Building Communication Capacity to Counter Infectious Disease Threats Proceedings of a Workshop (2017) / Chapter Skim
Currently Skimming:
3 Laying the Foundation for Effective Communication
3 Laying the Foundation for Effective Communication
Pages 11-42
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 11... ...
3 Laying the Foundation for Effective Communication "R isk communication is a bridging domain of research and prac tice, where the biomedical and the social and behavioral sci ences come together," said Douglas Storey, associate director at the Center for Communication Programs at the Johns Hopkins Bloomberg School of Public Health, when introducing the next section of the workshop, which discussed some of the foundational research on effective communication and decision science and examined the current state of science on understanding of risk and health-protective behaviors from both the United States and international contexts. The seven speakers who provided their insights were Baruch Fischhoff, the Howard Heinz University Professor at Carnegie Mellon University; Angie Fagerlin, inaugural chair of the Department of Population Health Sciences at the University of Utah and a research scientist at the Salt Lake City Veterans Affairs Center for Informatics Decision Enhancement and Surveillance; Gary Kreps, university distinguished professor and director of the Center for Health Risk Communication at George Mason University; Noel Brewer, professor of health behavior at the University of North Carolina at Chapel Hill; Rajiv Rimal, professor and chair of the Department of Prevention and Community Health at the George Washington University Milken Institute School of Public Health; Monique Turner, associate professor and assistant dean at the George Washington University Milken Institute School of Public Health; and Jeff Niederdeppe, associate professor of communication at Cornell University.
|
From page 12... ...
The public also needs to know which sources of information to trust and when news is real or fake, Fischhoff added. The public health community has its own information needs, such as the beliefs and concerns of the populations they serve, what resources they have, whom they prefer to get their information from and what their trusted information channels are, and what their experiences have been in past situations.
|
From page 13... ...
. Each chapter in this FDA report summarizes the science of a particular topic, such as health literacy, shared decision making, and practitioner perspectives; offers best guesses about the practical implications of the science; and shows how to evaluate communications for little or no money or for a larger amount of money commensurate with the personal, organizational, and political stakes riding on effective communication.
|
From page 14... ...
Fortunately, said Fischhoff, infectious disease threats have a particular set of characteristics that a modifiable and reusable structure can address without having to start from scratch for each new threat. FDA has developed a strategic plan for risk communication (FDA Risk Communication Advisory Committee, 2009)
|
From page 15... ...
Capacity building that views communications as a two-way process and includes trust-building activities can enable organizations to get out in front and stay ahead of problems, Fischhoff added. LEARNING FROM THE DECISION SCIENCES TO DESIGN TARGETED MESSAGES One story Fagerlin shared that McKenna did not mention in her list of inappropriate actions triggered by the West African Ebola crisis was that of a bridal shop in Akron, Ohio.
|
From page 16... ...
"A two-word difference affected people's willingness and interest to get vaccinated," she said. This study also found that talking about the typical symptoms of influenza had a bigger impact than discussing the most severe symptoms on people's risk perceptions and their willingness to vaccinate.
|
From page 17... ...
"As long as different approaches are equivalent in terms of knowledge, risk perception, and behavioral intentions, I think it is important that we ask people what they like and do not like so that we can communicate farther and wider," said Fagerlin. Persuasion can be a critical risk communication tactic for influencing behavior, but persuasion using social norms can be tricky, said Fagerlin.
|
From page 18... ...
He stressed that with infectious diseases, for which the situation can change quickly and there are many risks and issues involved, it is particularly important to communicate in ways that are most meaningful to the populations that need information and that provide them with information they can use. Strategic, evidence-based risk communication is a critical component of a strategy to achieve that goal, said Kreps, and he encouraged the workshop participants to develop the kind of strategic communication activities described in his presentation.
|
From page 19... ...
With regard to infectious diseases, which are always going to be around, he urged that evaluation should become a standard operating procedure that includes generating baseline data on what people knew and what they were doing before a program launches. Without such data, it is difficult to know if a program has met its goals.
|
From page 20... ...
Summative evaluation assesses patterns of program use and overall user satisfaction with the program. It evaluates message exposure and retention and tracks changes in key outcome variables, such as learning, health behaviors, service use, and health status.
|
From page 21... ...
