Journal of Health Communication, 20:121–122, 2015 Copyright # Taylor & Francis Group, LLC ISSN: 1081-0730 print/1087-0415 online DOI: 10.1080/10810730.2015.1007762
Perspectives Addressing Ebola and Other Outbreaks: A Communication Checklist for Global Health Leaders, Policymakers, and Practitioners ALLISON B. GOLDBERG1, SCOTT C. RATZAN1,2,3, KARA L. JACOBSON4, and RUTH M. PARKER5 1
Global Corporate Affairs, Anheuser-Busch InBev, New York, New York, USA Board of Scientific Counselors, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3 Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA 4 Department of Health Policy and Management, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA 5 Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA 2
Strong communication at all levels is critical to containing the rapid spread of disease. This has become particularly apparent in the current Ebola crisis, which has been characterized by apocalyptic predictions of infection rates, rumors, and widespread panic (Ratzan & Moritsugu, 2014). To address this pattern of communication chaos, mass media, global health experts, and international development agencies urgently called for the development of social and behavior change communication (SBCC) to complement global health efforts to contain the further spread of Ebola (Gurman, 2015). These urgent calls led the Health Communication Capacity Collaborative to establish the Ebola Communication Network (ECN) in October 2014. The primary goal of the ECN was to identify best practices and inform evidence-based SBCC so that programs could have greater impact on controlling the Ebola epidemic. Communication guides that have been developed and validated by public health leaders, policymakers, and experts to address disease outbreaks in the past are part of the SBCC evidence base for facilitating effective communication around the current Ebola crisis. The Maxims for Effective Communication on Health and Risk Issues that were initially developed in 1997 for the World Health Organization to help facilitate effective communication around the mad cow crisis provides a useful guide that could be adapted to help experts fight against Ebola (Ratzan, 1998). Address correspondence to Allison B. Goldberg, Global Corporate Affairs, Anheuser-Busch InBev, 250 Park Avenue, New York, NY 10177, USA. E-mail: Allison.Goldberg@ ab-inbev.com
This article offers a communication checklist, grounded in the original Maxims for Effective Communication on Health and Risk Issues (Ratzan, 1998) and informed by global health leaders, policymakers, researchers, and practitioners working on the Ebola crisis. Ideally, this checklist can aid social and behavior communication change experts working to stop the spread of Ebola and quell future threats of emerging infectious diseases.
Background On September 19, 2014 experts1 convened at Massachusetts General Hospital Center for Global Health to review Maxims for Effective Communication on Health and Risk Issues to ascertain applicability to the current Ebola outbreak (Ratzan, 1998). This multidisciplinary group of experts from the public and private sector in infectious disease, communication, media, disaster response, and international development reviewed the current approach to communication on Ebola and concluded that much more
1 The technical consultation includes inputs from David Bangsberg, MD, MPH, Director of the Mass General Hospital Center for Global Health; Mario Bravo, Senior Fellow=Adviser Development Communication, USAID; Hilarie Cranmer, MD, MPH, Director of Disaster Response, Mass General Hospital Center for Global Health; Rafael Obregon, PhD, Chief Communication for Development, UNICEF; Ami Schmitz, Senior Producer, NBC News Medical Unit; Scott Ratzan, MD, Vice President, Global Corporate Affairs, Anheuser-Busch InBev; and Allison Goldberg, PhD, Director, Global Corporate Affairs, Anheuser-Busch InBev.
122 could be done to enhance the Maxims to make them more applicable to infectious disease and Ebola communication. The experts provided direct feedback on how the Maxims could be updated in terms of content and design. Research experts in public health and health literacy2 then put the revised Maxims into checklist format so that global health leaders, policymakers, and practitioners could more easily use it and manage their communication around Ebola. The final communication checklist presented in the Appendix is grounded in health literacy principles and constructed in a way that is science-based, understandable, and useful to the public (Jacobson & Parker, 2014).
