The tool kit earned California the Public Relations Society of America 2005 PRism award for excellence in public relations. Phil Trans R Soc A, 364, 2167-2182. Bruine de Bruin, W., Downs, J.S., & Fischhoff, B. As the epidemiological investigation went deeper, new conclusions made the authorities change their statement, using expressions such as no evidence shows the disease has the characteristic of human-to-human transmission. 214215). The publics feedback enables the government to adjust its emphasis of information delivery and provide information in relation to the publics own interests and valuescommunication can be most effective when it reflects an understanding of what the public wants to know [43,45]. children's activity book (#59), also from the American Red Cross, has a Words to Know section defining important words. (2006). 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. This feedback reaffirms a function-based approach, which focuses on individual capabilities rather than on labels or broad generalizations about populations, and is consistent with what we learned in the interviews. 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. The Metropolitan Washington Area has evaluated several of its programs. The .gov means its official. Vulnerable Populations are Underrepresented in the Public Health Emergency Risk Communication Literature. As an example, it is highly likely that PWD will be dependent on assistance from others given their limited independence and will also require different communication channels. Eight resources were risk communications directed at the safety of responders themselves, rather than vulnerable populations. [(accessed on 15 February 2020)]; Risk Communication: A Handbook for Communicating Environmental, Safety, and Health Risks. Meet risk perception needs by remaining open and accessible to the public. In addition, Montgomery County has developed the Strengthening the Strengtheners program, which uses parish nurses to conduct outreach. News, social capital and health in the context of Katrina. Implementing a Seismic Computerized Alert System (SCAN) for Southern California: Lessons and Guidance from the Literature on Warning Response and Warning Systems. Specifically, team members and other area experts at RAND identified organizations targeting each of these areas. What have you learned?). We now highlight risk communication activities that are particularly innovative strategies for reaching at-risk populations. They help to reinforce messages for safety during a tornado (where you should be, what you should have with you, and how to keep yourself safe) and are important communications conduits--widely watched and respected. These reviewer pairs agreed on 18 of 20 determinations of all-star status (90 percent). After-action reports and other evaluation activities that occur after the acute stage of a disaster provide opportunities for emergency managers to share experiences and lessons with other counties and states. Barriers to communication success were defined based on previous research conducted by members of the research team[72, 74], as well as a review of the literature on public health emergency risk communication. [(accessed on 10 March 2020)]; Interview to Zeng Guang. In conjunction with the literature review, this compendium informs the case studies of state or local region risk communication practices as they relate to vulnerable populations (Task 5). First, no evidence was available in some areas. However, there is little evidence that the needs of these groups are being adequately addressed (Association of State and Territorial Health Officials [ASTHO], 2008; Ringel et al., 2007). Swift, clear, and accurate public health crisis communication plans prevent disasters from spiraling and they save lives. Native Americans, Emergency Evacuation Planning Guide For People with Disabilities, Emergency Preparedness Tips for Older Adults, Emergency Preparedness for your Service Animal or Pet, Emergency Preparedness and People who are Blind and Visually Impaired: A Handbook for the Consumer, Index of Printable Hurricane and Flood Materials, Yes--French, German, Haitian-Creole, Chinese, Portuguese, Spanish, Vietnamese, Tips for First Responders Possible Alcohol and Substance Abuse Indicators, Substance Abuse and Mental Health Services Association (SAMHSA), Center for Mental Health Services, Psychosocial Issues for Older Adults in Disasters, DP2 Disabled People and Disaster Planning, Points of Service (Food, Water, Financial Aid, etc. For individuals from diverse cultures, low-income backgrounds, and with chronic medical conditions (the top three vulnerable populations represented in the literature), we found that emergency response (e.g., evacuation) was most frequently addressed (Figure 1). Having at-risk population representatives involved in planning will facilitate message development to meet the specific needs of different groups. To address these policy questions, the RAND team undertook three key activities: We: (1) reviewed the literature on emergency preparedness risk communication and public health messaging strategies, particularly for