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Risk Communications/Emergency Public Information and Warning
Topic Collection
January 18, 2019

Topic Collection: Risk Communications/Emergency Public Information and Warning

Disasters can have significant health impacts on communities and their residents. Effective communication is a key component to properly managing and responding to incidents of all sizes. Communication includes providing the public with information through verbal, written, or symbolic means. As the world watched the 2014 Ebola outbreak spread through West Africa and land on American soil, medical professionals trained in risk communications sprang into action to release timely and effective messages providing public awareness, and other important information such as symptoms to look for. Clear, concise messages provided by trusted leaders before, during, and after an incident can help residents feel more in control and persuade them to make important health-related decisions to help ensure their safety. Resources in this Topic Collection include lessons learned; education and training modules; results from studies conducted on the effectiveness of risk communications; and plans, tools, and templates that can be tailored to meet the specific threats and needs of healthcare and medical professionals.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

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Must Reads

California Department of Public Health. (2011). Crisis and Emergency Risk Communications Toolkit.
This toolkit, adapted from the Centers for Disease Control and Prevention’s materials, can help healthcare emergency communications planners draft new plans or update and implement existing plans. It includes chapters on crisis communications planning, direct public outreach, the standardized emergency management system, state and federal medical countermeasures, and hazards (including public health threats). It also includes several templates for creating communications materials and plans.
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Centers for Disease Control and Prevention. (2014). The CDC Clear Communication Index.
This evidence-based tool can help healthcare emergency communications staff create and assess communication products on a variety of topics for diverse audiences. Users are prompted to provide information about seven key communications areas (e.g., main message, behavioral recommendations) and the Index provides an overall score. Links to message development resources are also provided on this webpage.
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Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication (CERC) and Ebola.
This website shares Ebola-specific risk communication information and emphasizes that the disease is accompanied by public fear and outrage, making clear communication even more important. The site includes information about transmission, stigma (and countering stigmatization), and provides quick tips for communicators (e.g., be empathetic, provide positive action steps).
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Drexel University. (2008). National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities.
This website provides links to resources geared towards disaster preparedness in culturally diverse communities. Materials are grouped into six main categories: Community, Type of Emergency, Resource Type, Language, U.S. Region, and those that fall under Multiple Categories.
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Emory University Interfaith Program. (2014). Public Health and Faith Community Partnerships: Model Practices to Increase Influenza Prevention Among Hard-to-Reach Populations. Association of State and Territorial Health Officials.
The guidance in this document can help healthcare coalition members work with faith- and other community-based organizations to develop influenza-specific messages that reach traditionally difficult to reach audiences.
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Health Canada. (2011). Communicating the Health Risks of Extreme Heat Events.
This toolkit can help health communicators tasked with developing or updating heat-related health communication strategies. It features strategies for reaching specific audiences.
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Li-Vollmer, M. (2013). Emergency Risk Communication. University of Washington, Northwest Center for Public Health Practice.
This 2.5 hour, interactive course teaches health communicators about the following topics: reactions the public might have during a public health emergency, effective communication strategies, how to communicate with the media, how to work with the community, and the importance of developing communication plans before an incident occurs.
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Public Health – Seattle & King County and Northwest Center for Public Healt. (n.d.). Texting for Public Health: Emergency Communication, Health Promotion, and Beyond. (Accessed 6/1/2015.)
This easy-to-use, online toolkit helps public health and healthcare entities plan for and implement text messaging programs for use in emergencies and for more general health promotion. It covers topics such as why text messaging is effective, how to get people to subscribe, legal issues, and technological options.
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The Southern Center for Communication, Health, and Poverty. (2007). Guidance for BT/Risk Communicators in Collaborating with Faith- Based African American Communities for Pandemic Flu Preparedness.
In this series of webcasts, health communicators will learn about the role of health ministry in faith-based African-American communities, and strategies for sharing messages through faith-based organizations.
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U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response. (2012). Disaster Response for Homeless Individuals and Families: A Trauma-Informed Approach.
