Infectious Disease PreparednessApril 5, 2005:  Essentials of Risk Communication for Public Health Practice Linda Neuhauser, DrPH Clinical Professor, UC Berkeley School of Public Health Rochelle, Ereman, MS, MPH Epidemiology Program Chief, Marin County Department of Health UC Berkeley Center for Infectious Disease Preparedness April 5, 2005 Session Objectives:  Session Objectives Review risk communication principles Discuss improve risk communication Review Marin County experience Origins of Risk Communication:  Origins of Risk Communication Developed over past 30 years Part of risk management process Based on psychological models of risk perception and communication Moving from 'expert' to 'participatory' approaches: 'power sharing' Subject of much debate Slide4:  Definition of Risk: 'The probability of loss of that which we value.' -Vincent Covello Slide5:  'A Science-based Approach for Communicating Effectively in: High-Concern, High Stress Emotionally Charged, or Controversial Situations' (Vincent Covello) Risk Communication Risk Communication “An interactive process of exchange of information and opinion among individuals, groups, and institutions; often involves multiple messages about the nature of risk or expressing concerns, opinions, or reactions to risk messages or to legal and institutional arrangements for risk management. ” (US DHHS “Communicating in a Crisis,” 2002):  Risk Communication 'An interactive process of exchange of information and opinion among individuals, groups, and institutions; often involves multiple messages about the nature of risk or expressing concerns, opinions, or reactions to risk messages or to legal and institutional arrangements for risk management. ' (US DHHS 'Communicating in a Crisis,' 2002) Slide7:  Risk communication is one of the most important and least appreciated components of public health preparedness Slide8:  Tsunami Photo #1 Slide9:  Tsunami Photo #2 Slide10:  The purpose of terrorism is to communicate extreme risk Slide11:  Your examples of risk communication situations? Types of Public Health Crises:  Types of Public Health Crises Catastrophic natural environmental disasters (e.g., hurricane, floods, earthquake) Infectious disease outbreaks (SARS, pandemic influenza, unknown) WMD (bombings, chemical, nuclear) Bioterrorism (smallpox, anthrax) 'Epidemics' of chronic disease (obesity, cancer) Increasing Disaster Risk:  Increasing Disaster Risk Increasing population density Increased settlement in high-risks areas Increased technological hazards and dependency Increased terrorism: biological, chemical, nuclear? Aging U.S. population Emerging infectious diseases (AMR) International travel (global village) (Barbara Reynolds, CDC) Psychology Before a Crisis:  Psychology Before a Crisis A disaster will not happen . . . A disaster will not happen to me . . . A disaster will not be that bad . . . If it happens and it is that bad, there is nothing I can do about it (Barbara Reynolds, CDC) Psychology in a Crisis:  Psychology in a Crisis Vicarious rehearsal Denial Stigmatization Fear and avoidance Withdrawal and feelings of hopelessness Heightened anxiety, public confusion and stress (Barbara Reynolds, CDC) Slide16:  How People Perceive Risk Slide17:  Slide18:  When people are stressed or upset, they have difficulty : hearing information understanding information remembering information (Vincent Covello) Mental Noise Theory Slide19:  When people are stressed or upset, they often distrust that others are: listening, caring, empathy honest, open competent, expert (Vincent Covello) Trust Determination Theory Slide20:  'There Is No Flu Vaccine Crisis!' (CNN - Oct 18, 2004) -- The shortage of flu vaccine in the United States is 'not a health crisis,' a spokesman for Health and Human Services Secretary Tommy Thompson said, urging people to be patient as the government works to reallocate the nation's limited number of vaccines. 'I would like to tell individuals just be calm and don't stand in line, because we have approximately 24 million doses of vaccine that have not been shipped yet.' Slide21:  Every year in the United States, on average: * 5% to 20% of the population gets the flu; * More than 200,000 people are hospitalized from flu complications; and * Approximately 36,000 people die from flu. . Bad Communication Adds to Crisis:  Bad Communication Adds to Crisis Mixed messages from multiple 'experts' Late information 'overcome by events' Over-reassuring messages No reality check on recommendations Myths, rumors, doomsayers not countered Improper modeling of behavior, lack of affect, bad humor by spokesperson/leader Public power struggles and confusion (Barbara Reynolds, CDC) Good communication can…:  Good communication can… Reduce public’s exposure to risk Mobilize coordinated responses among health andamp; safety workers Improve public’s response to crises Competency Areas:  Competency Areas Pre-event, Event and Post-event Communication Planning Psychology and use of Risk Communication Principles in a Crisis Working with the Media in a Crisis Spokesperson