Communicating During A Public Health Crisis

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MASSACHUSETTS REGIONAL PANDEMIC INFLUENZA
PLANNING CONFERENCE May 2006
THE IMPORTANCE OF RISK COMMUNICATION IN
PREPAREDNESS PLANNING Susan L. Santos, Ph.D.,
M.S. FOCUS GROUP Risk Strategic
Communications Medford, MA
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WHAT IS RISK COMMUNICATION?

• an interactive process of exchange of
  information and opinions among individuals,
  groups, and institutions.
• It involves multiple messages about the nature of
  risk and other messages that express concerns,
  opinions or reactions to risk messages or to
  legal and institutional arrangements for risk
  management.
• National Research Council, 1989

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CRISIS RISK COMMUNICATION

• is the effort by experts to provide
  information to allow an individual, stakeholder,
  or an entire community to make the best possible
  decisions about their well-being during the
  crisis.
• Centers for Disease Control

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WHY IS RISK COMMUNICATION IMPORTANT?

• In the absence of information - misinformation
  becomes news
• Perception Reality
• Research shows information is an antidote to
  panic not its cause
• The early release of information avoids loss of
  trust
• Risk Communication is a critical part of good
  planning

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PRINCIPLES OF EFFECTIVE RISK COMMUNICATION

• Effective communication requires planning
• Know why you are communicating
• Identify and understand your audiences
• Recognize that trust and credibility are key
• Develop messages that address audience concerns -
  and your own needs
• Select channels that target your audience
• Evaluate your efforts

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STAGES OF A CRISIS
Pre-crisis
Initial
Maintenance
Resolution
Evaluation

• Improve appropriate public response in future
  similar emergencies through education
• Honestly examine problems and mishaps, and then
  reinforce what worked in the recovery and
  response efforts
• Persuade the public to support public policy and
  resource allocation to the problem
• Promote the activities and capabilities of the
  agency

• Acknowledge the event with empathy
• Explain and inform the public, in simplest forms,
  about the risk
• Establish agency/ spokesperson credibility
• Provide emergency courses of action (including
  how/where to get more information)
• Commit to stakeholders and public to continued
  communication

• Help public understand its own risks
• Provide background and encompassing information
• Gain support for response/recovery plans
• Listen to stakeholder and audience feedback, and
  correct misinformation
• Explain emergency recommendations
• Empower risk/benefit decision-making

• Evaluate communication plan performance
• Document lessons learned
• Determine specific actions to improve crisis
  systems or the crisis plan

• Be prepared
• Foster alliances
• Develop consensus recommenda-tions
• Test messages

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WHO ARE YOUR AUDIENCES?

• Other agencies and health care providers
• Employees and their families
• Faculty, administrators, staff, students
• School aged children and parents
• Local businesses
• So-called Special Populations
• Your customers/suppliers, etc.
• Those who work in critical services

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IDENTIFY AUDIENCE CONCERNS

• What are their information needs?
• Who do they trust as information sources?
• What unique concerns will they have?
• Research shows that the information most wanted
  is on what steps individuals can take

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WHAT DO PEOPLE NEED/WANT TO KNOW

• How will business/essential services continue
  given high absenteeism
• How to deal with a disruption in normal
  services
• How to address health and healthcare concerns
• Coping with fear and anxiety

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UNDERSTAND RISK PERCEPTION

• Less Risky More Risky
• Voluntary Involuntary
• Individual Control Controlled by Others
• Familiar Unfamiliar
• Low Dread High Dread
• Affects Everybody Affects Children
• Naturally Occurring Human Origin
• Little Media Attention High Media Attention
• Understood Not Understood
• High Trust Low Trust
• Consequences Limited/Known Catastrophic
  Consequences
• Benefits Understood Benefits Unclear
• Alternatives Available No Alternatives

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WHAT MAKES A SOURCE CREDIBLE
Assessed in First 30-60 Seconds
Empathy and/or Caring
Competence and Expertise
Commitment and Dedication
Honesty and Openness
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BEHAVIOR IN AN EMERGENCY

• Vicarious rehearsal
• Denial
• Stigmatization
• Fear and avoidance
• Need to anticipate the worried well

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PLANNING FOR COMMUNICATIONWHAT WE KNOW

• Redefining Readiness Terrorism Through the Eyes
  of the Public Division of Public Health N.Y.
  Academy of Medicine, May 2004.
• Four part study included 14 focus groups
  nationwide and telephone survey of 2550 random
  selected adults

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WHAT WAS LEARNED SMALLPOX SCENARIO

• 31 are seriously concerned about catching
  smallpox
• 41 are seriously concerned about what officials
  will say or do
• 61 are seriously concerned about the smallpox
  vaccine
• 65 would try and avoid exposing themselves to
  people they didnt knowe.g. theyd ISOLATE

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WHAT WAS LEARNED DIRTY BOMB SCENARIO

• 50 of people know little or nothing at all about
  how theyd be taken care of in places theyd
  likely be
• 62 know nothing or only a little about how
  people they love would be cared for
• 60 of people would shelter in place if certain
  conditions were met
• They could communicate with loved ones
• They had confidence that loved ones were being
  cared for

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Harvard School of Public Health Avian Flu Survey,
January 2006 Telephone Survey Of 1043 Adults
Nationwide

• 57 were concerned (very or somewhat) about the
  spread of bird flu in the U.S. and 62 were
  concerned about pandemic flu
• 54 had been following the story in the news.
  Almost the same percentage thought that the
  medias portrayal of the danger was about
  right

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Have you gotten information about the avian flu
from any of the following sources?
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DEVELOPING MESSAGES
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MESSAGE IMPLICATIONS

• Give people realistic information about pandemic
  flu and the tangible steps they can take to
  prepare
• Create public buy in with planning process
  including use of isolation, sheltering in place,
  more limited access to healthcare, etc.
• Tell people what NOT to do (e.g. hoarding of
  antibiotics)
• Do education now - in a crisis it is more
  difficult!

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MESSAGE IMPLICATIONS

• Message salience and saturation around telling
  people to have a plan need to be addressed
• Personalized messages from employers, schools,
  faith based organizations will likely be more
  effective
• Messages change depending on the stage you are in
• Risk Communication will need to be ONGOING in the
  face of continuous media coverage

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SELECTING CHANNELS

• Deliver messages in a manner most
  appropriate to the audience/stakeholder
  group
• Have redundant channels/systems
• Enhance communication and information
  infrastructure
• Use trusted intermediaries

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SELECTING CHANNELS (Continued)

• Ensure communications are culturally,
  linguistically appropriate
• Develop tools to communicate (websites,
  telephone trees, pre-recorded messages, hotlines,
  etc.)
• Develop relationships with special populations

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IN SUMMARY

• Your organization can play an important role in
• Encouraging each person to have a plan
• Making sure your own organization has a plan
• The publics perception of risks from pandemic
  flu will likely be highand current knowledge is
  low
• Key messages are What actions can I take to
  protect myself and my family?
• The time to educate the public is now!
• Effective planning requires communication