Concept and principle of Risk Communication · Insight transforms into wisdom (literacy) Surveillance . Risk Communications • Risk Communications is the process of communicating

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


“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.”



“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.”


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.”


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.”


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.”



“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.”



“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.”



“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.”


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.

Documents

Concept and principle of Risk Communication · Insight transforms into wisdom (literacy) Surveillance . Risk Communications • Risk Communications is the process of communicating