Be First. Be Right. Be Credible. · 2019. 5. 13. · hurricanes Irma and Maria. Photo by Myron...

National Center for Environmental HealthAgency for Toxic Substances and Disease Registry

Be First. Be Right. Be Credible.

Crisis and Emergency Risk Communication Principles for Public Health Disasters

Vivi Siegel, MPHActing Associate Director for Communications

Division of Environmental Health Science and Practice

National Center for Environmental Health, CDC

Ragan Crisis Communications ConferenceOmaha, NE, May 9-10, 2019

The right message at the right time from the right person can save lives.

Overview

1. Communicating in a Crisis

• Why is crisis communication different?

• Six principles of Crisis and Emergency Risk Communication (CERC)

2. Psychology of a Crisis

3. Putting it into Action

• The JIC

• Messaging

4. Case study: Responding to Hurricanes Irma and Maria in St. Croix, USVI

COMMUNICATING IN A CRISIS

Types of Public Health Disasters

• Infectious disease outbreaks

• Natural disasters and severe weather

• Bioterrorism

• Chemical and radiation exposures

Communicating in a Crisis is Different

• In a catastrophic event, communication is different.

• In a serious crisis, all affected people

• Take in information differently.

• Process information differently.

• Act on information differently.

What is CERC?

CDC’s Crisis and Emergency Risk Communication (CERC) manual was first published in 2002 to provide an approach to health communications during emergencies based on experience and psychological and communication sciences.

www.cdc.gov/cerc

Fully integrated CERC helps

ensure that limited resources are

managed well and can do the

most good at every phase of an

emergency response.

Six Principles of CERC


1. BE FIRST:

Crises are time-sensitive.

• If your organization has information, and it is your responsibility to provide it, do so as soon as possible.

• If you can’t provide information, explain how you are working to get it.


2. BE RIGHT:

• Accuracy establishes credibility.

• Give facts in brief messages.

• Tell people what you know when you know it, tell them what you don’t know, and tell them what is being done to find more information.


3. BE CREDIBLE:

• Honesty should not be compromised.

• Tell the truth.

• Uncertainty is worse than not knowing.

• Rumors are more damaging than hard truths.


4. EXPRESS EMPATHY:

• Suffering should be acknowledged in words.

• Empathy can help build trust.

We are thinking of you during this difficult time.

During times like these, all of us feel a little uncertain.

…or…

Remember that we care about you.

These are difficult circumstances and I understand any fear you are feeling.

Example Expressions of Empathy


5. PROMOTE ACTION:

• Giving people things to do calms anxiety.

• Promoting action can help restore a sense of control.


6. SHOW RESPECT:

• Always treat people the way you want to be treated—the way you want your loved ones treated—even when hard decisions must be communicated.

• Showing respect to people is important when they feel vulnerable.

• Recognizing people’s value can help promote their cooperation and build rapport.

Exercise1. Be first.

2. Be right.

3. Be credible.

4. Express empathy.

5. Promote action.

6. Show respect.

Suffering should be acknowledged in words.

Giving people meaningful things to do calms anxieties.

People tend to remember the first message they hear.

Tell people what is known, what is not known, and what is being done to fill in

the gaps.

Honesty should not be compromised.

It is especially important to consider when people feel vulnerable.

Match the number of the CERC principle that goes with each concept below.

PSYCHOLOGY OF A CRISIS

What do people feel when a disaster threatens?

Psychological barriers:

1. Denial

2. Fear, anxiety, confusion, dread

3. Hopelessness or helplessness

Communicating in a Crisis is Different

People tend to

• Simplify messages

• Hold onto current beliefs

• Look for additional information and opinions

• Believe the first message

Hazard and Outrage Differences & Principles

• Hazard: Scientific Measure

• Outrage: Emotional Measure

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

How do we communicate about risk during an emergency?

