Risk Communication
Fundamentals
For Public Health
Professionals
Good Risk Communication..
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seeks to
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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
Good Risk Communication...
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seeks to
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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
Steps for Good Risk
Communication
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acknowledge other’s arguments
Ask permission
Apologize
Clean up
Share (benefits or control)
Give credit where it is due
Risk Communication
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need to consider
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the message (information)
the source (origination point of message)
The communicator
the channel (path)
receiver (termination point)
The Message
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Who is the target audience?
How can they be reached?
What level of education do they have?
What do you need to tell them?
The Source
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All sources are not equal (by decreasing
trustworthiness):
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Family Doctor
University researcher
media
Local government
Federal government
Industry
Mersereau & Dugandzic, 1999
The Communicator
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Needs to have:
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Empathy
Trustworthiness (must be earned)
Showing emotion
Good speaker
Eye contact
Identify with audience
Channel or Medium
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Very important to choose the correct one for
your target
Entire messages can be missed if wrong
medium is chosen
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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
Three Rules for Risk
Communication
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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)
EPA Risk Communication
Guidelines
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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
Powell’s Lessons in Risk
Communication

A risk information vacuum is a primary factor in
the social amplification of risk
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ensure the vacuum either does not exist, or fill it with
useful risk messages
Regulators are responsible for effective risk
communication
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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
Lessons (cont’d)
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Industry is responsible for effective risk
communication
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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)
Lessons (cont’d)
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If you are responsible, act early and often
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some upcoming risks in the next decade are
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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
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what about emotion, moral issues, etc.
Lessons (cont’d)
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Always put the science in a policy context
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whatever the risk controversy, the pubic will demand
action by the politicians
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Educating the public about science is no
substitute for good risk communication practice
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ban the substance, control the exposure, etc
provide lots of information, how and why things are
going to be done
Banish “no risk” messages
Lessons (cont’d)
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Risk messages should address directly the
“contest of opinion” in society
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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
How to Communicate Risk to
Public?
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all we have to do is:
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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
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by Baruch Fischoff
Avoid areas of confusion
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Zero risk
Probability
Significant
Too careful estimates
Negative vs. positive findings
Population vs. individual risk
Relative vs. absolute
Association vs. causation
Communication Problems
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occur when the message;
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is not what the audience wants to hear
is poorly presented
is improper
comes from the wrong source
is sent via the wrong channel
10 Deadly Sins of Presenting
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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.
Identifying Strategies
1
look for use of confusing terms in your message
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2
either remove them or explain them
step back and review wording
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listen to other non-scientific discussions to see use of
words and their meaning
adopt the popular usage of the word and its meaning
ID Strategies (cont’d)
3
Pre-test your message
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4
use friend or family member (non-scientific)
ask them to identify words of concern or confusion
Discuss your message with your “mock” audience
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may find out that your explanation is not good enough
may determine where your communication went
wrong
Dealing with the Mixed
Message
1
2
3
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
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4
5
right in the text of the message
use analogies, definitions, comparisons to help
explain the term
be consistent in the use of the term
Designing your Risk
Communication
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Choose your forum
Choose your message
Choose your source
Know your audience!
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Focus group
How People Learn
60
50
40
% 30
oral
visual
written
20
10
0
16-24 25-34 35-44 45-54 55+
Age groups
How do people learn?
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Figure 1-1. Easiest Format to Learn From Preferences by Age Group, From EPA, 2004,
Evaluation of Mercury Risk Communication
Messages.
Exercise: choose your
medium
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Break into groups
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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:
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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?
Know your audience
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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.
Characteristics of your Publics
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Concerns
Attitudes
Levels of interest
Levels of involvement
Histories
Levels of knowledge
Opinions
Reasons for interest
Types of involvement
Are they potential supporters
or potential adversaries?
Interacting with the
Community(Chess et al. 1988)
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Citizen involvement is important because
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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.
Creating the Message
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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)
Sound bite research:
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Assumption: national news, controversial
topic 7 to 9 seconds (21-27 words, 30 words
max.)
3 messages 9 second knowledge/trust
window (Vincent Covello)
Risk Information Vacuum
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work of risk communication is to fill the gap between
public knowledge and scientific assessment of risk
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gap will always exist
how to fill it is the question
risk information vacuum arises when
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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
Vacuum (cont’d)
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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
Vacuum (cont’d)
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the vacuum gets filled:
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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 ......”
Examples of Vacuums
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dioxins
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outrageous media headlines
scientific research
no communications on the issue until too late
Greenpeace filled the vacuum
mad cow disease
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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
Examples of Vacuums
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silicone breast implants
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manufacturers did not disclose their information in a
timely manner
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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
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lawsuits began and are still costing billions of dollars
no scientific information to support the claims
Examples (cont’d)
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genetically altered/engineered crops
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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
Why Aren’t the Experts
Trusted?
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expert group may have financial interest in
proving the risk is small
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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
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and handful of dissenters and activists were right
Why aren’t the experts
trusted? (cont’d)
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scientists tell us that risk assessment is a rough
science and subject to error
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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)
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better act now
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even though no evidence yet exists
What will good risk
communication do?
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over time good risk communication practices will:
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nurture a facility for interpreting risk numbers
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help people to put the whole assortment of risks
affecting them into a broad framework
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including the meaning of risk estimates and the uncertainty
associated with them
relative risk, comparative risk
build institutional structures for arriving at a consensus
on risk management options, and for allocating risk
reduction resources effectively
What is Risk?
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risk= hazard + outrage
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public cares too little about hazard
expert cares too little about outrage
experts need to realize
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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
Other Facts on Risk
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people overestimate hazard and are outraged
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which comes first?