This webpage emphasizes the fact that learning more about the effects of past traumatic events on homeless people can help emergency responders communicate more effectively with this population during a disaster and encourage them to comply with public health directives.
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At-Risk Populations

* Columbia University, National Center for Disaster Preparedness. (2015). Risk Communication for High Risk and At-Risk Populations.
This course can help health communicators understand and address the challenges associated with reaching and engaging members of high-risk groups.
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Crouse Quinn, S. (2008). Crisis and Emergency Risk Communication in a Pandemic: A Model for Building Capacity and Resilience of Minority Communities. (Abstract only.) Health Promotion Practice 9(4 Suppl):18S-25S.
The author addresses the challenges public health agencies have when communicating risk to certain populations during a pandemic (e.g., distrust of government, existing health disparities). The author also suggests the use of a risk communication strategy based on community engagement, disaster risk education, and crisis and emergency risk communication to help prepare minority communities and government agencies to prepare, respond, and work together in a pandemic.
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Drexel University. (2008). National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities.
This website provides links to resources geared towards disaster preparedness in culturally diverse communities. Materials are grouped into six main categories: Community, Type of Emergency, Resource Type, Language, U.S. Region, and those that fall under Multiple Categories.
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Emory University Interfaith Program. (2014). Public Health and Faith Community Partnerships: Model Practices to Increase Influenza Prevention Among Hard-to-Reach Populations. Association of State and Territorial Health Officials.
The guidance in this document can help healthcare coalition members work with faith- and other community-based organizations to develop influenza-specific messages that reach traditionally difficult to reach audiences.
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EthnoMed. (2015). Emergency Preparedness.
The resources under this tab on EthnoMed’s website are geared towards people who work with immigrants (including refugees fleeing war-torn areas of the world) and those residents as well. There are links to resources on general emergency preparedness, fire safety, and disaster planning. Most of these documents are available in a wide variety of languages.
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Healthy Roads Media. (2014). Healthy Roads Media.
The organization provides links to many free, multilingual resources on health information (e.g., videos and handouts on topics such as carbon monoxide poisoning, emergency preparedness, shelter-in place, and sirens and telephone alerts).
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Osorio, L., Castaneda, X., and Vostrejs, M. (2011). Improving Outreach to At-Risk Latino Populations for Pandemic Influenza and Public Health Emergency Preparedness. University of California, Berkeley, School of Public Health, Health Initiative of the Americas.
The guidance in this document includes promising practices for health authorities and providers to work with community-based organizations in order to reach Latino populations in the event of a pandemic or a public health emergency.
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* Powel, R., Sheikhattari, P., Barber, T., and Evans-Holland, M. (2009). A Guide to Enhance Grassroots Risk Communication Among Low-Income Populations. Maryland Department of Health and Mental Hygiene.
Many health and emergency management practitioners plan and implement emergency and disaster preparedness activities that entail working with grassroots organizations serving low-income populations. This guide contains strategies that can help stakeholders more successfully deliver health-specific messages to those populations.
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  • Aaron Gettinger broken link :-(
    5/28/2019 4:50:02 PM
Public Health – Seattle & King County and Northwest Center for Public Healt. (n.d.). Meeting the Needs of Vulnerable Populations: Equity in Emergency Response. Centers for Medicare &Medicaid Services (CMS), HHS.
This website includes resources that can help health department and healthcare facility staff better understand their customers, build relationships with other local agencies, work with translators, and conduct meetings to help prepare their communities for disaster.
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Tell Me. (n.d.). New Communication Strategies for Working with Different Sub-populations / Target Groups. (Accessed 3/23/2017.) British Medical Journal Publishing Group.
The guidance in this document is geared towards helping healthcare agencies increase the number of members of at-risk groups who get vaccinated against flu. The authors identify the at-risk groups, summarize traditional communication issues, and provide strategies for developing immunization messages. The emphasis in on communications for an influenza pandemic, although the principles can be adapted to other contexts.
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* The Southern Center for Communication, Health, and Poverty. (2007). Guidance for BT/Risk Communicators in Collaborating with Faith- Based African American Communities for Pandemic Flu Preparedness.
