Best practices for effective communication


1. Build trust

As the foundation for effective outbreak communication, the most critical

objective is to build, maintain, or restore public trust in those responsible

for managing the outbreak and issuing information about it. This primary

importance of trust was found to be true across cultures, political systems,

and levels of economic development.

Trust derives from public perceptions of the motives, honesty, and

competence of authorities. Public confidence that a government or agency

is acting first and foremost to safeguard health will influence compliance

with recommended control measures and thus hasten outbreak

containment. Trust in the honesty of authorities and confidence that no

disconcerting facts are being downplayed or concealed reduces public

anxiety during the inevitable uncertainties of an outbreak. Confidence that

the authorities are competent and in control further helps prevent reactions

that exacerbate an outbreak’s social and economic impact.

2. Announce early

Early announcement of an

outbreak is the best strategy. Since human behaviours nearly always play

a role in outbreak spread, early announcement contributes to early

containment in a situation where every day counts. Equally important,

early announcement wins public confidence that authorities are openly

reporting what they know when they know it, setting expectations that

information will not be concealed.

smallpox, poliomyelitis, human influenza caused by a novel virus subtype,

or SARS must be reported immediately.

The first communication about an outbreak is often the most important.

Because of the very nature of outbreaks, the announcement will be a

newsworthy item that comes as a surprise, captures media and public

attention, and has great potential to alarm. How that initial announcement

is handled – when the spotlight is most intense – is likely to colour the

reception of all subsequent messages. Delayed announcement of an outbeak

creates the impression that officials are concealing information and may

be more concerned about preventing public anxiety and loss of income

from trade and tourism than protecting public health. The resulting loss

of trust, right at the start, can prove impossible to regain.

3. Be transparent

Transparency characterizes the relationship between the outbreak

managers and the public. Transparency can be defined as communication

that is candid, easily understood, complete, and accurate. In general,

greater transparency results in higher trust. Transparency provides many

benefits, including showing how even at a time of uncertainty and many

unknowns, outbreak managers are systematically seeking answers. Since

transparency can also reveal management shortcomings, it provides a

strong incentive for deliberative and accountable decision-making.

Transparency also has limits, as some information, such as confidential

patient data, should not be made public for ethical reasons. The key is to

balance such concerns against the public’s right, need and desire for reliable

information. Establishing the limits of transparency may vary from

outbreak to outbreak, but if transparency limits become an excuse for

secretiveness, the likely result will be a loss of public trust.

4. Respect public concerns

The public is entitled to information that affects their health and the health

of their families. Public concerns should be treated as legitimate, explored,

and respected as a force that will influence an outbreak’s impact. Early

risk communication was didactic, setting out the facts, telling the public

how it should react, and then describing any other reactions as “irrational”.

Today, effective risk communication is viewed as a dialogue between

technical experts and the public.

Transparency has limits, as some information should not be made public for ethical

reasons.

An outbreak gains the attention of many different publics – those at risk,

patients and their families and neighbours, the media, researchers,

community leaders, trade partners, and tourists – and affects them in

many different ways. Outbreak communication works best when the views

of all these publics are considered when decisions are made about what to

say and how to say it. Once decisions are made, partners should strive to

present information in a coordinated and consistent way. In announcing

decisions early in an outbreak, the press will be helpful, especially if outbreak

management is transparent. But journalists can quickly turn adversarial

if they feel they have been deceived.

5. Plan in advance

Planning is essential for effective outbreak communication and yet it is

rarely done. Outbreak communication planning must be a part of outbreak

management planning from the start. Under the emergency conditions of

an outbreak, communication cannot be ideally effective when its principles

are considered only at the last minute in the rush to release information.

At the same time, however, outbreak communication that is not planned

in advance is not necessarily doomed to failure. As noted during the

consultation, many countries affected by SARS had no communication

plans in place, yet communicated very effectively with the public. Others

made major mistakes – and paid dearly; these could have been avoided

had the communication issues been considered in advance.

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