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Concept and Principle of Risk Communication
Vichan Pawun, M.D., MPH Director, Bureau of risk communication and
behavior development
Objectives
• After completing this lesson, you will be able to describe: – What risk communication is – Why is Risk Communication Important to – The key components to an effective risk
communication strategy i.e. Messenger, Message and Mean
VDO Risk communication
As mentioned on the video • RC is a tool in public health for risk reduction • RC principle:
– Credible & transparent information – Right audience / language / time / channel – Enhancing dialogue & understanding within stakeholder
and at risk population to guide decision making
• Basic model of RC: – Internal communication same direction & goal – Inter-institutional shared goal / dialogue – Media traditional & social media, media as a partners – Response/field team face to face communication,
building trust
5
Surveillance & Risk communication • Systematic ongoing collection, collation, and
analysis of data and the timely dissemination of information to those who need to know so that action can be taken. (Source: Last, Dictionary of Epidemiology)
DATA
INFORMATION
KNOWLEDGE
Rational Irrational (emotion)
Risk communication is about “translation of Risk Information for the public action”
Risk
Risk in Epidemiology & Risk in risk communication
“…risk professionals see ‘risk’ as ‘probability x magnitude’, whereas for most people ‘risk’ means ‘outrage’. By redefining ‘probability x magnitude’ to mean ‘hazard’ (instead of risk), we can couple risk with the more comprehensive concept of ‘hazard’ plus ‘outrage’…” Peter Sandman
Who will be harmed? How many of them will be harmed? How will they be harmed and how much? How long will the harm continue?
Risk probability questions
RISK = HAZARD+OUTRAGE
Combating fake news as part of RC Information Overload
Digitization Social connection
Individual are influenced by risk information in complex and unpredictable ways
Some people become fearful or suspicious of all people, regardless of their nationality or actual risk
SARS, 2003 MERS, 2012 NIPAH, 2018
Risk communications must tackle infodemics that now routinely appear! • Infodemics*:
– A few facts, mixed with fear, speculation and rumour, amplified and relayed swiftly worldwide by modern information technologies, that can affect national and international economies, politics and even security in ways that are utterly disproportionate with the root realities.
Ref: David J. Rothkopf
Translating Data into Wisdom
Data transforms into information
Information transforms into insight
wisdom
Insight transforms into wisdom (literacy)
Surveillance
Risk Communications
• Risk Communications is the process of communicating risk to the people concern i.e. public, internal audience and decision makers
• It requires risk assessment skills and the capacity to translate and transform technical scientific information into action-oriented messages, products, tactics and actions
• It is an on-going process of exchange of information and laying out of options and details for actions and responses, therefore it is ever changing
Trust Determination
• When people are stressed and upset, they want to know that you care before they care what you know
• Challenges:
– Under normal circumstances, people trust those who display competence and expertise in the subject they are talking about.
– In high stress situation, people place a higher value on compassion and empathy than on competence or experience
– More importantly, people in high stress situations will usually decide within as little as 30 seconds whether or not the spokesperson is empathetic, compassionate and trustworthy
Ref: Covello et al., Risk communication: evolution and revolution, 2001
Mental Noise
• When people are stressed and upset, they often have difficulty hearing, understanding and remembering more than three messages at a time
• Challenges: – Mental noise caused by denial, emotional stress and trauma,
among other things –can reduce a person’s ability to process information about the situation by as much as 80%
– Implications of mental noise factors include the following: • The number of messages people can hear, understand or remember is
severely limited • The time available for communication may also be limited • Important message should be repeated to increase the chance that
people will remember them Ref: Covello et al., Risk communication: evolution and revolution, 2001
Negative Dominance • In high-stress situation, people tend to give more
attention on negative information than positive info. • Challenges:
– Negative dominance factors include the following: • People who are upset tend to think negatively • Repetition of a negative reinforces and reaffirms the negative • Words like NO, NOT, CAN’T, DON’T, NEVER, NOTHING and NONE
aggravate the negative dominance
• Solution: One Negative = Three Positives – Research has shown that it takes three or more positives
points to balance out the negative effects of one negative – Negative words should be avoided if at all possible
Ref: Covello et al., Risk communication: evolution and revolution, 2001
The Risk Management Cycle
Source: World Health Organization. Rapid Risk Assessment of Acute Public Health Events. 2012
“Risk communication is a vitally important element of public health. During public health emergencies, people need to know what health risks they face, the nature and scale of the event, and what actions they can take to protect their health and live.” WHO, 4 April 2018
Risk communication capacities
Source: ASEF workshop report, 2015, Risk Communications for Public Health Emergencies:
Source: ASEF workshop report, 2015, Risk Communications for Public Health Emergencies:
Risk communication - First announcement warning - Helping at-risk pop take informed decision and adopt protective behavior - Obtaining Trust (authorities, population, stakeholder etc.) - Complementing existing surveillance - Coordinating with partners (health and non-health) - Minimizing and mitigating socio-economic impact
