Presentation is loading. Please wait.

Presentation is loading. Please wait.

TMI Public Health & Environmental Information The Three Mile Island Health and Environmental Information Series Prepared.

Similar presentations


Presentation on theme: "TMI Public Health & Environmental Information The Three Mile Island Health and Environmental Information Series Prepared."— Presentation transcript:

1 TMI Public Health & Environmental Information The Three Mile Island Health and Environmental Information Series Prepared and presented by Sandra Prince-Embury, Ph.D. At Penn State Capital Campus 1985

2 TMI Public Health & Environmental Information What was the TMI Public Health and Environmental Information Series? The TMI Public Health and Environmental Information Series was a series of educational sessions designed to provide information to community members in language that they could understand delivered by experts that were considered credible. The TMI Public Health and Environmental Information Series was a series of educational sessions designed to provide information to community members in language that they could understand delivered by experts that were considered credible. The Series consisted of twelve two hour sessions offered free of charge to the public at Penn State Capital Campus from February to March of The Series consisted of twelve two hour sessions offered free of charge to the public at Penn State Capital Campus from February to March of 1985.

3 TMI Public Health & Environmental Information The Three Mile Island Public Health and Environmental Series arose out of The Three Mile Island Public Health and Environmental Series arose out of proposals developed between 1983 and 1985 by Sandra Prince-Embury in proposals developed between 1983 and 1985 by Sandra Prince-Embury in conjunction with the TMI Health Issues Committee of TMI-PIRC, a conjunction with the TMI Health Issues Committee of TMI-PIRC, a community organization. Members of the committee included Beverly Hess, community organization. Members of the committee included Beverly Hess, Jane Lee, Mary Osborne, Patti Longenecker, Kay Pickering, & Judith Wisz. Jane Lee, Mary Osborne, Patti Longenecker, Kay Pickering, & Judith Wisz. Petitions for funding were submitted to Judge Rambo as mediated by the Berger Petitions for funding were submitted to Judge Rambo as mediated by the Berger law firm representing the TMI Public Health Fund. Funding was provided by law firm representing the TMI Public Health Fund. Funding was provided by the Three Mile Island Public Health Fund and sponsored by Penn State the Three Mile Island Public Health Fund and sponsored by Penn State Capital Campus beginning in spring of 1985 and extending for 12 weeks. Capital Campus beginning in spring of 1985 and extending for 12 weeks.

4 TMI Public Health & Environmental Information Psychosocial Circumstances The aftermath of the TMI accident was characterized by conflicting information and conditions of uncertainty regarding what had actually occurred during and after the Three Mile Island that had occurred March 28, 1979 and what risk these occurrences presented for the community. The aftermath of the TMI accident was characterized by conflicting information and conditions of uncertainty regarding what had actually occurred during and after the Three Mile Island that had occurred March 28, 1979 and what risk these occurrences presented for the community. Also at this time, community members demonstrated a loss of faith in experts which cast doubt on the credibility of information that had been provided. Also at this time, community members demonstrated a loss of faith in experts which cast doubt on the credibility of information that had been provided. At that time also the community was still fraught by intense polarization between those who supported restart of the nuclear facility and those who opposed it. At that time also the community was still fraught by intense polarization between those who supported restart of the nuclear facility and those who opposed it.

5 TMI Public Health & Environmental Information Why is the TMI Health & Environmental Information Series of Interest? The Series presented information of scientific complexity to community members; The Series presented information of scientific complexity to community members; The Series presented information for which there remained several unanswered questions pertaining to potential hazard; The Series presented information for which there remained several unanswered questions pertaining to potential hazard; The Series presented to a population that was highly polarized on issues pertaining to the TMI accident; The Series presented to a population that was highly polarized on issues pertaining to the TMI accident; it was presented at a time when the community faced imminent restart of the plant which many viewed as increasing potential hazard in the community. it was presented at a time when the community faced imminent restart of the plant which many viewed as increasing potential hazard in the community.