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misunderstand hazard and get outraged?
get outraged and misunderstand hazard?
who is right?
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usually experts are right about hazard
usually public is right about outrage
How to Solve Risk Dilemma?
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solution
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experts must
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take public outrage seriously
keep outrage separate from hazard
respect people’s outrage
Risk Communication: Myths
and Actions (Chess et al. 1988)
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Belief in some common myths often
interferes with development of an effective
risk communication program. Consider the
myths and actions you can take.
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Myth: We don't have enough time and resources
to have a risk communication program.
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Action: Train all your staff to communicate more
effectively. Plan projects to include time to involve the
public.
Myths 2
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Myth: Telling the public about a risk is more
likely to unduly alarm people than keeping
quiet.
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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.
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Action: Pay as much attention to your process for
dealing with people as you do to explaining the data.
Myths 3
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Myth: We shouldn't go to the public until we
have solutions to environmental health
problems.
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Action: Release and discuss information about
risk management options and involve
communities in strategies in which they have a
stake.
Myths 4
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Myth: These issues are too difficult for the
public to understand.
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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.
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Action: Provide the public with information. Listen
to community concerns. Involve staff with diverse
backgrounds in developing policy.
Myths 5
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Myth: Risk communication is not my job.
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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.
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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.
Myths 6
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Myth: If we listen to the public, we will devote
scarce resources to issues that are not a
great threat to public health.
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Action: Listen early to avoid controversy and the
potential for disproportionate attention to lesser
issues.
Myths 7
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Myth: Activist groups are responsible for
stirring up unwarranted concerns.
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Action: Activists help to focus public anger. Many
environmental groups are reasonable and
responsible. Work with groups rather than against
them.
High Hazard, low outrage
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Keep the risk message short.
Make the risk message interesting.
Stay on message.
Test the risk messages.
Plan and prepare for a long-term endeavour.
Appeal to needs.
Appeal to emotions, especially fear.
http://www.psandman.com/handouts/sand59a.pdf)
Cont’d
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See fear arousal as a competition
Don’t neglect other emotions. Identify and
give people task that they can do.
Give people a selection of tasks to choose
from.
Sequence recommended precautions.
Think in stages.
Focus resources on teachable moments.
Cont’d
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Be alert for a short-term over-reaction.
Be alert for signs of denial.
Identify and address persuasion facilitators.
Identify persuasion barriers and consider
addressing them.
Express empathy for apathy.
Consider an alternative: pre-crisis
communication.
What is a Focus Group?
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special kind of interview for the purpose of
collective information about a specific subject or
area of concern
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useful for gathering information on risk perceptions
used to assess needs, preferences and attitudes
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information can then be used to
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formulate risk messages
determine appropriate channel
choose a communicator
frame the risk information in an acceptable way
Focus Group Design
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facilitator spends 2-8 hours with eight to twelve people
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free flowing discussion
group usually made up of individuals who have
something in common
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job is to ensure all areas are explored
usually has a helper to make group work better
age, activity, employed by same company, etc.
record activities on flow chart or tape
Why use a focus group?
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allows participants to discuss a subject openly
and in great detail
research can be conducted quickly
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organize, conduct and analyse research from several
focus groups in as little as 2 weeks
decisions can then be implemented almost
immediately
far less intimidating or frustrating than other forms
of research
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anxiety of the individuals is lessened in the group
context
Goals for Collecting
Information
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determine the interests, needs, attitudes of a
sample of community members about a particular
risk issue
objectives
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determine attitudes and opinions already in existence
determine knowledge level about this particular risk
determine the resources necessary to better
communicate risk
obtain ideas on how to best communicate with this
community
Identifying Participants
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look carefully at the community
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demographics
determine who may have most need for the risk
information
who is more interested?
usually no more than 8 groups are necessary
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more important than numbers is how the groups are
chosen
How to Contact Participants?
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telephone
letters
meeting with people
meeting with leaders of already established
organizations
how to introduce yourself
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why is issue important
who you are
what is the objective of the focus group
why is the individual valuable
Planning and Preparation
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place
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find a comfortable location, accessible to the majority
make sure there are enough chairs and room for
everyone
time and date
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convenient to majority
be there an hour before hand
let everyone know how long it will be, and stick to it
don’t go longer than 2 hours
Leading the Focus Group
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guidelines
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no right or wrong answers
opinions are wanted
we do not have to agree
it is important for everyone to participate
we will finish in two hours
your names will be confidential
all the information will be used in your community
Focus Group Skills
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facilitator
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avoid a question and answer session
let it be open
set a cooperative tone
be open and pleasant
be prepared and organized
establish and maintain an easy rapport
be non-judgmental
use probing techniques (to get further information)
Closing the Focus Group
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summarize the session briefly
thank them for their ideas
ask if they want to know the results
ask them if they want to keep in touch
give them your name and number for future contact
let them know when the information will be released to
the community
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and when they will be able to give feedback
Nelson Fok
Case Studies
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Choose one of the 4 cases:
Who is your audience?
What is your message?
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What three things do you want to communicate?
What words will you use?
Who is your communicator?
What/who is your source?
What will be your method/forum?
Case 1
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E coli has been found in water supply for a
small area of cottage country, rural Canada.
Case 2
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Breast feeding rates are very low in your
health region. You have been tasked with
trying to improve the rate to national levels.
Case 3
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A local industry wants to build an incinerator
in your area. They have been a good
corporate citizen in the past, and have good
environmental history. Your department has
approved the incinerator. The local people
are upset and demanding answers. They are
worried about cancer and emissions.
Case 4
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A poor result from a food inspection has
resulted in closing down a famous restaurant
in the middle of tourist season. The owners,
some public and the mayor are upset with
your department.
Present results of Case Study