Transcript Document

Crisis & Emergency
Risk Communication
Barbara Reynolds, Ph.D.
Hong Kong H5N1 Outbreak, 1997
CDC Epidemiologic
Investigation
Surveillance & Control
1918 Pandemic Deaths by Age
Figure 2. "U-" and "W-" shaped combined influenza and pneumonia mortality, by age at
death, per 100,000 persons in each age group, United States, 1911–1918. Influenza- and
pneumonia-specific death rates are plotted for the interpandemic years 1911–1917
(dashed line) and for the pandemic year 1918 (solid line)
Jeffery K. Taubenberger* and David M. Morens†
*Armed Forces Institute of Pathology, Rockville, Maryland, USA; and †National Institutes of Health, Bethesda, Maryland, USA
Communicating in a crisis is
different
 In a serious crisis, all affected people . . .
– Take in information differently
– Process information differently
– Act on information differently
 In a catastrophic event: communication is
different
 Be first, be right, be credible
What the public seeks from
your communication
5 public concerns. . .
1. Gain wanted facts
2. Empower decisionmaking
3. Involved as a participant, not spectator
4. Provide watchguard over resource allocation
5. Recover or preserve well-being and normalcy
Crisis Communication Lifecycle
Precrisis
• Prepare
• Foster alliances
• Develop
consensus
recommendations
• Test message
• Evaluate plans
Initial
• Express empathy
• Provide simple risk
explanations
• Establish credibility
• Recommend
actions
• Commit to
stakeholders
Maintenance
• Further explain risk
by population groups
• Provide more
background
• Gain support for
response
• Empower risk/benefit
decisionmaking
• Capture feedback for
analysis
Resolution
• Educate a primed
public for future
crises
• Examine problems
• Gain support for
policy and resources
• Promote your
organization’s role
Evaluation
•
•
•
•
Capture lessons learned
Develop an event SWOT
Improve plan
Return to precrisis
planning
5 communication failures that
kill operational success
1.
2.
3.
4.
5.
Mixed messages from multiple experts
Information released late
Paternalistic attitudes
Not countering rumors and myths in real-time
Public power struggles and confusion
Six Principles of CERC
 Be First: If the information is yours to provide by
organizational authority—do so as soon as possible. If
you can’t—then explain how you are working to get it.
 Be Right: Give facts in increments. Tell people what
you know when you know it, tell them what you don’t
know, and tell them if you will know relevant information
later.
 Be Credible: Tell the truth. Do not withhold to avoid
embarrassment or the possible “panic” that seldom
happens. Uncertainty is worse than not knowing—
rumors are more damaging than hard truths.
Six Principles of CERC
 Express Empathy: Acknowledge in words
what people are feeling—it builds trust.
 Promote Action: Give people things to do. It
calms anxiety and helps restore order.
 Show Respect: Listen. Treat people the way
you want to be treated—the way you want your
loved ones treated—always—even when hard
decisions must be communicated.
Decisionmaking in
a Crisis Is Different
 People simplify
 Cling to current beliefs
 We remember what we see or previously
experience (first messages carry more weight)
 People limit intake of new information (3-7 bits)
How Do We Communicate
About Risk in an Emergency?
All risks are not accepted equally
 Voluntary vs. involuntary
 Controlled personally vs. controlled by others
 Familiar vs. exotic
 Natural vs. manmade
 Reversible vs. permanent
 Statistical vs. anecdotal
 Fairly vs. unfairly distributed
 Affecting adults vs. affecting children
Accuracy of
Information
__________
Speed of
Release
Empathy
+
Openness
CREDIBILITY
Successful
=
+
Communication
TRUST
Sources of Social Pressure
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What will I gain?
What will it cost me?
What do those important to me want me to do?
Can I actually carry it out?
