Risk Communication Fundamentals

1. Risk Communication Fundamentals For Public Health Professionals

2. Good Risk Communication.. seeks to translate the scientific findings and probabilistic risk assessment into understandable terms explain the uncertainty ranges, knowledge gaps and ongoing research programs address the issue of building credibility and trust understand the public’s framing of the risk issues, especially the qualitative dimensions

3. Good Risk Communication... seeks to acknowledge the specific questions that arise in this domain (public’s perception) analyse the conditions needed for allowing the public to acquire needed information, skills and participatory opportunities

4. Steps for Good Risk Communication acknowledge other’s arguments Ask permission Apologize Clean up Share (benefits or control) Give credit where it is due

5. Risk Communication need to consider the message (information) the source (origination point of message) The communicator the channel (path) receiver (termination point)

6. The Message Who is the target audience? How can they be reached? What level of education do they have? What do you need to tell them?

7. The Source All sources are not equal (by decreasing trustworthiness): Family Doctor University researcher media Local government Federal government Industry Mersereau & Dugandzic, 1999

8. Needs to have: Empathy Trustworthiness (must be earned) Showing emotion Good speaker Eye contact Identify with audience The Communicator

9. Channel or Medium Very important to choose the correct one for your target Entire messages can be missed if wrong medium is chosen Farmers and pesticide warnings on late night TV Complex written materials for Grade 6 education Written materials for evacuation notice due to fire Radio messages in English for French audience, etc

10. Three Rules for Risk Communication tell people that you have determined they need to know tell them what they must know so that they can understand and feel that they understand the info add qualifiers to prepare them for what you are not telling them (until more info becomes available)

11. EPA Risk Communication Guidelines Accept and involve public as a legitimate partner Plan carefully and evaluate performance listen to your audience be honest, frank and open coordinate and collaborate with other credible sources meet the needs of the media speak clearly and with compassion

12. Powell’s Lessons in Risk Communication A risk information vacuum is a primary factor in the social amplification of risk ensure the vacuum either does not exist, or fill it with useful risk messages Regulators are responsible for effective risk communication Health Canada has an established practice of not announcing the issuance of a regulatory decision US FDA regularly makes brief statements in conjunction with regulatory actions

13. Lessons (cont’d) Industry is responsible for effective risk communication primarily workplace hazards population health hazards (foodborne, etc) general environmental hazards (pesticides, etc) workplace and general env. hazards (metals, etc) incremental risks produced as a byproduct of beneficial industrial products (pharmaceuticals, modern transportation, etc)

14. Lessons (cont’d) If you are responsible, act early and often some upcoming risks in the next decade are food safety endocrine disruptors greenhouse gases and global climate change biotechnology, especially agricultural applications health impacts of atmospheric pollutants There is always more to a risk issue than what science says what about emotion, moral issues, etc.

15. Lessons (cont’d) Always put the science in a policy context whatever the risk controversy, the pubic will demand action by the politicians ban the substance, control the exposure, etc Educating the public about science is no substitute for good risk communication practice provide lots of information, how and why things are going to be done Banish “no risk” messages

16. Lessons (cont’d) Risk messages should address directly the “contest of opinion” in society acknowledge the divergent opinions explain the range of risk estimates legitimate the people who disagree with your risk estimates Communicating well has benefits for good risk management

17. How to Communicate Risk to Public? all we have to do is: get the numbers right tell them the numbers explain what we mean by the numbers show them that they have accepted similar risks in the past show them that it is a good idea for them treat them nicely make them partners All of the above by Baruch Fischoff

18. Avoid areas of confusion Zero risk Probability Significant Too careful estimates Negative vs. positive findings Population vs. individual risk Relative vs. absolute Association vs. causation

19. Communication Problems occur when the message; is not what the audience wants to hear is poorly presented is improper comes from the wrong source is sent via the wrong channel

20. 10 Deadly Sins of Presenting Appearing unprepared. Handling questions improperly. Apologizing for yourself or the organization. Not knowing knowable information. Unprofessional use of audiovisual aids. Seeming to be off schedule. Not involving participants. Not establishing rapport. Appearing disorganized. Providing the wrong content.

21. Identifying Strategies look for use of confusing terms in your message either remove them or explain them step back and review wording listen to other non-scientific discussions to see use of words and their meaning adopt the popular usage of the word and its meaning

22. ID Strategies (cont’d) Pre-test your message use friend or family member (non-scientific) ask them to identify words of concern or confusion Discuss your message with your “mock” audience may find out that your explanation is not good enough may determine where your communication went wrong

23. Dealing with the Mixed Message substitute less confusing words if the word is still needed, clearly define it in the text give examples of intended meaning and some misuses of the term right in the text of the message use analogies, definitions, comparisons to help explain the term be consistent in the use of the term

24. Designing your Risk Communication • Choose your forum • Choose your message • Choose your source • Know your audience! • Focus group

25. How People Learn

26. How do people learn? Figure 1-1. Easiest Format to Learn From - Preferences by Age Group, From EPA, 2004, Evaluation of Mercury Risk Communication Messages.

27. Exercise: choose your medium • Break into groups • Choose your medium based on who the intended audience is (reading from EPA Graph on how people best integrate knowledge) • How would you choose to tell: • 50+ women the risks of hormone replacement therapy? • Teenagers the risks of texting and driving? • A small community of the acceptability of a new incinerator?

28. Know your audience The likelihood of achieving a successful risk communication program increases with your knowledge of those with whom you are communicating. Early in the process, know who your publics are, what their concerns are, how they perceive risk, and whom they trust.

