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Risk Communications/Emergency Public Information and Warning
Topic Collection
September 21, 2023

Topic Collection: Risk Communications/Emergency Public Information and Warning

Effective communication is a key component of successful disaster management. Communication includes providing the public with information through verbal, written, or visual means. Clear, concise messages provided by trusted leaders before, during, and after an incident can help residents feel informed and empowered and facilitates actions that help ensure their personal safety and that of the community. The consistency of these messages is critical as misinformation (the spread of erroneous information), disinformation (the purposeful creation and proliferation of false/misleading information), and malinformation (based on fact, but used out of context to mislead or cause harm) proliferate online (Cybersecurity & Infrastructure Security Agency, 2022). Most recently, the word “infodemic” has been used to refer to the dissemination of too much information, especially misleading information, during an infectious disease outbreak (e.g., World Health Organization, 2023).

As healthcare organizations and public health authorities now use social media to communicate with the public, particularly during natural disasters, mass violence incidents, and the COVID-19 pandemic, we encourage users to access our Social Media in Emergency Response for more information.

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

Aiyer, I., Shaik, L., Kashyap, R., et al. (2022). COVID-19 Misinformation: A Potent Co-Factor in the COVID-19 Pandemic. Cureus. 14(10):e30026.
This article reviews the scope of the COVID-19 “infodemic,” which, amid social media misinformation and a lack of credible sources and strategies for disseminating health information, challenged health authorities responsible for disseminating COVID-19 vaccines. The authors call for partnership between scientists, public health agencies, government, and social media companies to combat misinformation.
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Albrecht, S. S., Aronowitz, S. V., Buttenheim, A. M., et al. (2022). Lessons Learned from Dear Pandemic, a Social Media-Based Science Communication Project Targeting the COVID-19 Infodemic. Journal of Public Health Reports, 137(3):449-456.
This article discusses the rapid spread of mis- and disinformation about the COVID-19 pandemic on social media, part of an “infodemic” of available information. The authors describe the “Dear Pandemic” social media project, an innovative and multidisciplinary effort to disseminate trusted scientific information and enable media literacy around social media content.
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ASPR TRACIE. (2023). ASPR TRACIE Roundtable: Lessons Learned in Health Care Communications.
Speakers representing a wide range of stakeholders and jurisdiction types (national, large/urban, regional, and rural/tribal) shared their perspectives on how they integrated lessons learned during recent incidents into current and future responses. Topics included channels used for outreach and continued engagement, strategies for reaching different community and cultural groups, tracking and countering rumors, and working with partners to create complementary messaging.
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ASPR TRACIE. (2023). Lessons Learned in Health Care Communications.
This article is based on a roundtable ASPR TRACIE hosted in April 2023 which featured speakers representing a wide range of health care stakeholders and jurisdiction types (national, large/urban, regional, and rural/tribal). Topics included channels used for outreach and continued engagement, strategies for reaching different community and cultural groups, tracking and countering rumors, and working with partners to create complementary messaging.
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Bean, H., Koutsoukos, A., Grevstad, N. and Meyer, A. (2021). Exploring the Use of Wireless Emergency Alerts for Notifications Regarding COVID-19: Initial Lines of Inquiry. Natural Hazards Review Journal, 22(2):06021001.
The authors studied the use of Wireless Emergency Alert (WEA) notifications at the state and local level to inform the public about COVID-19 developments. The authors compared rates of infections and deaths in jurisdictions which used the WEA system to those which did not. While sample sizes were small and rates of COVID-19 spread varied, the authors suggest WEA alerts may be an important way to encourage protective measures during pandemics.
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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 crisis and emergency risk communication training modules, resources, shared learning materials (e.g., case studies), and social media links.
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Centers for Disease Control and Prevention. (2021). How to Address COVID-19 Vaccine Misinformation.
This webpage highlights strategies to combat mis- and disinformation which affected COVID-19 vaccine confidence and vaccine uptake in the U.S. Strategies for addressing COVID-19 misinformation through social media listening and monitoring tools are shared and links to resources including a community engagement playbook and a case study from Tennessee’s COVID-19 Health Disparity Task Force.
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Centers for Disease Control and Prevention. (2021). 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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Drexel University. (n.d.). National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities. (Accessed 4/12/2023.)
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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Federal Emergency Management Agency. (2021). Improving Public Messaging for Evacuation and Shelter-in-Place: Findings and Recommendations for Emergency Managers from Peer-Reviewed Research.
The authors conducted a literature review of 127 articles and focused on five research questions specific to the effect of select variables on evacuation and shelter-in-place decisions. The conclusion includes key recommendations and suggestions for additional research.
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Hooker, C. and Leask, J. (2020). Risk Communication Should be Explicit About Values. A Perspective on Early Communication During COVID-19. Journal of Bioethical Inquiry. 17:581-589.
The authors argue that being explicit about values (e.g., condemning stigmatization and racism, clarifying whether stockpiling supplies is warranted) can help communicate risk with empathy and encourage self-determination during an emergency such as the COVID-19 pandemic. The authors also emphasize the need to communicate early and often to improve the response to crises such as the COVID-19 pandemic.
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Malecki, K., Keating, J., and Safdar, N. (2021). Crisis Communication and Public Perception of COVID-19 Risk in the Era of Social Media. Clinical Infectious Diseases. 72(4):697-702.
The authors discuss how cultural and economic factors such as the spread of misinformation on social media have impacted risk communication during COVID-19. They distinguish between hazard (the prevalence of exposure, infection, and illness) and outrage (the public’s response to messages about the hazard) as components of risk calculation and acceptance and provide strategies for applying risk communication principles.
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Public Health – Seattle & King County and Northwest Center for Public Health. (n.d.). Texting for Public Health: Emergency Communication, Health Promotion, and Beyond. (Accessed 4/10/2023.)
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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Ready.gov. (2021). Crisis Communications Plan. U.S. Department of Homeland Security.
This website contains information for businesses on developing a crisis communications plan. It recommends identifying the target audience, including customers, disaster survivors, employees, the news media, government officials, among other community members the business serves. It describes how to craft an appropriate message, obtaining contact information, and further resources which may be of use.
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Substance Abuse and Mental Health Services Administration. (2019). Communicating in a Crisis: Risk Communication Guidelines for Public Health Officials. U.S. Department of Health and Human Services.
This guide can help health officials (and others responsible for communicating to the public before, during, and after a crisis) prepare their messaging to ensure it is actionable and received effectively by the public.
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Takamura, N., Orita, M., Taira Y., et al. (2023). Experiences of Crisis Communication During Radiation Emergency and Risk Communication for Recovery of the Community In Fukushima. Journal of Radiation Research. 62(Supplement 1):i95-i100.
This article describes the role of risk communications between local authorities, healthcare providers, and residents in supporting the return of residents of Kawauchi Village, Fukushima Prefecture to their hometown in 2017 after the 2011 accident at the Fukushima Daiichi Nuclear Power Station.
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Tulane University. (2022). Strategies for Developing Public Health Crisis Communication Plans.
This website provides practical guidance for developing a robust emergency communications plan. Steps include coordinating response across multiple media outlets, incorporating trusted messengers, improving outreach to vulnerable populations, normalizing unknowns inherent in the scientific process, rapidly addressing mis- and disinformation, incorporating empathy, and empowering community members. Finally, it contains recommended readings and relevant sources.
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Wolkin, A., Schnall, A., Nakata, N., et al. (2019). Getting the Message Out: Social Media and Word-of-Mouth as Effective Communication Methods during Emergencies. Prehospital and Disaster Medicine. 34(1):89-94.
The authors used a rapid needs assessment to gather information on Americans’ preferred channels of information in an emergency. The study found that 75.0% of households used television as their primary information source; primary preference for social media ranged from 3.2%-41.8%, and 8.3%-10.4% of participants reported word of mouth was their main method of obtaining information. The study emphasizes the importance of multi-channel risk communication during emergencies.
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Education and Training

