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Crisis and Emergency Risk Communication

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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 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

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