Risk Analysis DOI: 10.1111/j.1539-6924.2011.01645.x
Communicating Actionable Risk for Terrorism andOther Hazards
Michele M. Wood,1,, Dennis S. Mileti,2 Megumi Kano,3 Melissa M. Kelley,3
Rotrease Regan,3 and Linda B. Bourque3
We propose a shift in emphasis when communicating to people when the objective is to mo-tivate household disaster preparedness actions. This shift is to emphasize the communicationof preparedness actions (what to do about risk) rather than risk itself. We have called this per-spective communicating actionable risk, and it is grounded in diffusion of innovations andcommunication theories. A representative sample of households in the nation was analyzedusing a path analytic framework. Preparedness information variables (including content, den-sity, and observation), preparedness mediating variables (knowledge, perceived effective-ness, and milling), and preparedness actions taken were modeled. Clear results emerged thatprovide a strong basis for communicating actionable risk, and for the conclusion both thatinformation observed (seeing preparedness actions that other have taken) and informationreceived (receiving recommendations about what preparedness actions to take) play key,although different, roles in motivating preparedness actions among the people in our nation.
KEYWORDS: Diffusion theory; disaster; path analysis; preparedness; risk communication
1.1. Problem and Purpose
We live in an era of information abundance andcommunication evolution; the information to which
Approvals of the study protocol were obtained from InstitutionalReview Boards at participating institutions to ensure the ethicaltreatment of research participants.
1Department of Health Science, California State University,Fullerton, CA, USA.
2Department of Sociology and Natural Hazards Center, Univer-sity of Colorado at Boulder, CO, USA.
3School of Public Health, University of California, Los Angeles,CA, USA.
Michele Wood was affiliated with the University of California,Los Angeles School of Public Health, Department of Commu-nity Health Sciences at the time of data collection, and with theCalifornia State University, Fullerton, Department of Health Sci-ence at the time of data analysis and article preparation.
Address correspondence to Michele Wood, Department ofHealth Science, California State University, 800 N. State CollegeBlvd, Fullerton, CA, USA; firstname.lastname@example.org.
we have access is growing exponentially, and theways in which it is received and shared are trans-forming. The number of information campaigns tomotivate public preparedness for terrorism and otherhazards throughout the nation is large,(1) and thediversity of channels for communicating such infor-mation is increasing. Growing penetration of the In-ternet and social media has led to a greater number ofwebsites to disseminate this information. Moreover,in our increasingly uncertain and complex world,there are a great many types of hazards for which oneought to prepare, including terrorism and natural andtechnological hazards.
Efforts to influence public preparedness behav-ior (i.e., developing emergency plans, stockpilingsupplies, purchasing things to be safer, duplicatingimportant documents, etc.) by communicating infor-mation to the U.S. public are varied and based ondifferent kinds of knowledge. The majority of edu-cation campaigns that inform the public about risk
1 0272-4332/11/0100-0001$22.00/1 C 2011 Society for Risk Analysis
2 Wood et al.
and disaster preparedness in place today, however,are largely shaped by intuition about what is im-portant, anecdotal experience, and/or the familiar.Although it feels good, our intuition about how tomotivate behavior change often misses the mark.Anecdotal experience of isolated events may notgeneralize. In the case of repeating the familiar,people continue to do what previously has beendone, even when what has previously been donehas not been particularly effective.(2) There hasbeen a dearth of evidence-driven policy shapingthe design of public education campaigns abouthazards and substantial underuse of theory fromthe social and behavioral sciences to inform suchefforts.(3)
The potential impact of policy decisions to de-sign and implement disaster preparedness campaignsthat are theory driven and based on sound empiricalevidence is great. Recent catastrophic events seemnumerous and extraordinary. The terrorist events ofSeptember 11, 2001 killed 2,973 people, excluding theterrorists.(4) The events were unique in the nationshistory and affected many Americans intensely,including those who were not directly harmed.The December 2004 SumatraAndaman tsunamiwas triggered by an earthquake that registered9.2 (Richter scale) and was one of the most devastat-ing natural disasters in recorded history, killing an es-timated 230,000 people.(5) Hurricane Katrina in Au-gust 2005 was the deadliest U.S. hurricane since 1928,flooded 80% of the city of New Orleans, and was re-sponsible for more than 1,500 deaths.(5,6) The Haitiearthquake in January 2010 was 7.0 in magnitude,killed an estimated 230,000 people, and left morethan 3.5 million displaced.(7) The death toll from theMarch 11, 2011 Tohoku, Japan earthquake (magni-tude 9.0) and the resulting tsunami and nuclear crisisis yet unknown.(8) There is no shortage of remindersof why people should prepare.