Centers for Disease Control and Prevention. (2019). Crisis and Emergency Risk Communication (CERC).
This website hosts the Centers for Disease Control and Prevention's crisis and emergency risk communication training modules, resources, shared learning materials (e.g., case studies), and social media links.
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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 improve 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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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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Office of the U.S. Surgeon General. (2021). A Community Toolkit for Addressing Health Misinformation. U.S. Department of Health and Human Services.
This resource outlines considerations for healthcare providers and others interested in learning more about health misinformation. It explains the concept, contains interactive questions on misinformation scenarios, and provides information on common disinformation tactics, and questions to ask before sharing information with colleagues, patients, and others.
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Ready: Global Readiness for Major Disease Outbreak Response. (2020). Session 1: Introduction to Risk Communication and Community Engagement (RCCE) During COVID-19.
Speakers in this brief video discuss risk communication and community engagement during COVID-19, including information on social behavior change, risk communication theories, and other considerations. Links to additional online training sessions are included.
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Sandman, P. (2022). Risk = Hazard + Outrage: Some Risk Comunication Basics (and Some COVID Comments).
Dr. Sandman highlights the difference between hazard and outrage and the related paradigms of risk communication: precaution advocacy, outrage management, crisis communication, and public participation. He comments about COVID-19 risk communication throughout the presentation.
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Slovic, P. (1987). Perception of Risk.
In this foundational risk communications article, the author examines and explains public perception of risk for various activities and technologies (e.g., nuclear power, handguns, smoking, and vaccination) and accidents and hazards. Findings indicate that while risk is quantifiable, communicating it is an intricate process that, according to the author must be “structured as a two-way process.”
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Training Source. (2022). Principles of Crisis and Risk Communication for COVID-19 Preparedness.
This 30 minute just-in-time training on risk communication and COVID-19 provides information on the importance of risk communication, theories and principles of risk communication, and emotional reactions people may have during a crisis.
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Twin Cities Public Television. (2017). ECHO Minnesota.
This YouTube channel contains risk communication resources for communities speaking Hmong, Somali, Spanish, and English. ECHO Minnesota aims to connect immigrant communities with emergency preparedness, health, safety, and civic engagement information.
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* University at Albany School of Public Health. (2013). Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness.
The speakers in this 1-hour webinar emphasize the importance of engaging the Latino community in preparedness and the need for disaster responder cultural awareness including suggestions for risk communication. While slightly dated, it can help planners reach immigrant and other culturally diverse communities. The webinar emphasizes core cultural values, coping strategies, unique risk factors, and usual sources of support and inspiration that can be valuable when planning communications and adapting them to themes that will resonate. Trust issues and ability to comply with directives relative to immigration status are also discussed. Access the related report here: https://unidosus.org/wp-content/uploads/2021/07/EmergencePreparednessTK_Print.pdf
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World Health Organization. (2022). COVID-19 Infodemic Management: Risk Communication and Community Engagement Challenges.
This approximately 2-hour multi-media course provides evidence-based risk communication and community engagement principles for an extended outbreak such as COVID-19. The World Health Organization explains the role of the “infodemic” in increasing mistrust in health authorities, causing uncertainty about actions which protect health, and potentially exacerbating the outbreak. The course includes case studies as concrete examples of these principles in practice.
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Evaluation

