1. Crisis and Emergency Risk Communication
Guatemala City, Guatemala
March 2014

2. Risk Communication vs Emergency Communication
During emergencies public health responders must effectively ensure the following types of communication
Institutional
Intra-inter-agencies/institutions, across levels
Inter-sectorial
Operational
To health care workers and respondents (e.g. alerts, guidance documents
To ensure the coordination of the response
To the public (risk communication)

3. Health crisis are unique
Extremely time pressuring
Unpredictable & unfolding
Socially and economically disruptive
Behaviour–centred & anxiety generator
Involving multiple stakeholders
Shifting from national to international
Context of risk communication - Health emergency is the "eye of the storm", and swirling around political, economic and cultural forces, which do the most damage. The primary goal of risk communication is to reduce the damage from these forces and speed the outbreak control.

4. Risk Communication Working Group, March 2009, Lyon
Communicating during crisis is a capacity requirement under the IHR
Under the IHR, risk communication includes a range of interventions through preparedness, response and recovery of a health crisis for
informed decisions
positive behaviour interventions
maintenance of trust
to minimize its public health impact.
More trustful, timely, transparent communications are required under the IHR
Countries have committed themselves to notify any event that may constitute a public health emergencies of international concern.
WHO confidential but pro-active verification with countries of unofficial reports creates incentives for greater openness.
Risk communication is an integral component of public health risk management. It is focused on dialogue with those affected and concerned, and strives to ensure communication strategies are evidence based.
Under the IHR, risk communication for public health emergencies includes the range of communication capacities required through the preparedness, response and recovery phases of a serious public health event to encourage informed decision making, positive behaviour change and the maintenance of trust.
Risk Communication Working Group, March 2009, Lyon

5. Risk assessment Risk perception Risk communication Risk management
Risk communication fills the gap between Risk assessment and Risk perception and is part of Risk management.
Risk management

6. Do we have a shared understanding of
‘risk communication’?
Risk Communication – Outbreak Communication – Crisis Communication – Emergency Communication - Information – Education - Communication – Public Awareness – Public Education – Social Mobilization – Community Mobilization – Advocacy – Information Officer – Media Officer – Communication Officer – Reporting Officer – Advocacy Officer - Development Support Communication – Pandemic Communication – Animal Health Communication – Human Health Communication – Media Relations – Donor Relations – Corporate Relations – External Relations – Public Relations - Risk Communication – Outbreak Communication – Crisis Communication – Emergency Communication - Behaviour Change Communication – Development Communication – Participatory Communication – Programme Communication – Information – Education - Communication – Public Awareness – Public Education – Social Mobilization – Community Mobilization – Advocacy – Information Officer – Media Officer – Communication Officer – Reporting Officer – Advocacy Officer - Development Support Communication – Pandemic Communication – Animal Health Communication – Human Health Communication – Media Relations – Donor Relations – Corporate Relations – External Relations – Public Relations - Risk Communication – Outbreak Communication – Behaviour Change Communication – Development Communication – Participatory Communication – Programme Communication – Information – Education - Risk Communication – Outbreak Communication – Crisis Communication – Emergency Communication - Behaviour Change Communication – Development Communication – Participatory Communication – Programme Communication – Information – Education - Communication – Public Awareness – Public Education – Social Mobilization – Community Mobilization - Risk Communication – Outbreak Communication – Crisis Communication – Emergency Communication - Behaviour Change Communication

8. IHR communication core capacity requires building up a communication plan and system during crises

9. Event management cycle
Event detection
WHO believes that it is high time to acknowledge
crisis communication
as essential to outbreak control as epidemiological training and laboratory analysis.
Risk assessment
Crisis communication
Evaluation
Control measures

