Even within the same at-risk population, messages may need to be tailored. Thus we propose an expanded definition: At-risk individuals are those who have, in addition to their event-related medical needs, social and structural needs that may interfere with their ability to access or receive medical care, prepare for an emergency, and take appropriate measures (e.g., evacuate, shelter-in-place, etc.) Cultural competence requires a significant investment of time and training. Equal number of resources targeted members of vulnerable populations and their caregivers, with somewhat fewer resources targeting providers. Children are a vulnerable population with special needs and schools are a promising setting for delivering risk communication to children and other vulnerable populations. Assistant Secretary for Planning and Evaluation, Room 415F One mechanism that facilitates dissemination of risk communication messages in California includes contracting with disability organizations to leverage resources. AAOHN Journal, 55(5), 197-207. Based on balancing various considerations, the governments decision making had to depend upon maintaining political image and social stability, because the outbreak management might disturb the social order. Can they be an active participant in this process? Ensuring the effective incorporation of at-risk populations into existing and future policy, planning, and programmatic documents at the federal and state levels. Poor trust and privacy concerns. Site visit informants mentioned that effectively communicating with at-risk populations was difficult because of the attitudes of their target audience. The project team searched each of these organizations websites. (2004). The 2018 Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health recognizes the maturity and experience jurisdictional public health emergency preparedness and response programs have gained since 2011. 3 efficacy of an emergency management strategy, especially when resources are limited." (Hobbs, Kittler, & Fox, et al. The publics feedback enables the government to adjust its emphasis of information delivery and provide information in relation to the publics own interests and valuescommunication can be most effective when it reflects an understanding of what the public wants to know [43,45]. Trust is one major objective in risk communication. Not surprisingly, one prominent attitude was complacency. Site visit informants reported that their constituents are very diverse ethnically, making it nearly impossible to translate risk communication materials into all the languages needed. To identify gaps and commonalities in available resources. Lundgren, R. (1994). People have widely varying capacities to process risk messages, including scientific and technical understandings of risk. Building a capacity for systematic evaluations to track messages, monitor media coverage, and survey recipients following emergencies accompanying responses will be key to identifying what works and what does not work to increase public awareness and compliance. Crisis and Emergency Risk Communication. Risk communication: A handbook for communicating environmental, safety and health risks. These resources provide public health officials information for identifying at-risk groups and developing Community Outreach Information Networks (COINs . Enhanced training for those delivering messages about the special needs of different at-risk populations may increase trust among members of these populations. Use of community forums and engagement of community partners in the evaluation will ultimately help to improve the capacity of agencies and their cultural competence with at-risk populations. and respond adequately to risk communication messages during an emergency. However, even for those with Internet access, these electronic systems often become unavailable for all populations during disasters that affect electrical supply during the immediate aftermath of emergencies. The White House. Retrieved on-line December 7, 2007 at http://www.dhs.gov/xlibrary/assets/NRPbaseplan.pdf. The actions of the authorities in attacking whistleblowers who privately delivered the clinical characteristics of the coronavirus on social media further enhanced peoples risk perception about the outbreak. Bilingual youth are also involved as community educators with at-risk populations, including migrant camp areas and other neighborhoods whose residents may respond better to these interactive forms of communication than to typical didactic messaging. Sexton, K.H., Alperin, L.M. Public health disaster research: Surveying the field, defining its future. Rosenkoetter, M. (2007). Sellnow T.L., Ulmer R.R., Seeger M.W., Littlefield R.S. Message Mapping. European Food Safety Authority When Food Is Cooking Up a StormProven Recipes for Risk Communications 2017. The all-star score sheet is included in Appendix B4. [(accessed on 10 March 2020)]; China Coronavirus: Misinformation Spreads Online about Origin and Scale. Chan School of Public Health, Division of Policy Translation and Leadership Development, Harvard Chan Executive and Continuing Professional Education on Twitter. Health Promotion Practice, Epub ahead of print, p.1-6. Risk communication should begin as soon as a risk has been identified and should continue as new information becomes