6 TMI Public Health & Environmental Information Access to Information about Possible Negative Circumstances

7 TMI Public Health & Environmental Information Ongoing need for Information The remaining need for TMI related information was substantiated in survey research of a stratified representative sample of Middletown residents by Prince- Embury & Rooney, then faculty of the Community Psychology Program at Penn State Capital Campus. The remaining need for TMI related information was substantiated in survey research of a stratified representative sample of Middletown residents by Prince- Embury & Rooney, then faculty of the Community Psychology Program at Penn State Capital Campus. Prince-Embury, S., & Rooney, J. F. (1987). Interest in information as a function of worry and perceived control in the aftermath of nuclear disaster. International Quarterly of Community Health Education, 8(1), 33–50. Prince-Embury, S., & Rooney, J. F. (1987). Interest in information as a function of worry and perceived control in the aftermath of nuclear disaster. International Quarterly of Community Health Education, 8(1), 33–50.

8 TMI Public Health & Environmental Information In their earlier survey of Middletown, Prince-Embury & Rooney (1983) had found that 30% to 60% of a stratified random sample of Middletown residents expressed interest in information on radiation epidemiology and cancer five years after the accident. These authors also found that interest in information was significantly correlated with worry about these topics among area residents. Ongoing need for information

9 TMI Public Health & Environmental Information Ongoing need for information Assumptions prevalent at the time of the course Assumptions prevalent at the time of the course were that stressed individuals do not desire information about adverse circumstances particularly if this information does not increase predictability. Miller (1984) addressing this issue found that delivery of information which matches the information seeking style of the individual minimized anxiety while that which does not match increases it. were that stressed individuals do not desire information about adverse circumstances particularly if this information does not increase predictability. Miller (1984) addressing this issue found that delivery of information which matches the information seeking style of the individual minimized anxiety while that which does not match increases it.

10 TMI Public Health & Environmental Information Ongoing need for information The TMI series was based on the assumption that part of the healing process in the aftermath of technological disaster was the availability of accurate, reliable and understandable information in a way that allows individuals to pace information intake consistent with their ability to integrate information into a meaningful context. The TMI series was based on the assumption that part of the healing process in the aftermath of technological disaster was the availability of accurate, reliable and understandable information in a way that allows individuals to pace information intake consistent with their ability to integrate information into a meaningful context.

11 TMI Public Health & Environmental Information Access to Information Access to information related to possible adverse circumstances is sought by impacted community members and can be delivered in a format and manner that increases the experience of understanding of the lay public. Access to information related to possible adverse circumstances is sought by impacted community members and can be delivered in a format and manner that increases the experience of understanding of the lay public.

12 TMI Public Health & Environmental Information Loss of Faith in Experts Lack of perceived credibility of information was associated with a significant loss of faith in experts and demoralization (Prince-Embury & Rooney, 1987; Dohrenwend, et al. 1979). Loss of faith in experts can occur for a variety of reasons such as withholding accurate information or for breach of promise such as failure of technology that has been presented as safe. Lack of perceived credibility of information was associated with a significant loss of faith in experts and demoralization (Prince-Embury & Rooney, 1987; Dohrenwend, et al. 1979). Loss of faith in experts can occur for a variety of reasons such as withholding accurate information or for breach of promise such as failure of technology that has been presented as safe.

13 TMI Public Health & Environmental Information Loss of Faith in Experts Survey research by Prince-Embury & Rooney indicated that members of the Three Mile Island vicinity has lost faith in those whom they once considered experts. Survey research by Prince-Embury & Rooney indicated that members of the Three Mile Island vicinity has lost faith in those whom they once considered experts. Prince-Embury, S., & Rooney, R. (1987). Perception of control Prince-Embury, S., & Rooney, R. (1987). Perception of control and faith in experts among residents in the vicinity of and faith in experts among residents in the vicinity of Three Mile Island. Journal of Applied Social Psychology, Three Mile Island. Journal of Applied Social Psychology, 17, 11, , 11,

14 TMI Public Health & Environmental Information History of Conflicting Information During the Accident Reports of incidents during and following the TMI accident suggest that the situation had lent itself to cognitive contradiction in that area residents were given contradictory messages during and after the accident; local radio stations had reported safe conditions, cable stations at a distance were reporting warnings; officials were offering reassuring messages to be followed by emergency evacuation instructions (Walsh, 1988; Lindy & Lindy, 1985). At the time, lack of consistent and accurate information was interpreted as intentional omission or falsification of information for vested interest of the information conveyers and not in the best interest of the public.