Communication Checklist for Addressing Ebola and Other Outbreaks The Communication Checklist for Addressing Ebola and Other Outbreaks (see Appendix) has been presented as part of an online nursing continuing education course on communication challenges with patients and the community around Ebola (Ratzan, Jacobson, Parker, & Goldberg, 2014). The goal of this course was to offer strategies for the use of this checklist and guidance on how to design health literate materials.
Conclusion A coordinated, health literate communication strategy for addressing Ebola is a vital component of addressing this ongoing threat. Existing guidelines, communication lessons from prior experiences, and health literacy principles that inform content, design and delivery can help to optimize how we work collaboratively across sectors to provide the public with information they need, want, and use in the midst of a public health emergency. The Communication Checklist for Addressing Ebola and Other Outbreaks provides a resource for addressing such an objective.
References Gurman, T. (2015). Back to basics: Improving the conceptualization and operationalization of programmatic exposure in social and behavior change communication through conceptual models. Journal of Health Communication, 20, 1–3. Jacobson, K. L., & Parker, R. M. (2014). Health literacy principles: Guidance for making information understandable, useful, and navigable. Discussion Paper, Institute of Medicine, Washington, DC. Retrieved from http://www.iom.edu/~/media/HealthLiteracyGuidance.pdf Ratzan, S. C. (1998). Global surveillance, Diagnosis and therapy of human transmissible spongiform encephalopathies: Report of a WHO consultation. Geneva: World Health Organization. Retrieved from www.who.int/csr/resources/publications/bse/whoemczdi989.pdf Ratzan, S. C., Jacobson, K. L., Parker, R. M., & Goldberg, A. (2014, November 10). Communication challenges with patients and the community about Ebola [Webinar]. In Continuing Education Series. Nurse.com. Retrieved from http://ce.nurse.com/course/web266/ communication-challenges-with-patients-and-the-communityabout-ebola/ Ratzan, S. C., & Moritsugu, K. P. (2014). Ebola crisis—Communication chaos we can avoid. Journal of Health Communication, 19, 1213–1215. 2
Ruth M. Parker, MD, Professor of Medicine for Pediatrics and Public
Health, Rollins School of Public Health, Emory University; Kara Jacobson, MPH, Senior Associate, Rollins School of Public Health, Emory University.
Perspectives Appendix: Communication Checklist for Addressing Ebola and Other Outbreaks 1. Agree on a Common Goal . Define clear long and short-term objectives. . Establish shared objectives and partners. This can be tough,
as it involves negotiating competing political=economic interests and priorities. . Define an evaluation process for revising strategies in realtime to meet these objectives. 2. Coordinate the Leadership . Identify one lead institution to manage and reconcile the common goal, its priorities and resources, and all active parties in consultation with national governments. . Identify credible individuals and organizations to build confidence and trust among key audiences, including healthcare providers, media, and the community. . Establish a strategic role for public and private entities, the media, academia, and others. . Remain flexible. The disease is spreading, which will require rapid, nimble adaption, message surveillance, and shifting of resources. 3. Develop a Communication Strategy . Prioritize the key messages to be disseminated. . Prioritize the key audiences for diffusing communication among multiple channels so that strategic alignment is attained. . Develop a detailed communication plan, to be implemented by the communications coordinator, delineating who is delivering what messages, in which format, and with what frequency. . Recruit a credible and competent spokesperson to provide a consistent face for all messages. . Recruit credible individuals or organizations as communication partners. 4. Launch a Communication Operation . Create mechanisms for message delivery. . Consider new partnerships with the private sector and nongovernmental organizations (NGOs) to advocate and support the response. . Facilitate and build ownership at the appropriate levels (e.g., sub-local to global) of the individuals or organizations. . Utilize existing media with humility, openness and accessibility. 5. Maximize Communication Effectiveness . Engage your audience. Develop messages that are visual, vocal, and evidence-based and, whenever possible, pretested. . Be health literate in developing materials. . Acknowledge and respond to emotions. Avoid abstract or harsh language about deaths, injuries, and illnesses. Communicate with compassion, using simple, non-technical language and multimedia. . Track and evaluate the implementation of the overall strategy in order to identify successes and weaknesses. Be prepared to modify your message or your strategies quickly and effectively in response to evaluations.
