Communicating with the public during health crises: experts' experiences and opinions

Governments and health agencies worldwide are planning for a potential influenza pandemic. Their plans acknowledge the importance of public communication during an outbreak and include related guidelines and strategies. Emerging infectious disease (EID) communication is a new addition to the literature, drawing on health promotion communication, crisis communication and environmental/technological risk communication. This paper adds to the literature, exploring the notion of ‘effective communication during health crises' by reporting on interviews with 22 public health officials, scientists and communications professionals responsible for communicating with the public. When analyzed in the context of the risk communication literature, the interviews reveal several considerations for health risk communicators. First, given the important role that mass media will play in an EID outbreak, there is an urgent need for public health to build partnerships with journalists based on an understanding of the two parties' unique societal roles. Second, seemingly practical communications considerations – such as how certain to be about information before sharing it and whether to engage in two‐way communication with the public – have ethical dimensions that deserve attention. Third, there are unique challenges associated with communicating uncertainty, which would benefit from an exploration of the role of trust in health crisis communication.     

Risk communication for catastrophic events: results from focus groups

Focus group methods are adapted here to address two important needs for risk communication: (1) to provide approaches to risk communication in very extreme and catastrophic events, and (2) to obtain risk communication content within the specific catastrophe area of chemical and biological attacks. Focus groups were designed and conducted according to well‐established protocols using hypothetical sarin and smallpox attacks resulting in a chemical or biological release in a confined public space in a transit system. These cases were used to identify content for risk communication information and suggest directions for further research in this area. Common procedures for conducting focus groups were used based on an initial review of such procedures. Four focus groups – two for each type of release – each lasted about two hours. Participants were professionals normally involved in emergencies in health, emergency management, and transportation. They were selected using a snowball sampling technique. Examples of findings for approaches to communicating such risks included how information should be organized over time and how space, locations, and places should be defined for releases to anchor perceptions geographically. Examples of findings for risk communication content are based on how professionals reacted to risk communications used during the two hypothetical releases they were presented with and how they suggested using risk communications. These findings have considerable implications for using and structuring focus groups to derive risk communication procedures and types of content to be used in the context of catastrophes.     

The euro exchange rate during the European sovereign debt crisis – Dancing to its own tune?

This paper studies the determinants of the euro exchange rate volatility during the European sovereign debt crisis, allowing a role for macroeconomic fundamentals, policy actions and the public debate by policy makers. It finds that the euro exchange rate mainly danced to its own tune, with a particularly low explanatory power for macroeconomic fundamentals. The findings of the paper also suggest that financial markets might have been less reactive to the public debate by policy makers than previously feared. Still, there are instances where exchange rate volatility increased in response to news, such as on days when several politicians from AAA-rated countries went public with negative statements, suggesting that communication by policy makers at times of crisis should be cautious about triggering undesirable financial market reactions.     

‘Real without being concrete’: the ontology of public concern and its significance for the Social Amplification of Risk Framework (SARF)

Abstract

Public concern is a pivotal notion in the risk perception, communication and management literature. It is, for example, a central concept with regard to the social amplification of risk, and as a justification for policy attention. Despite its ubiquity, the notion of public concern remains a ‘black box’ presenting a poorly understood state of affairs as a reified matter-of-fact. Paying attention to the deployment and metrics of public concern, and the work it is required to do, will enhance the power of approaches to understanding risk, and policymaking. Thus, the broad purpose of this paper is to unpack the notion of public concern by adopting an ontological yet critical perspective, drawing on a range of literature that considers ontology. We reflect on how publics and public concern have been conceptualised with regard to the dichotomies of individual/social and private/public, given that they imply different levels and dimensions of concern. We draw on empirical work that illuminates the assessment and measurement of public concern and how the public have responded to risk events. Considering public concern through an ontological lens affords a means of drawing renewed critical attention to objects that might otherwise appear finished or ready-made.     

