2. Session VII Risk and Crisis Communication

3. Session Overview What is risk communication? Risk communication theories Risk communication strategies to use Common myths and realities

4. Learning Objectives Understand what risk communication is Recognize theories of risk communication Understand basic strategies for implementing risk communication

5. What is Risk Communication? Crisis communication Issues management communication Risk communication Emergency risk communication

6. Crisis Communication Providing information about an event that occurs unexpectedly Efforts by community leaders to inform the public about a crisis and how to react Organization is experiencing the crisis and must respond

7. Issues Management Communication Similar to crisis communication Organization has advance knowledge of the impending crisis; has opportunity to choose the timing of communication about the issue and the plan to resolve it

8. Emergency Risk Communication An expert opinion provided in the hope that it benefits its receivers and advances a behavior or action that allows for rapid and efficient recovery from the event Attempt by experts to provide information to allow an individual or community to make the best possible decisions within time constraints

9. Risk Communication Providing information about the expected type and magnitude of an outcome resulting from a behavior or exposure Typically an adverse outcome and probability of that outcome occurring for an individual

10. Communication: Health vs. Risk vs. Crisis Health: prevent disease, promote good health behaviors—long time frame Risk communication: inform the public –Provide information about health affects –ID the hazard, explain the situation Crisis communication: –Has all the concerns above but higher emotional component, shorter time frame

11. Risk Communication Theories

12. Defining Risk Risk = Hazard + Outrage Outrage factors –Voluntariness –Controllability –Familiarity –Fairness –Benefits –Catastrophic potential –Understanding –Uncertainty –Delayed effects –Victim identity –Effects on children –Effects on future generations –Dread –Trust –Media attention –Accident history –Reversibility –Personal stake –Ethical/moral nature –Human vs. natural origin

13. Address Outrage Factors People weigh outrage according to their values Reducing outrage will help to reduce perceived risk

14. Trust Determination Theory When people are upset they often distrust that others care about them Higher emotion / distrust means more demand for consistently empathetic communication

15. Trust Determination Theory Credibility: –Typically high for health professionals –Based on perception as empathetic and caring –Determined within the first 9-30 seconds

16. Building Trust: Body Language Body language can override verbal communication –Use good eye contact –Keep your voice low and calm –Don’t sit back in your chair –Don’t cross your arms across your chest –Don’t frequently touch your hands to your face –Don’t drum or tap your hands or feet –Don’t rest your head in your hand

17. Mental Noise Theory When people are upset they have difficulty hearing, understanding, and remembering

18. Risk Communication Tips Don’t let the issue be defined by someone else –Listen early to avoid controversy and the potential for disproportionate attention to lesser issues. Meet the needs of the media Work with other credible sources Plan carefully and evaluate your efforts

19. Risk Communication Tips Accept and involve the public as a partner –Give people a chance to express their concerns. –Provide the public with information. Listen to the public's specific concerns –If you listen to people early and often, they are less likely to make demands. –Separate public disagreement with policies from misunderstanding of technical issues.

20. Risk Communication Tips Speak clearly and with compassion –Pay as much attention to your process for dealing with people as you do to explaining the data Be honest, frank, and open –Release and discuss information about options and involve communities in strategies in which they have a stake.

21. Risk Communication Tips Why should I have to worry about communication? This isn’t my job! –You have a responsibility to the public. Learn to integrate communication into your job and help others do the same.

22. Risk Communication Strategies

23. Reduce Mental Noise Use message mapping to create up to 3 key messages with supporting statements Keep messages brief: 10 seconds or 30 words Repeat messages Use visual aids Avoid unnecessary use of “No” words

24. Example: Message Maps Key Message 1Key Message 2Key Message 3 Smallpox spreads slowly compared to measles or the flu This allows time for us to trace contacts and vaccinate exposed people Vaccination within 3 to 4 days of contact will generally prevent the disease Question: How contagious is smallpox?

25. Message Maps Resource “Communication in Risk Situations: Responding to the Communication Challenges Posed by Bioterrorism and Emerging Infectious Diseases” http://www.astho.org/pubs/ASTHO Risk Communication e-Workbook.htm

26. Anticipate Questions Prepare and practice!

27. Anticipate Questions from the Media Who is in charge here? Is this thing being contained? What should we do? Why did this happen? Why wasn’t this prevented from happening? What else can go wrong? When did you begin working on this? Source: http://www.orau.gov/cdcynergy/erc/http://www.orau.gov/cdcynergy/erc/

28. Respond to Questions Consider how to answer general questions and specific inquiries –Be prepared –Track your key messages –Keep your answers short and focused –Practice self-management –Speak and act with integrity

29. Ask Questions of the Media Does the reporter specialize in an area? Where and when will the story appear? Will the interview be audio taped or video taped? Who else has the reporter interviewed? What is the focus of the interview? Will the reporter call back to verify the accuracy of specific quotes attributed directly to the person interviewed? http://www.state.in.us/isdh/bioterrorism/questions_%20reporters.htm

30. Message Development Audience Purpose of Message Method of Delivery Relationship to event Give facts / update Spokesperson (TV, other) DemographicsRally to actionPrint media Level of outrageClarify event statusWeb Address rumorsRadio Satisfy media requests When creating a message, consider:

31. Provide Information About... An infectious disease agent Related symptoms How the disease spreads Vaccine or treatment information Instructions to prevent and reduce transmission and exposure Release numbers of cases and their status

32. Basic Message Components 1.Expression of empathy and caring 2.Confirmed facts –Who, what, when, where, why, how 3.What you don’t know about the situation 4.Process to deal with the problem 5.Statement of commitment 6.Where people can get more information from Emergency Risk Communication Simulation

33. Example: Create a Message A virulent strain of Type A influenza has caused 1500 infections and 150 deaths in Southeast Asia In the past 3 days, people have become ill in New York and Los Angeles Today, 30 area residents were admitted to the hospital with high fever, difficulty breathing, and severe pneumonia; lab results will be available in 12-24 hours No vaccines or drugs are known to be effective Symptoms are treatable with supportive medical care Public health is operating on the assumption that this is the same flu reported in Asia and the US Public health is working closely with hospitals and medical staff to identify other cases

34. Example: Create a Message 1.Expression of empathy and caring “We’ve all been hearing news about the flu, and we’re concerned about what we might be facing in our communities.” 2.Confirming facts “Today, 30 people were admitted to hospitals with high fever, difficulty breathing, and severe pneumonia.”