Bodas, M., Ragoler, M., Rabby, Y., et al. (2021). The Effect of Risk Communication on Public Behavior to Non-Conventional Terrorism-Randomized Control Trial. International Journal of Environmental Research and Public Health. 19(1):342.
This article describes a study conducted in Israel to understand how the public would seek healthcare in the aftermath of a non-conventional terrorism event. When study participants were exposed to risk communication about these events, they reported being more likely to seek medical care. The findings emphasize the importance of risk communication on the public’s behaviors after terrorism or other emergencies.
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Federal Emergency Management Agency. (2021). Improving Public Messaging for Evacuation and Shelter-in-Place: Findings and Recommendations for Emergency Managers from Peer-Reviewed Research.
The authors conducted a literature review of 127 articles and focused on five research questions specific to the effect of select variables on evacuation and shelter-in-place decisions. The conclusion includes key recommendations and suggestions for additional research.
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Hipper, T., Popek, L., Davis, R., et al. (2022). Communication Preferences of Parents and Caregivers of Children and Youth With Special Healthcare Needs During a Hypothetical Infectious Disease Emergency. (Abstract only.) Health Security. 20(6).
The authors conducted surveys and semi-structured interviews with caregivers of youth with special healthcare needs to understand how they would respond to an infectious disease outbreak. The authors found that 84% of caregivers believed their child’s doctor is the best information source, followed by medical experts, the CDC, friends, family, and local and state health agencies.
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MacKay, M., Colangeli, T., Thaivalappil, A., et al. (2022). A Review and Analysis of the Literature on Public Health Emergency Communication Practices. Journal of Community Health, 47:150-162.
The authors reviewed 13 articles to identify 10 themes associated with public trust in crisis communications. They found that public trust depends on consistency, repetition, timeliness, transparency, and uncertainty. Other factors included using a health official as spokesperson and ensuring the presentation is not politicized. The authors found community leaders and family doctors were also trusted messengers.
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* Rainear, A., Lachlan, K. and Xu, Z. (2021). Storms of a Feather Tweet Together: An Exploratory Study Examining Houston-Area Emergency Management Communication on Twitter in Hurricane Harvey. (Abstract only.) Journal of Emergency Management, 20(1):53-60.
This study examines content shared during Hurricane Harvey by a Houston emergency management account on Twitter, with a focus on the number of retweets, linguistic considerations, and the emergence of opinion leaders. The findings are compared with other disasters and can be considered for risk communication in future emergencies.
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Seeger, M., Pechta, L., Price, S., et al. (2018). A Conceptual Model for Evaluating Emergency Risk Communication in Public Health. (Abstract only.) Health Security, 16(3):193-203.
This article outlines a conceptual model for disaster communications based on risk communication literature, interviews, and discussions with stakeholders. The model facilitates assessment of internal processes and deficiencies to improve outcomes.
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Shellington, E., Nguyen, P., Rideout, K. et al. (2022). Public Health Messaging for Wildfire Smoke: Cast a Wide Net. Journal of Frontiers in Public Health, 10:773428.
The authors surveyed 757 people who were representative of British Columbia’s demographics to understand prevention of wildfire smoke-related risks. The authors found that respondents receive information on wildfire smoke from websites, social media, radio, and television. They recommend environmental and public health officials tailor messages to at-risk groups such as Indigenous populations and those with lower educational attainment.
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Wolkin, A., Schnall, A., Nakata, N., et al. (2019). Getting the Message Out: Social Media and Word-of-Mouth as Effective Communication Methods during Emergencies. Prehospital and Disaster Medicine. 34(1):89-94.
The authors used a rapid needs assessment to gather information on Americans’ preferred channels of information in an emergency. The study found that 75.0% of households used television as their primary information source; primary preference for social media ranged from 3.2%-41.8%, and 8.3%-10.4% of participants reported word of mouth was their main method of obtaining information. The study emphasizes the importance of multi-channel risk communication during emergencies.
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Lessons Learned: COVID-19

