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Risk Communication Fundamentals

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Title: Risk Communication Fundamentals


1
Risk Communication Fundamentals
  • For Public Health Professionals

2
Good Risk Communication..
  • seeks to
  • translate the scientific findings and
    probabilistic risk assessment into understandable
    terms
  • explain the uncertainty ranges, knowledge gaps
    and ongoing research programs
  • address the issue of building credibility and
    trust
  • understand the publics framing of the risk
    issues, especially the qualitative dimensions

3
Good Risk Communication...
  • seeks to
  • acknowledge the specific questions that arise in
    this domain (publics perception)
  • analyse the conditions needed for allowing the
    public to acquire needed information, skills and
    participatory opportunities

4
Steps for Good Risk Communication
  • acknowledge others arguments
  • Ask permission
  • Apologize
  • Clean up
  • Share (benefits or control)
  • Give credit where it is due

5
Risk Communication
  • need to consider
  • the message (information)
  • the source (origination point of message)
  • The communicator
  • the channel (path)
  • receiver (termination point)

6
The Message
  • Who is the target audience?
  • How can they be reached?
  • What level of education do they have?
  • What do you need to tell them?

7
The Source
  • All sources are not equal (by decreasing
    trustworthiness)
  • Family Doctor
  • University researcher
  • media
  • Local government
  • Federal government
  • Industry

Mersereau Dugandzic, 1999
8
The Communicator
  • Needs to have
  • Empathy
  • Trustworthiness (must be earned)
  • Showing emotion
  • Good speaker
  • Eye contact
  • Identify with audience

9
Channel or Medium
  • Very important to choose the correct one for your
    target
  • Entire messages can be missed if wrong medium is
    chosen
  • Farmers and pesticide warnings on late night TV
  • Complex written materials for Grade 6 education
  • Written materials for evacuation notice due to
    fire
  • Radio messages in English for French audience, etc

10
Three Rules for Risk Communication
  • tell people that you have determined they need to
    know
  • tell them what they must know so that they can
    understand and feel that they understand the info
  • add qualifiers to prepare them for what you are
    not telling them (until more info becomes
    available)

11
EPA Risk Communication Guidelines
  • Accept and involve public as a legitimate partner
  • Plan carefully and evaluate performance
  • listen to your audience
  • be honest, frank and open
  • coordinate and collaborate with other credible
    sources
  • meet the needs of the media
  • speak clearly and with compassion

12
Powells Lessons in Risk Communication
  • A risk information vacuum is a primary factor in
    the social amplification of risk
  • ensure the vacuum either does not exist, or fill
    it with useful risk messages
  • Regulators are responsible for effective risk
    communication
  • Health Canada has an established practice of not
    announcing the issuance of a regulatory decision
  • US FDA regularly makes brief statements in
    conjunction with regulatory actions

13
Lessons (contd)
  • Industry is responsible for effective risk
    communication
  • primarily workplace hazards
  • population health hazards (foodborne, etc)
  • general environmental hazards (pesticides, etc)
  • workplace and general env. hazards (metals, etc)
  • incremental risks produced as a byproduct of
    beneficial industrial products (pharmaceuticals,
    modern transportation, etc)

14
Lessons (contd)
  • If you are responsible, act early and often
  • some upcoming risks in the next decade are
  • food safety
  • endocrine disruptors
  • greenhouse gases and global climate change
  • biotechnology, especially agricultural
    applications
  • health impacts of atmospheric pollutants
  • There is always more to a risk issue than what
    science says
  • what about emotion, moral issues, etc.

15
Lessons (contd)
  • Always put the science in a policy context
  • whatever the risk controversy, the pubic will
    demand action by the politicians
  • ban the substance, control the exposure, etc
  • Educating the public about science is no
    substitute for good risk communication practice
  • provide lots of information, how and why things
    are going to be done
  • Banish no risk messages

16
Lessons (contd)
  • Risk messages should address directly the
    contest of opinion in society
  • acknowledge the divergent opinions
  • explain the range of risk estimates
  • legitimate the people who disagree with your risk
    estimates
  • Communicating well has benefits for good risk
    management

17
How to Communicate Risk to Public?
  • all we have to do is
  • get the numbers right
  • tell them the numbers
  • explain what we mean by the numbers
  • show them that they have accepted similar risks
    in the past
  • show them that it is a good idea for them
  • treat them nicely
  • make them partners
  • All of the above
  • by Baruch Fischoff

18
Avoid areas of confusion
  • Zero risk
  • Probability
  • Significant
  • Too careful estimates
  • Negative vs. positive findings
  • Population vs. individual risk
  • Relative vs. absolute
  • Association vs. causation

19
Communication Problems
  • occur when the message
  • is not what the audience wants to hear
  • is poorly presented
  • is improper
  • comes from the wrong source
  • is sent via the wrong channel

20
10 Deadly Sins of Presenting
  • Appearing unprepared.
  • Handling questions improperly.
  • Apologizing for yourself or the organization.
  • Not knowing knowable information.
  • Unprofessional use of audiovisual aids.
  • Seeming to be off schedule.
  • Not involving participants.
  • Not establishing rapport.
  • Appearing disorganized.
  • Providing the wrong content.