Accounting practices and professional power dynamics during a crisis

This paper examines how changes in accounting practices during a crisis can affect organisational dynamics between hospital managers and clinicians. Our theoretical framework applies a multi-dimensional concept of power (Hardy, 1996) – which distinguishes power over resources, processes and meaning – to a longitudinal case study of a public university hospital during a budgetary crisis. Based on interviews with managers and clinicians, three successive time intervals with distinct power constellations are identified. Initially, we identify a pre-crisis phase where management formally controls resources, which seems to have limited effects on clinician dominance because managers lack ‘processual power’ and ‘power of meaning’. Next, an implantation phase emerges whereby the introduction of mandated budget cuts triggers shifts in the distribution of power, such that managers acquire power by securing the collaboration of clinicians – a phenomenon which has tangible benefits in terms of enabling budget compliance and increased service provision. Finally, the third phase may be conceptualized as a fiscal pressure regimen whereby, when budgetary pressures intensify further, management's newly gained ‘power of meaning’ is eroded because management are now seen to pursue unrealistic demands. Drawing on research insights gleaned during each phase, our analysis contributes to extant literature in at least three ways. First, we present novel findings regarding the impact of crises-related applications of accounting practices on intra-organisational power constellations. Second, our work highlights how accounting practices help shape the understanding of crisis, which, in turn, impacts the distribution of organizational power and influences intra-organizational patterns of collaboration. Third, we find that awareness of the meaning power of accounting practices can help shape strategic action in crisis situations.     

A literature review on the relationship between risk governance and public engagement in relation to complex environmental issues

Abstract

Over the last two decades demands for greater public engagement have emerged in policy circles and academia, particularly when it comes to risk-related decision-making, or risk governance. However, the literature shows there is a lack of evidence when it comes to the impact of public engagement initiatives and significant questions remain over who to include, what processes to follow and what outcomes to expect. Furthermore, the literature exhibits contradictions in how researchers with different theoretical approaches attempt to answer these kinds of questions. This paper therefore proposes a systematic literature review in order to map the current breadth and variation in the literature and to identify any major variations from previous findings. A methodical search query has been applied to Scopus and Web of Science to search for academic articles. These were subsequently assessed for their suitability through a structured literature selection process. The results identify a number of methodologically different approaches in which knowledge on risk governance and public engagement has been developed. These diverse approaches are eventually grouped into clusters based on similarities in co-citations and references that are identified through bibliometrics and a subsequent content analysis. The proposed clusters have been labeled risk governance; environmental science, policy and governance; disaster risk management; science and technology studies; post-normal science; and public understanding of science. These six clusters are ultimately discussed and differentiated based on their main features which is particularly relevant for researchers and policy-makers seeking to get an understanding of, or broaden their disciplinary engagement with, risk governance and public engagement.     

The implication of extreme events on policy responses

This paper considers a situation where a real risk exists that requires precautions, but the public mostly experiences the risk through infrequently occurring extreme events; this type of risk includes risk from climate change, international terrorism, natural calamities or financial crises. The analysis shows that if a risk-mitigating policy is based on the perceived riskiness of that risk, it will call for disproportionate responses (compared to what the ‘real’ risk suggests) by either under- or over-investing in risk-reducing policies, depending on the characteristics of the problem, implying significant volatility in the policy response. This type of response provides at least three challenges to society: policy cycles where implementation lags behind the actual change in risk, a lock-in to inefficient technologies and additional costs. Finally, this paper addresses the question of how the above-mentioned challenges can be managed through proper risk communication.     

Risk communication and social media during food safety crises: a study of stakeholders’ opinions in Ireland

Social media is a particular communication platform which has witnessed an exponential growth in use and influence in recent years, democratising the communication process, and offering risk communicators a way of putting into practice those principles which are advocated to be at the core of risk management and communication. However, little is known about stakeholders’ willingness to embrace this new form of communication in a food crisis. The current study presented an exploratory investigation of the opinions of Irish stakeholders on the position of risk communication in a crisis, with a particular focus on understanding what application social media may have. In-depth one-to-one interviews were carried out with key stakeholders holding frontline positions in managing and communicating about risk in the food sector in Ireland. The stakeholders identified risk communication as a central activity in a food safety crisis, driven by an obligation to protect both consumer health and the reputation of the Irish food sector. Stakeholders relied primarily on risk communication to disseminate information in a crisis so to educate and inform the public on a risk and to prevent confusion and alarmism; most did not explicitly value two-way risk communication in a crisis. The ability to effectively manage future crises may depend on stakeholders’ willingness to adapt to the changing communication landscape, namely – their willingness to adopt social media and use it effectively. The findings indicate that the stakeholders interviewed are appreciative of the need to engage with social media in times of a food safety crisis. However, most valued social media as a one-way channel to help spread a message and there was little reference to the interactive nature of this medium. Implications for integrating social media into crisis risk communication strategies are discussed.     

