Download Risk Communication

Pan-American Health Organization
Risks and health services
communication
Maria José de Freitas Rodrigues
Bogotá, April 2006
For WHO/PAHO:
“The communication strategies make up an
important component for the management of all
outbreaks of infectious diseases and they are
essential in the case of a pandemic. Exact and
timely information at all levels is fundamental for
reducing to a minimum the undesired and
unforseen social disruption, and the economic
consequences and maximizing the efficiency of
the responses result”.
(Pandemic Alert and Response –WHO Verification List from the preparation plan for an
Influenza, WHO, 2005)
Communication in the institutional
atmosphere:
The area of knowledge relative to the
production
and
dissemination
processes that involves an audience (or
public-white), information, instruments/
resources/ channels and audience
response (feedback). These elements
express themselves in determined
socioeconomic, political and cultural
contexts that must be analyzed for
communication initiatives.
Communication: implied in all institutional sector
activities, even if no specific political institutions
are constituted.
Pandemic imminence change in perspective about
the function of communication in institutional
spaces.
The need to plan institutional communication
actions, identify and/ or adapt existing ones.
Health Education: intermediation practices
between services and the population;
Communication: gradually start occupying this
space. Introduction to languages and other
practices (advertising marketing, as an example).
These practices do not exclude one another,
they can complement each other, especially in the
preparation for pandemic responses.
Expectations:
That communication should contribute to tasks
like:
Inform without creating panic
Expose limitations without expressing insecurity
Suggest possibilities without guaranteeing
results.
Warn about the most likely, recognizing a
possible mistake
Manage risk, fear, alertness in an uncertain
context
Risk Communication:
“An interactive exchange of information and
opinions between individuals, groups and
institutions, involving multiple messages
about the nature of the risk or expressing
worries, opinions and reactions to the
messages about the risks and the legal and
institutional arrangements for the
management of those risks.”.
(HHS, Services for Substance Abuse and Mental Health, USA)
Risk Communication
“Is an attempt from science and public health
professionals to provide information to allow
an individual or an entire community to make
the best decisions possible, during a crisis
that affects their well being. This
communication must be made with time
limitations and requires public acceptance of
the imperfect nature of the possible elections
for the action.”.
(CDC, Atlanta, USA)
Risk Communication
“Risk communication is a collection of
abilities and knowlege...”
“It uses responsible speculation,
recognizes uncertainty, shares dilemmas
about what should be done and it does
not try to completely eliminate fear”.
(Sandman P,J Lanard,Perspectives in Health,PHO,vol 10, no.2, 2005)
Risk Communication
interactive process, collection of abilities and
knowledge; a practice that requires planning,
recognizes uncertainty and the imperfect
nature of actions, shares dilemmas, looks for
points of equilibrium, identifies languages,
manages perceptions and acts in emergency
situations
Possible association with other concepts:
Duty: The duty of public institutions is to make
available to citizens the information related to
the risk. Immediate dissemination.
Right: of all the citizens to receive equally the
information about the risk and how to protect
themselves for their well being.
Social Responsibility: the frame of reference of
the relationship between institutions and their
public.
Context
risk, alert, threat, alarm, fear,
emergency, pandemic imminence,
uncertainty, possibilities and shortages
Risk Communication
Trust, Transparency, Public Knowledge,
Timely dissemination and Planning
(WHO Outbreak communication guidelines, 2005)
Trust (credibility)
For the WHO “the loss of public trust, especially in
times of crisis, threatens the stability and viability of
the health sectors and the government as a whole”
Fundamental principle: build, maintain and/or regain
trust from the public and official sources of
information, established in the first dissemination.
Transparency
Credibility factor. More difficult to adopt: possible impact
– economic or political. Demands preparation of health
professionals (including communicators) for their
contact with the media.
Allows the population to accompany the management of
risks and participation in actions for their own
protection.
Does not necessarily increase public trust even though,
the lack of transparency would lead to a lack of trust.
Public Knowledge
Socioeconomic, political and cultural contexts: literacy
rates, religious beliefs, gender, visual literacy, language
etc…
Timely dissemination
Trust and transparency parameters are established in the
first official
announcements – immediate.
Care: they may surprise allies and information may be
incomplete (imperfect nature” of the elections).
Population informed about the
risks of a bird flu pandemic:
Could help its hospitals and other health
units, schools, churches, companies etc…to
be prepared (community participation);
Could prepare emotionally, diminishing the
association of risk with the threat reaction or
indignation;
It is more likely for the risk to be understood,
in case a pandemic starts and the
recommendations are followed.