Trust and Mistrust
 Stakeholders judge the response to an issue or
crisis based on trust
 Trust is the natural consequence of promises
fulfilled
 Mistrust is an outgrowth of the perception that
promises were broken and values violated
 CDC fulfills trust by combining our best science
with strong ethics and values
Consequences of mistrust
 Health recommendations ignored and disease
and death go up
 Demands for misallocation of resources
 Public health policies circumvented
 Opportunists prey on others in the “trust gap”
 Fiscal and medical resources are wasted
We can’t accomplish our mission
Causes of conflict:
perception by either party of
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Superiority
Injustice
Distrust
Vulnerability
Helplessness
Stages of Values Disputes
1. Feels threatened (you survive or I do)
2. Situation becomes distorted (they are evil)
3. Rigid explanations for own behavior (we’re
protecting people from quacks)
4. Conflict becomes self-identity
Dealing With Angry People
Anger arises when people. . .
 Have been hurt
 Feel threatened by risks out of their control
 Are not respected
 Have their fundamental beliefs challenged
Sometimes, anger arises when . . .
 Media arrive
 Damages may be in play
Deescalating conflict with
“them”
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Seek input early
Seek common principles
Approach the process fairly
Acknowledge emotions, appeal to reason
H1N1 outbreak April 2009
 CDC had been on the hunt for a pandemic
influenza virus for nearly half a century
 Between 1997 and 2009, pandemic planning
included communication planning
 With H1N1, CDC used social media widely for
major outbreak
Crisis Communicator
Richard Besser
led the United
States’ top
public-health
agency as swine
flu broke out on
its doorstep. And
his
communication
shaped the early
days of a
pandemic
CERC Communication
Principles
 In his office at ABC News in New York, Besser
talks about the principles he looked to when
talking about the H1N1 pandemic. He refers to a
CDC pamphlet on crisis and emergency risk
communication with the subtitle: 'Be First, Be
Right, Be Credible'.
– 13 January 2010 | Nature 463, 150-152 (2010) |
doi:10.1038/463150a
Social Media:
Crisis Role
Social media in a crisis: the
good
 Need to be where people are
 Leverage unique characteristics of emerging
channels
 Tailored health messages
 Facilitates interactive communication and
community
 Empowers people in making health decisions
Social media . . . Good & bad
 Provided rich choices to support CDC’s desire to
communicate with, not to, the public in a more
personal and targeted way. (good . . . )
 What was essentially unknown was whether the
use of social media during the H1N1 outbreak
would work to increase or decrease the public’s
trust in CDC’s recommendations and response.
(bad . . . )
www.cdc.gov/socialmedia
CDC H1N1 Social Media
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Buttons & Badges
CDC-INFO
eCards
Image Sharing
Micro-blogs (Twitter)
Mobile
Online Videos
Podcasts
RSS Feeds
Social Networking Sites
Text Messaging Pilot
Widgets
Buttons and Badges
 Add a button to your Web site. Let your Web site visitors know how
to stop the spread of novel H1N1 flu and where to get more
information about novel H1N1 flu.
 Choose a novel H1N1 flu Button in English
 Choose a novel H1N1 flu Button en Español
E-Cards H1N1
 Keep your friends, family and coworkers
informed. Send them tips for staying healthy and
avoiding the flu by washing their hands. Visit the
CDC Health-e-Cards site today to send a loved
one an eCard.
H1N1 Image sharing
 View and share novel H1N1 flu images from the
CDC Flickr site
CDC Mobile Web site
 Your Mobile Source for Credible Health
Information
 CDC's health information is now available on
your mobile device. Visit m.cdc.gov on your
mobile phone or PDA for information on
seasonal flu, H1N1 flu, public health
emergencies, and more.
Public Inquiry
 CDC National Contact Center
– Representatives are available 24/7 to answer your questions in
English and Spanish. For up-to-date information about novel
H1N1 flu and hundreds of other health and safety topics:
– Call: 1-800-CDC-INFO (1-800-232-4636), TTY: (888) 232-6348,
English/Spanish, 24 Hours/Every Day
 Email: [email protected]
 Postal Mail:
Centers for Disease Control and Prevention
1600 Clifton Rd,
Atlanta, GA 30333
U.S.A.
Social media and trust building
 Trust is needed first
before someone will:
– Feel able to rely
upon a person
(organization),
– Take reasoned risks,
and
– Willingly cooperate
and achieve a goal.
Social media and trust . . . Our
intuition
 Public suspicions of scientific experts and
government are increasing
 Nonetheless, trust and credibility are essential
elements of persuasive communication.