Abrams, E. and Greenhawt, M. (2020). Risk Communication During COVID-19. Journal of Allergy Clinical Immunology Practice, 8(6):1711-1794.
The authors discuss risk communication during the COVID-19 pandemic. They emphasize that when infection rates and morbidity are high and there is an absence of therapeutic medications, as was the case early in the pandemic, effective risk communication is important to avoid the public stockpiling countermeasures such as medications or personal protective equipment. The authors recommend using social media and a consistent media presence to inform patients and colleagues of risks.
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Albrecht, S. S., Aronowitz, S. V., Buttenheim, A. M., et al. (2022). Lessons Learned from Dear Pandemic, a Social Media-Based Science Communication Project Targeting the COVID-19 Infodemic. Journal of Public Health Reports, 137(3):449-456.
This article discusses the rapid spread of mis- and disinformation about the COVID-19 pandemic on social media, part of an “infodemic” of available information. The authors describe the “Dear Pandemic” social media project, an innovative and multidisciplinary effort to disseminate trusted scientific information and enable media literacy around social media content.
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* Allen, E., Barranco, L., Mosites, E., et al. (2022). Communicating COVID-19 Risks and Prevention Measures among People Experiencing Homelessness. Centers for Disease Control and Prevention.
This plan describes how local, state, and federal public health agencies can communicate effectively about COVID-19 and other infectious diseases with people experiencing homelessness. The plan provides guiding principles, best practices, recommendations for a multi-tiered and collaborative approach, and considerations and challenges.
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ASPR TRACIE. (2023). ASPR TRACIE Roundtable: Lessons Learned in Health Care Communications.
Speakers representing a wide range of stakeholders and jurisdiction types (national, large/urban, regional, and rural/tribal) shared their perspectives on how they integrated lessons learned during recent incidents into current and future responses. Topics included channels used for outreach and continued engagement, strategies for reaching different community and cultural groups, tracking and countering rumors, and working with partners to create complementary messaging.
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ASPR TRACIE. (2023). Lessons Learned in Health Care Communications.
This article is based on a roundtable ASPR TRACIE hosted in April 2023 which featured speakers representing a wide range of health care stakeholders and jurisdiction types (national, large/urban, regional, and rural/tribal). Topics included channels used for outreach and continued engagement, strategies for reaching different community and cultural groups, tracking and countering rumors, and working with partners to create complementary messaging.
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Association of State and Territorial Health Officials. (2022). COVID-19 Public Health Communications Resource Hub.
This website contains links to resources that can help state and local public health officials enhance their risk communications strategies. Resources include results from polls on public perception of seasonal flu vaccines, communications when recommendations are updated, information on the importance of listening to community members, ways to enhance trust in public health, and other topics.
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Basch, C. H., Mohlman, J., Hillyer, G. C., et al. (2020). Public Health Communication in Time of Crisis: Readability of On-Line COVID-19 Information. Disaster Medicine and Public Health Preparedness, 14(5):635.
The authors emphasize research findings that indicate written information related to risk should be posted at a 6th grade reading level to have the maximum response. They searched Google Chrome using the keyword “coronavirus” and pulled the first 100 websites, then used readability tests to examine results. They found that the readability scores ranged from grade 6 to graduate school level; in some cases, readability exceeded 10th grade level, making it difficult for the average reader to understand. This information can be used by healthcare emergency managers to ensure risk communication materials are created to be readable and actionable by the general public.
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Bean, H., Koutsoukos, A., Grevstad, N. and Meyer, A. (2021). Exploring the Use of Wireless Emergency Alerts for Notifications Regarding COVID-19: Initial Lines of Inquiry. Natural Hazards Review Journal, 22(2):06021001.
The authors studied the use of Wireless Emergency Alert (WEA) notifications at the state and local level to inform the public about COVID-19 developments. The authors compared rates of infections and deaths in jurisdictions which used the WEA system to those which did not. While sample sizes were small and rates of COVID-19 spread varied, the authors suggest WEA alerts may be an important way to encourage protective measures during pandemics.
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Chan, L., Yuan, B., and Convertino, M. (2021). COVID-19 Non-Pharmaceutical Intervention Portfolio Effectiveness and Risk Communication Predominance. Scientific Reports. 11(1):10605.
This article used probabilistic modeling to understand the effectiveness of interventions such as resource allocation, risk communication, social distancing, and travel restriction on the spread of COVID-19. The authors found that risk communication was the most effective intervention and returning to normal was the least effective intervention. Overall, non-pharmaceutical interventions (e.g., risk communication, social distancing, and travel restriction) were key to suppressing the pandemic.
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Chatterjee, R., Bajwa, S., and Dwivedi, D. (2020). COVID-19 Risk Assessment Tool: Dual Application of Risk Communication and Risk Governance. Progress in Disaster Science. 7:100109.
This article introduces a risk assessment tool which uses four factors to assess risk: health, behavior, exposure, and social policy. The tool can improve awareness and inform decision making; findings indicate that the tool has improved understanding of key COVID-19 interventions.
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Chesser, A., Drassen Ham, A., and Keene Woods, N. (2020). Assessment of COVID-19 Knowledge Among University Students: Implications for Future Risk Communication Strategies. Health Education and Behavior. 47(4).
This article describes outreach to university students to assess their knowledge of COVID-19 and to what extent they were informed about the pandemic on social media. The authors emphasize that an increased public health presence on social media is important to ensure that those community members who rely on it have access to accurate information about the pandemic.
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Covello, V. and Hyer, R. (2020). COVID-19: Simple Answers to Top Questions – Risk Communication Field Guide Questions and Key Messages. Center for Risk Communication.
This webpage provides responses to more than 70 questions related to COVID-19 to help state and territorial health officials communicate risk to their communities. It emphasizes credible, timely, and compassionate communications without instilling unwarranted worry during an emergency response.
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Fakhruddin, B., Clark, H., Robinson, L., et al. (2020). Should I Stay or Should I Go Now? Why Risk Communication is the Critical Component in Disaster Risk Reduction. Progress in Disaster Science. 8:100139.
This article discusses the importance and complexity of risk communication in disaster and public health emergency preparedness and response. The authors examined the success of risk communications during the COVID-19 pandemic in New Zealand found it was due to transparency, engaging with communities, and building a “currency of trust” between government and the public before a crisis. They conclude by listing several recommendations for improving risk communications (e.g., media focused on the public interest, better internet governance, education systems which promote critical thinking, and media literacy).
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Hooker, C. and Leask, J. (2020). Risk Communication Should be Explicit About Values. A Perspective on Early Communication During COVID-19. Journal of Bioethical Inquiry. 17:581-589.
The authors argue that being explicit about values (e.g., condemning stigmatization and racism, clarifying whether stockpiling supplies is warranted) can help communicate risk with empathy and encourage self-determination during an emergency such as the COVID-19 pandemic. The authors also emphasize the need to communicate early and often to improve the response to crises such as the COVID-19 pandemic.
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Joslyn, S., Savelli, S., Duarte, H., et al. (2021). COVID-19: Risk Perception, Risk Communication, and Behavioral Intentions. Journal of Experimental Psychology: Applied, 27(4):599-620.
This study describes the public’s willingness to engage in behaviors protective against COVID-19, including mask-wearing and social distancing. The authors examine participants’ willingness to comply with government recommendations depending on their age, political affiliation, and risk perceptions.
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Khan, S., Mishra, J., Ahmed, N., et al. (2022). Risk Communication and Community Engagement During COVID-19. International Journal of Disaster Risk Reduction, 74:102903.
This article identifies risks associated with excess information and lack of information, classifying information environments as inadequate, ideal, and “infodemic.” The authors describe how risk communications can create risks when managing a disaster and how appropriate risk communication can encourage resilience during disasters and crises.
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Li, H. O., Pastukhova, E., Brandts-Longtin, O., et al. (2022). YouTube as a Source of Misinformation on COVID-19 Vaccination: A Systematic Analysis. BMJ Global Health, 7:e008334.
The authors examined the most viewed videos on YouTube about COVID-19 vaccines to understand whether the platform conveyed accurate information. They found that 11% of the most viewed videos about COVID-19 contradicted information from WHO or the CDC.
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Lohinica, A., Sane, J., Sibenberg, K., et al. (2020). Understanding Coronavirus Disease (COVID-19) Risk Perceptions Among the Public to Enhance Risk Communication Efforts: A Practical Approach for Outbreaks, Finland, February 2020. Eurosurveillance. 25(13).
This article describes an exercise which aimed to understand risk perception about COVID-19 in Finland. The authors collected real time social media and email data to inform risk communication efforts each week. The authors emphasize the need to inform risk communication by psychological, societal, and cultural considerations (which are constantly changing) and note that future surveys could be employed to understand public trust in health authorities. While conducted in Finland, the methodology may be useful in the U.S. and other parts of the world.
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MacKay, M., Colangeli, T., Gillis, D., et al. (2021). Examining Social Media Crisis Communication during Early COVID-19 from Public Health and News Media for Quality, Content, and Corresponding Public Sentiment. International Journal of Environmental Research and Public Health. 18(15):7986.
The authors of this article conducted a study on the quality and content of COVID-19 crisis communication from public health and news media on Facebook. They found that the principles were inconsistently implemented, often leading to negative sentiment from the public in responding comments. Using the crisis communication principles consistently can improve the public’s reactions to these communications.
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* Malecki, K., Keating, J., and Safdar, N. (2021). Crisis Communication and Public Perception of COVID-19 Risk in the Era of Social Media. Clinical Infectious Diseases. 72(4):697-702.
The authors discuss how cultural and economic factors such as the spread of misinformation on social media have impacted risk communication during COVID-19. They distinguish between hazard (the prevalence of exposure, infection, and illness) and outrage (the public’s response to messages about the hazard) as components of risk calculation and acceptance and provide strategies for applying risk communication principles.
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Malik, A., Khan, M., and Quan-Haase, A. (2021). Public Health Agencies Outreach through Instagram during the COVID-19 pandemic: Crisis and Emergency Risk Communication Perspective. International Journal of Disaster Risk Reduction. 61.
The authors examined how key health organizations used Instagram and image-based features to communicate with the public about COVID-19; the nature of messages and images and how they align with the CERC model; and how Instagram users engaged with key health organizations’ messaging during the pandemic. They found “an overwhelming level of engagement” when posts included celebrities, infographics, and/or clarified information.
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Mehta, A. M., Murray, S., and Weeks, C. S. (2022). Communicating COVID-19 Risk Changes: Signalling with Words, Phrases, and Messages. International Journal of Disaster Risk Reduction, 77:103004.
The authors examined how participants perceived efforts to convey risk during the COVID-19 pandemic. Results showed that increased negative affect, assertiveness, and communication of risk caused participants to take action. The authors also found that signal words could be improved to communicate risk and inspire action more effectively.
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Porat, T., Nyrup, R., Calvo, R., et al. (2020). Public Health and Risk Communication During COVID-19—Enhancing Psychological Needs to Promote Sustainable Behavior Change. Frontiers in Public Health. 8:573397.
The authors applied the “Self-Determination Theory” and related concepts to understand human behavior and motivation and design messaging and guidelines during the COVID-19 pandemic. Five guidelines for public health and risk communications were proposed by the authors (e.g., encourage a culture of autonomy in healthcare, provide choice, and create solidarity) to help create effective messaging that can be used during pandemics.
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Rahn, M., Tomczyk, S., Schopp, N., et al. (2021). Warning Messages in Crisis Communication: Risk Appraisal and Warning Compliance in Severe Weather, Violent Acts, and the COVID-19 Pandemic. Frontiers in Psychology. 12:557178.
This article describes how demographic characteristics influence a person’s responsiveness and willingness to comply with warning messages related to COVID-19, violent acts, and severe weather events. The authors surveyed 403 German participants and found that older participants were more likely to comply with COVID-19 messaging. For severe weather, age and female gender increased compliance. The authors conclude that sociodemographic factors have some influence on the impact of risk communications, but that more research is needed.
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Ratzan, S., Sommariva, S., and Rauh, L. (2020). Enhancing Global Health Communication During a Crisis: Lessons from the COVID-19 Pandemic. Public Health Research and Practice. 30(2):3022010.
This article discusses lessons learned in risk communication during the early phase of the COVID-19 pandemic. The authors created a checklist for COVID-19 (based on one created during the mad cow crisis and adapted for the 2014 Ebola outbreak). The authors highlight the challenge of misinformation and disinformation during the COVID-19 pandemic and share strategies for communicating risk in a challenging media environment. They recommend a five-item checklist for handling the media environment, including (1) setting shared goals, (2) establishing a coordinated response, (3) devising a communication strategy, (4) implementing the communication plan, and (5) being ready to adapt.
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Safarpour, H., Farahi-Ashtiani, I., Pirani, D., et al. (2021). Risk Communication in the COVID-19 Outbreak: Two Sides of the Same Coin. Disaster Medicine and Public Health Preparedness.
This article discusses accurate and timely risk communication during COVID-19. The authors emphasize considering cultural context, the local status of the pandemic, and characteristics of the population such as age and education when communicating risk and stress the importance of communicating about health behaviors, care, and prevention via both traditional and social media.
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Schwarze, M., Zelenski, A., Baggett, N., et al. (2020). Best Case/Worst Case: ICU, with Special Content for Patients with COVID-19. University of Wisconsin-Madison.
This framework is designed to help clinicians communicate with patients and their families to achieve treatment decisions that align with patient preferences. The toolkit contains step-by-step instructions for use, templates filled with hypothetical examples, a blank template, photos demonstrating use of the intervention, and an ICU pocket card.
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Sleigh, J., Amann, J., Schneider, M., et al. (2021). Qualitative Analysis of Visual Risk Communication on Twitter During the COVID-19 Pandemic. BMC Public Health. 810.
The authors used software to locate Twitter’s most retweeted COVID-19 messages from January-October 2020. Messages had to include visuals, be in English, come from verified accounts, and contain select keywords. Using a content analysis, they found that communications early in the pandemic were from media, health, and government institutions, but personal accounts had the highest retweet count. While more messages focused on “health loss,” “health gain” messages were retweeted more often.
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Sundelson, A., Huhn, N., Jamison, A., et al. (2023). Infodemic Management Approaches Leading up to, During, and Following the COVID-19 Pandemic. Johns Hopkins Center for Health Security.
The overwhelming amount of information that circled during the COVID-19 pandemic (i.e., infodemic) challenged already strained public health and health providers who were struggling to understand the threat and share vetted, proven information with each other and patients. This report describes related tools and approaches developed to counter infodemics, summarizes existing evidence specific to these approaches, and notes gaps and needs for future research.
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VitalTalk. (2020). COVID Ready Communication Playbook.
This playbook offers communications tips to help healthcare providers respond to questions from patients and their loved ones about COVID-19.
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Winograd, D., Fresquez, C., Egli, M., et al. (2020). Rapid Review of Virus Risk Communication Interventions: Directions For COVID-19. Patient Education and Counseling. 104(8):1834-1859.
The authors reviewed the literature on risk communication interventions from the perspective of reducing risks from viruses and found that more tailored communications are more likely to produce behavior changes for diseases like HIV versus influenza. The authors conclude that while effective, more research is needed to understand the complex relationship between messaging and behavior.
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Lessons Learned: General