In this series of webcasts, health communicators will learn about the role of health ministry in faith-based African-American communities, and strategies for sharing messages through faith-based organizations.
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U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response. (2012). Disaster Response for Homeless Individuals and Families: A Trauma-Informed Approach.
This webpage emphasizes the fact that learning more about the effects of past traumatic events on homeless people can help emergency responders communicate more effectively with this population during a disaster and encourage them to comply with public health directives.
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* University at Albany School of Public Health. (2013). Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness.
The speakers in this webinar emphasize the importance of engaging the Latino community in preparedness and the need for disaster responder cultural awareness.
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Education and Training

Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication for Health Educators, Part B: Understanding Your Role as a Health Educator.
This short, on-line course teaches health educators about their role in crisis and emergency risk communication.
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Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication for Health Educators: Part A: Recognizing Reactions.
This short, on-line course teaches health educators the basics of risk communication and overcoming challenges.
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* Centers for Disease Control and Prevention. (2019). Crisis and Emergency Risk Communication (CERC).
This website hosts the Centers for Disease Control and Prevention's updated crisis and emergency risk communication training modules, resources, shared learning materials (e.g., case studies), and social media links.
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* Columbia University, National Center for Disaster Preparedness. (2015). Risk Communication for High Risk and At-Risk Populations.
This course can help health communicators understand and address the challenges associated with reaching and engaging members of high-risk groups.
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Decosimo, K. (2013). Risk Communication: Basics of Public Health Preparedness, Module 10. (Users need to register for this free course.) University of North Carolina, Gillings School of Global Public Health, Center for Public Health Preparedness.
This webinar provides health communicators with the principles of risk communication and strategies for developing effective messages. Other topics include the role of the Public Information Officer and how risk communication fits into the Incident Command System.
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Li-Vollmer, M. (2013). Emergency Risk Communication. University of Washington, Northwest Center for Public Health Practice.
This 2.5 hour, interactive course teaches health communicators about the following topics: reactions the public might have during a public health emergency, effective communication strategies, how to communicate with the media, how to work with the community, and the importance of developing communication plans before an incident occurs.
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McDonald, L. and Ferguson, B. (2011). Road to Resilience: Risk Communication Principles and Challenges. University of Minnesota, School of Public Health, U-SEEE Preparedness and Emergency Response Learning Center.
Health communicators will learn about the factors that influence how people view risk, how to develop and maintain trust and credibility in a crisis, best practices for culturally appropriate forms of risk communication (with a focus on partnerships), and the role of social media in risk communication.
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Prepare Iowa. (2017). Don't Panic: Principles of Crisis and Risk Communication Scenario. Upper Midwest Preparedness and Emergency Response Learning Center.
Prepare Iowa created this interactive course to help health practitioners increase their ability to effectively communicate with the public, other practitioners, the response community, and the media during a public health emergency.
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Public Health – Seattle & King County Advanced Practice Center. (2013). Speak First: Communicating Effectively in Times of Crisis and Uncertainty.
This practical training can help health communicators build the skills necessary for delivering first messages in the early hours of a disaster or public health emergency. This training was designed for trainers and self-directed individuals and group learners.
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Reynolds, B., Seeger, M., Palenchar, M., et al. (2014). Crisis and Emergency Risk Communication: 2014 Edition. Centers for Disease Control and Prevention.
This introductory course can help participants learn about emergency risk communication principles and tools.
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  • Audrey Mazurek Thank you Melanie for your feedback. Though we include the CDC CERC site in this collection, we do not specifically mention the 2014 edition of this publication. It is available through our Resource Library and we will be sure to include it in our next iteration of this collection.
    10/6/2015 5:36:23 PM
  • Melanie Motiska The CDC has a 2014 version of the CERC publication: http://emergency.cdc.gov/cerc/resources/pdf/cerc_2014edition.pdf
    10/6/2015 12:17:20 PM
* The Southern Center for Communication, Health, and Poverty. (2007). Guidance for BT/Risk Communicators in Collaborating with Faith- Based African American Communities for Pandemic Flu Preparedness.