15 TMI Public Health & Environmental Information Attention to loss of faith in experts and sensitivity to inconsistency Design of the TMI Series assumed that an intervention delivered in a stressed population should be sensitive to and address sources of lowered credibility of experts such as vested interest of the expert and perceived and unexplained discrepancies between expert opinions. Design of the TMI Series assumed that an intervention delivered in a stressed population should be sensitive to and address sources of lowered credibility of experts such as vested interest of the expert and perceived and unexplained discrepancies between expert opinions.

16 TMI Public Health & Environmental Information Selection of Credible Expert Speakers Speakers were selected in collaboration with community members and the TMI Public Health Fund. Many had been identified by a panel of scientist commissioned by the Three Mile Island Public Health Fund, as politically neutral on potentially controversial issues relevant to their areas of expertise. Many of the speakers were already known to the community as experts who did not have a vested interest in the nuclear industry. Speakers were selected in collaboration with community members and the TMI Public Health Fund. Many had been identified by a panel of scientist commissioned by the Three Mile Island Public Health Fund, as politically neutral on potentially controversial issues relevant to their areas of expertise. Many of the speakers were already known to the community as experts who did not have a vested interest in the nuclear industry.

17 TMI Public Health & Environmental Information Selection of Credible Expert Speakers The choice of scientist experts included national experts in their areas of expertise, who were knowledgeable about areas of uncertainty and disagreement in their field and could discuss this openly. The choice of scientist experts included national experts in their areas of expertise, who were knowledgeable about areas of uncertainty and disagreement in their field and could discuss this openly. It had been identified that some conflicting information in the scientific community was due to actual uncertainty and objective differences of scientific opinion. It had been identified that some conflicting information in the scientific community was due to actual uncertainty and objective differences of scientific opinion.

18 TMI Public Health & Environmental Information Selection of Credible Expert Speakers Potential expert speakers were asked if they would be comfortable addressing lay community members in language that was understandable to the community and to address questions from community members.

19 TMI Public Health & Environmental Information Emotional Reactivity in a Traumatized Community

20 TMI Public Health & Environmental Information Attention to Emotional Reactivity in Stressed Populations Baum, Gatchel & Schaefer (1983) identified chronic, low-level elevated stress in the TMI community using repeated physiological measures. Baum, Gatchel & Schaefer (1983) identified chronic, low-level elevated stress in the TMI community using repeated physiological measures. Davidson and Baum (1990) identified members of a sample of TMI residents as manifesting symptoms of post-traumatic stress. Davidson and Baum (1990) identified members of a sample of TMI residents as manifesting symptoms of post-traumatic stress.

21 TMI Public Health & Environmental Information Hyper-vigilance; heightened Emotional Reactivity Researchers have noted that one aspect of post- traumatic stress state is hyper-vigilance or the ability to continue to respond to stimuli with emotional intensity appropriate only to emergency situations (Krystal, 1978; Kardiner, 1941; VanderKolk, 1987). McCurdy (1943) identified events that are "near-miss" catastrophes, such as the TMI accident, as critical determinants of hypervigilance. Researchers have noted that one aspect of post- traumatic stress state is hyper-vigilance or the ability to continue to respond to stimuli with emotional intensity appropriate only to emergency situations (Krystal, 1978; Kardiner, 1941; VanderKolk, 1987). McCurdy (1943) identified events that are "near-miss" catastrophes, such as the TMI accident, as critical determinants of hypervigilance.

22 TMI Public Health & Environmental Information Hyper-vigilance and lack of adequate Information Among the factors most frequently implicated as antecedents of hyper-vigilant reactions are lack of perceived control over dangerous events and lack of preparatory information about what is to be expected (Janis, 1971; Epstein, 1973; Monat, Averill & Lazarus, 1972). Among the factors most frequently implicated as antecedents of hyper-vigilant reactions are lack of perceived control over dangerous events and lack of preparatory information about what is to be expected (Janis, 1971; Epstein, 1973; Monat, Averill & Lazarus, 1972).