American Psychological Association (2014). As Ebola Concerns Mount, Psychology Offers Guidance on Health-Risks Communication.
This webpage (created during the 2014 Ebola outbreak) 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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Kusters, I., Gutierrez, A., Dean, J., et al. (2022). Spanish-Language Communication of COVID-19 Information Across US Local Health Department Websites. Journal of Racial and Ethnic Health Disparities. 1-8
The authors of this article examined COVID-19 communications in Spanish compared with English local health departments in the top ten most populous cities in the U.S. Coders reviewed six types of content in six different kinds of media (e.g., print resources and website text) to calculate each city’s score. The authors found that content types and delivery modes in Spanish were more varied and not as effective as their English counterparts. They conclude that information was not equivalently provided in Spanish despite federal guidelines.
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Lovari, A. and Bowen, B. (2019). Social Media in Disaster Communication: A Case Study of Strategies, Barriers, and Ethical Implications. Journal of Public Affairs, 20(3).
The authors of this study interviewed state emergency management leaders in South Carolina about their social media strategy during a flood in 2015. The article discusses social media policies, practices, strategies, and models, as well as media relations and communication with the public. Finally, the authors offer recommendations to improve social media communications during future disasters.
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* Rainear, A., Lachlan, K. and Xu, Z. (2021). Storms of a Feather Tweet Together: An Exploratory Study Examining Houston-Area Emergency Management Communication on Twitter in Hurricane Harvey. (Abstract only.) Journal of Emergency Management, 20(1):53-60.
This study examines content shared during Hurricane Harvey by a Houston emergency management account on Twitter, with a focus on the number of retweets, linguistic considerations, and the emergence of opinion leaders. The findings are compared with other disasters and can be considered for risk communication in future emergencies.
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Rural Health Information Hub. (2022). Rural Emergency Preparedness and Response Toolkit.
This evidence-based toolkit was developed in collaboration with the NORC Walsh Center for Rural Health Analysis. It provides practical guidance for planning for, responding to, and recovering from disasters and emergencies in rural communities. It also includes guidance and resources for different types of emergencies and considerations for special populations.
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Stovall, W., Ball, J., Westby, E., et al. (2023). Officially Social: Developing a Social Media Crisis Communication Strategy for USGS Volcanoes During the 2018 Kilauea Eruption.
The authors provide a history of USGS communication about volcanoes and eruptions since the Hawaiian Volcano Observatory was established in 1912 through current times, where information is primarily shared via social media. They found that social media updates during the Kilauea eruption were amplified by news media and helped take the pressure off scientists who would otherwise need to respond to media requests. The authors share successes and challenges from the event and make recommendations for the future.
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Takamura, N., Orita, M., Taira Y., et al. (2023). Experiences of Crisis Communication During Radiation Emergency and Risk Communication for Recovery of the Community In Fukushima. Journal of Radiation Research. 62(Supplement 1):i95-i100.
This article describes the role of risk communications between local authorities, healthcare providers, and residents in supporting the return of residents of Kawauchi Village, Fukushima Prefecture to their hometown in 2017 after the 2011 accident at the Fukushima Daiichi Nuclear Power Station.
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The National Academies Press. (2018). Emergency Alert and Warning Systems: Current Knowledge and Future Research Directions.
This book provides a summary of conference proceedings where risk communications experts discussed the public response to mobile alerts. A free PDF download is available or physical copies can be ordered for a fee.
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Toppenberg-Pejcic, D., Noyes, J., Allen, T., et al. (2019). Emergency Risk Communication: Lessons Learned from a Rapid Review of Recent Gray Literature on Ebola, Zika, and Yellow Fever. Journal of Community Health. 34(4):437-455.
The authors reviewed the gray literature (articles disseminated outside of commercial publishers) regarding outbreaks of Ebola, Zika, and yellow fever from 2015-2016. The literature emphasized the importance of involving local communities in risk communication ahead of an emergency. They indicate that social media is useful but should be considered supplemental to traditional risk communication.
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* Van Deventer, D., Marecaux, J., Doubleday, A., Errett, N. and Isaken, T. (2021). Wildfire Smoke Risk Communication Efficacy: A Content Analysis of Washington State’s 2018 Statewide Smoke Event Public Health Messaging. (Abstract only.) Journal of Public Health Management Practices, 27(6):607-614.
This article examines the August 2018 government and mainstream media communications about the risks of wildfire smoke in Washington. The authors performed a content analysis and found room for improvement in informing the public about what to do, targeting vulnerable groups, and emphasizing reliable sources of information.
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Misinformation and Disinformation