10. WHO crisis communication guidance started in 2004
Expert consultation on Outbreak Communication (2004)
WHO evidence-based communication guidance (2004)
Outbreak Communication Planning Guide (2008)
Communication for behavioural impact (COMBI) (2012)
SARS 2003 and Avian Influenza 2004
COMBI - This interagency (FAO, UNICEF, WHO) toolkit will be useful for anyone wanting to design effective outbreak prevention and control measures in community settings. Although, this toolkit is primarily intended for risk communication, developmental communication and health promotion/education personnel working in multidisciplinary teams to investigate and respond to disease outbreaks, it will also be useful for epidemiologists, clinicians, and public health officers who need to understand the local contexts and dynamics of an outbreak. It is based on the premise that each outbreak is unique, and community understanding of diseases and their spread is complex, context dependent, and culturally-mediated. Therefore, a one-size-fits-all response is not sufficient.
The toolkit contains a 7-step approach, with corresponding tools, checklists and templates for designing behavioural and communication interventions that support the development of outbreak prevention and control measures that are not only technically-sound, but are also culturally appropriate, relevant and feasible for communities to act upon - to limit loss of life and minimize disruption to families, communities and societies.
The toolkit contains essential background information, case studies, and further references. It is to be used in conjunction with the “COMBI toolkit: field workbook for COMBI planning steps in outbreak response”.
Literature & field experience

11. « The overriding goal for outbreak communication is to communicate with the public in ways that build, maintain or restore Trust  »
Builds upon the outbreak guidelines. The emphasis on trust, or source credibility, has been echoed in every guideline on emergency risk communication. Although all effective communication relies to some degree on perceived credibility of message source, social science research provides some reason for us to believe that, as the emergency communication guidelines say, it may be even more important during an emergency.
WHO Outbreak Communication Guidelines

12. Trust is the public perception of
Your motives
Are the risk managers acting to safeguard my health?
Your honesty
Are the risk managers holding back information?
Your skills
Are the risk managers skilled enough to do the job?

13. Trust is the pillar of outbreak control
« …the less people trust those who are supposed to protect them, the more afraid the public will be and less likely they will be to conform their choices and behavior with outbreak management instructions ».
WHO Outbreak Communication Guidelines

14. The internal trust relationship is the “Trust Triangle”
Building trust is also an internal process
Trust is essential between
communicators and policy makers;
communicators and technical responders.
Technical responders
Communicators
Trust
Policy makers
Trust is essential between
communicators and policy makers, as trust-building measures are often counter-intuitive;
communicators and technical responders, as these may not value communication as a tool to control the outbreak.
The internal trust relationship is the “Trust Triangle”

15. Crisis Communication - Core Capacity Components
1. Transparency and early announcement of a real or potential risk
2. Public communication
coordination
PLANNING
Transparency and Early announcement - « Maintaining the public's trust throughout an outbreak requires transparency ». «The parameters of trust are established in the outbreak's first official announcement ».
Listening - « Understanding the public is critical to effective communication. (…) it is nearly impossible to design successful messages that bridge the gap between the expert and the public without knowing what the public thinks »
Planning -is a core ability that is central to the effective implementation of the four components.
3. Information dissemination including media relations
4. Listening
through dialogue

16. 1. Transparency and Early announcement of a real or potential risk
Those at real or potential risk can protect themselves;
Trust between authorities populations and partners is maintained and strengthened.
The management of information related to a health emergency, including the first announcement warning a population of a potential risk, and ongoing transparency of decision making, helps ensure that those at real or potential risk can protect themselves; and that trust between authorities, populations and partners is maintained and strengthened.

17. 2. Public communication coordination
Existing public communication resources are used;
Messages are coordinated and confusion and overlap are reduced;
Reach and influence of provided advice are strengthened.
The cross-jurisdictional nature of public health emergencies demands that public health authorities be able to effectively engage and coordinate public communication with other involved organizations including designating roles and responsibilities of lead and supporting agencies. This capacity helps takes advantage of available public communication resources; allows for coordinated messaging reducing the
possibility of confusion and overlap; and strengthens the reach and influence of the advice provided.

18. 3. Information dissemination including Media relations
Rapid and effective dissemination of information is crucial during health crisis and mass media are the pillar of it.
Not only media!
Health care workers;
Local and religious leaders;
Citizens’ representatives;
SMS
Social media;
Internet;
Toll-free telephone numbers;
Door-to-door visits
The extreme time pressure associated with emergencies, high demand for information, and the crucial role of advice and warning to minimize a threat makes the rapid and effective dissemination of information crucial during serious public health events. Mass Media relations remains a pillar of effective information dissemination, however, it is increasingly important to access other trusted information sources of the population group at risk, including new media channels, existing information sharing networks and non-traditional media.