Copyright of Journal of Health Communication is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Perspectives Addressing Ebola and Other Outbreaks: A Communication Checklist for Global Health Leaders, Policymakers, and Practitioners ALLISON B. GOLDBERG1, SCOTT C. RATZAN1,2,3, KARA L. JACOBSON4, and RUTH M. PARKER5 1
Global Corporate Affairs, Anheuser-Busch InBev, New York, New York, USA Board of Scientific Counselors, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3 Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA 4 Department of Health Policy and Management, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA 5 Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA 2
Strong communication at all levels is critical to containing the rapid spread of disease. This has become particularly apparent in the current Ebola crisis, which has been characterized by apocalyptic predictions of infection rates, rumors, and widespread panic (Ratzan & Moritsugu, 2014). To address this pattern of communication chaos, mass media, global health experts, and international development agencies urgently called for the development of social and behavior change communication (SBCC) to complement global health efforts to contain the further spread of Ebola (Gurman, 2015). These urgent calls led the Health Communication Capacity Collaborative to establish the Ebola Communication Network (ECN) in October 2014. The primary goal of the ECN was to identify best practices and inform evidence-based SBCC so that programs could have greater impact on controlling the Ebola epidemic. Communication guides that have been developed and validated by public health leaders, policymakers, and experts to address disease outbreaks in the past are part of the SBCC evidence base for facilitating effective communication around the current Ebola crisis. The Maxims for Effective Communication on Health and Risk Issues that were initially developed in 1997 for the World Health Organization to help facilitate effective communication around the mad cow crisis provides a useful guide that could be adapted to help experts fight against Ebola (Ratzan, 1998). Address correspondence to Allison B. Goldberg, Global Corporate Affairs, Anheuser-Busch InBev, 250 Park Avenue, New York, NY 10177, USA. E-mail: Allison.Goldberg@ ab-inbev.com
This article offers a communication checklist, grounded in the original Maxims for Effective Communication on Health and Risk Issues (Ratzan, 1998) and informed by global health leaders, policymakers, researchers, and practitioners working on the Ebola crisis. Ideally, this checklist can aid social and behavior communication change experts working to stop the spread of Ebola and quell future threats of emerging infectious diseases.
Background On September 19, 2014 experts1 convened at Massachusetts General Hospital Center for Global Health to review Maxims for Effective Communication on Health and Risk Issues to ascertain applicability to the current Ebola outbreak (Ratzan, 1998). This multidisciplinary group of experts from the public and private sector in infectious disease, communication, media, disaster response, and international development reviewed the current approach to communication on Ebola and concluded that much more
1 The technical consultation includes inputs from David Bangsberg, MD, MPH, Director of the Mass General Hospital Center for Global Health; Mario Bravo, Senior Fellow=Adviser Development Communication, USAID; Hilarie Cranmer, MD, MPH, Director of Disaster Response, Mass General Hospital Center for Global Health; Rafael Obregon, PhD, Chief Communication for Development, UNICEF; Ami Schmitz, Senior Producer, NBC News Medical Unit; Scott Ratzan, MD, Vice President, Global Corporate Affairs, Anheuser-Busch InBev; and Allison Goldberg, PhD, Director, Global Corporate Affairs, Anheuser-Busch InBev.
122 could be done to enhance the Maxims to make them more applicable to infectious disease and Ebola communication. The experts provided direct feedback on how the Maxims could be updated in terms of content and design. Research experts in public health and health literacy2 then put the revised Maxims into checklist format so that global health leaders, policymakers, and practitioners could more easily use it and manage their communication around Ebola. The final communication checklist presented in the Appendix is grounded in health literacy principles and constructed in a way that is science-based, understandable, and useful to the public (Jacobson & Parker, 2014).
Communication Checklist for Addressing Ebola and Other Outbreaks The Communication Checklist for Addressing Ebola and Other Outbreaks (see Appendix) has been presented as part of an online nursing continuing education course on communication challenges with patients and the community around Ebola (Ratzan, Jacobson, Parker, & Goldberg, 2014). The goal of this course was to offer strategies for the use of this checklist and guidance on how to design health literate materials.
