Communicating during epidemics

Although scientific and medical knowledge has increased to respond to large epidemics, health authorities fail to increase vaccination uptake because of ineffective communication. Better communication strategies need to be developed and implemented.

The EU-funded E-COM@EU (Effective communication in outbreak management: Development of an evidence-based tool for Europe) project aims to investigate factors affecting vaccination uptake, such as community perception and official communication about risk. The final result will be a set of evidence-based tools for policy makers, customizable for each European country.

Team members first prepared a chronology of events regarding the A/H1N1 influenza pandemic, including media attention, for five European countries. Results indicated that media attention did not increase proportionally to the number of infections, but rather highlighted key events according to their news value. The group recommended that media attention should be considered a window of opportunity for authorities to inform the public about where to obtain reliable information during the further course of the epidemic.

Research also indicated that media attention peaked long before the height of the epidemic. This may explain the lowered risk perception and low vaccination uptake. Investigators recommended that media messages communicate coping options in addition to threat warnings. Messages about threat, lacking such options, will cause panic.

A behavioural review showed that people are not influenced by rational decision making alone, when deciding to comply with recommended measures. So far, not much consideration has been given to the emotional appeal in communications during epidemics. Behavioural models can help in this respect. There is a need for clear and consistent behavioural recommendations, so that different authorities do not recommend different behavioural responses in pandemic situations.

A literature review of risk perception during the A H1N1 pandemic showed that risk perception evolves over time and differs per region. It is therefore important to monitor risk perception and adjust communication accordingly.

Healthcare professionals should promote influenza vaccination, but many are not vaccinated themselves. Their uptake can be increased by educating them on their responsibility, improving access to vaccination, using incentives and/or disincentives, or using role models.

Under-vaccinated groups have distinct information, access and support needs. Policy makers should not wait for the next outbreak to initiate communication with them, but undertake regular communication to build relationships and trust, and prepare outbreak communication plans.

Based on these findings, the E-com team produced a set of web tools for public health experts, such as tools to review preparedness, to estimate vaccination uptake, and to assess risk perception of the public. Also, an infographic poster was developed “Journey through a flu pandemic” plus a prototype smartphone-App. These tools can help to improve communication preparedness for the next pandemic.