19. 4. Listening through dialogue
Community perceptions of risks are understood;
Adaptations to messages, materials and strategies are made;
Effectiveness of communication efforts is ensured to support sound decision making.
Listening to those affected and involved, in an organized and purposeful manner, is a crucial capacity to ensuring communication efforts are effective and support sound emergency management decision making. Understanding community perceptions of risk and then acting upon that understanding by making appropriate adaptations
to communication messages, materials and strategies demands a meaningful engagement with those affected and involved.
Case study – Ebola in DRC

20. If crisis are difficult to predict, an outbreak communication strategy can be planned
People respond to what outberak controllers do, not just to what they say.
Crisis communication must be integrated in risk management form the start.
Assessment
Coordination
Transparency
Listening
Communication evaluation
Emergency communication plan
Training

21. Crisis Communication - Lifecycle
Pre-Crisis
Initial
Resolution
Explain
Inform
Establish credibility
Guide action
Commit to communication
about risks
Educate for future response
Individual action
Support for relevant policies
Promote agency activities
Maintenance
Evaluation
Prepare
Make alliances
Agree on recommendations
Test messages
Foster understanding of risks
Provide background
Foster support for plans
Listen
Empower
Evaluate plan
Lessons learned
Identify improvement

22. Communication planning allows decision making
What is the situation?
Why communicate?
To whom?
How?
When?
Who?
With what?
How is it going on?
How effective?
Evaluate the situation in context and time
Set objectives
Define target audience(s)
Outline strategy, channels and tools
Draw a timeline of action
Identify roles and partners
List human and economic resources
Monitor communication impact
Adjust the communication strategy

23. Gaps and challenges (from experience and feedback)
General devaluation of communication, not seen as a science;
Disconnect between technical and communication responders;
Low recognition of crisis communication capacity needs before a crisis starts;
Perception of crisis communication as an “add-on” not integrated in planning processes;
Limited financial and human resources dedicated to communication planning;
Unsuitability of planned procedures due to other sectors’ involvement and/or lead taken by the highest government’s level.
Crisis communication is often listed last when it comes to risk management, which is not an accurate reflection of its importance.
To be effective, crisis communication needs to be planned and initiated early in a risk assessment and to continue as an iterative process throughout all phases of the assessment.
If this does not happen, risk assessment is easily perceived as a process of expert risk assessors advising stakeholders of the result of their assessment and their proposed management strategies.
This topdown approach implies that communication is largely one-way and ignores the need for consultation throughout the whole process.
Poor crisis communication can provoke outrage among stakeholders.

24. Crisis communication is designed for health crisis
Extremely time pressuring
Unpredictable & unfolding
Socially and economically disruptive
Behaviour–centred & anxiety generator
Involving multiple stakeholders
Shifting from national to international
Information dissemination
Dealing with uncertainty
Coordination - Listening
Listening
Coordination

25. Crisis Communication Resources
WHO Outbreak Communication Guidelines (2005)
WHO Outbreak Communication Planning Guide (2008)
WHO Communication for behavioural Impact (2012)
CDC Crisis and Emergency Risk Communication Manual
PAHO Risk and Outbreak Communication =1923&lang=en

26. Crisis Communication - Lifecycle
Pre-Crisis
Initial
Resolution
Explain
Inform
Establish credibility
Guide action
Commit to communication
about risks
Educate for future response
Individual action
Support for relevant policies
Promote agency activities
Maintenance
Evaluation
Prepare
Make alliances
Agree on recommendations
Test messages
Foster understanding of risks
Provide background
Foster support for plans
Listen
Empower
Evaluate plan
Lessons learned
Identify improvement

27. What the public seeks from your communication
5 public concerns. . .
Gain wanted facts
Empower decisionmaking
Involved as a participant, not spectator
Provide watchguard over resource allocation
Recover or preserve well-being and normalcy

28. Crisis and Emergency Risk Communication impacts
5 organizational concerns -- you need to. . .
Execute response and recovery efforts
Decrease illness, injury, and deaths
Avoid misallocation of limited resources
Reduce rumors surrounding recovery
Avoid wasting resources

29. 5 communication failures that kill operational success
Mixed messages from multiple experts
Information released late
Paternalistic attitudes
Not countering rumors and myths in real-time
Public power struggles and confusion

30. 5 communication steps that boost operational success
Execute a solid communication plan
Be the first source for information
Express empathy early
Show competence and expertise
Remain honest and open