Risk Communication and the Social Amplification of Public Sector Risk

Concerns exist within the public sector about the ability of organizations to communicate issues of risk. These concerns include: the nature and magnitude of risks; the vulnerability of those who may bear the consequences associated with an event; and the sense of helplessness felt by victim groups. Apart from the public sector's role as risk generator, regulator and communicator, it also has some responsibility for dealing with the consequences of a major catastrophic event through agencies such as health care and the emergency services. Under certain conditions, it is apparent that concerns over risk issues can escalate beyond a level expected by those charged with the management of that risk. Within this framework, the effective communication of risk and uncertainty is an integral, but often neglected, part of public sector activities. This article explores the process of risk communication and risk amplification and suggests a number of perspectives on policy development.     

Foresight and long-term policy-making: An analysis of anticipatory boundary work in policy organizations in The Netherlands

Public policy is founded on analysis and knowledge. However, knowledge – and especially knowledge about the future – is not a self-evident element of public policy-making. This paper conceptualizes the problematic relationship between anticipatory policy-making and anticipatory knowledge. Our study identifies possible key-variables in the linkage between foresight and policy, such as positioning, timing interfaces, professional background, instrument usage, procedures and leadership. We describe the organization and flow of policy and futures knowledge. Furthermore, we generalize these findings toward a theory concluding how ‘goodness of fit’ between knowledge about the future and policy can be achieved, so that the likelihood of informed future-oriented policies might increase.     

Public meetings about local cancer clusters: exploring the relative influence of official versus symbolic risk messages on attendees’ post‐meeting concern

Scholars have long lobbied for a view of risk communication that supplants a conventional ‘transmission’ model of risk communication with an alternative that considers the complex social environment that accompanies any risk communication effort. Along these lines, this study examines the relative influence of official health messages versus symbolic risk messages on public meeting attendees’ post‐meeting concern about cancer clusters in six US communities. As part of a larger study of cancer clusters, we obtained written responses from 125 individuals who attended a government‐sponsored public meeting in their community. We asked respondents whether attending the meeting influenced their concerns and, if so, why. The results found that, despite the largely reassuring messages that health officials were giving, most attendees reported feeling more concerned after the meetings in their communities. Regarding why, explanations that denoted symbolic risk messages – unofficial sources of risk information and procedural cues – outnumbered explanations that pointed to official risk messages – scientific presentations – by a score of three to one. The results lend support for a broader view of risk communication, which accounts not only for multiple sources of risk information but also for procedural cues regarding the trustworthiness of an investigation.     

Effective risk communication and CCS: the road to success in Europe

Over the past ten years or so, there have been multiple attempts to site and build carbon capture and storage (CCS) facilities in Europe, North America and elsewhere. To date, most of those attempts have not been successful. In Europe, for example, there are currently no commercial CCS facilities in operation. There are a number of reasons for this, ranging from lack of political will, the collapsing price of CO₂, lack of commercial drivers to capture and store CO₂, and public opposition to the proposed facilities. There have been several case studies examining the communication challenges associated with the siting of CCS facilities. Up till now, most of this research has been carried out by climate change or carbon policy experts as well as social researchers rather than scientists representing the wider risk communication community, aside from some notable exceptions. This study does the opposite by examining CCS from a broader risk communication perspective. It provides a brief overview of risk communication theory in order to situate some of the findings of the CCS communication research, and then, it makes some recommendations on how the siting of CCS facilities could be improved including the importance of trust, proactive communication and early stakeholder involvement. In conclusion, this study notes that if the science associated with the technology is communicated in the correct manner and if the key risk communication recommendations are adhered to, then the siting of future CCS facilities should be successful.     