Furthermore, natural hazards are becomingmore hazardous because of persistent developmentand increasing density in vulnerable settings.(9,10)
Meanwhile, concerns about future terrorist attackspersist. In fiscal year 2010, the Department of Home-land Security Grant Program (HSGP) dedicated$832.5 million towards the Urban Areas SecurityInitiative (UASI) to enhance regional preparednessin major metropolitan areas; at least 25% of fundshave been designated for law enforcement and ter-rorism prevention.(11) Public education about risk forterrorism and other hazards as well as recommendedpreparedness actions are paramount. Indeed, the
stakes are high, and at no point in our nations historyhas communication to motivate public preparednessfor high-consequence low-probability events been ingreater use or more visible as a political centerpiece.Yet despite the prominence of information andcommunication about preparedness for terrorismand other disasters, we lack clear evidence-basedknowledge of the underlying process through whichpublic education information is transformed intoconsequent desired behavior change. We remainuncertain as to how we can maximize publicpreparedness action resulting from our risk-communication-based interventions despite theavailability of rich theoretical frameworks that couldinform policies and programs.
1.2. Theoretical Orientation
Communication about risk is a broad area of in-quiry and involves diverse disciplines, frameworks,and theoretical orientations.(12) Disciplines includepsychology, sociology, medicine, public health, pub-lic policy, cognitive science, risk management, andmore.(13) Moreover, different labels and emphasesare employed, e.g., in public health risk communi-cation is known as health education;(14) in psy-chology, risk perception is studied. Many disciplinetributaries have asked questions like the one that isthe focus of this article:How should public educationcampaigns be designed to get the public to prepare forfuture disasters?
A variety of theoretical orientations existsthat could be used to inform research and practicefocused on communicating information to moti-vate public preparedness behavior. These includeindividual, interpersonal, and community/groupapproaches. Individual-level theories consider therole individuals play in their own behavior andfocus on internal factors.(15,16) Examples include thetheory of planned behavior,(17,18) the heath beliefmodel,(19,20) and protection motivation theory.(21,22)
Interpersonal-level theories consider the role otherpeople have on individual behavior and focus onexternal factors.(15,16) Social cognitive theory is aprominent example.(23) Such theories suggest that thebehavior of individuals can be influenced by chang-ing the norms that guide behavior. Community- andgroup-level theories instead understand behavior inthe context of social institutions and communities,and focus on factors within social systems.(15,16)
Examples include community organizing and
Communicating Actionable Risk 3
community building,(24) diffusion of innova-tions,(2528) and communication theory.(29,30)
For the explicit purpose of guiding communica-tion campaigns and mass media efforts to changehealth behavior, community and group models thathave a social diffusion perspective, such as(31)
diffusion of innovations(2527) and communicationtheories,(29,32,33) can be especially helpful. Diffu-sion of innovations defines an innovation as anidea, practice, or object perceived as new, and dif-fusion as the process by which an innovation iscommunicated through certain channels over timeamong members of the a social system to max-imize program reach.(27) Diffusion happens in asequence of five stagesknowledge, persuasion, de-cision, implementation, and confirmationand canoccur over interpersonal or mass media communi-cation channels or mediums. Alternatively, commu-nication theory examines who says what in whichchannel to whom and with what effects?(32) Com-munication frameworks highlight the importance ofinformation source, message, and channel, and howexposure to messages can affect behavior. In gen-eral terms, risk communication is a specialized sub-area within communication theory that has been de-fined as the purposeful exchange of informationabout health or environmental risks between inter-ested parties.(34) It typically involves transmitting in-formation about the level and significance of risks aswell as decisions, actions, or policies to manage them.