31. Psychology of a Crisis

32. What Do People Feel Inside When a Disaster Looms or Occurs?
Psychological barriers:
Denial
Fear, anxiety, confusion, dread
Hopelessness or helplessness
Seldom panic
Denial: Members of the community may experience denial for a variety of reasons. Some may
simply not receive a warning, have adequate information, or know about the recommended
actions. In other cases, the warning message may not be clear, or the person may seek further
confirmation. With some communities, this confirmation may involve additional factors, such as
the following:
A need to consult community leaders or experts for specific opinions
The desire to first know how others are responding
The possibility that the warning message of the threat is so far outside the person’s experience
that he or she simply can’t make sense of it—or just chooses to ignore it
An individual experiencing denial may not take recommended steps to protect life and safety until the
absolute last moments. In some cases, such as evacuations or vaccinations, these delayed responses may be too late.

33. Individuals at risk—the cost?
Demands for unneeded treatment
Dependence on special relationships (bribery)
MUPS—Multiple Unexplained Physical Symptoms
Self-destructive behaviors
Stigmatization
Negative Actions
Misallocation of Treatment
Needless Destruction
Accusation of Preferential Treatment
Unreasonable Travel/Trade Restrictions
Fraud
Stealing/Looting (Group Behavior)
Rumor Spreading
Doomsaying
Bribery for Scarce Resources
Self Destructive Behavior
MUPS

34. Communicating in a Crisis Is Different
Public must feel empowered – reduce fear and victimization
Mental preparation reduces anxiety
Taking action reduces anxiety
Uncertainty must be addressed

35. Decisionmaking in a Crisis Is Different
People simplify
Cling to current beliefs
We remember what we see or previously experience (first messages carry more weight)
People limit intake of new information (3-7 bits)

36. How Do We Communicate About Risk in an Emergency?
All risks are not accepted equally
Voluntary vs. involuntary
Controlled personally vs. controlled by others
Familiar vs. exotic
Natural vs. manmade
Reversible vs. permanent
Statistical vs. anecdotal
Fairly vs. unfairly distributed
Affecting adults vs. affecting children

37. Be Careful With Risk Comparisons
Are they similarly accepted based on
high/low hazard (scientific/technical measure)
high/low outrage (emotional measure)
A. High hazard
B. High outrage
C. Low hazard
D. Low outrage
Pandemic influenza—high hazard, low outrage
Bioterrorism attack with plague—high hazard, high outrage
Pertussis outbreak in elementary school—low hazard, low outrage
Hepatitis A outbreak among children who consumed USDA school lunch program frozen strawberries illegally imported to the U.S.—low hazard, high outrage.

38. Risk Acceptance Examples
Dying by falling coconut or dying by shark
Natural vs. manmade
Fairly vs. unfairly distributed
Familiar vs. exotic
Controlled by self vs. outside control of self

39. Emergency Risk Communication Principles
Don’t overreassure
Acknowledge that there is a process in place
Express wishes
Give people things to do
Ask more of people

40. Risk Communication Principles for Emergencies
When the news is good, state continued concern before stating reassuring updates
“Although we’re not out of the woods yet, we have seen a declining number of cases each day this week.”
“Although the fires could still be a threat, we have them 85% contained.”

41. Risk Communication Principles for Emergencies
Under promise and over deliver . . .
Instead of making promises about outcomes, express the uncertainty of the situation and a confident belief in the “process” to fix the problem and address public safety concerns.

42. Risk Communication Principles for Emergencies
Allow people the right to feel fear
Don’t pretend they’re not afraid, and don’t tell them they shouldn’t be.
Acknowledge the fear, and give contextual information.

43. Six Principles
Be First: If the information is yours to provide by organizational authority—do so as soon as possible. If you can’t—then explain how you are working to get it.
Be Right: Give facts in increments. Tell people what you know when you know it, tell them what you don’t know, and tell them if you will know relevant information later.
Be Credible: Tell the truth. Do not withhold to avoid embarrassment or the possible “panic” that seldom happens. Uncertainty is worse than not knowing—rumors are more damaging than hard truths.

44. Six Principles
Express Empathy: Acknowledge in words what people are feeling—it builds trust.
Promote Action: Give people things to do. It calms anxiety and helps restore order.
Show Respect: Treat people the way you want to be treated—the way you want your loved ones treated—always—even when hard decisions must be communicated.