23 TMI Public Health & Environmental Information Hyper-vigilance and restricted ability to process information Hyper-vigilance has been described as impairing Hyper-vigilance has been described as impairing cognitive functioning by constricting cognition with premature closure, restricting range of attention, narrowing range of perceived alternatives, reduction in immediate memory, and fostering of simplistic ideas, (George, 1974; Hamilton, 1975; Janis, 1971; Janis & Leventhal, 1968; Janis & Mann, 1977). cognitive functioning by constricting cognition with premature closure, restricting range of attention, narrowing range of perceived alternatives, reduction in immediate memory, and fostering of simplistic ideas, (George, 1974; Hamilton, 1975; Janis, 1971; Janis & Leventhal, 1968; Janis & Mann, 1977).

24 TMI Public Health & Environmental Information Structure for managing emotional reactivity to lessen the possibility of increased stress as an obstacle to understanding

25 TMI Public Health & Environmental Information Addressing Emotional Reactivity The TMI Series was based on the assumption that communication of information in an environment of intense polarization on different sides of the nuclear power debate (Walsh, 1988) must in some way address the possibility of intense emotionality among course participants. The TMI Series was based on the assumption that communication of information in an environment of intense polarization on different sides of the nuclear power debate (Walsh, 1988) must in some way address the possibility of intense emotionality among course participants.

26 TMI Public Health & Environmental Information Addressing Emotional Reactivity Ground rules were developed by this author to maximize the likelihood of information flow and comprehension by minimizing or controlling emotional reactivity. Ground rules were developed by this author to maximize the likelihood of information flow and comprehension by minimizing or controlling emotional reactivity. The specific ground rules were read to participants at the beginning of each session and were presented in the form of a mutually agreed upon verbal contract for participation in the sessions. The specific ground rules were read to participants at the beginning of each session and were presented in the form of a mutually agreed upon verbal contract for participation in the sessions.

27 TMI Public Health & Environmental Information Addressing Emotional Reactivity Break times between the first and second half of each session and following each session allowed informal debriefing to occur. Break times between the first and second half of each session and following each session allowed informal debriefing to occur. The opportunity to express questions and comments to the speaker in a formal way during the second half of each session served also as a tension release and an opportunity for attendees to ask questions to clarify points of uncertainty or perceived inconsistency. The opportunity to express questions and comments to the speaker in a formal way during the second half of each session served also as a tension release and an opportunity for attendees to ask questions to clarify points of uncertainty or perceived inconsistency. The coordinator of the series, a psychologist, and two psychology graduate students were available to individuals who wanted to express concerns individually. The coordinator of the series, a psychologist, and two psychology graduate students were available to individuals who wanted to express concerns individually.

28 TMI Public Health & Environmental Information Addressing Emotional Reactivity with Specific Ground rules for Participation Specific Ground Rules: Ground rules addressing tolerance of disagreement respecting the opinions of others, managing ones own emotions and anticipating uncertainty were stated at the beginning of each session. Specific Ground Rules: Ground rules addressing tolerance of disagreement respecting the opinions of others, managing ones own emotions and anticipating uncertainty were stated at the beginning of each session.

29 TMI Public Health & Environmental Information Ground Rule A It was stated that the mission of the course was conveyance of information not agreement among participants; that participants held varied opinions and perspectives and that each person was asked to respect the right of all others to hold a different opinion. Furthermore, course participants were asked to treat each other and speakers with respect. It was stated that the mission of the course was conveyance of information not agreement among participants; that participants held varied opinions and perspectives and that each person was asked to respect the right of all others to hold a different opinion. Furthermore, course participants were asked to treat each other and speakers with respect.

30 TMI Public Health & Environmental Information Ground Rule A cont. The specific request that participants acknowledge and accept diversity in opinion was intended to prepare participants with a more realistic expectation for the series so that emotional reactivity would not be aroused by discrepancies between expectation and reality. The specific request that participants acknowledge and accept diversity in opinion was intended to prepare participants with a more realistic expectation for the series so that emotional reactivity would not be aroused by discrepancies between expectation and reality.

31 TMI Public Health & Environmental Information Ground Rule B. It was acknowledged that some of the topics to be presented might be stressful for some participants. It was asked that each participant be responsible for controlling their own emotional reaction so that it not prevent them from hearing the information presented, or lead them to treat anyone else with disrespect. It was acknowledged that some of the topics to be presented might be stressful for some participants. It was asked that each participant be responsible for controlling their own emotional reaction so that it not prevent them from hearing the information presented, or lead them to treat anyone else with disrespect.

