Their materials were also available in Braille. Communication is highlighted within the Personal Plan section; specifically, elderly individuals are encouraged to communicate with family, neighbors, and home health workers regarding a plan for staying safe during a public health emergency. We have also described some of challenges or barriers that others might encounter when attempting to plan and execute their own risk communication activities. Risk Analysis, 14, 779-88. The identification of all-star materials was a subjective process, and one designed to identify exemplary materials rather than to provide a detailed evaluation of each resource (although inter-rater agreement was high). This assessment is intended to inform planning for risk communication regarding public health emergency preparedness, response, and recovery for at-risk populations. Kotler, P. (1989). CARF's CARF Guide to Accessibility: The CARF Guide to Accessibility[9] details the requirements that organizations must meet to successfully provide an environment that is accessible to individuals with disabilities. February 2017, Volume 27, Issue 1. A citation was excluded from review if it addressed the consequences of a public health emergency without addressing risk communication; if it only addressed risk perception and not risk communication; if it only described a preparedness training program without describing the results of training; if it addressed interagency communication but not risk communication to the public; or if at-risk populations were not specifically and substantively referenced in the title and/or abstract of the citation. Recommendation #76: Credible spokespersons for risk communication should be identified and coordinated as part of White House crisis communications efforts. Eight risk communication subthemes were identified: trust, empowerment, uncertainty, communicating the vaccine, inclusion, identification of subpopulations and at-risk groups, segmentation, and 2-way communication. Watching social media: understanding what questions and knowledge gaps are coming up and strategizing how to counter myths and threats actively. In our discussion, we also identify challenges to and gaps in the development of risk communication messages and methods of dissemination. (2004). In the compendium, 53 percent of the included resources targeted individuals at-risk, 53 percent targeted caregivers, and 38 percent targeted providers (i.e., there was often overlap). [(accessed on 23 February 2020)]; http://creativecommons.org/licenses/by/4.0/, https://onlinelibrary.wiley.com/doi/toc/10.1002/1539-6924.risk-analysis-and-coronaviruses, http://www.nhc.gov.cn/xcs/yqfkdt/gzbd_index.shtml, http://wjw.wuhan.gov.cn/front/web/ztzl/801, https://m.yicai.com/news/100495596.html?native.theme=1, http://www.xinhuanet.com/politics/xxgzbdgrdfyyq/index.htm, http://china.caixin.com/2020-01-30/101509478.html, http://news.sina.com.cn/c/2020-03-10/doc-iimxxstf7791853.shtml, https://new.qq.com/omn/20200130/20200130A04YF400.html, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3525558, https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1, https://www.nejm.org/doi/pdf/10.1056/NEJMoa2001316?articleTools=true, https://www.nytimes.com/2020/02/01/world/asia/china-coronavirus.html?_ga=2.72446106.827276418.1581872988-2133314739.1581872988, https://vp.fact.qq.com/home?ADTAG=wx.kyk%20, https://www.bbc.com/news/blogs-trending-51271037, https://news.sina.cn/gn/2020-02-01/detail-iimxxste8037653.d.html?vt=4, https://www.nytimes.com/2020/02/06/world/asia/chinese-doctor-Li-Wenliang-coronavirus.html?searchResultPosition=1, http://www.efsa.europa.eu/en/corporate/pub/riskcommguidelines170524, https://mp.weixin.qq.com/s/IwbIdlID3pzSQeGKcm4NCQ, Infuse risk communication into policy decisions. For example, the Oklahoma Department of Health regularly translates preparedness materials into Spanish but uses CDC-prepared materials translated into other languages spoken in the state. (1989). (2006b). Guan W., Ni Z., Hu Y., Liang W., Ou C., He J., Liu L., Shan H., Lei C., Hui D.S.C., et al. This approach can strengthen trust in the community (Eisenman et al., 2007; Meredith, Eisenman, Rhodes, Ryan, and Long, 2007). All data in this paper can be divided into three parts: (1) COVID-19 outbreak numbers are retrieved from the National Health Commission of China and the Wuhan Health Commission [9,10]. Use strategies to identify and track at-risk populations. Educational settings are stressed as an important venue in public health preparedness: school nurses are identified as important partners for addressing the communication needs of children, and high school and college students are identified as potential participants in emergency planning and response. See http://cancercontrol.cancer.gov/RiskCommBib/. [(accessed on 22 February 2020)]; Xu X., Chen P., Wang J., Feng J., Zhou H., Li X., Zhong W., Hao P. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. The academic community should fully focus on the scientific analysis of the risk and sharing findings, data, and materials. Stages of Emergency Preparedness, Response, and Recovery, Studies addressed risk communication in the context of response to public health emergencies most often[21, 22, 23, 25, 26, 28, 32, 33, 35, 36, 38, 39, 40, 41, 43, 44, 47, 58, 61, 62, 66, 67, 69, 70, 72] (Figure 1), followed by preparedness,[7, 24, 26, 29, 31, 32, 34, 35, 36, 38, 39, 40, 41, 45, 47, 56, 57, 61, 62, 66, 67, 68] and recovery. There has also been promising growth in activities designed specifically for at-risk populations, including the availability of messages in different languages and formats for those who do not speak English or who have disabilities, respectively. Interviewees were a convenience sample based on referrals, cold calls, and contacts we made or had in the four