45. Stigmatization

46. Stigmatization Can affect product, industry, animal, place, people
Four characteristics to stigmatization
Problem stigmatizer believes he can control
Must be distinguishable
Stigma associated with the party
Reaction that distances

47. Why people stigmatize
Shortcut when uncertainty and threat are both present to protect against physical and emotional harm
Occurs in a social context
Expect it early in a severe influenza pandemic unless dominant group first to become ill

48. The toll of stigmatization
Emotional pain (e.g., stress & anxiety)
Limited access to health care, education, housing, and employment
Physical violence
Affects minority groups differently
Potential for group conflict (i.e., a group-level ethnocentric worldview)

49. Role for communication
Communication must balance the real risk with needless association of an identifiable group
Take an active role in dispelling misperceptions
Correct faulty assumptions

50. Steps before, during & after
Avoid geographic links if not necessary (e.g., Spanish pandemic versus 1918 pandemic)
Avoid visuals that link group to threat--watch out for subconscious links: Avian Influenza H5N1
Teach response professionals about stigma
Share with media the concern
Scan for stigma and confront quickly
Watch out when creating historical products

51. Understanding loss and bereavement

52. Grief and mourning The circumstances of the death
Nature of the relationship to deceased
Prior loss experience
Secondary losses
Grieving is done in a cultural context

53. Severe outbreak and loss
Multiple deaths in families
Truncated bereavement rituals
Potential for kinship from shared misery
Responders could feel guilt

54. Compassion in communication
People will expect demographic details of first deaths (“How do I compare?”)
Look of official reports must be respectful (web)
Responders may be losing members too
People mourn financial loss too

55. Theories of grief & mourning
Dual process model (loss-oriented vs restoration-oriented
Integrative model—family oriented
Death of a child (“Parents expect to see their children grow and mature”)
Disenfranchised grief

56. Cultural differences Acceptance versus avoidance
U.S. dominant group culture
Little interaction with death/dying
Care ends at gravesite ceremony
No transition period from life to death
Death is failure, to be avoided

57. Dominant group expectations
Rational is more important than emotion
Move to restoration orientation quickly
Rituals not important
Understanding bereavement rituals of host culture is important—South American Wari tribe

58. Cultural differences?
Have you been to a funeral outside your own culture? What is the color of mourning?
What matters matters a lot
Acculturation attenuates differences—don’t stereotype
Religious difference are cultural differences
Bereavement ignored will cost in personal/community resilience

59. Messages and Audiences

60. The STARCC Principle Simple Timely Accurate Relevant Credible
Your public messages in a crisis must be:
Simple
Timely
Accurate
Relevant
Credible
Consistent

61. What the Public Will Ask First
Are my family and I safe?
What have you found that may affect me?
What can I do to protect myself and my family?
Who caused this?
Can you fix it?

62. What the Media Will Ask First
What happened?
Who is in charge?
Has this been contained?
Are victims being helped?
What can we expect?
What should we do?
Why did this happen?
Did you have forewarning?

63. Judging the Message Speed counts – marker for preparedness
Facts – consistency is vital
Trusted source – can’t fake these

64. Match Audiences and Concerns
Victims and their families
Politicians
First responders
Trade and industry
Community far outside disaster
Media
Concerns
Opportunity to express concern
Personal safety
Resources for response
Loss of revenue/liability
Speed of information flow
Anticipatory guidance
Family’s safety

65. Perceptions of government
Wide range from distrust to confidence
Government withholds information
Importance of local health and elected authorities
Government should operate with complete openness and disclosure

66. Emergency Information
Any information is empowering
Benefit from substantive action steps
Plain English
Illustrations and color
Source identification

67. Accuracy of Information
__________
Speed of Release
CREDIBILITY
Successful Communication = +
Empathy +
Openness
TRUST

68. Initial Message Must Be short Be relevant Give positive action steps
Be repeated

69. Initial Message Must Not Use jargon Be judgmental
Make promises that can’t be kept
Include humor

70. Writing for the Media During a Crisis
The pressure will be tremendous from all quarters.
It must be fast and accurate.
It’s like cooking a turkey when people are starving.
If information isn’t finalized, explain the process.