21
Identifying Strategies
  • look for use of confusing terms in your message
  • either remove them or explain them
  • step back and review wording
  • listen to other non-scientific discussions to see
    use of words and their meaning
  • adopt the popular usage of the word and its
    meaning

22
ID Strategies (contd)
  • Pre-test your message
  • use friend or family member (non-scientific)
  • ask them to identify words of concern or
    confusion
  • Discuss your message with your mock audience
  • may find out that your explanation is not good
    enough
  • may determine where your communication went wrong

23
Dealing with the Mixed Message
  • substitute less confusing words
  • if the word is still needed, clearly define it in
    the text
  • give examples of intended meaning and some
    misuses of the term
  • right in the text of the message
  • use analogies, definitions, comparisons to help
    explain the term
  • be consistent in the use of the term

24
Designing your Risk Communication
  • Choose your forum
  • Choose your message
  • Choose your source
  • Know your audience!
  • Focus group

25
How People Learn
26
How do people learn?
  • Figure 1-1. Easiest Format to Learn From -
    Preferences by Age Group, From EPA, 2004,
    Evaluation of Mercury Risk Communication Messages.

27
Exercise choose your medium
  • Break into groups
  • Choose your medium based on who the intended
    audience is (reading from EPA Graph on how people
    best integrate knowledge)
  • How would you choose to tell
  • 50 women the risks of hormone replacement
    therapy?
  • Teenagers the risks of texting and driving?
  • A small community of the acceptability of a new
    incinerator?

28
Know your audience
  • The likelihood of achieving a successful risk
    communication program increases with your
    knowledge of those with whom you are
    communicating.
  • Early in the process, know who your publics are,
    what their concerns are, how they perceive risk,
    and whom they trust.

29
Characteristics of your Publics
  • Concerns
  • Attitudes
  • Levels of interest
  • Levels of involvement
  • Histories
  • Levels of knowledge
  • Opinions
  • Reasons for interest
  • Types of involvement

Are they potential supporters or potential
adversaries?
30
Interacting with the Community(Chess et al. 1988)
  • Citizen involvement is important because
  • people are entitled to make decisions about
    issues that directly affect their lives
  • input from the community can help the agency make
    better decisions
  • involvement in the process leads to greater
    understanding of - and more appropriate reaction
    to - a particular risk
  • those who are affected by a problem bring
    different variables to the problem-solving
    equation and
  • cooperation increases credibility.

31
Creating the Message
  • What are the three most important things you
    would like your audience to know?
  • What are the three most important things your
    audience would like to know?
  • What are the three most important things your
    audience is most likely to get wrong unless they
    are emphasized? (Vincent Covello)

32
Sound bite research
  • Assumption national news, controversial topic 7
    to 9 seconds (21-27 words, 30 words max.)
  • 3 messages 9 second knowledge/trust window
    (Vincent Covello)

33
Risk Information Vacuum
  • work of risk communication is to fill the gap
    between public knowledge and scientific
    assessment of risk
  • gap will always exist
  • how to fill it is the question
  • risk information vacuum arises when
  • over a long period of time, scientists make no
    special effort to communicate the results being
    obtained regularly and effectively to the public
  • instead, partial scientific info dribbles out
    here and there, being interpreted in apparently
    conflicting ways and increases the publics fear

34
Vacuum (contd)
  • failure to implement good risk communication
    practices gives rise to a risk information vacuum
  • this failure can have grave and expensive
    consequences for those regarded as being
    responsible for protecting the publics interest
  • society abhors a vacuum, so it is filled from
    other sources

35
Vacuum (contd)
  • the vacuum gets filled
  • events reported in the media will become the
    basis for the public framing of these risks
  • an interest group takes up the challenge and
    fills the vacuum with its own information and
    perspectives
  • the intuitively based fears and concerns of
    individuals grow spread until they become a
    substantial consensus in the arena of pubic
    opinion
  • vacuum is filled by soothing sentiments of
    politicians
  • there is no risk of danger from ......