Conclusion A coordinated, health literate communication strategy for addressing Ebola is a vital component of addressing this ongoing threat. Existing guidelines, communication lessons from prior experiences, and health literacy principles that inform content, design and delivery can help to optimize how we work collaboratively across sectors to provide the public with information they need, want, and use in the midst of a public health emergency. The Communication Checklist for Addressing Ebola and Other Outbreaks provides a resource for addressing such an objective.
References Gurman, T. (2015). Back to basics: Improving the conceptualization and operationalization of programmatic exposure in social and behavior change communication through conceptual models. Journal of Health Communication, 20, 1–3. Jacobson, K. L., & Parker, R. M. (2014). Health literacy principles: Guidance for making information understandable, useful, and navigable. Discussion Paper, Institute of Medicine, Washington, DC. Retrieved from http://www.iom.edu/~/media/HealthLiteracyGuidance.pdf Ratzan, S. C. (1998). Global surveillance, Diagnosis and therapy of human transmissible spongiform encephalopathies: Report of a WHO consultation. Geneva: World Health Organization. Retrieved from www.who.int/csr/resources/publications/bse/whoemczdi989.pdf Ratzan, S. C., Jacobson, K. L., Parker, R. M., & Goldberg, A. (2014, November 10). Communication challenges with patients and the community about Ebola [Webinar]. In Continuing Education Series. Nurse.com. Retrieved from http://ce.nurse.com/course/web266/ communication-challenges-with-patients-and-the-communityabout-ebola/ Ratzan, S. C., & Moritsugu, K. P. (2014). Ebola crisis—Communication chaos we can avoid. Journal of Health Communication, 19, 1213–1215. 2
Ruth M. Parker, MD, Professor of Medicine for Pediatrics and Public
Health, Rollins School of Public Health, Emory University; Kara Jacobson, MPH, Senior Associate, Rollins School of Public Health, Emory University.
Perspectives Appendix: Communication Checklist for Addressing Ebola and Other Outbreaks 1. Agree on a Common Goal . Define clear long and short-term objectives. . Establish shared objectives and partners. This can be tough,
as it involves negotiating competing political=economic interests and priorities. . Define an evaluation process for revising strategies in realtime to meet these objectives. 2. Coordinate the Leadership . Identify one lead institution to manage and reconcile the common goal, its priorities and resources, and all active parties in consultation with national governments. . Identify credible individuals and organizations to build confidence and trust among key audiences, including healthcare providers, media, and the community. . Establish a strategic role for public and private entities, the media, academia, and others. . Remain flexible. The disease is spreading, which will require rapid, nimble adaption, message surveillance, and shifting of resources. 3. Develop a Communication Strategy . Prioritize the key messages to be disseminated. . Prioritize the key audiences for diffusing communication among multiple channels so that strategic alignment is attained. . Develop a detailed communication plan, to be implemented by the communications coordinator, delineating who is delivering what messages, in which format, and with what frequency. . Recruit a credible and competent spokesperson to provide a consistent face for all messages. . Recruit credible individuals or organizations as communication partners. 4. Launch a Communication Operation . Create mechanisms for message delivery. . Consider new partnerships with the private sector and nongovernmental organizations (NGOs) to advocate and support the response. . Facilitate and build ownership at the appropriate levels (e.g., sub-local to global) of the individuals or organizations. . Utilize existing media with humility, openness and accessibility. 5. Maximize Communication Effectiveness . Engage your audience. Develop messages that are visual, vocal, and evidence-based and, whenever possible, pretested. . Be health literate in developing materials. . Acknowledge and respond to emotions. Avoid abstract or harsh language about deaths, injuries, and illnesses. Communicate with compassion, using simple, non-technical language and multimedia. . Track and evaluate the implementation of the overall strategy in order to identify successes and weaknesses. Be prepared to modify your message or your strategies quickly and effectively in response to evaluations.
Copyright of Journal of Health Communication is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