71. International Crises & Cultural Competence

72. Communication assumptions
Job to prevent illness or death, restore or maintain calm, engender confidence in response
Emergencies are chaotic so roles should be simplified
Confusion is reduced with fast, relevant, simple and consistent messages
Communication resources will be limited

73. What we know
The more the public knows about our efforts to openly share information, the more they trust us
Messages are judged based on trustworthiness
Some differences don’t matter, some do

74. Differences that matter
Role of culture
All individuals like no other (individual)
All individuals like some others (culture)
All individuals like all others (homo sapiens)
Collectivism and Individualism (in-group versus out-group)
Cultural beliefs held more strongly during crisis
Communication styles differ by culture

75. Let’s discuss what culture is
Countless value, languages, customs, ethics . .
Culture-general knowledge and culture-specific knowledge
Example: culture general—enter new culture look for differences in: authority, delegation, etiquette, communication styles
Example: culture specific—know the specifics of a culture as it compares to your own

76. Value of cultural competence
Reduces ethnocentric thinking and behavior (adaptability in crisis is a strength)
Trust builds more quickly
Beware of cultural “gotchas” in self and others

77. Quick exercise: How cultures differ
Crowd or audience behaviors
How often we smile or to whom
How we see old age
How open or guarded we are with information
What is or is not ethical behavior
Importance of competition
How time is understood and used
The importance of harmony in a group
What’s polite or impolite
If, how and when we touch each other
What is beautiful or ugly
What we believe we need or don’t need

78. Cultural Conflict
Cultural conflict dimensions. content and relational all have, cultural conflict adds the third one--"a clash of cultural values."
Acknowledge conflict contains a cultural dimension
Understanding your own culture and developing cultural awareness by acquiring a broad knowledge of values and beliefs of other cultures

79. Cultural communication styles
Communication occurs when sender’s message is received
Messages that do not challenge cultural beliefs will be more easily received

80. Stakeholder/ Partner Communication

81. Stakeholder/Partner Communication
Stakeholders have a special connection to you and your involvement in the emergency.
They are interested in how the incident will impact them.
Partners have a working relationship to you and collaborate in an official capacity on the emergency issue or other issues.
They are interested in fulfilling their role in the incident and staying informed.

82. Stakeholders can be . . . Advocate–maintain loyalty
Adversary–discourage negative action
Ambivalent–keep neutral or move to advocate

83. Sources of Social Pressure
What will I gain?
What will it cost me?
What do those important to me want me to do?
Can I actually carry it out?

84. Trust and Mistrust
Stakeholders judge the response to an issue or crisis based on trust
Trust is the natural consequence of promises fulfilled
Mistrust is an outgrowth of the perception that promises were broken and values violated
CDC fulfills trust by combining our best science with strong ethics and values

85. Consequences of mistrust
Health recommendations ignored and disease and death go up
Demands for misallocation of resources
Public health policies circumvented
Opportunists prey on others in the “trust gap”
Fiscal and medical resources are wasted
We can’t accomplish our mission

86. Causes of conflict: perception by either party of
Superiority
Injustice
Distrust
Vulnerability
Helplessness

87. Egregious Mistakes Deny the problem exists Shoot the messenger
Respond with silence
Respond with evasion/half truths
Selectively tell the story
Overtell the story
Take an “I” perspective
Point fingers

88. Why do people come to the town hall?
Then why do we conduct meetings the way we do?

89. Convening a Citizen’s Forum
Acknowledge concerns
Encourage fact-finding
Share power
Act trustworthy
Offer contingent commitments

90. Empower Group Decisionmaking
Identify alternatives
Analyze alternatives
Present all scientific information
Choose “want” versus “must” criteria
Reach a clear, justifiable decision

91. Don’t lecture at the Townhall
Easy but not effective
Doesn’t change thoughts/behaviors
Key: don’t give a solution, rather help audience discover solution by asking questions

92. Dealing With Angry People
Anger arises when people. . .
Have been hurt
Feel threatened by risks out of their control
Are not respected
Have their fundamental beliefs challenged
Sometimes, anger arises when . . .
Media arrive
Damages may be in play

93. High-Outrage Public Meetings
“Do’s”
The best way to deal with criticism and outrage by an audience is to acknowledge that it exists. (Don’t say, “I know how you feel.”)
Practice active listening and try to avoid interrupting.
State the problem and then the recommendation.

94. High-Outrage Public Meetings
“Don’ts”
Don’t take personal abuse. You represent your agency and you are not alone. Bring along a neutral third party who can step in and diffuse the situation.
Don’t look for one answer that fits all and don’t promise what you can’t deliver.