29. Characteristics of your Publics • Are they potential supporters • or potential adversaries? • Concerns • Attitudes • Levels of interest • Levels of involvement • Histories • Levels of knowledge • Opinions • Reasons for interest • Types of involvement

30. Interacting with the Community(Chess et al. 1988) • Citizen involvement is important because • people are entitled to make decisions about issues that directly affect their lives; • input from the community can help the agency make better decisions; • involvement in the process leads to greater understanding of - and more appropriate reaction to - a particular risk; • those who are affected by a problem bring different variables to the problem-solving equation; and • cooperation increases credibility.

31. Creating the Message What are the three most important things you would like your audience to know? What are the three most important things your audience would like to know? What are the three most important things your audience is most likely to get wrong unless they are emphasized? (Vincent Covello)

32. Sound bite research: Assumption: national news, controversial topic 7 to 9 seconds (21-27 words, 30 words max.) 3 messages 9 second knowledge/trust window (Vincent Covello)

33. Risk Information Vacuum work of risk communication is to fill the gap between public knowledge and scientific assessment of risk gap will always exist how to fill it is the question risk information vacuum arises when over a long period of time, scientists make no special effort to communicate the results being obtained regularly and effectively to the public instead, partial scientific info dribbles out here and there, being interpreted in apparently conflicting ways and increases the public’s fear

34. Vacuum (cont’d) failure to implement good risk communication practices gives rise to a risk information vacuum this failure can have grave and expensive consequences for those regarded as being responsible for protecting the public’s interest society abhors a vacuum, so it is filled from other sources

35. Vacuum (cont’d) the vacuum gets filled: events reported in the media will become the basis for the public framing of these risks an interest group takes up the challenge and fills the vacuum with its own information and perspectives the intuitively based fears and concerns of individuals grow & spread until they become a substantial consensus in the arena of pubic opinion vacuum is filled by soothing sentiments of politicians “there is no risk of danger from ......”

36. Examples of Vacuums dioxins outrageous media headlines scientific research no communications on the issue until too late Greenpeace filled the vacuum mad cow disease panic ensued when government did not provide details on the suspicions around the spread of BSE vacuum was filled by media and individual suspicions that become consensus

37. Examples of Vacuums silicone breast implants manufacturers did not disclose their information in a timely manner failed to encourage a frank and open discussion of potential risks vacuum was created by the lack of this discussion panic and fear of autoimmune diseases filled the vacuum lawsuits began and are still costing billions of dollars no scientific information to support the claims

38. Examples (cont’d) genetically altered/engineered crops people upset because the technology is unfamiliar government doesn’t want to talk about the issues with the public vacuum will be filled, and it may be damaging to the industry

39. Why Aren’t the Experts Trusted? expert group may have financial interest in proving the risk is small remediation technology spokesperson wanting to use the technology local mayor wanting to get re-elected company spokesperson not wanting plant shut down historical examples exist of where experts were wrong and handful of dissenters and activists were right

40. Why aren’t the experts trusted? (cont’d) scientists tell us that risk assessment is a rough science and subject to error need to better explain how risk assessment is done need to better explain the use of safety factors some environmental risks are gradual, delayed, geometrical (made worse by other risks) better act now even though no evidence yet exists

41. What will good risk communication do? over time good risk communication practices will: nurture a facility for interpreting risk numbers including the meaning of risk estimates and the uncertainty associated with them help people to put the whole assortment of risks affecting them into a broad framework relative risk, comparative risk build institutional structures for arriving at a consensus on risk management options, and for allocating risk reduction resources effectively

42. What is Risk? risk= hazard + outrage public cares too little about hazard expert cares too little about outrage experts need to realize outrage is as real as hazard outrage is as measurable as hazard outrage is as manageable as hazard outrage is as much a part of risk as hazard outrage is as much a part of your job as hazard Peter Sandman

43. Other Facts on Risk people overestimate hazard and are outraged which comes first? misunderstand hazard and get outraged? get outraged and misunderstand hazard? who is right? usually experts are right about hazard usually public is right about outrage

44. How to Solve Risk Dilemma? solution experts must take public outrage seriously keep outrage separate from hazard respect people’s outrage

45. Risk Communication: Myths and Actions (Chess et al. 1988) • Belief in some common myths often interferes with development of an effective risk communication program. Consider the myths and actions you can take. • Myth: We don't have enough time and resources to have a risk communication program. • Action: Train all your staff to communicate more effectively. Plan projects to include time to involve the public.

46. Myths 2 • Myth: Telling the public about a risk is more likely to unduly alarm people than keeping quiet. • Action: Decrease potential for alarm by giving people a chance to express their concerns. • Myth: Communication is less important than education. If people knew the true risks, they would accept them. • Action: Pay as much attention to your process for dealing with people as you do to explaining the data.

47. Myths 3 • Myth: We shouldn't go to the public until we have solutions to environmental health problems. • Action: Release and discuss information about risk management options and involve communities in strategies in which they have a stake.

48. Myths 4 • Myth: These issues are too difficult for the public to understand. • Action: Separate public disagreement with your policies from misunderstanding of the highly technical issues. • Myth: Technical decisions should be left in the hands of technical people. • Action: Provide the public with information. Listen to community concerns. Involve staff with diverse backgrounds in developing policy.

49. Myths 5 • Myth: Risk communication is not my job. • Action: As a public servant, you have a responsibility to the public. Learn to integrate communication into your job and help others do the same. • Myth: If we give them an inch, they'll take a mile. • Action: If you listen to people when they are asking for inches, they are less likely to demand miles. Avoid the battleground. Involve people early and often.

50. Myths 6 • Myth: If we listen to the public, we will devote scarce resources to issues that are not a great threat to public health. • Action: Listen early to avoid controversy and the potential for disproportionate attention to lesser issues.