In this series of webcasts, health communicators will learn about the role of health ministry in faith-based African-American communities, and strategies for sharing messages through faith-based organizations.
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* University at Albany School of Public Health. (2013). Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness.
The speakers in this webinar emphasize the importance of engaging the Latino community in preparedness and the need for disaster responder cultural awareness.
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University at Albany, School of Public Health (n.d.). Risk Communication for Community Health Centers. (Accessed 3/23/2017.)
This course is geared towards clinicians and managers in community practice sites who may interact with the public or the media during a public health emergency. Participants learn the basics of risk communication and how to create risk and crisis communication maps.
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University at Albany, School of Public Health (2007). Risk Communication & Psycho-Social Issues in Radiation Events.
Participants such as bioterrorism coordinators, clinical staff and administrative personnel will learn to be better prepared to manage psychosocial reactions of communities and individuals, and to communicate effectively internally, between response partners, and with the public during radiological emergencies.
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University of Arizona, Mel and Enid Zuckerman College of Public Health, Mountain West Preparedness and Emergency Response Learning Center. (2012). Crisis and Emergency Risk Communication During Mass Prophylaxis. (Free registration required.)
This online course takes participants through an interactive emergency scenario, where they must make decisions, solve problems, and apply public health emergency principles.
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University of Minnesota, School of Public Health (2007). Risk Communication: Public Engagement in Public Health Practice.
The speakers in this training module teach participants how to apply risk communication principles and integrate them into daily and crisis communications.
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Viswanath, K. (2012). Public Communication of Risk in 21st Century: Promises and Challenges. Harvard University, Harvard School of Public Health, Preparedness and Emergency Response Learning Center.
In this course, participants will learn the principles of risk communication, how to recognize residents' reactions, and how to identify and respond to challenges associated with communicating risk.
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Wessman, N. (2008). Understanding Emergency Public Health Risk Communication: Partners and Preparedness beyond the Public Health System. Tulane University, School of Public Health and Tropical Medicine.
In this course, participants will learn how to identify and work with members from other stakeholder groups to ensure consistent health risk communication before, during, and after an incident.
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Wessman, N. (2008). Understanding Emergency Public Health Risk Communication: Resources and Relationships Within the Public Health System. Tulane University, School of Public Health and Tropical Medicine.
Participants in this course will learn how to identify and work with members from other stakeholder groups as well as how to develop and use a health risk communication plan.
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Evaluation

Elledge, B., Brand, M., Regens, J., and Boatright, D. (2008). Implications of Public Understanding of Avian Influenza for Fostering Effective Risk Communication. Health Promotion Practices. 9(4 Suppl):54S-59S.
The authors of this study conducted 12 focus groups in Tulsa, OK to help the local public health department understand the community's level of awareness and develop effective messages about avian influenza.
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Freimuth, V., Hilyard, K., Barge, J., and Sokler, L. (2008). Action, Not Talk: A Simulation of Risk Communication During the First Hours of a Pandemic. (Abstract only.) Health Promotion Practices. 9(4 Suppl):35S-44S.
The authors summarize a simulated pandemic scenario that health risk communicators from 17 Georgia districts participated in. The authors include strengths, challenges, and lessons learned in their summary.
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Meredith, L., Eisenman, D., Rhodes, H., et al. (2007). Trust Influences Response to Public Health Messages During a Bioterrorist Event. (Abstract only.) J Health Communications 12(3): 217-32.
The authors of this study examined qualitative data from focus groups held with 75 African American adults living in Los Angeles County to better understand their traditionally lower levels of trust in public health messaging regarding terrorism preparedness. They found that perceived honesty and consistency of information most frequently determined trust/distrust.
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Meredith, L., Shugarman, L., Chandra, A., et al. (2008). Analysis of Risk Communication Strategies and Approaches with At-Risk Populations to Enhance Emergency Preparedness, Response, and Recovery. RAND Health.
This assessment is intended to inform planning for risk communication regarding public health emergency preparedness, response, and recovery for individuals with access and functional needs.