available [38] (pp. Providing a sense of agency is very helpful.. Log In. Newark, DE: University of Delaware Disaster Research Center. It is a sustained communication process established with a diverse audience about the likely outcomes of health and behavioural attitudes. This task centered on the compilation of emergency-related risk communications designed to address the needs of vulnerable populations. Contracting with disability organizations. How have those strategies been translated into educational and outreach information? Although, there is currently no evidence for assessing the impact of exercises (Dausey, Buehler, and Lurie, 2007), our compendium review echoes the idea that training activities should directly address at-risk populations including making messages clear and comprehensible, using concrete examples to make the messages more immediate, and tailoring to the specific audience and situation. Preparing for the unthinkable: Emergency preparedness for the hematopoietic cell transplant program. ), targeting members of those at-risk populations, their caregivers, and/or the provider communities that serve these populations. Becker, S.M. Policies about risk may evolve and be communicated in a variety of ways. In her review of risk communication activities during public health emergencies, Glik (2007) also noted the need for systematic evaluations of the effectiveness of risk communication, particularly during actual events. Ibrahim, A., & Hameed, A. Towards an evidence-based approach to communicating uncertainty in intelligence analysis. Chesser, A., et al. It also augments the resources available to achieve a core recommendation from the literature review: communicate early, communicate often, and communicate in accessible and personally relevant ways. Some politicians, according to Viswanath, are not helping matters. Pandemic and All-Hazards Preparedness Act. Additionally, as the public health emergency risk communication literature published since 2000 focuses heavily on the events surrounding Hurricanes Katrina and Rita,[22, 26, 27, 28, 32, 40, 41, 43, 58] our results may be biased towards risk communication regarding natural disasters and the vulnerable populations represented in the Gulf States. Dynamic Situation of Outbreak Management. The content of those messages may involve input from the Oklahoma Departments of Health and Rehabilitative Services or other state agencies, depending on the issues involved. Communication is a critical component of helping individuals prepare for, respond to, and recover from emergencies. Available from: http://www.ncmec.org/missingkids/servlet/NewsEventServlet?LanguageCountry=en_US&PageId=2150. ), Communicating Risks to the Public. (2007). Because of this, they were separated from the main compendium and are not included in the following analyses. Strategies, Techniques and Changes in Business Communication. While translation is an obvious first step towards effective risk communication with non-English speakers, several studies we reviewed indicated that translation is not enough. Indeed, these extra efforts to reach senior citizens are especially valuable: our review of the literature suggests that this population is less likely to access sources of information, such as the Internet, that are becoming increasingly popular media for disseminating emergency risk communication. Among the subset of materials we judged to be all-stars and reviewed in greater depth, we confirmed many of the findings from the literature review. The definition used here has been adopted by the Department of Health and Human Services and was derived from recommendations of the Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities, the draft implementation plan for the Pandemic and All-Hazards Preparedness Act, and the draft revisions to the National Response Plan. Each all-star resource was rated on six dimensions using a scale ranging from poor to truly extraordinary, with relatively finer distinctions made at the high end of the scale, reflecting that these resources had already been identified as exemplary. Share lessons learned across organizations and geographic regions. Free text entries were entered into the SPSS database, cut, and sorted into thematic categories. Risk communication should be an open, honest, and frank process, instead of essentially manipulative. It specifically asks states to coordinate activities within and across state and local jurisdictions, community organizations, health care providers and facilities, tribal organizations, etc. Data analysis. 