Commonplaces in Risk Talk: Face Threats and Forms of Interaction

Talk about risk is problematic for interaction; it can involve the speaker or hearer saying things that threaten participants' ‘face’, the ways they want themselves to be seen by others. One way of dealing with these threats to face, and to keep the conversation going, is the use of commonplaces. Commonplaces, generally applicable and generally known arguments, play an important role in interaction, invoking shared, taken‐for‐granted perspectives embedded in familiar roles and everyday practices. They are similar to some of the frames discussed in risk communication, but they focus our attention on rhetoric and interaction rather than cognition. In this paper, I show how commonplaces are used in focus group discussions of public choices involving dangers to life or health. They tend to be used in response to dilemmas, when a speaker is put on the spot, and they tend to lead to other commonplaces. Analysis of commonplaces supports those who argue that studies of public perception of risks and programmes of communication about risks need to be sensitive to the personal interactions, rhetorical strategies, and cultural embeddedness of any risk talk.     

Talking aggressively about GMOs? Examining the effect of aggressive risk communication with communicator’s facial expression and gender

Abstract

Two experiments (N = 229 and N = 268) assessed the effect of aggressive risk communication about GMOs by a scientist on respondents’ perceptions of message quality and writer (the scientist communicator) likability. We also considered two factors from the communicator that may influence how individuals process aggressive messages – facial expression (study 1) and the gender (study 2). Both studies showed that aggressive communication has a negative effect on both perceived message quality and writer likability, which is explained by the level of negative expectancy violation individuals perceived. Moreover, study 1 showed that smiling appeared to be a negative influence on the outcomes and study 2 showed that gender did not influence how people perceive aggressive messages. The findings provided both scholarly and practical implications for science and risk communication.     

Beyond under the dome: an environmental documentary amplified public risk perception about air pollution in China

Abstract

Air pollution is a major environmental problem in China and it poses serious risks to public health. Based on the social amplification of risk framework (SARF), this study examines how media, in particular, an impactful environmental documentary titled Under the Dome, influenced Chinese citizens’ risk perception about air pollution. Survey results showed that exposure to the documentary amplified risk perception and risk perception was significantly related to viewers’ information seeking behaviors, policy support, and individual mitigation action about this issue.     

What role for social scientists in risk expertise?

When it comes to risks – health and environmental risks, like those linked to the use of nanotechnologies, pesticides, etc. – three main groups of actors are easily identified, brought together through boundary organisations such as environmental and sanitary risk agencies: the natural and technical scientists, who provide their expertise to assess risks (especially toxicologists, epidemiologists and microbiologists); the policy makers, who take decisions regarding risk management and risk regulation; the lay public, who are more and more involved in participatory frameworks. Sometimes three other groups of actors are added: the ‘economists’ who can for instance conduct cost–benefit assessments or multi-criteria analyses (especially ecological economists, public economists, political economists and social economists); the ‘philosophers’/‘ethicists’ who can use ethics to highlight moral choices and responsibilities in face of risks; and the ‘jurists’/‘legal experts’ who can justify authorisation or interdiction according to law. Inversely, there is a group of actors which is not clearly identified, that of social scientists, even though a considerable quantity of social science knowledge on risk has been produced. Why is there such a discrepancy? This article, based on a critical review of the literature, aims to make sense of the fuzziness surrounding the involvement of social scientists when it comes to risk expertise. The article shows that one reason for this puzzling situation is to be found in the gap between what social scientists often want to do when they are called in as risk experts and what natural scientists and public policy makers actually expect from them.     

Comparing perceptions of the important environmental characteristics of the places people engage in consumptive,non-consumptive and spiritual activities

Managers, risk assessors, tribal leaders, public policy makers, and the public are increasingly interested in the characteristics of natural habitats where people like to engage in recreational, subsistence, or spiritual activities. Such data are critical for making decisions about human and ecological risk deriving from contaminants, as well as resource protection and land use. In this study we examined the perceptions of Native Americans and Caucasians about the natural places they prefer to engage in consumptive, non-consumptive, and spiritual activities which might expose them to contamination or other stressors. Subjects were interviewed at Post Falls and Fort Hall in Idaho, Cookeville in Tennessee, and at two sites in Long Island, New York, and northern New Jersey. Our objectives were to determine differences in perceptions as a function of category of activity, type of activity, location, and ethnicity. The data indicate that: (1) the highest rated characteristics were unpolluted water, lack of radionuclides that present a health risk, clean air, and no visible smog in the air; (2) all four were among the top-rated ones for each of the four sites; (3) all four were among the top-rated ones for places to perform consumptive, non-consumptive, and spiritual activities; (4) at each site, mean ratings were lowest for spiritual activities; (5) where there were differences, Native Americans rated all characteristics as more important than did Caucasians; and (6) where there were differences, ratings in New Jersey/New York were lower than those from respondents elsewhere. There are many statistically significant response differences between Native Americans and Caucasians, but overall one is impressed by the similarity in relative rankings. These perceptions will be helpful to risk assessors and risk managers in evaluating risk and potential solutions, to land managers for managing environmental resources, and to public policy managers for evaluating how people view natural environments.     