High Hazard Low Hazard

High Outrage

Low Outrage

Example: Hazard and Outrage

Bioterrorism attack with anthrax in your area

Example: Hazard and Outrage

Bioterrorism attack with anthrax in your area


High Outrage

Low Outrage


High Outrage

Low Outrage

Scenario Example: Hazard and Outrage

Severe flu in your area

Scenario Example: Hazard and Outrage

Severe flu in your area


High Outrage

Low Outrage

PUTTING IT INTO ACTION

The Joint Information Center

CDC Joint Information Center: Primary Functions

▪ The JIC centralizes CDC’s communication response to public health emergencies

• Strategic communication planning and execution

• Monitoring news, social media, and public inquiries

• Creating materials across all channels and audiences

• Evaluating message effectiveness

• Coordinating with emergency partners

• Managing the emergency clearance process

CDC Joint Information Center: Primary Audiences

▪ The JIC provides health information to the following audiences:

• General public

• Vulnerable populations

• International agencies

• Media

• Clinicians

• Public health workforce

• CDC employees

CDC Joint Information Center: Primary Channels

• News

• Social media

• CDC web site

• CDC-INFO call line

• Health Alert Network (HAN)

• Clinician Outreach and Communication Activity (COCA)

• Public Health Partners

• Internal CDC web site

Staffed by Lead CIO (augmented by other CIOs)

Staffed by ERCB

Staffed by OADC

Staffed by other

CIOs

Legend

Triage

Communication Field

Staff Support

Research & Evaluation

Outreach

Web

Clinician Communication

Emergency Clearance

(ERCB)

Staffing

JIC Lead JIC Co-Lead

OADC LNO

Media

Global

CDC Connects

Communication Services

Social Media

Content

CDC-INFO

CDC Joint Information Center: Structure


Messaging

Phase-Based Messaging

▪ Developed during response to Hurricane Katrina and used since

▪ Messages are planned in advance to anticipate and meet needs at different stages of a response

▪ Uses risk communication principles

▪ Adaptable as needed

Phase-Based Messages for a Hurricane

Coordinating Phase-Based Messaging

▪ Clear and share in advance with all relevant organizations

▪ Allow suggestions and comments – iron out any disagreements

▪ Decide who leads on each type of message

▪ During the response, stay in sync through constant contact

Phase-based messaging for a radiation disaster

(adapted from US plan for IND communications)


The Communications Plan

▪ Communications Objectives (WHY)

▪ Audiences (WHO)

▪ Key Messages (WHAT)

▪ Channels (HOW)

▪ Proposed Timetable (WHEN)

Key Messages:

▪ Message 1

• Supporting message



▪ Message 2




▪ Message 3




Short-term vs. Long-term planning. What changes?

Lo

ng

te

rm

• Maintaining trust• Engaging audiences• Adapting channels• Timing must be planned• Changing, new messaging• Two-way communications• Resources scarcer

Sh

ort

te

rm

• Establishing trust• Identifying audiences• Using all channels• Timing is event-based• Pre-planned messaging• One-way communications• Resources available

Trust and Consistency

▪ Don’t blow it at the beginning

▪ Consistency builds trust: set and adhere to expectations

▪ Transparency

▪ Acknowledge audience needs

▪ Are your partners trustworthy?

▪ Build relationships

▪ Maintain trusted spokespeople

Communications Infrastructure

▪ Personnel

▪ Ongoing planning

▪ Translations and printing

▪ Meeting space

▪ Earned and paid media

Prepare for communications infrastructure needs: include communicators at ALL STAGES of the planning process


In the Field

Principles are the SAME

Methods May Differ

▪ Language

▪ Cultural considerations

▪ Channels

▪ Government Structure

▪ Barriers to Action

Language

Be specific.

Who are your audiences?• Language

• Dialect

• Accent

• Speaker

• Photos

Don’t forget to UPDATE materials in all languages.

Ti-Joël, a famous Haitian cartoon character, stars in six animated educational films that show young people how to avoid and treat cholera. - Produced by UNESCO and Haiti’s Ministry of Public Health and Population

Language

SI Units (International) Common Units

Radioactivity becquerel (Bq) curie (Ci)

Absorbed Dose gray (Gy) rad

Dose Equivalent sievert (Sv) rem

Exposurecoulomb/kilogram (C/kg)

roentgen (R)

International System of Units (SI) Unit and Common Unit Terminology

https://www.remm.nlm.gov/radmeasurement.htm

Culture

▪ Do suggested actions conflict with cultural practice?