95. Acting Trustworthy Share information early
Acknowledge the concerns of others
Under-promise and over-deliver
Select a spokesperson who is never condescending
Use third-party validators/advocates

96. Stakeholder Preplanning
Do an assessment
Identify stakeholders
Query stakeholders
Prioritize by relationship to incident
Determine level of “touch”

97. Responding to Stakeholders
Standby statement
Reaction action plan
Web page for partners
Conference call
Meet face-to-face
Commit to a schedule of updates

98. Gaining Acceptance
Accumulate “yeses”
Don’t say “but”—say “yes, and”

99. Risk Communications Plan

100. Create and update your plan
Integrate into overall emergency response plan
Endorsed by higher-ups
Input from stakeholders
Coordinate with partners
Longer is not better
Practice, practice, practice

101. 10 Steps for Success Obtain signed endorsement from leadership
Designate responsibilities for media, public, social media, and partner teams
Verify clearance/approval procedures
Establish agreements on who releases what, when, and how
Maintain current staff, partner and media contact lists (including after-hours contacts)
Build relationships with partners and media
Establish procedures to coordinate with other response teams
Designate spokespersons for public health issues
Have agreements and procedures to join the joint information center of the emergency operations center
Develop procedures to secure needed resources (space, equipment, people)

102. Applying the Plan Verify the situation Notify others
Conduct crisis assessment
Organize assignments quickly
Prepare information and obtain approvals
Release information through prearranged channels
Obtain feedback and conduct evaluation
Conduct public education
Monitor events

103. Social Media: Crisis Role

104. Sources of Social Pressure
What will I gain?
What will it cost me?
What do those important to me want me to do?
Can I actually carry it out?

105. CDC: Why social media in a crisis
Need to be where people are
Leverage unique characteristics of emerging channels
Tailored health messages
Facilitates interactive communication and community
Empowers people in making health decisions

106. CDC Audiences Use Social Media
Those who use social media on CDC.gov:
Have higher satisfaction ratings (84 out of 100) than those who do not use CDC social media tools (79 out of 100)
Are more likely to return and recommend the site to others than those who do not use CDC social media tools
Rate CDC as more trustworthy that those who do not use CDC’s social media tools

107. Trust, transparency & participation in government
Pilot to measure TTP in government
CDC scored higher than other Fed agencies/benchmark
Largest difference for collaboration online
Participant
CDC
Total
Difference
Online participation 73 65 8
Collaboration 80 68 12
Trust 87 81 6

109. Working With the Media

110. Disasters Are Media Events
We need the media to be there.
Give important protective actions for the public.
Know how to reach their audiences and what their audiences need.

111. Response Officials Should
Understand that their job is not the media’s job
Know that they can’t dismiss media when they’re inconvenient
Accept that the media will be involved in the response, and plan accordingly

112. Response Officials Should
Attempt to provide all media equal access
Use technology to fairly distribute information
Plan to precredential media for access to EOC/JOC or JIC
Think consistent messages

113. Response Officials Should Not
Hold grudges
Discount local media
Tell the media what to do

114. How To Work With Reporters
Reporters want a front seat to the action and all information NOW.
Preparation will save relationships.
If you don’t have the facts, tell them the process.
Reality Check: 70,000 media outlets in U.S. Media cover the news 24/7.

115. Media, Too, Are Affected by Crises
Verification
Adversarial role
National dominance
Lack of scientific expertise

116. Command Post
Media will expect a command post. Official channels that work well will discourage reliance on nonofficial channels.
Be media-friendly at the command post—prepare for them to be on site.

117. Spokesperson

118. Role of a Spokesperson in an Emergency
Take your organization from an “it” to a “we”
Build trust and credibility for the organization
Remove the psychological barriers within the audience
Gain support for the public health response
Ultimately, reduce the incidence of illness, injury, and death by getting it right

119. Pitfalls for Spokespersons
Use of jargon
Humor
Repeating the negative
Expressing personal opinions
Showing off your vocabulary

120. Spokesperson
How to be an effective and trusted spokesperson in 5 minutes of less

121. Great Spokesperson Step 1
It’s more than “acting natural.” Every organization has an identity. Try to embody that identity.
Example: CDC has a history of going into harm’s way to help people. We humbly go where we are asked. We value our partners and won’t steal the show. Therefore, a spokesperson would express a desire to help, show courage, and express the value of partners. “Committed but not showy.”

122. Great Spokesperson Step 2
Know your audience
Your audience is NOT the reporter interviewing you