Diffusion of innovations and communicationtheories can help guide information campaigns tomotivate preparedness because they can inform cam-paign structure and help explain the process throughwhich people receive and then respond to informa-tion by taking action. In addition, the social diffusionorientation implicit in both theories incorporatesconstructs from individual-level models as mediat-ing variables.(29) Hence, these frameworks are ide-ally suited to guide intervention-focused researchsince they provide a perspective that informs concep-tualizing the elements of public education campaignsabout disaster preparedness that can be studied.
Although some have linked the first structuredrisk analysis to the Babylonians in 3200 BC,(35) theterm risk communication became an establishedpresence in the academic and policy literature in1986.(14,36) The professionalization of risk has beentraced to three developments: (1) the rise of the mod-ern state in the late 18th century, (2) the develop-ment of public health institutions in the 20th century,and (3) decision analysis, which emerged and was re-
fined between the 1940s and late 1960s.(14) When theEnvironmental Policy and the Occupational Healthand Safety Acts were passed in 1969 and 1970, andthe Office of Technology Assessment was created in1972, the institutionalization of risk analysis in theUnited States was complete. The need for defensiblerisk assessments increased, as did graduate course-work emphasizing decision analysis. Research focus-ing on risk perception cognitions and risk behavior inpsychology, and on societal protective behaviors insociology, ensued. Thus far, however, despite a largeliterature, risk communication research has yieldedfew definitive empirical results.(37) The theoreticalchallenges we face today are similar to those we facedin the 1980s: we must bring existing empirically vali-dated theory from the social and behavioral sciencesto bear on the demand for increased public prepared-ness to produce an evidence-based approach.(2,12,38)
What is of critical importance to the nation,though absent, is an empirically validated model ofactionable risk communicationone that facilitatesaction by the general publicthat can frame edu-cation campaigns for public preparedness. A modelthat draws on existing theory and focuses on thoseparameters that can be directly manipulated by pub-lic education campaigns would be useful in guidingfuture efforts to educate the general public aboutpreparing for disasters and holds the potential to bemore effective than the well intended but all too of-ten unempirical bases for such efforts.(2) It is our pur-pose to build and test such a model.
1.3. An Actionable Risk Communication Model
Social science research into how communicatingrisk information to the public to motivate householdpreparedness action-taking began almost 40 yearsago. Initial research was conducted on a range ofhazard types, for example, tsunamis,(39) floods,(40)
and hurricanes.(41) However, most research exam-ined the public information-to-action linkage forearthquakes;(42,43) and was conducted in a varietyof contexts that included after-quakes;(44) after pre-dictions of pending earthquakes;(45,46) and duringmore general times when no event had occurredor had been predicted.(44) Not surprisingly, most ofthis research was conducted in California, it var-ied by community type, and included rural com-munities(47) as well as large urban centers.(4345,48)
Inquiry into how information motivates householdpreparedness action-taking for terrorism has only re-cently begun.(49)
4 Wood et al.
Regardless of hazard type, the key question thatunderlies both theory and practice is behavioral:What can public information best say and how can itbest be made available to reach, teach, and motivatepeople to prepare for future disasters that most thinkwill not really happen, and, if they do, they thinkwill happen to other people and not them? Manybelieve they are not at risk of high-consequence,low-probability events, and perceptions of being safeare reinforced every day a disaster does not oc-cur. Perceptions of being safe change to those ofbeing at risk immediately after the occurrence ofa community-wide disaster. In fact, historical evi-dence suggests that experiencing a disaster may bethe strongest public motivator to prepare, albeit af-ter the event. The phenomenon has been popular-ized by practitioners as the window of opportunity.However, the window quickly closes as the effect ofexperiencing an event on motivating preparednessdeclines as time passes, and perceptions of safety re-emerge and rise back to preevent levels, typicallywithin a two-year period.(5052)
To inform the use of public information, thecommunication and diffusion of innovations theoret-ical frameworks combined with a review of empiricalfindings identified seven pertinent constructs to in-clude in a model predicting household preparednessaction as a result of public education campaigns.
1.3.1. Content of Preparedness Information Received
A fundamental tenet of general communicationtheory is that information received is a key motiva-tor of future actio...