▪ Show respect

▪ Be specific

Culture

“Marianne and the other wise people approach the villagers in the traditional manner, speaking of peace and brotherhood, apologizing for the intrusion, offering their condolences and handing out cola nuts. Soon they are surrounded by dozens of women and men, young and old, whose anger subsides as they finally begin to open their hearts: they have lost friends and family – the majority of the more than 100 people who have become ill with Ebola in Guékédou, have died. Marianne listens to the people and then tells the villagers how they can protect themselves from the disease. The process is lengthy and can take up to three hours. Marianne has visited 7 villages in two weeks.”

http://www.who.int/features/2014/ebola-in-villages/en/

Channels

▪ How do your audiences get their information?▪ Which sources are trusted? ▪ Are any channels unavailable – and what are the backups?

• Person-to-person• Mass media– radio, newspaper, internet? • Social media and apps• Text messages• Printed fliers• Loudspeakers• Government bulletins• Community leaders• Partnerships

Channels

Between November 1986 and

September 2002, approximately 180

900 cases of Bovine Spongiform

Encephalopathy (also known as

Mad Cow Disease) were confirmed

in the United Kingdom (UK).

CHANNELS

http://www.euro.who.int/__data/assets/pdf_file/0009/98397/E87919.pdf

Channels

http://www.unmultimedia.org/radio/english/2016/02/ebola-hero-shares-how-radio-saved-lives-in-liberia/#.WWpKsIdlJD8

Structure

• Who is in charge? • Where do I or my counterparts sit? • What processes, systems, and

relationships are in place? • What clearance will I need for

communications products? • Whose buy-in do I need?• Are leaders open to new ideas? Am I?

BarriersWhy might people not be following public health messages?

Physical barriers

• Lack of access to equipment, transportation, education, sanitation

• Violence

• Telecommunications system differences

Cultural barriers

• Different customs, diet, values

• Religious differences

Lack of trust

• Distrust of “experts,” government, or outsiders

• Misunderstandings

Getting started

▪ Plan.

▪ Ask.

▪ Listen.

▪ Build trust.

▪ https://emergency.cdc.gov/cerc/index.asp

▪ http://www.who.int/risk-communication/en/

CASE STUDY: USVI 2017

2017 Hurricane Season – Major Impacts in USVI

▪ Drowning

▪ Carbon monoxide poisoning

▪ Displaced persons

▪ Power loss

▪ Contaminated drinking water

▪ Damaged/destroyed infrastructure

▪ Non-functional clinics and hospitals

▪ Affected medical and public health staff

▪ Mold in homes and buildings

U.S. Virgin Islands after Hurricane Maria landfall

A scene of damage in St. Croix in October, 2017. The island suffered 100 percent power outages and extensive infrastructure damage due to back-to-back hurricanes Irma and Maria. Photo by Myron Douglas/CDC

Field CommunicationsSt. Croix, USVI, Oct. 2017

▪ One staff communicator for entire health department

▪ CDC deployed 12 communicators over 6 months

▪ Our mission: to support state/territorial health department in communications activities, be the link between the health department and CDC messaging, and help strategize as needed

A scene of damage in St. Croix in October, 2017. The island suffered 100 percent power outages and extensive infrastructure damage due to back-to-back hurricanes Irma and Maria. Photo by Myron Douglas/CDC

Communication Channels

How do you get messages out with no internet and no power?

USVI DOH Communications Director Nykole Tyson, right, shares health messages on Straight Talk with Redfield radio show, WVVI 93.5, with hosts Holland Redfield and Cassandra Dunn. Jonny Andia, Nathan Huebner and Vivi Siegel assist. Photo by Myron Douglas/CDC

Radio

Communication team member Myron Douglas, right, with USVI DOH epidemiologist Monifa Corillo with table of health information materials at Plessen Health Fair, St. Croix, USVI, Oct. 14, 2017. Photo by Vivi Siegel/CDC

Health Fairs

Home improvement store mold cleanup display. These materials show people the equipment and supplies they need to safely clean mold.

Displays

Friends and Family

CDC and USVI DOH collaborated to create a one-page flyer with priority health and safety information. With assistance of CDC Foundation, Office Max, USPS, and USPIS, the flyer was distributed to all 51,000 households and PO boxes in the territory.

Direct Mail

For more information, contact NCEH1-800-CDC-INFO (232-4636)TTY: 1-888-232-6348 www.cdc.govFollow us on Twitter @CDCEnvironment

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Questions?

Be First. Be Right. Be Credible. · 2019. 5. 13. · hurricanes Irma and Maria. Photo by Myron...

Documents

Transcript of Be First. Be Right. Be Credible. · 2019. 5. 13. · hurricanes Irma and Maria. Photo by Myron...