Aiyer, I., Shaik, L., Kashyap, R., et al. (2022). COVID-19 Misinformation: A Potent Co-Factor in the COVID-19 Pandemic. Cureus. 14(10):e30026.
This article reviews the scope of the COVID-19 “infodemic,” which, amid social media misinformation and a lack of credible sources and strategies for disseminating health information, challenged health authorities responsible for disseminating COVID-19 vaccines. The authors call for partnership between scientists, public health agencies, government, and social media companies to combat misinformation.
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Bruns, R., Hosangadi, D., Trotochaud, M., et al. (2021). COVID-19 Vaccine Misinformation and Disinformation Costs an Estimated $50 to $300 Million Each Day. Johns Hopkins Center for Health Security.
This brief describes the economic repercussions of COVID-19 mis- and disinformation. The authors calculate that (including the costs of hospitalization, valuation of lives lost, and long-term COVID-19 morbidity) voluntary declination of COVID-19 vaccination caused $1 billion of harm per day and that $50-300 million of that total could be attributed to mis/disinformation between the time when vaccines became available and the time of publication.
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Centers for Disease Control and Prevention. (2021). How to Address COVID-19 Vaccine Misinformation.
This webpage highlights strategies to combat mis- and disinformation which affected COVID-19 vaccine confidence and vaccine uptake in the U.S. Strategies for addressing COVID-19 misinformation through social media listening and monitoring tools are shared and links to resources including a community engagement playbook and a case study from Tennessee’s COVID-19 Health Disparity Task Force.
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Chan, M., Jones, C., Jamieson, K., and Albarracín, D. (2017). Debunking: A Meta-Analysis of the Psychological Efficacy of Messages Countering Misinformation. Psychological Science. 28(11): 1531–1546.
This meta-analysis investigated the factors underlying effective messages to counter attitudes and beliefs based on misinformation. Based on findings, the authors present three recommendations for debunking information: "reduce the generation of arguments in line with the misinformation"; "create conditions that facilitate scrutiny and counterarguing of misinformation"; and "create conditions that facilitate scrutiny and counterarguing of misinformation but keep expectations low."
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Cybersecurity and Infrastructure Security Agency. (n.d.). Mis-, Dis-, and Malinformation. (Accessed 4/11/2023.)
This website provides an overview of the different types of false information which can be spread online. CISA’s role is building national resilience to mis-, dis-, and malinformation, including during COVID-19 when inaccurate information undermined public confidence and caused confusion.
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Cybersecurity and Infrastructure Security Agency. (2020). COVID-19 Disinformation Toolkit.
This toolkit contains information for state and local health officials responding to disinformation. It includes an article on the topic, a customizable pamphlet, and graphics that can be used on various social media outlets.
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* Malecki, K., Keating, J., and Safdar, N. (2021). Crisis Communication and Public Perception of COVID-19 Risk in the Era of Social Media. Clinical Infectious Diseases. 72(4):697-702.
The authors discuss how cultural and economic factors such as the spread of misinformation on social media have impacted risk communication during COVID-19. They distinguish between hazard (the prevalence of exposure, infection, and illness) and outrage (the public’s response to messages about the hazard) as components of risk calculation and acceptance and provide strategies for applying risk communication principles.
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Mheidly, N., and Fares, J. (2020). Leveraging Media and Health Communication Strategies to Overcome the COVID-19 Infodemic. Journal of Public Health Policy. 41(4):410-420.
The authors propose a 12-item checklist for countering the infodemic. The checklist includes providing increased exposure for medical and public health professionals, verifying their accounts, and promoting their posts on social media. Other recommended strategies include providing programs supporting mental health and for coping with stress, employing an empathic communication style, sharing personal stories to combat misinformation, directing communications towards people of different classes and ethnicities, and increasing research and development of health communication best practices.
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National Academies of Sciences, Engineering, and Medicine. (2023). Navigating Infodemics and Building Trust During Public Health Emergencies: Proceedings of a Workshop in Brief.
Participants in this two-day workshop examined the history of public health infodemics, the impact of infodemics on trust in the public health enterprise, and strategies for addressing infodemics in the future.
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Otto, L. (2021). Mapping the Harm of COVID-19 Misinformation on Social Media. UWM Report.
The authors of this article examined social media using GIS, finding a correlation between the location of where misinformation spread and the number of COVID-19 infections and deaths in the weeks afterwards. The author identified prominent messages and mapped them onto the parts of the country where they were most prevalent.
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Sell, T.K. (2022). Meeting COVID-19 Misinformation and Disinformation Head-On. Johns Hopkins Center for Health Security.
This document provides answers to questions related to COVID-19 misinformation (unwittingly inaccurate claims) and disinformation (deliberately inaccurate claims). Topics covered include common threads in mis- and disinformation, treating the infodemic as a matter of national security, social media platforms’ role in combatting inaccuracies, and how to identify them.
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Sell, T.K., Hosangadi, D., Smith, E., et al. (2021). National Priorities to Combat Misinformation and Disinformation for COVID-19 and Future Public Health Threats: A Call for a National Strategy. Johns Hopkins Center for Health Security.
This report emphasizes the importance of addressing misinformation at the national level. The authors explain the role of consistent risk communication in addressing gaps in information and preventing mis- or disinformation.
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Plans, Tools and Templates: Ebola and Flu

