1. AN INTRODUCTION TO RISK COMMUNICATIONS December 2014 1 RESEARCH INSTITUTE FOR TROPICAL MEDICINE

2. 2 Session Objectives To ensure that participants have an understanding of the function of risk communications in EVD prevention and control To ensure participants have a basic understanding of the process of risk communication in EVD prevention and control DECEMBER 2014

3. 3 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Risk Communications defined “ Risk communication is an interactive process of exchange and evaluation of information among stakeholders and the establishment of appropriate and effective communication actions and responses. It is an integral component of public health risk management.” (Asia Pacific Strategy for Emerging Diseases, 2010*). 3 * http://www.wpro.who.int/emerging_diseases/documents/docs/APSEDTechnicalPapers03Sep10Final.pdf DECEMBER 2014

4. 4 RESEARCH INSTITUTE FOR TROPICAL MEDICINE “ For a highly lethal disease like Ebola, which has no vaccine or cure, information aimed at behavioural change becomes the principal preventive measure. ” (WHO, 2004) 4 DECEMBER 2014

5. 5 RESEARCH INSTITUTE FOR TROPICAL MEDICINE 5 Principles of Risk Communications i)Trust: communications should build, maintain and restore trust between public and outbreak managers ii)Announcing early: late announcements erode trust between public and outbreak managers iii)Transparency: new developments should be communicated in a timely and complete way iv)Listening: seek to understand how the public perceive a given risk and what their existing beliefs and practices are v)Planning: integral to achieving i – iv. 5 DECEMBER 2014

6. 6 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Priority Groups/Target Audiences Primary Target Audiences (PTA): people who may be directly affected by EVD, through direct exposure to a case –Travellers from countries of intense EVD transmission, relatives of travellers, community members who live where the positive case lives Secondary Target Audiences (STA): people who can influence the health decisions of the PTA –Health professions, HEPO, teachers, politicians, media professionals, celebrities 6 DECEMBER 2014

7. 7 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Evidence based risk communications Formative research in planning stages to assess: Knowledge and attitudes around transmission modes Perceived EVD susceptibility KAP around EVD prevention measures Perceived benefits of adopting preventive behaviours Perceived self-efficacy of adapting preventive behaviours Perceived barriers and costs of adopting preventive behaviours 7 DECEMBER 2014

8. 8 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Stages of Change Model 8 DECEMBER 2014

9. 9 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Stages of Change (cont) Note that this is not always a linear process! –Pre-contemplation: no intention to change –Contemplation: aware that problem exists but not yet made commitment to take action –Determination: intending to take action –Intention: considering making change –Action: behaviour is trialled –Maintenance/advocacy: maintains desired behaviour and becomes an advocate [relapse] 9 DECEMBER 2014

10. 10 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Risk communication is results orientated 10 DECEMBER 2014

11. 11 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Stages of EVD prevention & control: a risk communications perspective 11 Pre-event Introduction of disease Rapid increase Peak transmission Decrease in incidence Eventual resolution DECEMBER 2014 Fig 1. Number of presumptive case-patients with EVD, by week of onset: Uganda, August 2000 – January 2001

12. 12 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Adapting communications 1 Pre-event: basics of EVD (transmission routes and prevention) 2 Introduction of EVD: transparency is key in communicating facts around index case 3 Rapid increase of EVD and peak transmission: manage fear and panic while addressing misconceptions. May need to re-adapt initial objectives at this stage. 4 Decrease in EVD and eventual resolution: Re-emphasise preventive measures. 12 DECEMBER 2014

13. 13 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Key messages for Ph Pre-event: –Infection prevention –Signs and symptoms of EVD –Promote EVD call centre number: 711 1001/02 –Address misperceptions and stigmas Introduction of EVD/Rapid increase/Peak Transmission: –Get to a health facility if sick with EVD symptoms –Care and treatment increases the chance for survival and can reduce transmission to others –Promote safe funeral and burial practices –Condom use for convalescent men –Support and provide accepting environment for Survivors Decrease in EVD/Eventual resolution: –Emphasise that recovered people are no longer infectious –Condom use for convalescent men –Promote unity, cooperation and hope to fight against EVD 13 DECEMBER 2014

14. 14 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Opportunities for Risk Communication in PH Total Adult Literacy Rate (2012) 95.4% Risk communications already initiated Strong communication networks, for eg. 36% internet penetration rates, high social media usage Media engaged in the issue Administrative Order on risk communications [currently in draft] 14 DECEMBER 2014

15. 15 RESEARCH INSTITUTE FOR TROPICAL MEDICINE Further Reading 1.www.wpro.who.int/emerging_diseases/docume nts/docs/APSEDTechnicalPapers03Sep10Final.pdfwww.wpro.who.int/emerging_diseases/docume nts/docs/APSEDTechnicalPapers03Sep10Final.pdf 2.www.fsnnetwork.org/sites/default/files/resource _uploads/dbc_english.pdfwww.fsnnetwork.org/sites/default/files/resource _uploads/dbc_english.pdf 3.www.who.int/csr/resources/publications/WHO_ CDS_2005_32web.pdfwww.who.int/csr/resources/publications/WHO_ CDS_2005_32web.pdf 15 DECEMBER 2014

16. 16 RESEARCH INSTITUTE FOR TROPICAL MEDICINE 16 RISK COMMUNICATIONS: Communicating RISK not PANIC DECEMBER 2014