Risk communication is typically defined as an interactive process that involves the exchange of information between parties about a sensitive issue (Commission on Risk Perception and Communication, Commission on Behavioral and Social Services and Education, Commission on Physical Sciences, and National Research Council, 1989). The two-way nature of this exchange is essential for giving people the information they need to make informed choices about potential risks they may encounter. 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. Even if the recipients of the information do not actively participate in the communication interaction, it is essential that they are comfortable with the quality of the information received (i.e., feel they have heard the truth and they received all of the information).
For this report, we present our findings within the context of guidance provided to the states by the CDC for renewing cooperative agreements, which provide funds to strengthen states’ public health emergency preparedness (PHEP) capacity and build capability. As initially presented, the guidance was organized around Focus Areas, one of which specifically related to risk communication and health information dissemination (CDC & HHS, 2004). The guidance asked states to develop plans to meet the specific needs of at-risk populations, which included people with disabilities (PWD), people with serious mental illness, minority groups, non-English speakers, children, and senior citizens. In addition, the guidance identifies the general risk communication activities states were expected to perform under the funding they receive from the CDC. Specifically, the guidance encouraged states engage in five types of activities:
Develop response plans that include the media, public, partners, and community stakeholders.
Conduct trainings, drills, and exercises (including those that include risk communication for at-risk populations).
Coordinate risk communication planning with state/local agencies and non-government partners.
Train key state and local public health spokespersons in risk communication principles and standards.
Establish mechanisms to translate emergency messages into priority languages spoken.
More recent guidance has focused on a framework that makes the CDC’s emergency response efforts more congruent with efforts of DHS. This guidance is organized around six CDC preparedness goals: Prevent, Detect and Report, Investigate, Control, Recover, and Improve (CDC and HHS, 2006). This guidance continues to emphasize the importance of including at-risk populations in emergency preparedness activities; documenting efforts to identify, quantify, and communicate with at-risk populations; and ensuring that these populations participate in all preparedness planning activities and exercises. It specifically asks states to coordinate activities within and across state and local jurisdictions, community organizations, health care providers and facilities, tribal organizations, etc. The guidance also continues to emphasize the support of preparedness education and training activities. A strong focus of this guidance is on being more efficient and reducing the time to respond/act by improving coordination among different entities.
We do not evaluate specific federal, state, or local risk communication activities in this report. However, the CDC guidance provides a useful framework for thinking about what might be considered expected or usual risk communication practice and to distinguish this from activities that may be considered more innovative (e.g., a practice that stands out from typical or core activities as determined by informants and the research team).
For this study, we framed our results in accordance with the five types of activities encouraged by the CDC guidance. Specifically, we explain risk communication activities as well as innovative practices identified in this research in terms of the development of response plans with the local community; trainings, drills and exercises; coordinated planning with government entities, training of risk communicators, and translation mechanisms. Our conclusions also consider how they map across phases of an emergency event in accordance with a Haddon Matrix (Haddon, 1972, 1980) which looks at factors and attributes before, during, and after an event. By utilizing this framework, one can then think about evaluating the relative importance of different factors and design interventions. This approach makes the risk communication practices more actionable.
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