35. Example: Create a Message 3.What you don’t know about the situation “We suspect it is the same influenza that has recently appeared in southeast Asia and parts of the US, but we cannot conclusively identify this disease at this time.” 4.Process to deal with the problem “However, specimens have been sent to the state laboratory and we are awaiting the results. In the meantime, we have brought together the best medical and scientific expertise to care for the sick, learn the cause of their illness, and if it is a contagious disease, work to contain it.”

36. Example: Create a Message 5.Statement of commitment “This is a process that is going to take a little time. We will update the public on any information as it comes to light.” 6.Where people can get more information “We have established a public health hotline to answer people’s questions and have important information on our Web site. The number to call is 1-800-555-1FLU, or visit www.FluInfo.gov.”

37. CDC Motto for Risk Communication “Be first. Be right. Be credible.”

38. Session VII Summary Risk communication has several unique branches: –Risk communication provides information about expected outcomes resulting from a behavior or exposure. –Crisis communication is an effort to inform the public about a crisis and how to react. –Emergency risk communication attempts to provide information to people so they can make decisions.

39. Session VII Summary Effective risk communication takes into account theories of defining risk, trust determination, and mental noise. Basic strategies for implementing risk communication include: –Having a plan before the crisis arises –Listening to the public –Responding to media requests –Preparing for questions –Paying attention to body language

40. Session VII Summary During a crisis, people external to your public health agency will be frightened and seeking information, guidance, and reassurance. Communication should be open and honest. Communication should respect the rights of the public to gain information, ask questions, and disagree with the experts

41. Session VII Summary To get your message to the public, keep messages clear, short, consistent, and memorable. When delivering your message, remember that your audience is human: speak with compassion and show your personal concern, in addition to presenting facts and instructions.

42. References and Resources Association of State and Territorial Health Officials. (2004) “Communication in Risk Situations: Responding to the Communication Challenges Posed by Bioterrorism and Emerging Infectious Diseases.” Available at: http://www.astho.org/pubs/ ASTHO Risk Communication e-Workbook.htm. http://www.astho.org/pubs/ ASTHO Risk Communication e-Workbook.htm Association of State and Territorial Health Officials. “Keeping Your Head in a Crisis: Responding to the Communication Challenges Posed by Bioterrorism.” Web cast. Available at: http://www.astho.org/docs/productions/0411webcast.html. http://www.astho.org/docs/productions/0411webcast.html Association of State and Territorial Health Officials. “Risk Communication: Responding to the Communication Challenges Posed by Bioterrorism.” Web cast. Available at: http://www.astho.org/docs/productions/0306riskcomm.html. http://www.astho.org/docs/productions/0306riskcomm.html Association of State and Territorial Health Officials. “Risk Communication Workbook.” Available at: http://www.astho.org/docs/productions/workbook.htm. http://www.astho.org/docs/productions/workbook.htm

43. References and Resources Centers for Disease Control and Prevention. “Emergency Risk Communication CDCynergy.” Online step-by-step tutorial with resources, checklists, support materials, and more. Available at: http://www.orau.gov/cdcynergy/erc/. http://www.orau.gov/cdcynergy/erc/ Covello,V. and Sandman, P. (2001) "Risk Communication: Evolution and Revolution," in Wolbarst A. (ed.) Solutions to an Environment in Peril. Baltimore, MD: John Hopkins University Press: 164-178. Johns Hopkins Center for Public Health Preparedness. “Risk Communication: What Every Public Health Practitioner Needs to Know.” Real Audio tutorial with PowerPoint slides. Available at: http://www.jhsph.edu/CPHP/Training/Symposia/Risk_Comm.html http://www.jhsph.edu/CPHP/Training/Symposia/Risk_Comm.html Sandman, P. (2004) “Crisis Communication: A Very Quick Introduction.” Available at: http://www.psandman.com/col/crisis.htm.http://www.psandman.com/col/crisis.htm

44. References and Resources Sandman, P. (2003) “Dilemmas in Emergency Communication Policy.” Available at http://www.psandman.com/ articles/dilemmas.pdf.http://www.psandman.com/ articles/dilemmas.pdf Sandman, P. (2003) “Four Kinds of Risk Communication.” Available at http://www.psandman.com/col/4kind-1.htm. http://www.psandman.com/col/4kind-1.htm Sandman, P. (1998) “The Seesaw of Risk Communication.” Available at http://www.psandman.com/handouts/sand48.pdf. http://www.psandman.com/handouts/sand48.pdf University of North Carolina at Chapel Hill School of Public Health. “Talking About Scary Stuff – Health Communication in Crisis.” Web cast. Available at: http://www.sph.unc.edu/about/webcasts/scary_stuff/.http://www.sph.unc.edu/about/webcasts/scary_stuff/ Warner, J.E. (November 2004). Keeping Control of the Story: Communicating Effectively in Times of Crisis and Confusion. PowerPoint presentation, Advanced Practice Centers Training Conference, St. Louis, MO.