Communication challenges in Public Health Emergencies with particular attention to the Underserved

Transcription

1 Communication challenges in Public Health Emergencies with particular attention to the Underserved K. Vish Viswanath, PhD Harvard School of Public Health Dana-Farber Cancer Institute Dana-Farber Harvard Cancer Center 1 Today s Presentation Context of Communications in Public Health What we know from our research: Two case studies What DID NOT work What WORKED Implications for practice 1

2 Population groups of interest Members of lower socioeconomic position Ethnic and Minority groups Groups at the intersection of race/ethnicity and social class Communication and Media within the PHEP System Public health system is fragmented City, county, and state departments Structure and functions vary Non public health partners Health care, policy, EMS, media, 2

3 What are they seeing? Complexity of the information environment Sheer amount of information Quality of information Where do people go for information? Who do they trust? Do all people gain equally from this information? What are the consequences? What do we do? Information Environment on A(H1N1) What are they seeing? Problem with ubiquity 23 Million hits on Google!! Almost 200,000 stories from April-December 2009! 3.6 million blog entries! 3

4 Information Environment on A(H1N1) Information Environment on A(H1N1) 4

5 Shortages and Confusion in Flu Fight Doctors swamped by swine flu vaccine fears Swine Flu Fact Check: Separating Fact From Fiction Pandemic Flu: There's still no reason to panic. World Health Organization: Swine Flu Pandemic Imminent Information Environment on A(H1N1) Track the Swine Flu Outbreak With a Google Map Mashup Should You Give Your Child The Swine Flu Shot? 28 Apr 2009 by geeksugar Iowa Cat Makes Swine Flu History Appears To Catch Virus From Humans H1n1 5

6 Challenges in the Information Age Challenge# 1 More information does not necessarily mean more communication 6

7 The Swine Flu Are Pigs to Blame? NRI dies of swine flu in Ahmedabad, death toll rises to four 7

8 Communication under uncertainty Communication under Uncertainty No defined cause or solution Too much grey area leaves a lot of room for interpretation leading to mistakes Clear and defined statement are more helpful 8

9 Sources of Information National Survey Received the most information from: 32% Local TV news 21% National Network News 19% Internet 14% Cable News 6% Newspapers Results from Harvard Opinion Research Survey fielded in April 2009, not statistically different in May 2009 survey Trusted Sources for Information Low SEP Focus Groups Doctors were viewed as highly credible sources of information The multiple number of doctors on local television, however, caused confusion among some and made them wonder whom to trust. But it was like each station had their own little doctor expert. I don t know if we have a Surgeon General, because it used to be like, if there was a real emergency, the Surgeon General would come on and tell you, But it was like Channel 7 had this person, 4 had that person 5 had another person While most participants first heard about A (H1N1) from TV, they did not rate it as a highly trusted source 9

10 Behavior Change National Survey Washed hands or used hand sanitizer more frequently: 59% (April) 67% (May) 62% (June) Stopped shaking hands with people: 14% (May) 12% (June) Swine flu fallout rattles sports world 10

11 Behaviors Information overload 11

12 Challenges in the Information Age Challenge #2 Information is always unequally distributed There exists a Communication Inequality among individual and groups where some people have better access to information, pay more attention to it, learn more from it and have the capacity to act on it. Using the Internet for Health Purposes 12

13 Using the Internet for Health Purposes Use of internet for health by household income 2005 HINTS Prev valence of internet health use (%) <100% FPL 100%- 300% FPL 300% FPL Houshold income (% of the Federal Poverty Level) Results/main source of information/ education & race 13

14 Results/main source of information/ education & race Results/barriers to information access/ self efficacy & education 14

15 Results/barriers to information access/ self efficacy & vaccination Results/health information seeking/ information source & education 15

16 Flushed cold water faucets after crisis 31 Likelihood beliefs 32 16

17 First source of information: by age 33 First source of information: by education 34 17

18 First source of information: by race 35 Information sharing: channels by age (all participants) 36 18

19 Information sharing: channels by education (all participants) 37 Information sharing: channels by race (all participants) 38 19

20 Information sharing: number of people 39 Implications There are significant differences among social groups in the way people acquire information during a public health emergency Among different channels Local TV still matters Internet and social media s influence is questionable at this stage People perceive an Information Overload with the possible danger of ignoring the message Need someone they can trust and find reliable to deliver the information Confusion persists despite sustained coverage Need more careful attention to inequalities in communication 20

21 Implications It is possible to overcome inequalities with careful planning Preparedness should include public health communication The water crisis i showed that t appropriate planning can bridge communication divides Members of the Viswanath Lab Cassandra Anderson, BA Jaclyn Alexander-Molloy, MS Carmenza Bruff Josephine Crisostomo, MPH Rachel Faulkenberry, MPH Ezequiel Galarce, PhD Lisa Lowery, BS Michael McCauley, PhD Sara Minsky, MPH Rebekah Nagler, PhD Divya Ramamurthi. MS Shoba Ramanadhan, ScD Neyha Sehgal, MPH 21