He noted that social media posts have been a critical source of information in public health crises. Fischhoff added there is a misconception that data collection is always expensive and time consuming, when there are ways of collecting data quickly and with virtually no expense.
|
From page 22... ...
The general model for changing risky behavior is to communicate risk in a way that alters risk beliefs to trigger risk-reducing behavior, Brewer explained. One way to communicate risk, and the approach federal law requires FDA to take with new drugs, for example, is to just say it.
|
From page 23... ...
. This multistep process includes Environmental Hazards Risk analysis Probability theory Risk Assessment Dissemination Communication theory Risk Communication Comprehension; persuasion Health literacy Risk Perception Action Behavioral theory Behavior Change FIGURE 3-3 How risk can be translated into behavior change.
|
From page 24... ...
Rimal and his colleagues have been focusing on the last step of the model he presented, the translation of risk perception into behavior change. There are many ways to measure perceived risk, he explained; one way is to consider the dichotomy between susceptibility -- how much risk there is to become infected -- and severity, or how horrible it would be to become infected.
|
From page 25... ...
He classifies individuals who perceive both their risk and efficacy to be low as indifferent and those who have a high risk perception and low levels of efficacy as avoidant. Individuals who have a low risk perception but higher levels of efficacy are proactive, and those with a strong perception of risk and a strong belief in their ability to do something about that risk are considered responsive.
|
From page 26... ...
"Feeling efficacious, that is a wonderful basket in which to put all your eggs." SOURCES OF INFORMATION: LESSONS FROM COMMUNICATION IN LIBERIA At the time of the recent West African Ebola outbreak, Liberia was unprepared to deal with a massive public health crisis. The country had few medical resources, no isolation units, little in the way of protective garb, and few health workers who had the proper training to use what resources were available.
|
From page 27... ...
Turner noted a number of rumors were circulating that the Liberian government had brought Ebola to the country on purpose. Stories that were run on popular radio stations largely blamed the United States and nongovernmental organizations (NGOs)
|
From page 28... ...
28 COMMUNICATION CAPACITY TO COUNTER INFECTIOUS DISEASE TABLE 3-1 Sources of Risk Communication on the Ebola Outbreak in Liberia During the 2014 West African Ebola Crisis Ellen Liberian African Johnson Sources Cited Government Union Sirleaf ECOWAS Newspaper Mentioned/Cited 447 15 171 26 Expertise mentioned 232 6 74 12 Trustworthiness mentioned 12 1 5 0 Lack of trustworthiness 39 0 8 0 mentioned Radio Mentioned/Cited 2 0 12 0 Expertise mentioned 2 0 12 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned Radio program Mentioned/Cited 2 4 2 0 Expertise mentioned 2 4 2 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned SMS Mentioned/Cited 0 0 0 0 Expertise mentioned 0 0 0 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned Chalkboard Mentioned/Cited 0 0 4 0 Expertise mentioned 0 0 0 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned
|
From page 29... ...
LAYING THE FOUNDATION FOR EFFECTIVE COMMUNICATION 29 U.S. Centers for Health Care Education Disease Workers Officer WHO Control Doctor(s)
|
From page 30... ...
30 COMMUNICATION CAPACITY TO COUNTER INFECTIOUS DISEASE TABLE 3-1 Continued Ebola Family of Community U.S. Sources Cited Patient Patient Member Government Newspaper Mentioned/Cited 125 53 262 99 Expertise mentioned 22 2 103 46 Trustworthiness mentioned 1 0 6 4 Lack of trustworthiness 3 0 4 2 mentioned Radio Mentioned/Cited 6 4 26 0 Expertise mentioned 0 0 4 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned Radio program Mentioned/Cited 3 1 21 0 Expertise mentioned 1 0 3 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned SMS Mentioned/Cited 0 0 24 0 Expertise mentioned 0 0 0 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned Chalkboard Mentioned/Cited 0 0 15 0 Expertise mentioned 0 0 0 0 Trustworthiness mentioned 0 0 0 0 Lack of trustworthiness 0 0 0 0 mentioned NOTE: ECOWAS = Economic Community of West African States; SMS = Short Message Service; U.S.
|
From page 31... ...