sites.3 The distribution of interviewees by site was as follows: California (n=11), Metropolitan Washington Area (n=9), Florida (n=14), and Oklahoma (n=15). McCallum & M.T. Evaluation of risk communication strategies (e.g., Have you evaluated the impact of existing risk communication activities for at-risk populations? Informants also noted the importance of factors emphasized in the compendium report (Appendix B): Messages should be crisp and easily understandable, and include actionable recommendations. Program and abstracts of the American Public Health Association 132nd Annual Meeting; November 6-10, 2004; Washington, DC. Crisis and emergency risk communication in a pandemic: A model for building capacity and resilience of minority communities. Thus, organizations need to have a robust communications surveillance strategy in place for future crises. In fact, rapid assessment that can help to identify any hidden audiences, identify specific environmental factors that may increase risk, uncover critical audience questions and concerns, and identify any potential trusted spokespersons or partners is proposed by the literature (Quinn, Thomas, and McAllister, 2005). The core approach relies on Plan 9 (Montgomery County, Maryland) or Be Ready DC (Washington, DC), a county-wide educational campaign and tool kit emphasizing preparing a disaster kit with nine essential items needed in the event of an emergency: water, food, clothes, medications, flashlight, can opener, radio, hygiene items, and first-aid. The interim reports use the term vulnerable populations instead of at-risk populations. Additionally, as the public health emergency risk communication literature published since 2000 focuses heavily on the events surrounding Hurricanes Katrina and Rita,[22, 26, 27, 28, 32, 40, 41, 43, 58] our results may be biased towards risk communication regarding natural disasters and the vulnerable populations represented in the Gulf States. From the literature on public health emergency risk communication, we reviewed the relatively small portion (20 percent) that specifically addresses vulnerable populations. Source: This timeline is a processing of data from Website of Wuhan Health Commission and a generalized report and in-depth investigation from China Business Network [10,11]. Fostering public preparations for natural hazards. Medical Care--Individuals who are not self-sufficient or do not have or have lost adequate support from caregivers and need assistance with managing medical conditions. The results of the literature review suggested that weather reporters are a particularly trusted source of emergency information; they are seen as non-political, objective messengers who appear on the easily accessed communication medium of television. Nationwide Plan Review: Phase 2 Report. The Tennessee Fire Marshals Office Offers a Course for Safety Educators in Reaching People with Hearing Disabilities in the Event of Fire, State of Tennessee, Department of Commerce and Insurance, Readiness Training and Materials for Individuals with Disabilities and Other Special Needs, Center for Disabilities and Special Needs Preparedness (DPC), Look Hot! When children are affected by a public health emergency, their developmental levels and their psychological reactions must be taken into account regarding communication. (1989). The PAHPA (P.L. Our interviews with state and local informants revealed common themes regarding how communities are currently developing and implementing their risk communication strategies for at-risk populations. Disaster planning and risk communication with vulnerable communities: Lessons from Hurricane Katrina. (2007). We then highlight those innovative practices that are at the forefront of risk communication for at-risk populations (III B). Non-English speakers will require language translation and bilingual spokespersons with the appropriate social and cultural competencies and those from diverse cultures will also have a high likelihood of mistrusting authorities. Kasperson, R.E. Findings from the evaluation suggest that the field, defined by the intersection of public health emergency risk communication and at-risk populations, is relatively new. Specific messages have not yet been developed; however, the Push Partner Program offers a unique opportunity for getting messages out to at-risk populations through a community partnership approach. The first example addresses not only language translation but also strategies for making cultural competency an integral component of translation. Vulnerable populations are often not able to access and use the standard resources offered in disaster preparedness, response, and recovery.[3] For example, people with physical disabilities may have mobility limitations and special needs related to access to emergency preparedness communications. Her e-mail address is: Emily.Rosenoff@hhs.gov. American Journal of Preventive Medicine, 32(5S), S97-S103. The Multiphase Optimization Strategy (MOST) and the Sequential Multiple Assignment Randomized Trial (SMART): New methods for more potent eHealth interventions. This part of the task was more qualitative, although structure was provided through the use of a standardized score sheet. This is true for the public generally (See [42]), and for vulnerable populations in particular, who may need additional time or specific accommodations to adequately follow emergency instructions. Wingard, J.R., Leahigh, A.K., et al. However, where resources that met inclusion criteria are translated, these other languages are noted (in Appendix B1, final column). Inconsistent or ambiguous messaging,[7, 21, 22, 23, 26, 28, 29, 33, 44, 57, 69, 72] emotional interference,[30, 32, 33, 37, 38, 46, 62, 65, 67, 69] and incorrect assumptions[7, 23, 28, 29, 31, 32, 72] were addressed in several citations as