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    1. Overview ofRisk Communication Buddy Ferguson Risk Communication Specialist Minnesota Department of Health buddy.ferguson@health.state.mn.us (651) 215-1306

    2. Resources: Sandman articles Covello articles ASTHO Handbook MDH Risk Communication Web Page: www.health.state.mn.us/oep/ riskcommunications.htm CDCynergy CD-ROM (Call or e-mail Buddy for a copy)

    3. How do we deal with the emotional component of how people respond to risk?

    4. What do people respond to..in a crisis? Hazard vs. Outrage What pushes peoples buttons?

    5. The Goal: tailor communication so it takes into account emotional response to event prevent negative behavior that hampers response or causes more harm encourage constructive responses to crisis

    6. Negative Behaviors demands for unneeded treatment (or testing, vaccinations, isolation/quarantine, etc.) reliance on special relationships (I know a guy who can..) unreasonable restrictions on trade and travel MUPS (Multiple Unexplained Physical Symptoms)

    7. Role of Risk Communication build support for response plan assist in executing response plan prevent misallocation & wasting of resources keep decision-makers well informed counter/correct rumors decrease illness, injury & deaths

    8. Different kinds of risk communication: public relations apathetic but credulous audience low hazard/low outrage

    9. Different kinds of risk communication: stakeholder relations attentive but not too upset to listen variable hazard/variable outrage (targeted communication)

    10. Different kinds of risk communication: outrage management core group of outraged individuals/activists low hazard/high outrage

    11. Different kinds of risk communication: health education/issue management audience may be fairly apathetic high hazard/low outrage

    12. crisis/emergency risk communication high hazard/high outrage everybody is a stakeholder

    16. Whats the score on occupational health & safety messages? Bottom line youre probably in the apathy zone, most of the time.

    17. From Sandmans website: 24 Reasons Why Employers Sometimes Ignore Safety Procedures 16 Reasons Why Employees Sometimes Ignore Safety Procedures

    18. Outrage Factors

    19. What are people not so afraid of? auto accidents? smoking? influenza? vaccine-preventable diseases? radon? occupational hazards?

    20. What ARE people afraid of?

    21. Is the risk seen as: voluntaryor involuntary (coerced) within your controlor controlled by others? familiaror unfamiliar (new)? knowable...or unknowable? (well understood vs. not well understood; visible vs. invisible)

    22. Is the risk seen as: well understood by science..or not? natural.or of human origin? not dread...or dread (in terms of consequences)? chronic...or catastrophic (i.e., concentrated in time and space)?

    23. Is the risk seen as: imposed fairly...or unfairly (in terms of risks and benefits)? coupled with possible benefits..or not? morally neutral...or morally relevant? based on information from a trustworthy source..or not? memorable.or not?

    24. Is the risk seen as: controlled by a process that is responsive to public concerns or not? imposed equally on everyone. .or uniquely focused on children? reversible..or not?

    25. Is the risk seen as: something not directly affecting youor something that affects you personally? statistical..or anecdotal (involving identifiable victims)? certain..or uncertain? ignored by media..or a focus of media attention?

    27. Covello simplifies: Factors involving trust are twice as important as factors involving control or benefits.

    28. How do people respond? fear (not necessarily a bad thing) not panic.but denial (dangerous) anger (especially if they arent empowered) helplessness/hopelessness vicarious rehearsal

    29. Vicarious Rehearsal the not our problem zone the we could be next zone the right next door zone

    30. Vicarious Rehearsal some examples anthrax pandemic flu SARS bird flu

    31. What happens when a crisis hits?

    32. Lifecycle of a Crisis pre-crisis (planning phase) initial phase (the critical first 48 hrs.) maintenance phase (expansion of response) resolution phase (the educable moment) evaluation (lessons learned)

    33. The first 48 hours are CRITICAL!

    34. Rememberin an emergency: Be first. Be right. Be credible.

    35. What makes for a poor response? dueling experts delayed communication paternalism unrealistic recommendations lack of immediate response to rumors & myths visible power struggles & conflicts

    36. What makes for a good response?

    37. In a crisis. Dont wait until you have all your ducks in a row before you speak. Stress the process youll use to get answers & address the problem. Provide anticipatory guidance.

    38. Speak with one voice have a consistent message work with partners work through the emergency response system (EOC/JPIC model)

    39. Acknowledge fear Dont pretend theyre not afraid, and dont tell them they shouldnt be. Acknowledge their fears, and put their fears in context. Dont over-reassure Worry about denial not panic.

    40. Acknowledge uncertainty take your seat on the risk communication see-saw (per Sandman) focus on process express wishes

    41. Start with the worst case present the good news as things become clearer dont ever have to say worse than we thought (per Sandman)

    42. Put good news in the subordinate clause Were still not out of the woods yet, although things are looking better.

    43. Beware of risk comparisons Being struck by lightning is not the same as being attacked by a terrorist. school buses and HIV-positive children flu versus SARS

    44. Show respect & empathy Be a human being not just a professional

    45. Give people things to do channel peoples fear dont let it flip into anger or denial provide a range of options what you must do what you should do what you could do

    46. Have a solid communications plan in place (before the crisis hits). message(s) spokesperson(s) audience(s) delivery vehicles partners

    47. Messages

    48. Simplify your message mental noise (makes it harder to:) hear understand remember negative dominance (3 positives = 1 negative)

    49. Message Basics Keep messages short and focused (think single sentences & headlines). Save the background info for later. Covello suggests 7-9 seconds/27 words. Give action recommendations in positive terms (do rather than dont do).

    50. Message Basics Use rhymes, acronyms, groups of 3. Use personal pronouns. Use common figures of speech (cliches). Express caring and empathy. Tell the truth.

    51. Crisis Message no-nos technical jargon too much information condescending or judgmental language attacking/fighting with other people

    52. Crisis Message no-nos promises you cant keep speculation (worst case discussion) (Sandman disagrees) premature discussion of money inappropriate humor

    53. Who speaks? know who your messengers are train them in risk communications emphasize caring and empathy work to build trust

    54. What determines trust? its not about being a natural communicator caring and empathy (acknowledge fear, pain, suffering, uncertainty) (most important half the battle)

    55. What determines trust? competence and expertise (personal and institutional) honesty and openness (if you cant talk explain why) (avoid telling the truth slowly) dedication and commitment (the importance of being there)

    56. The Media

    57. The media perspective The media have their own criteria for assessing information. They arent being perverse -- just acting as surrogates for their audience. Ultimately, they decide what counts as news.

    58. Media During a Crisis Everything speeds up. Less time to verify information. Less adversarial (during the 48-hour initial phase). Expect period of recrimination (later on).

    59. Media During a Crisis Expect them to rely on JPIC as a primary information source. Also expect them to seek out other information sources.

    60. Media During a Crisis Expect their version of event to diverge from yours, more and more, as time goes by. Your version of facts may not be accepted at face value.

    61. Dont count on: balanced coverage, from experienced reporters reporters who take the time to understand complex issues

    62. Dont count on: getting a better story if you avoid talking (until you have all the facts) reporters who still take the time to verify facts (even if they have to work faster)

    63. Dont count on: media who will play it as you say it

    64. You will have to be out there when you dont have all the answers.

    65. The big, big picture transparency (let people in on the process) humility (acknowledging uncertainty) be first and be accurate (set the informational agenda, counter rumors) expect the unexpected get to know your partners