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Paek, H., Hilyard, K., Freimuth, V., et al. (2008). Public Support for Government Actions During a Flu Pandemic: Lessons Learned from a Statewide Survey. (Abstract only.) Health Promotion Practices 9(4 Suppl): 60S-72S.
The authors of this study analyzed telephone survey data and found that public health and healthcare risk communicators should personalize risk in order to build trust before a pandemic occurs. This personalized risk communication should also continue through all phases of response and recovery.
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Prue, C., Lackey, C., Swenarski, L., and Gantt, J. (2003). Communication Monitoring: Shaping CDC’s Emergency Risk Communication Efforts. (Abstract only.) Journal of Health Communication 8(3 supp 1): 35 - 49.
This article details how the Centers for Disease and Prevention modified their media monitoring system after the 9/11 incident and the anthrax incidents that followed.
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Thomas, C., Vanderford, M., and Crouse Quinn S. (2008). Evaluating Emergency Risk Communications: A Dialogue with the Experts. (Abstract only.) Health Promotion Practices 9(4 Suppl): 5S-12S.
The authors list the challenges associated with evaluating emergency risk communications and share sample evaluation resources and measures.
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Wood, M. M., Mileti, D. S., Kano, M., et al. (2011). Communicating Actionable Risk for Terrorism and Other Hazards. (Abstract only.) Risk Analysis. 32(4):601-15.
The authors propose a different approach when communicating to people when the objective is to motivate household disaster preparedness actions. Based on their study, they recommend emphasizing what to do about risk rather than sharing information about the actual risk.
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General Resources

Alabama Public Health. (2012). Risk Communication Disease Fact Sheets.
These tip sheets can help healthcare providers and community members recognize the symptoms associated with anthrax, blister and blood agents, botulism, nerve agents, plague, smallpox, and tularemia.
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American Psychological Association (2014). As Ebola Concerns Mount, Psychology Offers Guidance on Health-Risks Communication.
This webpage is geared towards medical risk communicators and emphasizes that fear and other emotions can interfere with community members' judgment and behavior, particularly during an Ebola outbreak. This makes it extremely important to evaluate and test messages before releasing them to the public, and tailor messages to various audiences (e.g., young people, limited or non-English speakers, the elderly).
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ASPR TRACIE. (2019). No-Notice Incidents: Community Response and Media Management.
This ASPR TRACIE tip sheet (which is part of a series) can help healthcare system planners incorporate issues related to security, volunteers, media affairs, and donations into their no-notice incident plans.
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Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication (CERC) and Ebola.
This website shares Ebola-specific risk communication information and emphasizes that the disease is accompanied by public fear and outrage, making clear communication even more important. The site includes information about transmission, stigma (and countering stigmatization), and provides quick tips for communicators (e.g., be empathetic, provide positive action steps).
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Committee on Public Response to Alerts and Warnings on Mobile Devices: Current Knowledge and Research Gaps; National Research Council. (2011). Public Response to Alerts and Warnings on Mobile Devices: Summary of a Workshop on Current Knowledge and Research Gaps. (Free registration required for download.)
This book provides a summary of conference proceedings where risk communications experts discussed the public response to mobile alerts.
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Garrow, J. (2015). The Face of the Matter.
Jim Garrow is the author of this blog which covers emerging issues related to risk communication, social media, and health. He also serves as the Director of Digital Public Health at the Philadelphia Health Department.
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Lowrey, W., Evans, W., Gower, K., et al. (2007). Effective Media Communication of Disasters: Pressing Problems and Recommendations. BMC Public Health, 7: 97.
The authors describe proceedings from a convention of 26 public information officers (PIOs), state health officials, journalists, and other communications experts. The most significant challenges mentioned by the participants were lack of coordination, the inability to efficiently evaluate and disseminate information, and confusion about the roles of the journalist and the PIO. The group developed a list of recommendations to address these challenges.
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Reynolds, B. and Quinn Crouse, S. (2008). Effective Communication During an Influenza Pandemic: The Value of Using a Crisis and Emergency Risk Communication Framework. (Abstract only.) Health Promotion Practices. 9(4 Suppl):13S-17S.