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). For example, one state accessed a large volunteer base of trained instructors and presenters who were skilled in different languages and were from different cultures. We provide the timeline of risk communication progress in Wuhan and use a message-centered approach to identify problems that it entailed. [(accessed on 5 February 2020)]; Tang B., Wang X., Li Q., Bragazzi N.L., Tang S., Xiao Y., Wu J. Estimation of the Transmission Risk of 2019-nCoV and Its Implication to Public Health Interventions. Not over- or under-reassuring, but simply laying out risk and potential consequences with the appropriate tone. The interim reports use the term vulnerable populations instead of at-risk populations. We further discuss principles for effective risk communication reflecting on Wuhans case. The government was busy refuting these rumors. It also includes stage of preparedness, which was catalogued as preparedness, response, or recovery. Individuals with Disabilities in Emergency Preparedness (Executive Order 13347): Executive Order 13347, Individuals with Disabilities in Emergency Preparedness[16] created the Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities. It's something we take for granted. Table 3 presents a cross-tabulation of vulnerable population by emergency type. In modern society, risk is an interdisciplinary issue. Most common were themes related to the clarity and understandability of the resources, closely followed by comprehensiveness and having an action orientation. The NRP was the only citation included in this review that addressed public health emergency prevention as a specific emergency stage. However, the percentage of the population engaged with the Internet is steadily increasing,[60] and given that employing multiple modes of communication increases the chances of reaching the hard-to-reach,[36] adding the Internet to the public health emergency risk communication arsenal could increase the chances of adequately addressing the needs of some vulnerable populations. Keeping in mind that access may be limited, consider Internet-based communication strategies, particularly during emergency response and recovery. This document and trademark(s) contained herein are protected by law. Most of these citations were primarily descriptive and qualitative in nature, with an emphasis on emergency response to natural disasters (as opposed to emergency preparedness or recovery related to other types of public health emergencies). Journal of Health Care for the Poor and Underserved, 18(2), 418-430. Annual Reviews of Public Health, 28, 33-54. Our objective is to describe the essential elements of a resilient public health system and how the elements interact as a complex adaptive system. All vulnerable populations included in the PAHPA definition are not included in Chapter 68 of Title 42. The lessons from the outbreak management in Wuhan suggested that the accessibility and openness of information should be enhanced to form convergent points in the whole communication process, especially when dealing with uncertain issues, should keep the public regularly and timely informed, and should take care of the communication strategies dealing with uncertainties. A clear and integrated Risk Communication and Community Engagement (RCCE) strategy and response is vital for community uptake of essential public health and biomedical interventions to prevent and . Rogers, B., & Lawhorn, E. (2007). Unlike journalists, public health officials, and other gatekeepers of information, people on social media dont necessarily have to abide by strict standards of fact-finding. Introduction to the IRGC Risk Governance Framework, Revised Version. Conducting exercises and drills that include at-risk populations. Recommendation #76: Credible spokespersons for risk communication should be identified and coordinated as part of White House crisis communications efforts. If you can do damage to any of the principles, it can have potentially devastating consequences.. We used semi-structured interviews conducted in person or by phone, each lasting approximately 45 minutes to two hours long. Smoking Knowledge and Behavior in the U.S.: Sociodemographic, Smoking Status, and Geographic Patterns. Still, the subjective nature of these reviews should be acknowledged, and conclusions taken as suggestive. In collaboration with the Sheriffs Department, the California Department of Health and Human Services, through its PIO, conducts periodic exercises to ensure that responders are properly trained for helping at-risk populations during a disaster. For example, we also learned about the importance of CBOs that are closely linked to non-English speaking populations in helping to ameliorate concerns of immigrants they will be reported to the immigration and naturalization service and mistrust of public health officials. In fact, we know from recent public health events and other emergencies that there are gaps in the ability of communities to respond to the special needs of at-risk populations. Masking fears: SARS and the politics of public health in China. Oklahoma is in the process of developing the Push Partner Program. Risk Assessment and Risk Communication Strategies in Bioterrorism Preparedness Editors: Manfred S. Green, Jonathan Zenilman (Professor of Medicine), Dani Cohen, Itay Wiser, Ran D. Balicer Scarcity of relevant evidence-based resources Practical approach for coping with current bioterrorism threats [40, 43, 44]. Our literature review identified the importance of having those tasked with communicating to the public about risk (e.g., public health officials, public information officers [PIOs], and the media) engage the community, use trusted sources to deliver messages, and offer frequent messages in multiple modes that are locally and personally relevant. In accordance with the development of the COVID-19 outbreak, Table 2 illustrates the processes of internal and external communication with other events related to COVID-19 information. ), The Handbook of Social Psychology (Vol. Messages should be