 In fact, the more people know about efforts to
openly share accurate information, the more
they trust the government or industry as the
source.
Before we got started . . .
 CDC made the conscious decision to maintain
its scientific integrity in its messaging through
these new media (e.g., it used simple but still
formal language not jargon)
 and also to respect the norms of the social
networks it joined.
Facebook entries:
shot or no shot?
 Male: Never had any flu vaccination for 10 years and never had any
problem...UNTIL last month I give it a try..BIG mistake, first time
feeling sick like a dog...tsk tsk...talking about conspiracy theory by
Ex-Governor J Ventura was talking about...
 Female 1: baaaa baaaaa Amazing how many of you are clueless. I
would swear that you are being paid to post your nonsense here. By
whom? I can think of a few possibilities.hmmmm Oh and my uncle
just got his h1n1 shot and got sick with the flu within 1 weeks time.
Go ahead baaaaaaaaaaa get that shot.
 Female 2: what flu did he get sick with? was it confirmed h1n1? If
he got sick within a week his inoculation was too late, it takes 2
weeks before the antibodies make you immune to the virus. Makes
me sick how many people think the flu vaccines are killing so many
people and causing autism. Now there is the conspiracy. Go take a
microbiology class, and an anatomy and physiology class. Stop
reading junk science articles.
CDC Tweets targeted & quick
 RT @FluGov: Be Advised of New Spam Myth in
Circulation. CDC has NOT implemented a
vaccination program requiring registration.
 RT @CDCFlu H1N1 Flu Vaccine -- Why the
Delay? Watch a new CDC video to find out how
flu vaccines are made: http://is.gd/4OVFq
 RT @CDCFlu Anyone with asthma is at higher
risk for flu-related complications. Learn more:
http://is.gd/3jwfB
Benchmarking:
Top Federal Twitter Profiles
1. The White House
2,372,328 Followers
2. CDC Emergency
1,299,476 Followers
3. NASA
1,353,095 Followers
4. Federal Communications
Commission
434,338 Followers
5. Department of Justice
412,711 Followers
6. WomensHealth.gov
277,476 Followers
7. Federal Bureau of Investigation
222,560 Followers
8. Food and Drug Administration
194,769 Followers
9. Food Safety and Inspection Service
188,973 Followers
10. CDC_eHealth
165,934 Followers
CDC Audiences Use Social
Media
 Those who use social media on CDC.gov:
– Have higher satisfaction ratings (84 out of
100) than those who do not use CDC social
media tools (79 out of 100)
– Are more likely to return and recommend the
site to others than those who do not use CDC
social media tools
– Rate CDC as more trustworthy that those
who do not use CDC’s social media tools
The good: Trust, transparency &
participation in government
 Pilot to measure TTP in government
 CDC scored higher than other Fed agencies/benchmark
 Largest difference for collaboration online
Participant
CDC
Total
Difference
Online
73
participation
Collaboration 80
65
8
68
12
Trust
81
6
87
The ugly
 Crass, anonymous discussions (stigmatization,
xenophobia, conspiracies . . . )
Swine Flu #1 Google in News
Category, 2009
Google News Fastest
Rising
1. swine flu
2. susan boyle
3. jon and kate
4. adam
lambert
5. rihanna
(chris brown)
6. new moon
7. inauguration
8. michael
jackson
9. nadya
suleman
10. missing link
found
CDC Earthquakes Web site
Page Views for January 1st through 24th
Haiti Earthquake Web
 Search terms focus on
earthquake preparedness
and response.
 Large spikes in traffic
over norm.
 Professional guidance
getting heavy traffic
(wound management,
crush injury, etc.).
 Many Spanish speakers
visiting site.
Earthquake PSAs and Podcasts
 CDC Earthquake PSAs
and Podcasts provide
messages about what
you can do to protect
yourself and your family
before, during, and after.
 To subscribe to this and
other CDC podcasts, visit
the CDC Podcast
Subscriptions page.
Conclusions
 “trust is the natural consequence of promises
fulfilled.” Social media helped CDC to fulfill a
promise to provide fast, accurate, and credible
information to the public that recognized their
emotional stake in the event and respected their
need for autonomy and individuality.