The authors provide an overview of the risk communication framework and emphasize the importance of building trust and credibility during a crisis to move the public towards positive action.
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Tell Me. (n.d.). New Communication Strategies for Health Agencies and Healthcare Professionals. (Accessed 5/13/2015.) British Medical Journal Publishing Group.
The guidance in this document is geared towards helping healthcare agencies increase the number of healthcare professionals who get vaccinated against flu. The authors summarize research, identify existing gaps, describe different segments in the healthcare profession, and suggest strategies for communicating with healthcare providers and patients.
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The National Academies Press. (2013). Public Response to Alerts and Warnings Using Social Media: Report of a Workshop on Current Knowledge and Research Gaps. The National Academies Press.
This report summarizes presentations made at a 2012 workshop organized by the Committee on Public Response to Alerts and Warnings Using Social Media. Chapters cover the fundamentals of alerts, warnings, and social media, how social media has been used in emergencies by local agencies, the dynamics of social media, message credibility, privacy and legal issues, and research gaps and other challenges.
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* The Southern Center for Communication, Health, and Poverty. (2007). Guidance for BT/Risk Communicators in Collaborating with Faith- Based African American Communities for Pandemic Flu Preparedness.
In this series of webcasts, health communicators will learn about the role of health ministry in faith-based African-American communities, and strategies for sharing messages through faith-based organizations.
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U.S. Department of Health and Human Services. (n.d.). Health Information Privacy – Is HIPAA Privacy Rule Suspended during a National or Public Health Emergency? (Accessed 3/23/2017.)
This webpage provides guidelines regarding the application of the Health Insurance Portability and Accountability Act during emergencies.
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World Health Organization. (2014). Key Messages for Social Mobilization and Community Engagement in Intense Transmission Areas: Ebola Guidance Package.
These messages were developed during the 2014 Ebola outbreak for risk communicators to share with community residents. The messages can be tailored to other hazards, and focus on risk minimization and tips for caring for/supporting relatives and community members.
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Plan, Tools and Templates: Ebola and Flu

Covello, V., and Hyer, R. (2014). Top Questions On Ebola: Simple Answers Developed by the Association of State and Territorial Health Officials.
The authors worked with risk communication consultants and state health officials to develop messaging written at a 6th to 8th grade reading level. Questions are divided into the following categories: basic, preparedness, medicines and vaccines, healthcare response, quarantine and isolation, monitoring and contact tracing, mental health, travel and transport, and media.
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* North Shore-LIJ Health System. (2014). Ebola Virus Disease (EVD) Preparedness Manual.
Section VI of this manual focuses on external and internal communications and can be tailored by emergency communications planners to other hazards.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2014). Risk Communication Toolkit for Seasonal Influenza.
This toolkit can help local health authorities develop public messaging before and during the influenza season. It includes background information, links to key resources, talking points, sample press releases, printable materials, and sample social media messages for Twitter and Facebook.
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Pan American Health Organization, World Health Organization. (2014). Communicating About Ebola: A Guide for Leaders.
This document can help health communication staff learn about the key concepts of risk communication, how to share information about the first case of imported Ebola, and communications goals. It also includes templates that can be downloaded and customized.
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Pan American Health Organization, World Health Organization. (2014). Risk Communication Checklist for Ebola.
The guidance in this document can help health risk communicators create and activate a national Ebola risk communication plan. The steps can also be customized for more local initiatives.
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Pan American Health Organization, World Health Organization (2014). Risk Communication Plan for the First Case of Ebola.
This document can help health communication staff design public announcements of a potential first case of Ebola in their country. The information can also be customized to suit local initiatives.
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Plan, Tools and Templates: General

California Department of Public Health. (2011). Crisis and Emergency Risk Communications Toolkit.
This toolkit, adapted from the Centers for Disease Control and Prevention’s materials, can help healthcare emergency communications planners draft new plans or update and implement existing plans. It includes chapters on crisis communications planning, direct public outreach, the standardized emergency management system, state and federal medical countermeasures, and hazards (including public health threats). It also includes several templates for creating communications materials and plans.