Centers for Disease Control and Prevention. (2015). Crisis and Emergency Risk Communication (CERC) and Ebola.
This factsheet shares Ebola-specific risk communication information and emphasizes that the disease can be accompanied by public fear and misinformation, 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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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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Oregon Health Authority, Public Health Division Health Security, Preparedness, and Response Program. (2016). 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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Tell Me. (n.d.). New Communication Strategies for Health Agencies and Healthcare Professionals. (Accessed 1/17/2023.) 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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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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Plans, Tools and Templates: General

ASPR TRACIE. (2019). Mass Violence/Active Shooter 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. (2017). Public Service Announcements for Disasters.
This collection provides public service announcements to help communicators respond to a wide variety of public health emergencies, including earthquakes, floods, hurricanes, wildfires and more. Topics also include messaging around common all-hazards topics, such as the needs of at-risk populations, safe cleanup, and safe use of medication after a disaster. The PSAs are available in a variety of formats, including text message, short scripts for broadcast use, short videos for use on social media and more.
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Centers for Disease Control and Prevention. (2021). 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 improve 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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InterWeb Designs, Inc. (2009). Risk Communication in Rural Settings.
This webpage contains a toolkit for healthcare organizations and local public health to use to improve communication with the public, patients, and stakeholders. It includes resources for communicating during a natural disaster, biological emergency, chemical or radiological incident, and information on non-traditional methods of communication. Downloadable Word documents provide information in English and Spanish about actions to take during a variety of scenarios. Much of the material is applicable to both rural and urban settings.
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Louisiana Department of Health. (2020). Crisis and Emergency Risk Communications Plan.
This plan describes how the state health department handles communications during a disaster or public health emergency. The plan describes decision structures, leadership for coordinating emergency communications, and collaborations with other agencies and levels of government. The document is a framework for internal communications and external messaging.
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Office of Minority Health. (n.d.). Ensuring Culturally and Linguistically Appropriate Crisis Communication. (Accessed 7/7/2022) U.S. Department of Health and Human Services.
The guide lays out best practices for cultural inclusion when designing crisis communications. It includes information on understanding the demographics of the area being served, engaging community members, and setting a respectful and open tone to encourage understanding.
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Public Health – Seattle & King County and Northwest Center for Public Health. (n.d.). Texting for Public Health: Emergency Communication, Health Promotion, and Beyond. (Accessed 4/10/2023.)
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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Ready.gov. (2021). Crisis Communications Plan. U.S. Department of Homeland Security.
This website contains information for businesses on developing a crisis communications plan. It recommends identifying the target audience, including customers, disaster survivors, employees, the news media, government officials, among other community members the business serves. It describes how to craft an appropriate message, obtaining contact information, and further resources which may be of use.
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Substance Abuse and Mental Health Services Administration. (2019). Communicating in a Crisis: Risk Communication Guidelines for Public Health Officials. U.S. Department of Health and Human Services.
This guide can help health officials (and others responsible for communicating to the public before, during, and after a crisis) prepare their messaging to ensure it is actionable and received effectively by the public.
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Tulane University. (2022). Strategies for Developing Public Health Crisis Communication Plans.
This website provides practical guidance for developing a robust emergency communications plan. Steps include coordinating response across multiple media outlets, incorporating trusted messengers, improving outreach to vulnerable populations, normalizing unknowns inherent in the scientific process, rapidly addressing mis- and disinformation, incorporating empathy, and empowering community members. Finally, it contains recommended readings and relevant sources.
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Washington State Department of Health. (n.d.). Emergency Preparedness Fact Sheets. (Accessed 12/5/2022.)
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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World Health Organization. (2020). Risk Communications and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response.
This tool aims to improve risk communication for national health authorities. It can assist with community engagement among local stakeholders and families to improve outcomes for COVID-19, natural disasters, and other emergencies.
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Plans, Tools and Templates: Natural Disasters

Ali, A., Rana, I., Ali, A., et al. (2022). Flood Risk Perception and Communication: The Role of Hazard Proximity. (Abstract only.) Journal of Environmental Management.
This article discusses how risk communication can change flood risk perception. The authors evaluated public perception of flood risk by surveying 420 households in Pakistan to identify the social determinants of risk perception. They found that people living away from the river perceived stronger risk, and there was a strong correlation between perception of risk and receipt of (and seeking out) risk communication. The findings may inform risk communications efforts in the U.S.
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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, including the public, healthcare professionals, and rural populations as well as "coaching" on what messages to emphasize at what times prior to and during a heat event.
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National Weather Service. (2020). 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. (2017). Crisis and Emergency Risk Communication.
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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* Van Deventer, D., Marecaux, J., Doubleday, A., Errett, N. and Isaken, T. (2021). Wildfire Smoke Risk Communication Efficacy: A Content Analysis of Washington State’s 2018 Statewide Smoke Event Public Health Messaging. (Abstract only.) Journal of Public Health Management Practices, 27(6):607-614.
This article examines the August 2018 government and mainstream media communications about the risks of wildfire smoke in Washington. The authors performed a content analysis and found room for improvement in informing the public about what to do, targeting vulnerable groups, and emphasizing reliable sources of information.
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Populations with Access and Functional Needs