at-risk populations; (2) assembled a compendium of current emergency preparedness communication, outreach, and education materials/practices directed at at-risk individuals and their caregivers, including providers of long-term care services; and (3) conducted site visits in four states/regions regarding promising or emerging efforts to educate and inform at-risk populations and their providers. The consequence was that lots of people queued up purchasing Shuanghuanglian at midnight. Free text entries were entered into the SPSS database, cut, and sorted into thematic categories. In sum, this study proceeds as follows: (1) a timeline concerning risk communication of the 20192020 Wuhan COVID-19 outbreak is given, (2) the case is then analyzed using the message-centered approach, and (3) a simplified model of effective risk communication is formed in the discussion section. Relevant to the peer-reviewed literature that addresses diverse populations and populations with limited English proficiency, the Minority Emergency Preparedness Demonstration program places an emphasis on the development of public health emergency education that is culturally competent. The message-centered approach offers scientific and systematic methods to achieve convergence and to avoid asymmetric information around issues of risk. We have proved, as a system, singularly unprepared to handle this aspect. The developmental and cognitive limitations of children regarding emergency risk communication are discussed; in particular, the Guide highlights childrens increased psychological vulnerability related to traumatic incidents associated with disasters and their limited cognitive resources with which to interpret relevant information. The outbreak management of COVID-19 has testified that the public cannot form a general perception of risk if the strategic communication is absent. For parents, emergency risk communication should be frequent and instructive, as parents of young children are likely to experience additional anxiety related to protecting their children. 2829). Below we describe several promising practices pertaining to involving key groups in emergency planning. Literature review. Study Reminders. As we summarized earlier, at-risk populations are not only at increased risk of poor consequences during an event; they often are more susceptible to challenges in establishing daily life after disaster. However, given the relatively small sample of statutes, regulations, and related reports deemed relevant for inclusion and the limited applicability of the DAF in characterizing these references (e.g., items such as Type of Study, Sample Size do not apply), rather than present aggregate data on DAF items we will briefly summarize the content relevant to emergency risk communication for vulnerable populations from each citation below. As we mentioned above, the initial intention behind the Wuhan government concealing information was based on the consideration of maintaining social stability. Meredith, Lisa S., Lisa R. Shugarman, Anita Chandra, Stephanie L. Taylor, Stefanie Howard, Ellen Burke Beckjord, Andrew M. Parker, and Terri Tanielian, /content/admin/rand-header/jcr:content/par/header/reports, /content/admin/rand-header/jcr:content/par/header/blogPosts, /content/admin/rand-header/jcr:content/par/header/multimedia, /content/admin/rand-header/jcr:content/par/header/caseStudies, Lessons Learned from the COVID-19 Outbreak, How China Might React to Shifting U.S. Posture in the Indo-Pacific, The Equity-First Vaccination Initiative's Challenges and Successes, Wait Times for Veterans Scheduling Health Care Appointments, Ukraine's Dream Could Be Taiwan's Nightmare, Improving Psychological Wellbeing and Work Outcomes in the UK, Getting to Know Military Caregivers and Their Needs, Planning for the Rising Costs of Dementia. Health communication refers to communication strategies built to enrich health information to the public and community and impact their health behaviours, practices and decisions. One of the critical functions of public health emergency risk communication is to provide actionable information about functional areas of importance to vulnerable populations. Categories are not mutually exclusive, so sum to more than 100%. Would an Internet-based risk communication strategy for PHEP, response, and recovery be valuable to vulnerable populations? In Self-Contained Organizations, Leadership is Key to Communication Success. Such motivations can serve to demystify recommendations by suggesting contextual considerations. According to Viswanath, Public health communications operate on the principles of transparency, reliability, and trust. Current risk communication practices for at-risk populations (e.g., How were strategies developed? (2007). Wuhans case reflects the prerequisite of a message-centered approach, which means that the institution can be a barrier to information disclosure. You must listen; do not make assumptions. Our informants identified as innovative several coordination activities that involve planning with the community to better reach at-risk populations. [7, 26] Most studies relied on a qualitative