communicating environmental health risk uncertainty: a systematic review of the literature cindy...
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Communicating Environmental Health Risk Uncertainty: A Systematic Review of the Literature
Cindy JardineUniversity of Alberta
S. Michelle DriedgerUniversity of Manitoba
Study Objectives
To evaluate empirical studies of communicating uncertainty about environmental health risk to the public
To produce evidence-based recommendations that can be used by health practitioners
Focus of Extraction & Synthesis
1. What are the domains/categories/sources of uncertainty relevant to communicating uncertainty in environmental health risks to different stakeholders, with a specific focus on the public?
2. What empirical evidence exists regarding strategies, methods or channels to communicate uncertainty about environmental health risks to the public?
3. What empirical evidence exists about the optimal timing in communicating uncertainty to the public?
Methods
English language articles Published between January 1985 and Sept.
2008 Input from collaborators representing regional,
provincial and national health agencies
Systematic Review ProcessScreening Level Criteria Total
Broad Screening 31 databases, 38 related terms, key journal search, key author search 29,499
Quick Exclusion Health risks only23,104
General Exclusion Relevant to communication, uncertainty, environmental health risk 2,365
Detailed Exclusion Relevance, empirical, description of methods 1,026
Full Text Screening Available, relevance, empirical, detailed description of methods 282
Final Extraction Domains of risk uncertainty, evidence on communication methods/processes, and evidence on timing
28
Overview of Final Articles
28 articles from 1985 to 2008 (Sept.) 21 articles from 2000 to 2008 7 articles from 1985-1999
Most studies from the US (14) and the UK (5)
Quantitative, qualitative and mixed methods
Disciplinary perspectives: public health, health policy, communication studies, risk management, medicine, social sciences, nutritional sciences
Overview of Lessons Learned
Domains of Uncertainty
Trust: linked to source credibility
and perceived degree of knowledge
people lose trust of media and government when irrelevant or inadequate risk information is released
Reprinted with permission ScienceCartoonsPlus.com
Domains of Uncertainty
Ambiguity: impacts the public’s ability to
make health protection decisions and may intensify anxiety
does not impact perceptions of preventability
suggests that risk communication should focus on presenting concrete health protection recommendations in uncertain risk scenarios
Reprinted with permission © 2009 Dave Granlund politicalcartoons.com
Domains of Uncertainty
Appropriate Scientific Boundaries: discomfort with technological
advances in biotechnology or genetically modified organisms
linked to trust when concerns are discounted
information (including uncertainty) needs to be framed in relation to current concerns instead of the abstract future
Reprinted with permission ScienceCartoonsPlus.com
Strategies, Methods & Channels
Meet the needs of the audience: explicitly stating uncertainty is received differently by different
people - for some it will signal honesty, for others it will signal incompetence (linked to trust)
range estimates work when presented simply risk comparisons are generally not effective graphics are received differently by different people flow charts are best for understanding, but people prefer to read
FAQ sheets. brochures and leaflet mail-outs are useful for discussing
common risks, but not for not unfamiliar or new risks
Strategies, Methods & Channels
Reprinted with permission. Cartoon by Bradford Veley/bradveley.com
Strategies, Methods & Channels
Meet the needs of the media: journalists are often bound by
deadlines and the need for a compelling story
daily oral updates during emergencies followed by more formal written news releases shown to combat rumours or poor media information source choices
Strategies, Methods & Channels
Spokespeople matter: scientists are great spokespeople
choices because they have existing expertise and/or understanding of the risk situation
limiting the number of spokespeople allows for greater message control, decreases contradictory and inconsistent messages and limits the damage to the institutions image
credibility of the spokespersons’ organization impacts public trust/willingness to listen to communications involving uncertainty
Reprinted with permission ScienceCartoonsPlus.com
Optimal Timing
Initial information accuracy: information learned at the
beginning of the situation remains most salient, regardless of the new information released e.g. slow information releases
by the CDC during the anthrax attacks prompted the media to release misinformation due to impatience and news deadlines.
e.g. food safety learned at early ages most effective
Reprinted with permission www.CartoonStock.com
Optimal Timing
Release information as soon as possible: communicating
uncertainty or lack of information is more palatable when released early.
being candid about why information is not yet available is more understandable and palatable to the public
Reprinted with permission Cartoon by Bradford Veley/bradveley.com
Take home messages
Represented with permission © Mischa Richter / The New Yorker Collection
Acknowledgements
Funded by: Canadian Institutes of Health Research, Knowledge Synthesis & Knowledge Translation
Research Assistants: Alison Watson, Chantal Ritcey, David Sulz, Darby Love, Andrea Milne, Elizabeth Deblois, Erica Wright, Amanda Boyd, Elizabeth Cooper, Bhavnita Mistry, Stephanie Kowal
Collaborators: Dr. Mike Routledge (Manitoba Health), Dr. Maura Ricketts (Canadian Medical Association), Mr. Alex MacKenzie (Alberta Health and Wellness), Mr. Nelson Fok (Alberta Health Services), Ms. Tamara Magnan (Health Canada)