36
Examples of Vacuums
  • dioxins
  • outrageous media headlines
  • scientific research
  • no communications on the issue until too late
  • Greenpeace filled the vacuum
  • mad cow disease
  • panic ensued when government did not provide
    details on the suspicions around the spread of
    BSE
  • vacuum was filled by media and individual
    suspicions that become consensus

37
Examples of Vacuums
  • silicone breast implants
  • manufacturers did not disclose their information
    in a timely manner
  • failed to encourage a frank and open discussion
    of potential risks
  • vacuum was created by the lack of this discussion
  • panic and fear of autoimmune diseases filled the
    vacuum
  • lawsuits began and are still costing billions of
    dollars
  • no scientific information to support the claims

38
Examples (contd)
  • genetically altered/engineered crops
  • people upset because the technology is unfamiliar
  • government doesnt want to talk about the issues
    with the public
  • vacuum will be filled, and it may be damaging to
    the industry

39
Why Arent the Experts Trusted?
  • expert group may have financial interest in
    proving the risk is small
  • remediation technology spokesperson wanting to
    use the technology
  • local mayor wanting to get re-elected
  • company spokesperson not wanting plant shut down
  • historical examples exist of where experts were
    wrong
  • and handful of dissenters and activists were right

40
Why arent the experts trusted? (contd)
  • scientists tell us that risk assessment is a
    rough science and subject to error
  • need to better explain how risk assessment is
    done
  • need to better explain the use of safety factors
  • some environmental risks are gradual, delayed,
    geometrical (made worse by other risks)
  • better act now
  • even though no evidence yet exists

41
What will good risk communication do?
  • over time good risk communication practices will
  • nurture a facility for interpreting risk numbers
  • including the meaning of risk estimates and the
    uncertainty associated with them
  • help people to put the whole assortment of risks
    affecting them into a broad framework
  • relative risk, comparative risk
  • build institutional structures for arriving at a
    consensus on risk management options, and for
    allocating risk reduction resources effectively

42
What is Risk?
  • risk hazard outrage
  • public cares too little about hazard
  • expert cares too little about outrage
  • experts need to realize
  • outrage is as real as hazard
  • outrage is as measurable as hazard
  • outrage is as manageable as hazard
  • outrage is as much a part of risk as hazard
  • outrage is as much a part of your job as hazard

Peter Sandman
43
Other Facts on Risk
  • people overestimate hazard and are outraged
  • which comes first?
  • misunderstand hazard and get outraged?
  • get outraged and misunderstand hazard?
  • who is right?
  • usually experts are right about hazard
  • usually public is right about outrage

44
How to Solve Risk Dilemma?
  • solution
  • experts must
  • take public outrage seriously
  • keep outrage separate from hazard
  • respect peoples outrage

45
Risk Communication Myths and Actions (Chess et
al. 1988)
  • Belief in some common myths often interferes with
    development of an effective risk communication
    program. Consider the myths and actions you can
    take.
  • Myth We don't have enough time and resources to
    have a risk communication program.
  • Action Train all your staff to communicate more
    effectively. Plan projects to include time to
    involve the public.

46
Myths 2
  • Myth Telling the public about a risk is more
    likely to unduly alarm people than keeping quiet.
  • Action Decrease potential for alarm by giving
    people a chance to express their concerns.
  • Myth Communication is less important than
    education. If people knew the true risks, they
    would accept them.
  • Action Pay as much attention to your process for
    dealing with people as you do to explaining the
    data.

47
Myths 3
  • Myth We shouldn't go to the public until we have
    solutions to environmental health problems.
  • Action Release and discuss information about
    risk management options and involve communities
    in strategies in which they have a stake.

48
Myths 4
  • Myth These issues are too difficult for the
    public to understand.
  • Action Separate public disagreement with your
    policies from misunderstanding of the highly
    technical issues.
  • Myth Technical decisions should be left in the
    hands of technical people.
  • Action Provide the public with information.
    Listen to community concerns. Involve staff with
    diverse backgrounds in developing policy.

49
Myths 5
  • Myth Risk communication is not my job.
  • Action As a public servant, you have a
    responsibility to the public. Learn to integrate
    communication into your job and help others do
    the same.
  • Myth If we give them an inch, they'll take a
    mile.
  • Action If you listen to people when they are
    asking for inches, they are less likely to demand
    miles. Avoid the battleground. Involve people
    early and often.

50
Myths 6
  • Myth If we listen to the public, we will devote
    scarce resources to issues that are not a great
    threat to public health.
  • Action Listen early to avoid controversy and the
    potential for disproportionate attention to
    lesser issues.

51
Myths 7
  • Myth Activist groups are responsible for
    stirring up unwarranted concerns.
  • Action Activists help to focus public anger.
    Many environmental groups are reasonable and
    responsible. Work with groups rather than against
    them.