analytical approach,[7, 21, 23, 24, 25, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 41, 43, 44, 45, 46, 47, 56, 61, 62, 65, 67, 69, 70, 71] while a few employed descriptive or bivariate analyses[22, 28, 40, 57, 58, 68, 72] and two used multivariate analyses. The evaluation, which was performed at two sites, revealed that health promotores do affect recipients actions with regard to emergency planning. That is, in keeping with previous definitions of risk communication (See [8]) this review addressed public health emergency communication for vulnerable populations that does not simply describe the nature or consequences of a risk, but rather that provides information on how to prepare for, protect against, or respond to the risk. Health Language Business Management Personal . A common concern across the sites was that the disabled community is not always involved in the planning process, which also can damage the communitys trust in first responders and government agencies responsible for public health and emergency response. Canadian Journal of Public Health-Revue Canadienne De Sante Publique, 95(1), 27-31. 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. Risk Assessment and Risk Communication Strategies in Bioterrorism Preparedness Editors: Manfred S. Green, Jonathan Zenilman (Professor of Medicine), Dani Cohen, Itay Wiser, Ran D. Balicer Scarcity of relevant evidence-based resources Practical approach for coping with current bioterrorism threats Chan School of Public Health, Division of Policy Translation and Leadership Development, Harvard Chan Executive and Continuing Professional Education on Twitter. Retrieved September 16, 2008, from http://training.fema.gov/EMIWeb/edu/docs/Nationwide%20Plan%20Review%20-%20Phase%201%20Report.pdf. We deemed a practice as innovative if it stood out from typical or core activities as determined by informants and the research team. The NIEHS Superfund Research Program (SRP) hosted a Risk e-Learning webinar series focused on strategies to communicate potential environmental health risks to reduce exposures and improve health. Lundgren, R. (1994). 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. Implications for Tasks 4 and 5: Continued work should determine whether available outreach and education materials have been developed in a community-based participatory way (Task 4), and to what degree community members are involved with the development and execution of public health emergency risk communication efforts, as recommended by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)[10] (Task 5). Some generalized reports and in-depth investigations related to infected cases released by Chinese authoritative media, such as China Business Network, are referred to as well [11]. Though functional areas were well distributed across types of vulnerable populations, some gaps exist; for example, none of the literature we reviewed described emergency communication regarding maintaining independence, transportation, or supervision for individuals with disabilities. Involve the public in dialogue about risk. The effectiveness comes from the ability to quickly digest the key points in dynamic response environments. Evaluate the impact of risk communication efforts. Quantitative Study . Continuation Guidance, Budget Year Five, Attachment F, Focus Area F: Risk Communication and Health Information Dissemination (Public Information and Communication). Background/information. Centers for Disease Control and Prevention & U.S. Department of Health and Human Services. [14], Community involvement may help emergency risk communications overcome common barriers to success related to trust and available resources for communication dissemination. Table 3 presents a cross-tabulation of vulnerable population by emergency type. Use of community forums and engagement of community partners in the evaluation will ultimately help to improve the capacity of agencies and their cultural competence with at-risk populations. An American Red Cross coloring book (#62) includes pictures of what children should be doing during an emergency. The collective exposure is causing stress. Several preparedness indicators are examined state-by-state; however, none of the indicators included in Ready or Not? are specific to communication. The booklet, Listen, Protect, and Connect: Psychological First Aid for Children and Parents, (#250) from the U.S. Department of Homeland Security (DHS), includes places to write in details, which helps to ground the risk communication in an individuals experiences. Although other sites (Florida and DC) also involve at-risk populations in risk communication activities, the level of involvement in California was particularly noteworthy. Finally, our literature review, compendium search, and interviews provided triangulating information about how risk communication for at-risk populations is used and highlighted those activities that are particularly innovative and that hold promise for broader use across states. For ease of comprehension, categories have been ordered in descending frequency, except for stage of preparedness, which has a natural ordering. 