Cultural theory and risk perception: a proposal for a better measurement

Why do members of the public disagree – sharply and persistently – about facts on which expert scientists largely agree? We designed a study to test a distinctive explanation: the cultural cognition of scientific consensus. The ‘cultural cognition of risk’ refers to the tendency of individuals to form risk perceptions that are congenial to their values. The study presents both correlational and experimental evidence confirming that cultural cognition shapes individuals’ beliefs about the existence of scientific consensus, and the process by which they form such beliefs, relating to climate change, the disposal of nuclear wastes, and the effect of permitting concealed possession of handguns. The implications of this dynamic for science communication and public policy‐making are discussed.     

The social amplification of risk on Twitter: the case of ash dieback disease in the United Kingdom

It has long been recognised that the traditional media play a key role in representing risk and are a significant source of information which can shape how people perceive and respond to hazard events. Early work utilising the social amplification of risk framework (SARF) sought to understand the discrepancy between expert and lay perceptions of risk and patterns of risk intensification and attenuation with reference to the media. However, the advent of Web 2.0 challenges traditional models of communication. To date there has been limited consideration of social media within the SARF and its role in mediating processes of risk perception and communication. Against this backdrop, we focus on the social media platform Twitter to consider the social amplification of risk in relation to ash dieback disease (Hymenoscyphus fraxineus); a tree health issue that attracted intense media attention when it was first identified in the UK in 2012. We present an empirical analysis of 25,600 tweets in order to explore what people were saying about ash dieback on Twitter, who was talking about it and how they talked about it. Our discussion outlines the themes around which talk about ash dieback was orientated, the significance of users’ environmental ‘affiliations’ and the role of including links (URLs) to traditional media coverage. We utilise the notion of ‘piggybacking’ to demonstrate how information is customised in line with group/individual identities and interests and introduce the concept of the ‘frame fragment’ to illustrate how information is selected and moved around Twitter emphasising certain features of the messages. The paper affords a detailed consideration of the way in which people and organisations simultaneously appropriate, construct and pass on risk-relevant information. A conclusion is that social media has the potential to transform the media landscape within which the SARF was originally conceived, presenting renewed challenges for risk communication.     

People’s responses to risks of electromagnetic fields and trust in government policy: the role of perceived risk,benefits and control

Trust in government policy affects the way people perceive and handle risks. In our study, we investigated the relationships between trust in government policy regarding electromagnetic fields (EMF), perceived risk and perceived benefits of public and personal EMF sources, perceived control over exposure to EMF and responses to the possible EMF health risk (e.g. protest against placement of mobile phone base stations or power lines, or taking own measures against EMF exposure). Previous research indicated that perceived risk and benefits mediate the relationship between trust and people’s risk responses. Additionally, we suggest that perceived control over EMF exposure affects the relation between trust in government policy and perceived risk, and, consequently, the risk responses. We performed a survey among the Dutch population (n?=?1009), which contained questions about risk responses to EMF, perceived risk and benefits of several EMF sources, trust in government policy and perceived control over EMF exposure. Comparing public EMF sources, i.e. power lines and mobile phone base stations, to personal EMF sources, i.e. microwave ovens and cordless and mobile phones, we tested our hypotheses. Variations in risk responses to both public and personal EMF sources were mainly explained by risk perception. In addition, perceived risk partially mediated the relationship between trust in government policy and risk responses. For public sources, perceived control over exposure weakened the negative relationship between trust and perceived risk. We conclude that, especially in people with low perceived control, a lack of trust in government policy may enhance perceptions of health risks, thereby increasing their inclination for risk responses.