LAYING THE FOUNDATION FOR EFFECTIVE COMMUNICATION 31 U.S. Liberian Ministry AFRICOM/ Liberian of Information, U.S.
|
From page 32... ...
TABLE 3-3 Multiple Sources Receiving Credit for Resolving the Ebola Crisis According to Different Media Sources Radio Source Newspaper Radio Program Chalkboard Cuban Government 0.1% 0.0% 0.0% 5.9% Other Foreign Government 7.8% 0.0% 0.0% 5.9% Liberian Government 21.5% 0.0% 0.0% 17.6% Ellen Johnson Sirleaf 5.3% 0.0% 0.0% 11.8% United States 8.1% 0.0% 0.0% 5.9% Health Care Workers 11.5% 0.0% 0.0% 0.0% Victims Themselves 3.5% 0.0% 0.0% 0.0% Ebola Itself 0.2% 0.0% 0.0% 0.0% WHO 7.0% 0.0% 0.0% 0.0% NGO 19.6% 0.0% 0.0% 0.0% Religion 3.7% 0.0% 0.0% 0.0% Witchcraft/Voodoo/Karma 0.0% 0.0% 0.0% 0.0% Family of Sick 0.1% 0.0% 0.0% 0.0% God 0.4% 100.0% 100.0% 0.0% No One 11.1% 0.0% 0.0% 52.9% Other 0.0% 0.0% 0.0% 0.0% NOTE: NGO = nongovernmental organization; WHO = World Health Organization. SOURCE: Turner presentation, December 13, 2016.
|
From page 33... ...
To address the first question, he argued that health risk campaigns work when they focus on behaviors and their context, not necessarily the risks per se. As an example, he said the reason society cares about smoking is that it kills people, but harping on the health risks of smoking may not be the most effective way to prevent people from smoking or get them to quit smoking.
|
From page 34... ...
. "The point is, you do not necessarily have to start with the premise that health risk beliefs are going to be the most effective communication strategy," said Niederdeppe.
|
From page 35... ...
. Another major factor for success is having resources such as sufficiently staffed quit lines available to help people stop smoking.
|
From page 36... ...
. Niederdeppe noted that the tobacco control community debates whether to emphasize how to quit or why to quit in its messages.
|
From page 37... ...
. As a final thought, Niederdeppe talked about health risk communication as it relates to infectious disease threats and policy change.
|
From page 38... ...
There was an initial fear with online cancer support groups that some members would provide bad information, but what has been happening is that these groups are self-policing and are providing the latest, most accurate information. "I have a feeling that within social media communities, there will be more watch dogs who will spring up and out people who are providing bad information," said Kreps.
|
From page 39... ...
" After that first question, he continued, we then ask how quickly people need better information, how quickly that better information can come, and how information can be conveyed in a nuanced way to people who are willing to listen. Fagerlin agreed with Siegel that the risk communication field needs to better understand the implications of putting out an incorrect message, but she noted that information will never be perfect in the middle of an outbreak.
|
From page 40... ...
She noted that she and her colleagues are preparing to look at how different communities react to different communication strategies for addressing outbreaks involving four infectious diseases -- Middle East respiratory syndrome, Ebola, Zika, and influenza -- to see if the exact same messaging tactics work in those four domains. Rima Khabbaz, deputy director for infectious diseases and director of the Office of Infectious Diseases at CDC, commented that communication about an endemic health risk, such as smoking, is likely to be different than the communication taking place at a time of crisis, which may warrant
|
From page 41... ...
Brewer responded that the effectiveness of risk communication depends on the intended goal and context. Rimal explained further that it is important to keep in mind that behaviors are heterogeneous, so the approaches -- whether they are risk communication campaigns, policies, or other interventions -- implemented for behavior change vary, depending on the type of behavior, the context in which the behavior is being enacted, and the underlying characteristics that define that behavior.
|
From page 42... ...
Rimal's point was that it is important to remember to look at behavior change from the perspective of the target audience, which is often different from a disease prevention perspective. Niederdeppe added that one inexpensive way of gaining that perspective is to pay attention to the kinds of conversations that are happening around a particular issue, such as tanning beds.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.