Analysis of Risk Communication Strategies and Approaches with At-Risk Populations to Enhance Emergency Preparedness, Response, and Recovery: Final Report. B. Compendium Search

12/01/2008

We identified risk communication materials for at-risk populations by searching publicly available websites. We scanned and reviewed websites for communication materials that were at the intersection of three domains: PHEP), at-risk populations, and risk communication. Figure 1 depicts the intersection of these three domains and provides three examples of risk communication materials that fit in this intersection. Many of the materials we identified focused on some but not all of these domains. Figure 1 also provides examples of materials that do not fit in the intersection of the domains and hence are not included in the compendium.

  FIGURE 1. The Intersection of Public Health Emergency Preparedness, At-Risk Populations, and Risk Communication  
Overlapping Organizational Chart: At-Risk Populations -- Survey findings on disaster elder care; Children's disaster activity book; Multi-Lingual messages; Child workbook on flu prevention; Readiness tips for elderly and caregivers; Cultural compentency guide for disaster mental health programs; Legislation regarding disabilities and disaster response. Risk Communication -- Children's disaster activity book; Multi-Lingual messages; Child workbook on flu prevention; Readiness tips for elderly and caregivers; Cultural compentency guide for disaster mental health programs; Guidelines for getting out risk messages; General evacuation instructions; General post-disaster mental health guidelines. PHEP -- Survey findings on disaster elder care; Children's disaster activity book; Readiness tips for elderly and caregivers; Cultural compentency guide for disaster mental health programs; Legislation regarding disabilities and disaster response; General post-disaster mental health guidelines.

The materials in our compendium largely focused on the needs or special circumstances of one or more at-risk populations (those with disabilities, children, and pregnant women, etc.), targeting members of those at-risk populations, their caregivers, and/or the provider communities that serve these populations. We included materials targeted at service providers only if the materials provided actionable recommendations for communicating with the at-risk populations, not merely general advice or considerations. We did not include materials that were simply translations of materials intended for the general population unless the materials devoted specific attention to the broader issues affecting limited English or non-English speakers. However, where materials that met inclusion criteria were translated, we noted these other languages.

Compendium search methods. We focused the compendium search on material that was both widely and readily available (from websites of major national organizations) through a snowball-sampling strategy that began with the identifying organizations whose focus was on public health and emergency preparedness, at-risk populations, or both. Specifically, team members and other RAND experts identified organizations targeting these areas. The project team searched the website of each organization, followed links from these to other websites one or two “clicks” deep, and cataloged eligible items. 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.

Compendium sample. The compendium construction involved three progressive phases of review. Phase 1 focused on the identification of candidate materials to populate the compendium and catalogue key dimensions. We identified 309 different risk communication documents or other media from 73 different organizations. After removing 40 of these that we deemed outside the scope of the project and 27 that were unavailable for download and hence not immediately available to our audiences, 242 materials remained in the final compendium.

In Phase 2, each resource was reviewed by a randomly assigned team member, and catalogued data were double-checked. Reviewers were also instructed to identify exceptional materials (“all-stars”). Materials were identified as all-stars if they met two criteria: (1) if they conveyed actionable information; and (2) that the information is appropriate for the intended audience (i.e., were formatted and contained content matched to the target at-risk population). Of these, 41 (17 percent) were identified by Phase 2 reviewers as “all-stars.”

In Phase 3, four team members divided up materials flagged as “all-stars” and reviewed them in more depth to identify key messages and strategies. 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. More details about this task, including the compendium, are available in Appendix B.

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