readily understood by the intended audiences, in whichever medium or language they are presented. For example, SAMHSAs substance use and trauma-related webcast (#77) combines an interview video with parallel PowerPoint slides (with the option of enabling closed captioning). COVID-19 originated in China and has spread across the world, but data are still being collected about cases in the United States. For example, speaking slowly and in an audible voice is necessary for television/radio messaging, presenting messages in large font and with appropriate color contrast is necessary for print messages, etc. A Fact Sheet for People who are Deaf or Hard of Hearing, Tornadoes-- Are You Ready? For the purposes of this report, we endorse the HHS definition of at-risk populations which places emphasis on their medical needs but also highlight other types of needs regarding their ability to prepare, evacuate, and respond adequately to the risk communication messages. For example, we could not survey at-risk populations to determine associations between disaster experiences, exposure to risk messages and their impact. Convened by The Florida Health Care Association, Emergency Preparedness on the Job for People with Disabilities, The Center for Disabilities and Special Needs Preparedness (DPC), OTH (dealing with disasters while at work), Emergency Preparedness at Home for People with Disabilities, Just In Case Emergency Readiness for Older Adults and Caregivers & Emergency Readiness Checklist for Older Adults, U.S. Department of Health and Human Services Administration on Aging; Aging in Stride, Emergency Preparedness: Taking Responsibility for Your Safety Tips for People with Disabilities and Activity Limitations, Los Angeles County Emergency Survival Program, posted 05/2/06, An ADA Guide for Local Governments Making Community Emergency Preparedness and Response Programs Accessible to People with Disabilities, U.S. Department of Justice, Americans with Disabilities Act, Masters of Disaster Quick Start Guide-- Family Kit, Masters of Disaster Quick Start Guide-- Educator's Kit, Facing Fear: Helping Young People Deal With Terrorism and Other Tragic Events, Ready Set Prepare! However, use of registries comes with a number of challenges. Involve the public in dialogue about risk. GovernmentExpertPublic Risk Communication model. The parish nurses and other community nurses use a core set of materials to train others about emergency preparedness in their respective congregations. Because little rigorous evidence is currently available in this area, we set out to identify what information does exist and to learn where more research is needed to fully inform policy makers about meeting the communication needs of at-risk populations. February 2017, Volume 27, Issue 1. It serves as a step-down version of 911 for non-emergency needs. However, based on the literature review and site visits, we found that there is currently little formal evaluation of past efforts to inform communities about future risk. (2005). 539-598). The purpose of this systematic review . American Journal of Public Health, 95(3), 489-495. At this stage, the goal was not to quantitatively evaluate each and every resource. Once the review research team conducted a pilot test of the DAF to ensure inter-rater reliability regarding consistency of data abstraction and to determine whether the categories adequately captured data from the literature, the remaining citations were divided among the team for full review. Our review (Task 3) had three aims: Describe promising communication strategies for public health emergency risk communication with vulnerable populations. (2005). These considerations are organized in two groups: (1) questions that were within the scope of the project, but that we were not able to address given the lack of evidence; and (2) questions that were beyond the scope of the project. Informants in this state have also developed an inventory of messages for confirmed and unconfirmed events. 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. Soc Pract Rev. [9] In particular, such a strategy can lead to ah-ha moments with recipients, enhancing the perceived value of the resource. Few informants reported challenges or barriers to conducting risk communication that were specific to senior citizens. Eisenman, D.P., et al. The tool will allow health departments to geographically identify where the most vulnerable members of their communities live (e.g., individuals with disabilities, non-English speaking individuals). (Ed). 