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Centers for Disease Control and Prevention. (2011). Using HealthMap's Web-Based Risk Analysis Tools Before and During Public Health Emergencies.
The speakers in this webinar discuss the use of HealthMap (a mobile application that allows users to submit information related to local diseases or outbreaks) during the 2010 cholera outbreak in Haiti.
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Centers for Disease Control and Prevention. (2014). The CDC Clear Communication Index.
This evidence-based tool can help healthcare emergency communications staff create and assess communication products on a variety of topics for diverse audiences. Users are prompted to provide information about seven key communications areas (e.g., main message, behavioral recommendations) and the Index provides an overall score. Links to message development resources are also provided on this webpage.
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Group Health Research Institute. (2015). Program for Readability in Science and Medicine (PRISM).
This free toolkit and training can help medical communicators learn how to use plain language and improved the readability of their messages. These resources are useful for healthcare and public health staff who need to translate data and other technical information for general audiences.
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Kansas Department of Health and Environment. (2011). Public Information and Communications Standard Operating Guide.
Local health department communicators can customize this template before and in response to a variety of scenarios such as mass prophylaxis dispensing, disease outbreaks, and acts of terrorism.
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* North Shore-LIJ Health System. (2014). Ebola Virus Disease (EVD) Preparedness Manual.
Section VI of this manual focuses on external and internal communications and can be tailored by emergency communications planners to other hazards.
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Office of the Assistant Secretary for Preparedness and Response. (2019). National Health Security Strategy. U.S. Department of Health and Human Services.
The goal of the National Health Security Strategy (NHSS) is to strengthen and sustain communities’ abilities to prevent, protect against, mitigate the effects of, respond to, and recover from disasters and emergencies. This webpage includes links to the full text of the plan, an overview, the NHSS Implementation Plan, the NHSS Evaluation of Progress, and an NHSS Archive.
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* Powel, R., Sheikhattari, P., Barber, T., and Evans-Holland, M. (2009). A Guide to Enhance Grassroots Risk Communication Among Low-Income Populations. Maryland Department of Health and Mental Hygiene.
Many health and emergency management practitioners plan and implement emergency and disaster preparedness activities that entail working with grassroots organizations serving low-income populations. This guide contains strategies that can help stakeholders more successfully deliver health-specific messages to those populations.
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  • Aaron Gettinger broken link :-(
    5/28/2019 4:50:02 PM
Public Health – Seattle & King County and Northwest Center for Public Healt. (n.d.). Texting for Public Health: Emergency Communication, Health Promotion, and Beyond. (Accessed 6/1/2015.)
This easy-to-use, online toolkit helps public health and healthcare entities plan for and implement text messaging programs for use in emergencies and for more general health promotion. It covers topics such as why text messaging is effective, how to get people to subscribe, legal issues, and technological options.
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Santa Clara County Public Health Department Advanced Practice Center. (2008). Hospital Surge Capacity Toolkit. (Registration required.) National Association of County and City Health Officials.
This toolkit provides customizable operational strategies and tools that can help healthcare facilities create a surge plan to manage mass casualties. Tips for communicating with the public are included in the toolkit.
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Santa Clara County Public Health Department Advanced Practice Center. (2011). A Toolkit on How to Build, Use, and Maintain a Dark Site for Public Health Emergencies. (Registration required.) National Association of County and City Health Officials.
During the 2009 H1N1, the Santa Clary County Public Health Department’s server went down, and they activated their “Dark Site.” This toolkit can help healthcare facilities and related organizations create and maintain a public health emergency dark site (“a static Web page used to post critical public health emergency messages when a server goes down”).
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Santa Clara County Public Health Department Advanced Practice Center. (2011). Managing Mass Fatalities: A Toolkit for Planning. National Association of County and City Health Officials.
Based on lessons learned from actual events (e.g., the Oklahoma City bombing, 9/11, and Hurricane Katrina) this toolkit provides customizable operational strategies and tools that can help jurisdictions create a plan for managing mass fatalities. Tips for communicating with the public are included in the toolkit.