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). They also conduct grassroots activities in the community and work in collaboration with other agencies. This literature review informed the development of a compendium of communication materials (Task 4) and case studies of sites with promising approaches to risk communication for vulnerable populations (Task 5). Each all-star resource was then rated on six dimensions, including the extent to which the resource clearly stated and addressed objectives, clearly stated and addressed risks associated with the public health emergency, reasonably covered issues salient to the specified vulnerable population(s), provided specific guidance on how to act on the advice given, was clear and easy to understand, and was engaging. Effectiveness evaluation. Israel, B.A., et al. Public Health Reports, 122, 422-426. Meredith, L.S., Eisenman, D.P., Rhodes, H., Ryan, G., & Long, A. One of the plans key concepts is the provision of coordinated communication between federal, state, and local government, as well as between members of the public and private sectors, in response to a public health emergency (generally referred to as Incidents of National Significance). Oklahoma relies heavily on the community and the Oklahoma Standard (a high standard of civic behavior and generosity in helping others), encouraging residents to check on their neighbors following an emergency to ensure that they are okay, to help them if evacuation is ordered, or to determine their needs. Two organizations addressed issues of pregnant women, children, non-English speaking populations, and those from diverse cultures. The reports and case study disclosed a gap between international guidelines and their local-level implementation. Dwelling on such information could potentially damage credibility of the source. Nor did we examine the effectiveness of new technology approaches for reaching at-risk populations. Before, during, and after an incident, members of at-risk populations may have additional needs in one or more of the following functional areas: Earthquakes, fires, floods, and landslides; terrorist threats to the Golden Gate Bridge and shipping ports, Diverse cultures (26% foreign-born) and non-English speakers (20% speak English less than very well); the vast majority (94%) of the 35 million residents live in urban areas in which commuting during disasters is a concern, Hurricanes and flooding; receives evacuees from other states due to natural disasters, Senior citizens (17%); disabled (22%); and diverse cultures (17% foreign-born); and non-English speakers (10% speak English less than very well), Hurricanes, winter storms and flooding; domestic terrorism; as the nations capital, this area remains a high-risk target for terrorism, Disabled (22%) and living below the federal poverty limit (>18%); relatively high percentage using the transportation system, which could make a large proportion of the population at-risk during a disaster, and a high proportion of African Americans (60%), Tornadoes, floods, and severe winter storms; domestic terrorism, Less populated state (3.5 million persons) with a relatively high number of rural persons living below the poverty limit (14%), disabled persons (22%), and diverse cultures (38 federally recognized Native American tribes), Establishing planning committees that include representatives of at-risk populations, Strengthening training by directly addressing the needs of at-risk populations, Evaluate the impact of risk communication efforts, Use new technology to enhance communication reach, Share lessons learned across organizations and geographic regions, Present clear facts with actionable plans, Tailor the risk communication to the unique needs of at-risk populations, Offer risk communication in multiple modes and multiple languages, Develop messaging for post-event risk communication, Prevention, preparedness, response, and recovery. From the timeline of risk communication in Wuhan, we can generalize three aspects related to risk communication: governments decision making, governments information dissemination, and risk interpretation. Compendium search methods. Phase 1 review identified 309 resources from 73 different organizations (as well as websites linked from those organizations websites). 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. Finally, the Internet was identified as a viable mode of risk communication but it is important to ensure that all individuals, including PWD, have access to that information on the websites. Abramson, D.M., Morese, S.S., Garrett, A.L., Redlener. Audiences also maintain a certain amount of disbelief about the potential for an emergency to arise. Visual, acoustic, and physical barriers to communication are included in the guide, such as inadequate lighting that interferes with lip reading or sign viewing, lack of signage and accessibility symbols, and high noise levels. [7, 22, 26, 28, 36, 39, 44, 47, 67, 68, 71] Additionally, several studies addressed children,[7, 30, 33, 41, 46, 56, 62, 65, 68, 71] individuals with little or no English proficiency,[7, 29, 33, 34, 37, 38, 62, 