Rapid response strategy:
Risk communication : emergency
operation
information
command
ICS/EOC
Integrating Risk communication
into emergency response systems
Conceptual framework of RC in disease control system
Information exchange Persuasion Reinforce
Perception Request support
Health impact
Preventive behavior
Preparedness & operational response - Be first - Be right - Be credible
Informed decision
At –risk pop Trust /Transparency coordination
Risk communication flow chart: Monitoring and Response
1. Diseases and Hazard information input
2. Information and risk analysis
3. Risk communication practice
4. Monitoring and Evaluation
Information and Risk analysis
Risk
IMMR informed before 0900 am. during weekdays
- DG / deputy DG - Advisory group - RC director
Moderate risk Notify
- Press release -Press interview
assign
Media monitoring
from start to the end , within 1-3 days
-Minister/ permanent secretariat - DG / deputy DG - Advisory group/ Spokesperson
High risk
-Press conference -Press interview -Field visit
Media monitoring
Yes
Health promotion agenda DDC media watch committee
MOPH media watch committee
PMOC, MOPH EOC, DDC EOC meeting
Call center 1422/ DDC information center
No
Yes
Notify
from start to the end , within 4 hrs-1 days
assign
ID chat- issue discussion IA chat- issue assignment IR chat- issue report
RC in SITUATION MANAGEMENT • Audience-focused communication
– Predetermination of specific audience – Audience centered approach
• Managing negative feedback /outrage – Factor affecting risk perception – Evaluation of risk perception
• Anticipating concerns – Focus group to determine the concern – Monitoring
• The choice of messenger – Who people trust – People are unlikely to change behavior if
they distrust the source of risk information
Monitor media & social media
Issue management and anticipating concerns
Communicating risk in public health emergencies
A. Building trust and engaging with affected populations
“ To build trust, risk communication interventions should link to functioning and accessible services, be transparent, timely, easy-to-understand, acknowledge uncertainty, address and engage affected populations, link to self-efficacy, and be disseminated using multiple platforms, methods and channels”
WHO ERC guideline, 4 April 2018
A. Building trust and engaging with affected populations
“Communicating uncertainty: Communication by authorities to the public should include explicit information about uncertainties associated with risks, events and interventions, and indicate what is known and not known at a given time.”
WHO ERC guideline, 4 April 2018
A. Building trust and engaging with affected populations
“Community engagement: Identify people whom the community trusts and build relationships with them and involve them in decision-making to ensure that interventions are collaborative and contextually appropriate, and that the community owns the process of communication.”
WHO ERC guideline, 4 April 2018
B.Integrating Emergency risk communication into emergency response system
“Information systems and coordination: Tailor information and communication systems to users’ needs and involve local stakeholders to guarantee the flow of information across sectors.”
WHO ERC guideline, 4 April 2018
B.Integrating Emergency risk communication into emergency response system
“Capacity building: Preparation and training of personnel for ERC should be organized regularly and focus on coordination across involved stakeholders.”
WHO ERC guideline, 4 April 2018
C. Emergency risk communication practice
“Strategic communication planning: ERC planning must occur well in advance, and be a continuous process with a focus on preparedness as well as response. Planning should be sensitive to stakeholders’ needs, participatory, responsive to the context and incorporate feedback from affected groups.”
WHO ERC guideline, 4 April 2018
C. Emergency risk communication practice
“Social media: Social media and traditional media should be part of an integrated strategy with other forms of communication to achieve convergence of verified, accurate information.”
WHO ERC guideline, 4 April 2018
C. Emergency risk communication practice
“Messaging: Risk should not be explained in technical terms, as this is not helpful for promoting risk mitigation behaviors. Consistent messages should come from different information sources and emerge early on in the emergency. Messages should promote specific actions people can realistically take to protect their health.”
WHO ERC guideline, 4 April 2018
C. Emergency risk communication practice
“Monitoring and evaluation tools: Research is required to establish best mechanisms and methods for rapidly evaluating ERC interventions, and incorporating evaluation findings and feedback from stakeholders and communities to inform and improve ongoing and future responses.”
WHO ERC guideline, 4 April 2018
Notifying WHO
Activated EOC
External RC action
Internal RC action
Risk Communication in the 21st Century
• Some of the recurrent recommendations emerging from lessons learnt in the field of emergency risk communication include:
• The paradigm must shift systematically from telling people what to do to systematically listening to those affected;
• View risk communication, especially in outbreaks and emergencies as a broad umbrella that requires many types of communication and engagement to be used in the most suitable mix based on the context;
• Community engagement is one of those strategies, but one which requires its own expertise and capacity building. Community should be empowered to shape strategies, not just implement them;
• The need to engage and coordinate with the many professional disciplines, program and partners in order to supply the expertise needed for effective RC;
• RC must be part of health operations and preparedness. It must be part of outbreak investigation and remain central at all stages of the emergency management cycle.