32 TMI Public Health & Environmental Information Ground rule B cont. This ground rule was intended to clarify that This ground rule was intended to clarify that information presented was not designed to assuage emotion and might be stressful. information presented was not designed to assuage emotion and might be stressful. This ground rule also addressed expectations by predicting elevated stress. This ground rule also addressed expectations by predicting elevated stress. It was believed that anticipation of stress would allow participants to prepare for this with the suggestion of possible control of emotions as a positive act. It was believed that anticipation of stress would allow participants to prepare for this with the suggestion of possible control of emotions as a positive act.

33 TMI Public Health & Environmental Information Ground Rule C It was stated that the purpose of the series was to give information that was understandable but that everyone's questions would not necessarily be answered either because the answer was not available or perhaps because the answer was not yet known. It was stated that the purpose of the series was to give information that was understandable but that everyone's questions would not necessarily be answered either because the answer was not available or perhaps because the answer was not yet known.

34 TMI Public Health & Environmental Information Ground Rule C cont. Ground rule C was based on the assumption that unwarranted expectation of certainty would lead to disappointment and distrust whereas an expectation of incomplete knowledge would prepare participants more realistically for what they would receive. Ground rule C was based on the assumption that unwarranted expectation of certainty would lead to disappointment and distrust whereas an expectation of incomplete knowledge would prepare participants more realistically for what they would receive.

35 TMI Public Health & Environmental Information TMI Health and Environmental Series Content The series was divided into three segments to address three areas of interest expressed by area residents. Each segment was divided into several individual sessions addressing different aspects of the topic. Basic explanations of relevant concepts and general issues were presented earlier in sequence. Topics and questions relevant to TMI specifically were presented in the middle or towards the end of each segment. The series was divided into three segments to address three areas of interest expressed by area residents. Each segment was divided into several individual sessions addressing different aspects of the topic. Basic explanations of relevant concepts and general issues were presented earlier in sequence. Topics and questions relevant to TMI specifically were presented in the middle or towards the end of each segment.

36 TMI Public Health & Environmental Information TMI Health & Environmental Information Series: Content Session 1: Series Overview "Introduction to Health effects and radiation epidemiology.“ Speakers: Dr. K. C. Morgan, Dr. Sandra Prince-Embury Session 2: "Radiation in the environment, basic concepts, definitions and findings." Speakers: Arthur Sokolow, Director of the Pennsylvania Bureau of Topographical and Geological Survey; Dr. Paul Todd, Professor of Biophysics at Penn State.

37 TMI Public Health & Environmental Information TMI Series Content (cont.) Session 3: "Three Mile Island Accident Dose Assessment:” Dr. Jan Beyea, Senior Staff Scientist of the National Audubon Society. Session 4: "Radiation monitoring, basic concepts, methods and understanding results." Dr. Ruth Patrick of the Academy of Natural Sciences. Session 5: "Overview of Health Effects of Radiation.“ Dr. Daniel Hoffman, Senior Epidemiologist of the National Cancer Institute.

38 TMI Public Health & Environmental Information TMI Series Content cont. Session 6: "Cancer, basic concepts and relationship to immunological functioning." Dr. John W. Kreider, Professor of Pathology and Microbiology At Penn State College of Medicine. Session 7: "Radiation related cancer and treatment." Dr. Robert L. Comis, Chairman of Medical oncology at the Fox Chase Cancer Center. Session 8: "Stress and immunological functioning the Three Mile Island area." Dr. Andrew Baum, Health Psychologist, Uniformed Services, University of Health Sciences.

39 TMI Public Health & Environmental Information TMI Series Content cont. Session 9: "Local facilities for cancer early detection and treatment." Dr. Andrea Manni, Division of Endocrinology, Penn State College of Medicine, Christine Wilson, Fox Chase Session 10: "Overview of basic concepts of epidemiology and application in the community.” Dr. Vilma R. Hunt, Professor of Environmental Health at Penn State. Session 11: "Health Findings in the Three Mile Island Area and ongoing studies." Dr. John Cobb, Dr. Maureen Hatch of the Department of Epidemiology at Columbia University.