well. [24, 26, 34, 36, 56, 57, 58] The potential for Internet-based messaging to improve emergency communication with vulnerable populations is limited by Internet access,[3, 26, 57] and some vulnerable populations may be especially limited in their use of the Internet. What does the public know about ebola? Develop risk communication materials that address at-risk populations for the post-event/recovery stage of disasters. Each all-star resource was then reviewed carefully, rated on six dimensions, including the extent to which the resource: Reviewers made notes on the motivation behind their ratings and also noted key messages delivered by the resource. ), Social Theories of Risk. For example, GIS maps could be used to determine where vulnerable populations may cluster (e.g., locations of hospitals, nursing homes, low-income housing) and could use this information to target risk communication campaigns. Risk Communication: The Mental Models Approach. Ensure your labs are safe, free of health hazards, and promote a healthier environment in Guidelines for Laboratory, In health care, issues like algorithmic bias and a lack of AI knowledge among health care executives are preventing, Learn from distinguished Harvard faculty and network with professionals from prominent organizations in Leadership, This online course provides participants with the knowledge and skills to analyze how environmental hazards impact, Copyright 2022 The President and Fellows of Harvard College, Executive and Continuing Professional Education, Developing Public Health Communication StrategiesAnd Combating MisinformationDuring COVID-19, Its Not Just Personal: The Economic Value of Preventing Bullying in the Workplace, The Importance of Meta-Leadership During the COVID-19 Crisis, Harvard T.H. Informants were quick to report that most people, whether or not they belong to an at-risk population, think about emergency preparation after an emergency, not beforehand. This medium of dissemination is likely to be inaccessible to many at-risk populations including the economically disadvantaged, the mentally ill, the visually impaired, low-literacy and non-English speaking individuals, young children, and older adults. Not over- or under-reassuring, but simply laying out risk and potential consequences with the appropriate tone. Statistic of Rumors Refuting. Communication was the functional area was most commonly addressed in the literature,[7, 21, 22, 24, 25, 26, 27, 29, 30, 32, 33, 34, 35, 36, 37, 38, 40, 41, 44, 45, 46, 47, 57, 58, 61, 65, 66, 67, 68, 69, 70, 71, 72] followed by medical care,[21, 22, 23, 28, 30, 33, 35, 37, 39, 47, 58, 66, 67, 68, 71] transportation,[31, 32, 34, 35, 37, 39, 47] maintaining independence,[27, 31, 71] and supervision. Effective risk communicators must be trained to understand emergency risk communication, know their stakeholders, and be trusted in the community. Our review (Task 3) had three aims: Describe promising communication strategies for public health emergency risk communication with vulnerable populations. As described previously, most of the states we studied employed community partnerships and networks to build capacity by better understanding local concerns and identifying ways to best address them (Quinn, 2008). Public Law 101-336. According to the U.S. House of Representatives,[2] public health emergency communication should be non-discriminatory, with equal access and utility to all individuals. Virtually no resources specifically targeted pandemic diseases, which may differ from other public health emergencies in time horizon (two or three waves of 6-8 weeks duration versus days), greater immunologic risks for certain vulnerable populations, and greater need for personal resilience. As noted previously, this community participation approach is well supported by the literature review. Many of the materials we identified focused on some but not all of these domains. This research was funded by the National Social Science Fund Youth Program, grant number 18CZZ010. Training for PWD. Coordinating risk communication activities before emergencies involves a variety of collaborative training activities (i.e., local businesses and other coalitions engaged in preparing at-risk populations). The results presented in this report could inform federal, state, tribal, territorial, and local emergency preparedness planning on how to address the unique needs of at-risk populations in existing emergency preparedness, response, and recovery plans. Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats. Health Promotion Practice, 9, 5S-12S. B. Quantitative Study . Risk communication is a part of everyday life. Networking with the faith community. Doxtator, L.A., Gardner, C.E., & Medves, J.M. Criteria for choosing sites. There are a few limitations worth noting; first, by only including peer-reviewed literature in our review, we may have eliminated books or other reports that include relevant information. 