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. However, by focusing on peer-reviewed literature, we are confident that the conclusions drawn from the literature review and the guidance of these conclusions for subsequent project tasks grounded our study in empirical evidence. The date boundaries of our review may have also affected our results; as the public health emergency risk communication literature published since 2000 focuses heavily on the events focuses heavily on the events surrounding Hurricanes Katrina and Rita, our results may be biased towards risk communication regarding natural disasters and the at-risk populations represented in the Gulf States. Finally, though we reviewed a relatively small sample of statutes, regulations, and related reports deemed relevant for inclusion added a useful dimension of evidence to the review, because of the limited applicability of the data abstraction form in characterizing these references, our ability to synthesize these citations into the larger review of peer-reviewed literature was somewhat limited.
The compendium targeted materials that are widely available (e.g., through national organizations) and easily accessible on the Internet. Given the wide-ranging set of possible sources, we chose to use a snowball-sampling strategy. This strategy may have limited the search, unintentionally excluding some materials, such as those not available on the Internet. However, the compendium is not intended to be a census of risk communication: such a database would not be cost-effective to create and would be quickly outdated. Hence, caution should be used when making generalizations from the compendium. 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 part of the task was more qualitative, although structure was provided through the use of a standardized score sheet. Still, the subjective nature of these reviews should be acknowledged, and conclusions taken as suggestive.
Another limitation of our site visit approach is that we are not able to generalize the findings beyond the particular perspectives of the informants we interviewed. Although we strived to speak with informants in all of the organizations listed in Table 2, differences in state structures and access to individuals across the types did not allow for uniform coverage of informant type across states. In addition, our description of risk communication activities does not represent the totality of any state’s efforts in the area. Nevertheless, the site visits provide a snapshot of emergency preparedness activities at the state and local levels where we were able to collect information. As such, these findings provide a sense of how some local and state planners approach risk communication to address the needs of at-risk populations in emergencies.
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