Trust and Credibility in an Emergency Crisis Communication Plans and the 9 Steps of Response Media and Public Health law Messages and Audiences Needs in a Crisis Bioterrorism and Emergency Risk Communication Meeting Partner and Stakeholders Needs Roles and Responsibilities in the Official Response Human Resource Management for Communicators in a Crisis 7 Steps to Improve Risk/Crisis Communication:  7 Steps to Improve Risk/Crisis Communication Planning Risk Communication:  Planning Risk Communication 1. Assess health department expertise andamp; resources 2. Identify a risk communication/media advisor 3. Define risk communication goals andamp; action steps 4. Train spokespeople and staff 5. Identify key audiences and form partnerships 6. Develop and test messages/communication 7. Continuously evaluate and improve Crisis/Risk Communication course for state/local/federal:  Crisis/Risk Communication course for state/local/federal Interactive CD-Rom 'certification' course Comprehensive emergency risk communication tool Plan, prepare and train in advance Provide tools during an emergency to guide the public information response according to the type of emergency CDC Training:  CDC Training Pre-event, Event and Post-event Communication Planning Psychology and use of Risk Communication Principles in a Crisis Working with the Media in a Crisis Spokesperson Trust and Credibility in an Emergency Crisis Communication Plans and the 9 Steps of Response Media and Public Health law Messages and Audiences Needs in a Crisis Bioterrorism and Emergency Risk Communication Meeting Partner and Stakeholders Needs Roles and Responsibilities in the Official Response Human Resource Management for Communicators in a Crisis Identify Key Audiences & Partners:  Identify Key Audiences andamp; Partners Audience characteristics: Age Race/ethnicity Languages Educational level andamp; literacy Geographic differences Disabilities Experience with past crises Slide30:  COMMUNITY PARTNERS Health and safety officials Media (Print, TV, radio, Internet, etc.) Political representatives Health care organizations (hospitals, clinics, health plans, etc.) Professional health organizations Preparedness organizations (Red Cross, etc.) Advocacy/neighborhood organizations Schools andamp; other educational institutions Slide31:  In High Concern Situations, People Want to Know That You Care Before They Care What You Know (Vincent Covello) Assessed in first 9- 30 seconds Listening/Caring/ Empathy 50% 1993 National Adult Literacy Survey:  1993 National Adult Literacy Survey Module 1 Slide33:  What are the three most important things you would like your audience to know? What are the three most important things your audience would like to know? What are the three most important things your audience is most likely to get wrong unless they are emphasized? (Vincent Covello) Message Mapping Slide34:  Key Word Message Map 1 Message Map Stakeholder: Question/Concern Key Message/Fact 1. Key Message/Fact 2. Key Message/Fact 3. Keywords: Supporting Fact 1.1 Keywords: Supporting Fact 1.3 Keywords: Supporting Fact 1.2 Keywords: Supporting Fact 2.1 Keywords: Supporting Fact 2.2 Keywords: Supporting Fact 2.3 Keywords: Supporting Fact 3.1 Keywords: Supporting Fact 3.2 Keywords: Supporting Fact 3.3 Slide35:  Sound bite research: Assumption: national news, controversial topic 7 to 9 seconds (21-27 words, 30 words max.) 3 messages 9 second knowledge/trust window (Vincent Covello) Risk Communication Risk Communication Resources:  Risk Communication Resources CDC Crisis and Emergency Risk Communication Courses: www.cdc.gov/communication Academic Centers of Public Health Preparedness: www.phppo.cdc.gov Association of State and Territorial Health Officials: www.astho.org National Association of County and City Health Officials: www.naccho.org Why Risk Communication in an Epidemiology Program?:  Why Risk Communication in an Epidemiology Program? High-concern, emotionally charged – media-prone arena Media reports undermining progress Disjointed community No Information from us? 'Stories' defined by media/others Needed to reduce fear provoking reports and start making breast cancer risk reduction recommendations Process:  Process Admit Need and Importance! Started with One 'Hot Topic' Identified Risk Communication Coordinator Risk Communication Experts Local Risk Communication Task Force – key stakeholders in breast cancer arena + Needs Assessment – key stakeholders objectives Material Development – as we learned, we applied knowledge – eg. 'What we know about BC in Marin' Practice, Practice, Practice Challenges:  Challenges Cross Training Staff Turnover Time and Resources Diligence Importance throughout Division, Department Next Steps:  Next Steps 'Beyond Breast Cancer' Communication Plan – proactive approach Component Development and Distribution Communication Plan for Health Reports What To Do When the Media Calls Pull content group together – don’t talk first Decide Three Talking Points Create Fact Sheet for Media Training

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