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* Ware County Board of Health. (2011). Risk Communication in Rural Settings. National Association of County and City Health Officials.
Healthcare practitioners in rural areas can use the strategies in this toolkit to communicate with their community during a variety of disasters including natural, biological, chemical, radiological, and mass vaccination/medical events.
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Washington State Department of Health. (n.d.). Emergency Preparedness Fact Sheets. (Accessed 3/23/2017.)
This website contains links to one-page fact sheets for the general public on infectious diseases, chemical and biological agents, radiation, severe weather, natural disasters, and emergency preparedness and response. Each resource is available in seven languages; some are available in large type.
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Health Canada. (2011). Communicating the Health Risks of Extreme Heat Events.
This toolkit can help health communicators tasked with developing or updating heat-related health communication strategies. It features strategies for reaching specific audiences.
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National Weather Service. (2011). Tsunami Message Subscriptions.
The National Weather Service provides links to sources that provide tsunami event messages.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2014). Crisis and Emergency Risk Communication Toolkit for Extreme Heat. Health Promotion Practice 9(4 Suppl):18S-25S.
This toolkit can help local health authorities develop public messaging during periods of extreme heat. It includes key messages, talking points, sample press releases, fact sheets, sample social media messages for Twitter and Facebook, and links to related information in English and Spanish.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2015). Crisis and Emergency Risk Communication Toolkit for Wildfire Smoke.
This toolkit can help local health authorities develop public messaging during a severe wildfire smoke event. It includes key messages, talking points, sample press releases, sample social media messages for Twitter and Facebook, and links to related information.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2015). Risk Communication Toolkit for Flooding.
This toolkit can help local health authorities develop public messaging during a flood event. It includes information relevant to the actual event and the recovery period: key messages, talking points, sample press releases, factsheets, links to key resources, and sample social media messages for Twitter and Facebook.
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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2017). Risk Communication Toolkit for Winter Weather.
This toolkit can help local health authorities develop public messaging during periods of extreme cold weather. It includes key messages, sample press releases, factsheets, links to key resources, and sample social media messages for Twitter and Facebook.
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Rural/Frontier

Heideman, M. and Hawley, S. (2007). Preparedness for Allied Health Professionals: Risk Communication Training in a Rural State. (Abstract only.) Journal of Allied Health. 36(2): 72-6.
This article is a summary of a workshop on risk communication and message mapping in Kansas. The authors emphasize that in rural states, health workers should be able to communicate to the public from both a health and first responder perspective.
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* Ware County Board of Health. (2011). Risk Communication in Rural Settings. National Association of County and City Health Officials.
Healthcare practitioners in rural areas can use the strategies in this toolkit to communicate with their community during a variety of disasters including natural, biological, chemical, radiological, and mass vaccination/medical events.
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Agencies and Organizations

* Centers for Disease Control and Prevention. Crisis and Emergency Risk Communication (CERC).
This website hosts the Centers for Disease Control and Prevention's updated crisis and emergency risk communication training modules, resources, shared learning materials (e.g., case studies), and social media links.
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ECHO Minnesota.
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National Public Health Information Collection (NPHIC).
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The Peter M. Sandman Risk Communication Website.
Peter Sandman’s website on risk communication includes links to articles, videos, and other resources. A link to “Outrage Prediction and Management Software” is also provided and can help medical information communicators estimate and plan for the amount of public “outrage” that may ensue after a message is released.
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This ASPR TRACIE Topic Collection was comprehensively reviewed in May 2015 by the following subject matter experts (listed in alphabetical order):Molly Carbajal, Public Health Preparedness, Santa Clara Public Health Department,Meredith Li-Vollmer, Ph.D., Risk Communication Specialist, Public Health-Seattle & King County, and Jacquelyn Nash Gallego, MPA, Hospital Preparedness Program Coordinator, Santa Clara Public Health Preparedness.

Additional assistance provided by John Hick, MD, HHS ASPR and Hennepin County Medical Center, Alicia Livinski, Biomedical Librarian, HHS National Institutes of Health, and James Paturas, Director, Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System.
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