* Allen, E., Barranco, L., Mosites, E., et al. (2022). Communicating COVID-19 Risks and Prevention Measures among People Experiencing Homelessness. Centers for Disease Control and Prevention.
This plan describes how local, state, and federal public health agencies can communicate effectively about COVID-19 and other infectious diseases with people experiencing homelessness. The plan provides guiding principles, best practices, recommendations for a multi-tiered and collaborative approach, and considerations and challenges.
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Allen, E., Smither, B., Barranco, L., et al. (2022). Communicating Effectively with People Experiencing Homelessness to Prevent Infectious Diseases. The Journal of Infectious Diseases. 226(3): S340–S345.
This article describes focus groups conducted with people experiencing homelessness in four cities to understand how COVID-19 messaging was targeted and received by this population. Findings indicated that using trusted messengers and multiple sources was important. People experiencing homelessness preferred face-to-face communication, but they also received news through the media, internet, and social media.
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Calo, W., Murray, A., Francis, E., et al. (2020). Reaching the Hispanic Community About COVID-19 Through Existing Chronic Disease Prevention Programs. Preventing Chronic Disease. 17.
This article examines how Hispanic communities have been disproportionately at risk and impacted by COVID-19 in the U.S. The authors describe how two programs used existing infrastructure for chronic disease prevention to address the needs of these communities during the pandemic. They reached out to communities via video conferencing in Spanish, sharing information on COVID-19, adapting the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH) program and partnering with Penn State Project ECHO.
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Centers for Disease Control and Prevention. (2021). Access and Functional Needs Toolkit: Integrating a Community Partner Network to Inform Risk Communication Strategies. U.S Department of Health and Human Services.
This resource discusses communication planning for individuals with access and functional needs, as well as guidance for integrating community partners into communication strategies. It replaces CDC’s Public Health Workbook: To Define, Locate, and Reach Special, Vulnerable, and At-Risk Populations in an Emergency published in 2010.
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Community-University Health Care Center. (2022). Project Findings: Communicating COVID-19 Information with At-Risk Somali, Latino, and Hmong Elders.
This PowerPoint presentation provides an overview of COVID-19 outreach to Somali, Latino, and Hmong populations in Minnesota, including message development, delivery, and data analysis. The authors recommend a participatory approach to messaging, reinforcing prior knowledge, focusing on behavior change, considering the audience’s familiarity with technology. They also highlight the importance of including people from the community in messaging and of community health workers to provide information to difficult to reach populations.
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National Health Care for the Homeless Council. (2014). Integrating Homeless Service Providers and Clients in Disaster Preparedness, Response, and Recovery.
This issue brief outlines strategies to integrate the needs of people experiencing homelessness into broader emergency preparedness efforts. It examines individuals experiencing homelessness' and service providers' awareness and perception of targeted preparedness efforts, and offers recommendations for other communities looking to improve disaster assistance for people experiencing homelessness.
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Natural Hazards Center. (n.d.). Risk Communication and Social Vulnerability: Guidance for Practitioners. (Accessed 4/11/2023.) University of Colorado Boulder.
This website synthesizes what is known about communication with at-risk populations from a multi-year partnership between the Natural Hazards Center research team and the U.S. Army Corps of Engineers Institute for Water Resources. It includes an annotated bibliography on communication with at-risk populations, a guide for practitioners, and a worksheet booklet which may facilitate communication with these populations.
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Office of Minority Health. (n.d.). Engaging Community Partners to Support Equitable Crisis Response and Recovery. (Accessed 12/5/2022.) U.S. Department of Health and Human Services.
This resource emphasizes the importance of identifying cultural and linguistic groups to be reached, building relationships with stakeholders, and listening to and involving the community in decision-making when developing and providing equitable disaster response and recovery services.
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Rowel, 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
Rural Health Information Hub. (2023). Public Safety and Crisis Communication in an Emergency or Disaster.
This website contains information for rural health agencies planning for crisis communications in a disaster, including identifying disasters possible in a community, populations which may be at risk for adverse events, alert and notification procedures, and activation criteria. Recommendations include interpreting social media messages into languages spoken in the community, keeping digital accessibility in mind when messaging, using multimodal communication, and pretesting messages to ensure they are appropriate. The website also contains case studies.
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Tell Me. (n.d.). New Communication Strategies for Working with Different Sub-populations / Target Groups. (Accessed 12/5/2022.) 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 is on communications for an influenza pandemic, although the principles can be adapted to other contexts.
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* University at Albany School of Public Health. (2013). Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness.
The speakers in this 1-hour webinar emphasize the importance of engaging the Latino community in preparedness and the need for disaster responder cultural awareness including suggestions for risk communication. While slightly dated, it can help planners reach immigrant and other culturally diverse communities. The webinar emphasizes core cultural values, coping strategies, unique risk factors, and usual sources of support and inspiration that can be valuable when planning communications and adapting them to themes that will resonate. Trust issues and ability to comply with directives relative to immigration status are also discussed. Access the related report here: https://unidosus.org/wp-content/uploads/2021/07/EmergencePreparednessTK_Print.pdf
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Agencies and Organizations

Center for Health and Risk Communication.
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Centers for Disease Control and Prevention. Crisis and Emergency Risk Communication (CERC).
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National Hazards Center. Risk and Outbreak Communication.
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National Public Health Information Collection (NPHIC).
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Peter Sandman. The Peter M. Sandman Risk Communication Website.
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Substance Abuse and Mental Health Services Administration. Communications. U.S. Department of Health and Human Services.
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University of Colorado Boulder. CONVERGE Natural Hazards Center Communications.
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This ASPR TRACIE Topic Collection was refreshed in April 2023 and reviewed by the following subject matter experts (SMEs), listed in alphabetical order: Eric Alberts, Senior Director, Emergency Management, Orlando Health; James Bolen, MS, Planning Section Chief, Butler County, State of Ohio AHIMT; Peter Brewster, Program Manager, Office of Emergency Management, Veterans Health Administration; April Finnen, Senior Communications Specialist, U.S. Food and Drug Administration; John Hick, MD, Hennepin Healthcare; Elizabeth Jarrett, Public Affairs Specialist, ASPR Web Communications; James Paturas, Director, Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System; Jeff Rubin, PhD, CEM; Mary Russell, EdD MSN, Healthcare Emergency Response Coalition Palm Beach County, Florida; Tara Kirk Sell, PhD, Johns Hopkins Center for Health Security.

It was originally comprehensively reviewed in May 2015 by 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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