Planning: key point
Decentralized: roles and responsibilities of the initiatives
at a national, departmental / state, municipal / local
level. Public knowledge: socioeconomic, political and
cultural contexts at a local level. Communication
networks.
National: political articulation for multi sector, media
and academic participation; initial public warning,
training, support of initiatives at other levels, level
coordination, collaboration with other countries and
international organisms.
Risk Communication: Myths and Action
Myth: There is not enough time or resources to
have a program or communications plan.
Action: Train your personnel in communications
and plan actions that include enough time to
involve the public.
How and when can health services train their
personnel and involve the public in the topics
of communication?
Myth: Informing the public about the
risks is more likely to aggravate the level
of alarm (and not “calm” it)
Action: Diminish the alarm potential
giving the public the opportunity to
express their worries.
How can health services open this space
so their public can express their worries?
Myth: Communication of risks is not my job
Action: As public institution officials you have
responsibilities towards the public, especially in
emergency situations. Learn to incorporate
some communication basics in your job and
help others do the same.
How to involve health professionals in the
efforts to communicate risk?
(ATSDR -Agency for Toxic Substances and Disease Registry, EUA)
Topics for Communication Planning
Sources of information (responsible ones)
Public targets (health, agriculture and veterinary
professionals, government officials, farmers,
travelers, air and transportation carriers, among
others). Internal (sector and multi sector) and external.
Information objectives (defined for each phase and each
level)
Messages (phase and level). Timely dissemination
Media/instruments/channels. Language
 Topics for Communication Planning
 Channels of communication between sources
of information and the public (feedback)
 Message pre-test
 Production and distribution of materials
(criteria: sector or multi sector)
 Evaluation of the impact of the messages.
 Adaptation or updating of the messages and
materials
 Costs
Suggestions for contact with the media
Accept the media as a legitimate ally
Perceive the interests and needs of the media
Promote training for journalists and media
professionals
Use different communication channels (radio, TV)
Plan your contacts with the media
Before speaking, listen attentively to the
Prepare key messages for emergencies
Avoid looking defensive or argumentative in
Never say anything “off the record”.
Adequate contacts with the
communications media can help:
Building, maintenance and/or restoration of
public trust.
Development of knowledge and abilities.
Adoption of attitudes, adequate decisions and
behavior.
Strengthening of collaboration and cooperation
among governments, institutions, international
organisms and others.
(WHO, Effective Media Communication During Public Health Emergencies, Geneva, 2005)
Ten things you must know about the pandemic flu
(OMS, October 2005)
1. The pandemic flu is different from the bird flu
2. Flu pandemics are recurring episodes
3. The world could be on the verge of a new pandemic
4. All countries will be affected
5. Many people will be infected
6. There will be a shortage of medical supplies (vaccines and antiviral)
7. Many people will die
8. There will be great economic and social upheaval
9. All countries will be affected
10. The WHO will tell the world when the risk of a pandemic increases
According to the principles of risk communication,
how would health services inform that:
Language: The strain H5N1 is a stock that has the
potential of becoming a pandemic, since it could acquire
characteristics that would make it contagious from person to
person. Once the virus appears it is very contagious, and it is
considered inevitable for it to spread throughout the
entire world.
Avoid panic: No country has enough vaccines and or antiviral
drugs and few countries have the personnel, installations,
equipment and hospital beds required to tend to the large
number of people that would suddenly become ill.
Public communication and communication
between those that participate in the response *
Public communication:
Prepare the National Plan, study the public, the media
and the dissemination mechanism and distribute
materials for each phase of the pandemic; Site official.
Interpandemic period prepare material about anti
pandemic actions.
Build a collaborative relationship with media
professionals;
Designate and train the spokepeople and define the
chain of responsibilites.
*WHO, Pandemic Alert and Response, Verification List from the preparation plan for an Influenza, 2005)
Communication between the response
participants:
Designate a sector or multi sector group to coordinate the
dissemination of information. All phases.
Create mechanisms and communication channels for the
exchange of information in the national environment – a
communications network, at all levels. Hospitals, health
centers, even emergency, must participate in this network.
Exchange information between national authorities, the
WHO and other UN agencies. Coordinate efforts for the
execution of International Sanitary Regulations.
Communication between response participants:
Create mechanisms and communication channels for the
exchange of information between national authorities and
regional organisms. The information must be, among
others:
Assumed and confirmed cases
Vaccination policies and the use of antiviral medicines
Clinical management norms
Number of cases identified and their location
Deaths (influenza stock pandemic)
Effect of the pandemic on health services
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Thank you