Background

As stressed in the report of the Task 2.2. of the ASSET project, on “unsolved scientific question concerning epidemics and pandemics”, currently, the collaboration between international and local communities concerning public health (PH) communication and PH decisions is far from ideal and there are a lot of heterogeneities between international guidelines and their national versions. This is mostly due to the fact that international guidelines for risk communication take very little consideration of local problems: this is what we call one way, top-down communication.

Therefore, one of the challenges of PH communication of interest for epidemics and pandemics (e.g. risk communication) is to take into consideration possible local problems and concerns, which could be achieved through a two-way communication strategy. This strategy would largely lessen the challenges of one-way risk communication with respect to the current one-sided approach: feedback from local entities and from public would become an integral part of the process of communication strategies and PH decisions. Moreover, this approach would be more appropriate given the inherent dynamic nature of communication.

The two-way adaptive decision making is an increasingly important part of general political decision making and communication, where political decision-makers are shifting from the traditional top-down approach to the two-ways paradigms of governance and communication. A more dialogue-based PH communication is considered important in general and not only in relation to health risks. However, the one-to-many traditional communication approach is easier and, consequently, it is the preferred approach of communication professionals.

A two-way communication is the optimal communication for PH problems related to epidemics and pandemics (and not only), because only by using this approach, the authorities responsible of communication are able to stay tuned with the perception of the public. For example, several studies showed that theories underlying risk communication are strictly related to theories concerning risk perception. Two-way communication also represents an efficient way to design tailored communication campaigns. Moreover, the public is more inclined to follow recommendations or to listen to a communicated message when having been involved in the decision-making process.

Project description

For example, in 2009, in USA, the Association of State and Territorial Health Officials (ASTHO) surveyed the population on their attitude towards vaccination, in order to adapt their communication messages and clearly and accurately promote the benefits of vaccination in ways that resonate with family decision makers. A total of 1,278 parents and guardians were interviewed using an online established survey panel.

Main aims of the study were to:

• explore the reason of parents/guardians for not vaccinating their children
• evaluate potential effective messages to address this refusal of vaccination
• identify most trusted and influential information sources about vaccination
• understand the differences between parents who vaccinate their children from those who do not in terms of their beliefs, attitudes, demographics, etc.

The collected information was afterwards used to create a toolkit for communication for health officers to use, including methods of effective communication about vaccines, key messages to communicate, but also personalized messages depending on the target audiences. In 2010, draft messages issued from the toolkit were tested in focus groups of mothers in Atlanta, Washington D.C. and Seattle. Feedback from these focus groups was incorporated in the final messages.

Lessons learned and challenges

The majority of parents vaccinate their children, while remaining concerned with their safety and related adverse events. Even if immunization rates are high, the level of concern is growing, therefore convincing parents to vaccinate is a persisting challenge. The results of this survey suggest that paediatricians, as well as public health officials and the CDC are seen as reliable sources of information on vaccine issues. Once the key messages on vaccination benefits that will resonate with general public are found, the challenge consist in a successful delivery of these messages by the public health officials. Unfortunately, results of the efficacy of the tailored messages of this particular study is not available; it would be useful to see if these kind of tailored campaigns have an impact on vaccination rates or attitudes towards vaccination in a community.

Status of the project

The project is currently finished. It would be interesting to conduct similar studies before conceiving awareness or vaccination campaigns in other communities too.