40 TMI Public Health & Environmental Information TMI Series Content cont. Session 12: "Community/Expert Collaboration in the Assessment of Health Effects." Health Effects." Dr. Marvin S. Legator, Professor of Environmental Dr. Marvin S. Legator, Professor of Environmental Toxicology at University of Texas. Toxicology at University of Texas.

41 TMI Public Health & Environmental Information Series Attendance Total attendance of the series was 278, this represented repeated attendance by some of a group of 117 distinct individuals who attended the series one or more times. Average attendance of the twelve sessions in the TMI series was slightly over 47 persons per session. Attendance ranged from a high of 80 persons at session three which addressed dose assessments of radiation released at the time of the TMI accident, to a low of 12 persons at session ten addressing basic concepts of epidemiology and application in the community.

42 TMI Public Health & Environmental Information Series Attendees Seventy-one percent of participants had lived in the Middletown area at the time of the accident, 36% had evacuated at that time, 35% had not; 51% were male, 49% were females; 62% were parents, 38% were not; 49.8% reported some college or more. The average age of course participants was 41 years.

43 TMI Public Health & Environmental Information Series Attendees Professions Course attendees represented a variety of professional and educational backgrounds including homemakers (12%), teachers (12%), nurses (4%), engineers and environmental scientist (10%), pipefitters and laborers (5%), lobbyist (1%), activists (10%); retired individuals (8), employees of the U.S. Environmental Protection Agency, the U.S. Nuclear Regulatory Commission, and the Pennsylvania State Health Department (5%), mental health professionals (4%), students (6%), clerical/sales (10%), and (15%) occupation unaccounted for. Course attendees represented a variety of professional and educational backgrounds including homemakers (12%), teachers (12%), nurses (4%), engineers and environmental scientist (10%), pipefitters and laborers (5%), lobbyist (1%), activists (10%); retired individuals (8), employees of the U.S. Environmental Protection Agency, the U.S. Nuclear Regulatory Commission, and the Pennsylvania State Health Department (5%), mental health professionals (4%), students (6%), clerical/sales (10%), and (15%) occupation unaccounted for.

44 TMI Public Health & Environmental Information Series attendees compared to Middletown representative sample Course participants was a group were not representative of the general population in the area. They were younger, better educated, reported less worry about TMI issues and reported slightly less faith in experts than a normative sample of TMI area residents. (See Prince-Embury, 1991 for a discussion of these differences). Prince-Embury, S. (1991). Information seekers in the aftermath of technological disaster. Journal of Applied Social Psychology, 21, 7,

45 TMI Public Health & Environmental Information Attendee Response Open-ended questionnaires were distributed to participants to allow them to record their responses. In addition, self- reported assessment of information attributes as perceived by participants was conducted in each session (Prince- Embury, 1992). Participation was voluntary. Therefore findings are offered as suggestive rather than conclusive. Prince-Embury, S. (1992). Information attributes as related to psychological symptoms and perceived control among information seekers in the aftermath of technological disaster. Journal of Applied Social Psychology, 22, 14,

46 TMI Public Health & Environmental Information Self-Reported Information Attributes Understandability Assessment of information attributes revealed that participant mean self-reported understandability was (.98) on a scale of zero to one. However, it is important to note that increased understandability reported by course participants was not synonymous with answered questions and increased certainty. Seventy-five percent of respondents to open-ended surveys reported that they still had unanswered questions about radiation. Also self-reported degree that questions had been answered in each session was (.76) on a scale of zero to one.

47 TMI Public Health & Environmental Information Credibility/Reliability of information Presented Subjective experience of reliability of information received the second highest rating (.82) on a scale of zero to one. Regarding credibility of information, comments made by some community participants reflected an increased appreciation for "the other side" for experts who were investigating unanswered questions. (Notable in an extremely polarized community).

48 TMI Public Health & Environmental Information Impact of TMI Information Series on Stress Findings suggest that the average level of stress did not increase across the duration of the Series, across all participants of all sessions or considering only repeat attendees. Also, self-reported understanding was slightly related to a lower level of psychological symptoms (Prince-Embury, 1992), suggesting that the experience of greater understanding is related to lower levels of psychological stress.


Download ppt "TMI Public Health & Environmental Information The Three Mile Island Health and Environmental Information Series Prepared."

Similar presentations


Ads by Google