109-59), DHS found clear deficiencies in communication and information-sharing strategies used by state and local emergency managers (DHS, 2006a, 2006b). Table 3 summarizes the key factors of risk communication as they apply to at-risk populations organized within the five CDC guidance areas (rows) across each phase of an emergency event (columns). Emergency preparedness: Knowledge and perceptions of Latin American immigrants. They have developed a DVD that is distributed to all schools in the state and includes Oklahomas First Lady, a popular weather reporter in the state, and the Oklahoma Gas and Electrics mascot talking about preparedness issues. (2005). Sandman, P.M. (2003). Additionally, each of the reviewed references addressed the broad points that early and consistent risk communication is key in public health emergencies (See [21]) and that risk communication must take into account the special needs of vulnerable populations (See [10, 22]). After the initial outbreak of COVID-19, conspiracy theories and rumors spread online regarding the origin and scale of the virus. Hence, caution should be used when making generalizations from the compendium or this summary. Risk communication strategies require information sharing and establishing networks of working relationships among individuals, groups, and agencies. Risk communication, risk perception, and public health. Effective risk communicators should make immediate contact with the public about risk and maintain regular information to the public concerning risk levels and tendency throughout an incident. Weather reporters are also key assets in the state in communicating messages in preparation for, during, and in the immediate aftermath of a disaster. The lessons from the outbreak management of COVID-19 in Wuhan stress the need for effective risk communication to prepare in advance for an infectious disease emergency. Included in the risk communication process is some opportunity to elicit and respond to concerns, opinions, reactions, and legal issues (e.g., mandated responsibilities and liability) related to the message. The effects of the virus change every day, and some states have gone so far as to ask that residents shelter in place and not leave the house unless absolutely necessary. Telling people what they can do and how they can act to keep themselves and others safe. The final Phase of review (Phase 3) consisted of carefully reviewing each resource labeled an all-star in Phase 2, with the goals of identifying promising risk communication strategies and providing examples of these strategies drawn from this set of resources. With respect to risk communication for public health emergencies, we reviewed the dynamic process of risk communication of the outbreak management of COVID-19 and used a message-centered approach to identify weaknesses in the risk communication process. A suggestion or recommendation in this document does not imply that agencies have failed to take such action. A Fact Sheet for People who are Deaf or Hard of Hearing, Emergency Preparedness for Dialysis Facilities-- A Guide for Chronic Dialysis Facilities, Centers for Medicare and Medicaid Services (CMS), Administration on Aging: Emergency Assistance Guide, Bioterrorism and Other Public Health Emergencies Altered Standards of Care in Mass Casualty Events Prepared by: Health Systems Research, Inc. AHRQ Publication No. The first provides a detailed, qualitative analysis of promising emergency risk communication strategies for vulnerable populations among the risk communications included in the compendium. Accordingly, the SNAKE report suggests that the Federal Communications Commission remind purveyors of emergency information that emergency communications must be accessible to individuals with visual and hearing disabilities. Phase 1 review identified 309 resources from 73 different organizations (as well as websites linked from those organizations websites). The games were created by the youth (so they learned in the process) and enjoyed by the residents. Informants in this state have also developed an inventory of messages for confirmed and unconfirmed events. Relatively few resources were found for those who are institutionalized, pharmacologically dependent, from diverse cultures, transportation disadvantaged, pregnant, or who have limited English skills or are non-English speakers.3 Most of the resources identified did not specify emergency type. Below we describe both advancement and barriers. Risk communication that both characterized the risk and provided information that was actionable. More details about the literature review search methods are provided in Appendix A. The site is secure. The survey highlighted the need to increase manager awareness about the utility of registries for enhancing emergency preparedness, response, and recovery efforts. Audio/visual and pictorial displays can have great impact. Highlights the importance of citizens in all stages of emergencies and describes where communication procedures are housed in a JFO. The amount and nature of information available to the public is changing and evolving constantly. Ability to Engage the Audience. (2002). U.S. Department of Homeland Security. Distancing from misinformation and disinformation prevents the spread of falsehoods. Chapter 68 (Disaster Relief) of Title 42 (Public Health and Welfare) (retrieved from the U.S. House of Representatives Downloadable U.S. Code website). Our literature review emphasized their importance in presenting messages from trusted members of the community. Thus, across research and practice, use of GIS may play an increasing role in emergency risk communication for at-risk populations. The DAF was used to extract data, where applicable, from the statutes and regulations included in the review. Before, during, and after an incident, members of at-risk populations may have additional needs in one or more of the following functional areas: Maintaining Independence--Individuals in need of support that enables them to be independent in daily activities. The research in this report was conducted by RAND Health and prepared for the United States Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Web-based Training - Self-study. Here, the compendium found that resources specifically designed for children were prevalent, and addressed a wide variety of types of public health emergencies. A research conclusion cited by Xinhua News Agency indicates that a preliminary study shows that Chinese patent medicine Shuanghuanglian can inhibit the novel coronavirus. Global early warning systems for natural hazards: Systematic and people-centered.
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