70] those who are transportation disadvantaged,[7, 26, 28, 32, 34, 39, 43, 71] the elderly,[7, 36, 37, 39, 47, 56, 62] and disabled individuals. In addition, risk communication (National Center for Missing and Exploited Children, 2005; National Organization on Disability, 2006) specifically includes actionable information (Altman, Bostrom, Fischoff, and Morgon, 1994; Covello and Allen, 1988). They have been approved for circulation by RAND but may not have been formally edited or peer reviewed. These guidelines will include provisions related to communication and accessibility both in shelters and more broadly during public health emergency response and recovery. Clearly, there is a commitment to public health education and a recognition that communication is essential to coping with the methyl parathion situation. As the evidence base regarding risk communication strategies for vulnerable populations grows, policy makers and decision makers can draw upon the general literature on public health emergency risk communication to design strategies for success. One hundred and twenty-five recommendations are made at the end of the report, organized within 17 Critical Challenges. One of the Challenges is Public Communications, which includes five recommendations specific to risk communication. Mountain Research and Development, 24(4), 298-302. At this stage, the goal was not to quantitatively evaluate each and every resource. This assessment is intended to inform planning for risk communication regarding public health emergency preparedness, response, and recovery for at-risk populations. Vulnerability assessments. The initiative focuses primarily on work within congregations, but there are plans to use bus advertising to reach out to congregants in the community. Mass media use, neighborliness, and social support: Assessing causal links with panel data. Emergency preparedness: Knowledge and perceptions of Latin American immigrants. Subscribe to the weekly Policy Currents newsletter to receive updates on the issues that matter most. Our literature review highlighted the central role of vulnerability assessment in program development. U.S. Department of Health and Human Services, Administration on Aging. Background Using the most effective methods and techniques for communicating risk to the public is critical. The occurrence of the outbreak corresponded with Chinas political season, when officials gather for annual meetings of the Peoples Congressesthe Chinese Communist Party (CCP)-run legislatures for discussing policies and praising government. When links led to other rich sources of information, those sites were added to our existing list of organizations and returned to later for thorough searches. Florida purchased and developed software to determine and map community resources, with attention to the needs of at-risk populations. Just in Case: Emergency Readiness for Older Adults and Caregivers (retrieved from the Administration on Aging website). Health risk communication has to be responsive to developing (and potentially highly differentiated) social representations of risk (Petts, 2005). February 2017, Volume 27, Issue 1. One potential way to address public concerns is to strengthen educational activities by including CBOs, agencies, and other partners in the training itself. The tool will allow health departments to geographically identify where the most vulnerable members of their communities live (e.g., individuals with disabilities, non-English speaking individuals). We have highlighted several risk communication practices that could be modified and adopted by others. We also asked informants about whether they conduct any formal (or informal) evaluation of the impact of communication activities that have been conducted. Combining exercises to test different aspects of response plans with after-action evaluation provide Oklahoma with insight into what works, what does not, and what needs to be modified for future response planning and response efforts. More systematic evaluation to determine the impact of risk communication for at-risk populations would provide valuable information to guide the field in enhancing preparedness, response, and recovery. Still, the subjective nature of these reviews should be acknowledged, and conclusions taken as suggestive. An official website of the United States government. We identified a number of innovative practices involving training in the sites we studied. Manoff, R.K. (1985). J Expo Anal Environ Epidemiol. A Fact Sheet for People who are Deaf or Hard of Hearing, Text Alerts & 9-1-1-- Are You Ready? An assessment of the cultural appropriateness of emergency preparedness communication for low income minorities. Principles and guidelines for improving risk communication. Timely information Task order Monitor and a further seven doctors were interrogated spreading. Determine the public to avail verified and timely information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions have evaluated. Identified documents, the local/county governments adopt state messaging unchanged or adapt it/add to as. 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