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. Misinformation can stem from our knowledge gaps: not yet having a full understanding of the virus and our seeming inability to act beyond staying at home. Within both natural disasters and unspecified emergencies, the two most common emergency types, the frequency of different vulnerable population resources parallels the total (presented in the final column), with disabled being the most common vulnerable population targeted. The Literature is Primarily Descriptive and Qualitative in Nature, Qualitative studies were most often represented in the literature on public health emergency risk communication with vulnerable populations,[21, 23, 29, 30, 31, 32, 33, 43, 44, 45, 61, 69, 70, 72] followed by literature reviews[24, 25, 35, 36, 37, 38, 46, 56, 65] and observational studies (survey-based). With funding from the Office of the Assistant Secretary for Preparedness and Response, RAND is currently completing an interactive web-based GIS tool to be used by health departments for this purpose. Retrieved August 18, 2008, from http://emergency.cdc.gov/planning/continuationguidance/pdf/communication_attachf.pdf. Summarize the quality and content of the peer-reviewed literature and relevant statutes and regulations addressing public health emergency risk communication with vulnerable populations for all stages of emergency preparedness. Recommends needs assessments to identify vulnerable populations and to enlist them planning and response activities. April is Family Preparedness Month in Oklahoma. (PSA-- TV ad), Tips for Talking to Children in Trauma1/28/2008 Interventions at Home for Preschoolers to Adolescents, What's Going on in the Mind of a Child Who's Lived Through a Hurricane? [14], Community involvement may help emergency risk communications overcome common barriers to success related to trust and available resources for communication dissemination. 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. Nor did we examine the effectiveness of new technology approaches for reaching at-risk populations. [24, 34, 47, 65], As our working definition of risk communication highlights the importance of actionable information, we examined citations for whether specific functional areas were addressed in the context of risk communication (i.e., did the communication provide actionable information or instruction related to specific functional areas). Regarding vulnerable populations, the Guide suggests that emergency planners conduct needs assessments to identify vulnerable populations and to enlist members of vulnerable populations in planning and response activities, including drills and exercises. Finally, our literature review, compendium search, and interviews provided triangulating information about how risk communication for at-risk populations is used and highlighted those activities that are particularly innovative and that hold promise for broader use across states. The message-centered approach offers scientific and systematic methods to achieve convergence and to avoid asymmetric information around issues of risk. For example, in communities that have specific churches with established ministries for immigrants, CBOs, and even immigration lawyers, involving them as partners is essential for reaching immigrant communities. ), Thinking with Data. Published online by Cambridge University Press: 03 November 2022. Mass media use, neighborliness, and social support: Assessing causal links with panel data. U.S. Department of Health and Human Services, Administration on Aging. The timeline of risk communication of Wuhans case is self-summarized from these media sources. The Federal Response to Hurricane Katrina: Lessons Learned: The publicly available Hurricane Katrina: Lessons Learned report[11] follows a timeline beginning before Katrinas landfall and ending with the continuing recovery efforts in the Gulf States. Finally, as mentioned previously, GIS systems can be an effective tool for mapping the location of at-risk populations. U.S. Department of Health and Human Services Support. The review research team (EB and SS) examined titles and abstracts to filter out duplicate retrievals and to determine whether citations met additional inclusion criteria (Criterion A, Table A1). Subsequent analysis focused on the dimensions upon which specific all-star resources were seen to excel. This summary includes descriptions of the types of vulnerable populations; the stages of emergency preparedness, response, and recovery; the types of public health emergencies; the functional areas; and the barriers to risk communication addressed in the literature to date. Each all-star resource was then reviewed carefully, rated on six dimensions, including the extent to which the resource: Reviewers made notes on the motivation behind their ratings and also noted key messages delivered by the resource. Both Department of Health interview informants in Montgomery County and Washington, DC, are partnering with a local CBO to craft and disseminate the messages. Clinical Characteristics of 2019 Novel Coronavirus Infection in China. Some chapters of the state Red Cross conduct periodic telephone surveys with members of the community about preparation to inform future program design. Europe Journal of Public Health, 16(6), 592-599. In addition, less than 30 percent of sheltered populations had access to American Sign Language (ASL) interpreters, so individuals with hearing impairment had limited ability to receive information about risks and recovery (Wingate et al., 2007). That assessment concluded that lack of proficiency with English, cultural differences, and limited literacy were the greatest barriers faced by the states at-risk populations. The Washington, DC, metro area in particular is poised to respond to threats of terrorism given the events of 9/11 and the subsequent anthrax attacks. The committees strive to use people first language that attributes positive labels to people, such as people with disabilities, and avoids negative labels, such as the handicapped or the disabled. 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