52
High Hazard, low outrage
  • Keep the risk message short.
  • Make the risk message interesting.
  • Stay on message.
  • Test the risk messages.
  • Plan and prepare for a long-term endeavour.
  • Appeal to needs.
  • Appeal to emotions, especially fear.
  • http//www.psandman.com/handouts/sand59a.pdf)

53
Contd
  • See fear arousal as a competition
  • Dont neglect other emotions. Identify and give
    people task that they can do.
  • Give people a selection of tasks to choose from.
  • Sequence recommended precautions.
  • Think in stages.
  • Focus resources on teachable moments.

54
Contd
  • Be alert for a short-term over-reaction.
  • Be alert for signs of denial.
  • Identify and address persuasion facilitators.
  • Identify persuasion barriers and consider
    addressing them.
  • Express empathy for apathy.
  • Consider an alternative pre-crisis communication.

55
What is a Focus Group?
  • special kind of interview for the purpose of
    collective information about a specific subject
    or area of concern
  • useful for gathering information on risk
    perceptions
  • used to assess needs, preferences and attitudes
  • information can then be used to
  • formulate risk messages
  • determine appropriate channel
  • choose a communicator
  • frame the risk information in an acceptable way

56
Focus Group Design
  • facilitator spends 2-8 hours with eight to twelve
    people
  • job is to ensure all areas are explored
  • usually has a helper to make group work better
  • free flowing discussion
  • group usually made up of individuals who have
    something in common
  • age, activity, employed by same company, etc.
  • record activities on flow chart or tape

57
Why use a focus group?
  • allows participants to discuss a subject openly
    and in great detail
  • research can be conducted quickly
  • organize, conduct and analyse research from
    several focus groups in as little as 2 weeks
  • decisions can then be implemented almost
    immediately
  • far less intimidating or frustrating than other
    forms of research
  • anxiety of the individuals is lessened in the
    group context

58
Goals for Collecting Information
  • determine the interests, needs, attitudes of a
    sample of community members about a particular
    risk issue
  • objectives
  • determine attitudes and opinions already in
    existence
  • determine knowledge level about this particular
    risk
  • determine the resources necessary to better
    communicate risk
  • obtain ideas on how to best communicate with this
    community

59
Identifying Participants
  • look carefully at the community
  • demographics
  • determine who may have most need for the risk
    information
  • who is more interested?
  • usually no more than 8 groups are necessary
  • more important than numbers is how the groups are
    chosen

60
How to Contact Participants?
  • telephone
  • letters
  • meeting with people
  • meeting with leaders of already established
    organizations
  • how to introduce yourself
  • why is issue important
  • who you are
  • what is the objective of the focus group
  • why is the individual valuable

61
Planning and Preparation
  • place
  • find a comfortable location, accessible to the
    majority
  • make sure there are enough chairs and room for
    everyone
  • time and date
  • convenient to majority
  • be there an hour before hand
  • let everyone know how long it will be, and stick
    to it
  • dont go longer than 2 hours

62
Leading the Focus Group
  • guidelines
  • no right or wrong answers
  • opinions are wanted
  • we do not have to agree
  • it is important for everyone to participate
  • we will finish in two hours
  • your names will be confidential
  • all the information will be used in your community

63
Focus Group Skills
  • facilitator
  • avoid a question and answer session
  • let it be open
  • set a cooperative tone
  • be open and pleasant
  • be prepared and organized
  • establish and maintain an easy rapport
  • be non-judgmental
  • use probing techniques (to get further
    information)

64
Closing the Focus Group
  • summarize the session briefly
  • thank them for their ideas
  • ask if they want to know the results
  • ask them if they want to keep in touch
  • give them your name and number for future contact
  • let them know when the information will be
    released to the community
  • and when they will be able to give feedback

65
Nelson Fok
66
Case Studies
  • Choose one of the 4 cases
  • Who is your audience?
  • What is your message?
  • What three things do you want to communicate?
  • What words will you use?
  • Who is your communicator?
  • What/who is your source?
  • What will be your method/forum?

67
Case 1
  • E coli has been found in water supply for a small
    area of cottage country, rural Canada.

68
Case 2
  • Breast feeding rates are very low in your health
    region. You have been tasked with trying to
    improve the rate to national levels.

69
Case 3
  • A local industry wants to build an incinerator in
    your area. They have been a good corporate
    citizen in the past, and have good environmental
    history. Your department has approved the
    incinerator. The local people are upset and
    demanding answers. They are worried about cancer
    and emissions.

70
Case 4
  • A poor result from a food inspection has resulted
    in closing down a famous restaurant in the middle
    of tourist season. The owners, some public and
    the mayor are upset with your department.

71
Present results of Case Study
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