Recommendations for Improving the Effectiveness of Health Risk Communication

From an analysis of the case studies, members of the Subcommittee were able to identify a number of areas for improvement among the agencies in their attempts to design and implement effective health risk communication campaigns. The following recommendations emphasize the need for both short- and long-term actions to improve health risk communication planning and practice.

Area One for Improvement:
Increased understanding of the health risk communication process and its importance in achieving agency mission, goals, and communication objectives.

Specific Recommendation:
PHS agencies should consider developing a focus specific to health risk communication. One approach would be to form an office or designated group within each agency to help identify and clarify the role of health risk communication beyond its traditional function of information dissemination. A major task of the office/group would be to create an awareness of health risk communication as an integral agency component, interrelated to other functional areas and well established within the larger planning/budget process. Developing a systematic approach to health risk communication process planning and management can enhance an agency's awareness and recognition level.

Area Two for Improvement:
Lack of a systematic approach to planning leads to poor conceptualization and execution in the preparation, production, and dissemination of health risk communication messages, materials, and campaigns.

Specific Recommendation:
Each PHS agency should develop a set of generally accepted practices or guidelines for effective health risk communication. Agencies should develop their own set of generally accepted practices, perhaps using the EPA Cardinal Rules of Risk Communication or through organizing a consensus conference of communication experts and practitioners to set standards for health risk communication. Agencies should consider using the case studies in this report to provide a starting point for identifying guidelines for their own health risk communication initiatives and activities. Some of the basic principles contained in the case studies for improving health risk communications include the following:

• Ongoing communication, information dissemination, and followup build public trust and support for risk communication activities.
  
• Involving the audience early in communication, planning, and problem-solving processes enhances the efficacy and acceptability of the intended message.
  
• Active listening and recognition of verbal/nonverbal cues build credibility and empower the audience to create its own agenda.
  
• Releasing information that is timely, accurate, and understandable helps to allay some of the public's concerns and fears.
  
• Communication directed at increasing cooperation and coordination among individuals, groups, and agencies reduces competing interests of political and social groups that can inhibit communication. (5)

Area Three for Improvement:
Lack of a well-organized and broad-based approach for increasing awareness and visibility of health risk communication issues and trends within/between Federal agencies.

Specific Recommendation:
The Subcommittee on Risk Communication and Education, in coordination with other PHS components, should undertake an interagency initiative aimed at increasing awareness and visibility of health risk communication issues and trends within and between PHS agencies. Possible examples of this initiative could include health risk communication workshops and focus groups jointly organized and sponsored by the Subcommittee and the Office of the Assistant Secretary for Health (OASH). The proposed initiatives provide several key benefits, including the following:

• Providing a public forum for the discussion and debate of current health risk communication issues and trends.
• Promoting broader dissemination of research to health communication practitioners within the public health community.
• Covering developments in current health risk communication trends, priorities, and practices.
• Improving coordination in linking health risk communication expertise, information, and resources among Federal agencies.

Area Four for Improvement:
The Subcommittee's analysis of the case studies described in this report showed that only 3 of the 10 agencies conducted any type of formal outcome and impact evaluation. The remainder of the evaluations ranged from simple implementation measures to no evaluation at all. Not having this type of data limited the agencies' ability to judge the quality and worth of their communication activities and products. Also limited were judgments made in relation to statements of intended outcomes.

Specific Recommendation:
Each PHS agency should develop a set of generally accepted practices or guidelines for effective evaluation of communication activities and products. Agencies should become familiar with evaluation standards and practices, perhaps through hiring evaluation specialists or by developing similar expertise among current staff members. Clear objectives should be developed for each health risk communication effort and tracked to the activity's completion.

• PHS agencies identified some specific implementation strategies the EHPC might consider pursuing to address the four major recommendations. PHS actions to implement the recommendations are found in Appendix 3. Implementation strategies common to PHS agencies emerged in the following five areas: (1) program development; (2) building partnerships; (3) developing training; (4) expanding information technologies; and (5) conducting research and evaluation.

ENDNOTES

(5) A health communication model, similar to a model developed by the National Cancer Institute (NCI), is presented for the consideration of PHS agencies in Appendix 2. The Subcommittee intends the model to be suggestive, not prescriptive, of the design and delivery of health risk communication messages.