Face the Media
Working with the Media
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What is news?
Messenger
Message
Method of delivery
What is news?
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Change or controversy
Black or white, not gray
Crises or opportunities
Entertain versus inform
Individual versus group/officials
Information sought by media
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Casualty numbers, condition, treatment
Property damage
Response and relief activities
Resulting effects (anxiety, stress)
Questions are predictable
Define your agenda
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What’s your goal?
Who’s the audience?
What’s the audience outcome?
What’s your message?
Developing good messages
 Simple—pay attention to length of sentences
and numbers of syllables in words
 Clear—be wary of convoluted phrases and
assumptions about audience knowledge
 Support statements of belief, judgment, calls for
action with supporting facts
 Headlining—state your conclusion first
The STARCC Principle AGAIN!
Your public messages in a crisis must be:
Simple
Timely
Accurate
Relevant
Credible
Consistent
SPAR
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Set-up
Problem
Action
Result
Preparation Saves Jobs
 Anticipate the hard questions
 Answer the hard questions before they are
asked
 Written Q/As for consistency and Internet
– headline sentence
– supporting facts
– background
How To Work With Reporters
 Reporters want a front seat to the action and all
information NOW.
 Preparation will save relationships.
 If you don’t have the facts, tell them the process.
 Reality Check: 70,000 media outlets in U.S.
Media cover the news 24/7.
Tools To Reach the Public
Through the Media
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Press conferences
Satellite media tours
Telephone news conferences
E-mail listservs and broadcast fax
Web sites/video streaming
Response to media calls
Pitfalls for Spokespersons
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Use of jargon
Humor
Repeating the negative
Expressing personal opinions
Showing off your vocabulary
Sensational or Unrelated
Questions
“Bridges” back to what you want to say:
 “What I think you are really asking is . . .”
 “The overall issue is . . .”
 “What’s important to remember is . . .”
 “It’s our policy to not discuss [topic], but what I
can tell you . . .”
Watch Out For . . .
 Machine gun questioning. Reporter fires rapid
questions at you. You respond, “Please let me
answer this question.”
 Feeding the mike and the pause. Seldom will
dead air make scintillating viewing, unless you’re
reacting nonverbally. Relax.
 Hot mike. It’s always on—always—including
during “testing.”
Watch Out For . . .
 Reporter asks a sensational question and
gives you an A or B dilemma. Use positive
words, correct the inaccuracies without
repeating the negative, and reject A or B if
neither is valid. Explain, “There’s actually
another alternative you may not have
considered,” and give your message point.
Television Interview Tips
 Drive out monotone. The more practice, the less
fear and the greater the prospect that animation
will reappear in the voice.
 Don’t look at yourself on the TV monitor.
 Look at the reporter, not the camera, unless
directed otherwise.
 Do an earphone check. Ask what to do if it pops
out of your ear.
What To Wear on Television
Men
 Avoid patterned suits, stripes, and checks.
 Button double-breasted suits; unbutton single-breasted
suits. Sit on your coattails.
 White or light blue shirts are the most conservative,
serious shirts.
 Neckties should be somber. Do not “advertise” a product
or point of view on your tie—you know what they are.
What To Wear on Television
Men
 Urgent: Wear knee-length socks darker than
your suit. You lose credibility with a “skin shot” of
your legs when your pant legs creep up.
 Be clean shaven.
What To Wear on Television
Women
 Tailored clothes work best.
 Urgent: Short skirts kill credibility as quickly as
short socks on men.
 Neutral colors and less pattern work best.
 Wear dark shoes.
 Avoid jangles.
 Wear regular makeup. For women who never
wear makeup, consider color on the lips.
What To Wear on Television
Men and Women
 Neat, trimmed hair is best.
 If your skin is shiny under the lights, ask for
powder. Men, don’t forget powder for the top of
your head.
 If you can take off the glasses without squinting,
take them off. Consider nonglare glasses if you
must wear them.
Effective Nonverbal
Communication
 Do maintain eye contact
 Do maintain an open posture
 Do not retreat behind physical barriers such as
podiums or tables
 Do not frown or show anger or disbelief through
facial expression
 Do not dress in a way that emphasizes the
differences between you and your audience