communicating health risk uncertainty: busting the myths · results – overview of research 28...
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Communicating Health Risk Uncertainty: Busting the myths
Cindy Jardine University of Alberta
S. Michelle Driedger University of Manitoba
© Mischa Richter / The New Yorker Collection
Cartoon by Bradford Veley/bradveley.com
Study Objectives
To evaluate empirical studies of communicating uncertainty to the public in environmental health risk
To produce evidence-based recommendations that can be used by health practitioners
Methods
English language articles Published between January 1985 and Sept.
2008 Input from collaborators representing
regional, provincial and national health agencies
Search Techniques
Database search 38 databases in range of disciplines 38 related terms and synonyms
Key journal search e.g. Risk Analysis, Journal of Risk Research, Health Risk
and Society
Key author search 109 key risk communication authors
Health Sciences (6) e.g. Medline
Business/ Commun. (3) e.g. Business
Source Complete
Science/ Technology (5)
e.g. BioOne Abstracts
Interdisc (10) e.g. Academic
Source Complete
Agric/Env (4) e.g. Agricola, Environment
Complete
Psych/Soc/Ed (3)
e.g. ERIC, PsycINFO
38 DATABASES SEARCHED
Search Techniques
Database search 38 databases in range of disciplines 38 related terms and synonyms
Key journal search e.g. Risk Analysis, Journal of Risk Research, Health Risk
and Society
Key author search 109 key risk communication authors
Environment, health, pandemic, genetic,
etc.
Uncertainty, probability,
chance, credibility, etc.
Risk, hazard, crisis, etc.
Communication , disclose, inform,
etc.
Environmental Health
Risk Communication Uncertainty
Search Techniques
Database search 38 databases in range of disciplines 38 related terms and synonyms
Key journal search e.g. Risk Analysis, Journal of Risk Research, Health Risk
and Society
Key author search 109 key risk communication authors
Search Techniques
Database search 38 databases in range of disciplines 38 related terms and synonyms
Key journal search e.g. Risk Analysis, Journal of Risk Research, Health Risk
and Society
Key author search 109 key risk communication authors
Volume of Applicable Literature Screening Level Total
Quick Exclusion 29,499
Broad Screening 23,104
Sorting Paper Types 2,365
Review with Full Text 1,026
Literature Used for Extraction
282
Final 28
Methods – Data Extraction
Inclusion: Explicit focus on the public and uncertainty
Exclusion: where uncertainty is only mentioned in passing no empirical evidence; and studies about occupational health or economic risk
Results – Overview of research
28 articles from 1985 to 2008 (Sept.) 22 articles from 2000 to 2008 6 articles from 1985-1999
Most studies from the US(14) and the UK (5)
Quantitative, qualitative and mixed methods
Disciplinary perspectives: Public Health, Health Policy, Communication studies, Risk Management, Medicine, Social Sciences, Nutritional Sciences
Myth #1: All uncertainty is the same
One size (doesn’t) fit all
Cartoon by Bradford Veley/bradveley.com
Variability vs. Uncertainty
Conflicting knowledge vs not knowing
Source of uncertainty
Consequences of uncertainty
ScienceCartoonsPlus.com
Presentation of uncertainty
ScienceCartoonsPlus.com
Interpretations of uncertainty
Copyright © Alex Alexeev. Awaiting artist’s permission.
Interpretations of uncertainty
ScienceCartoonsPlus.com
Policy default assumptions
ScienceCartoonsPlus.com
Myth #2: People will not accept uncertain information
People need some information
ScienceCartoonsPlus.com
Importance of plain language
ScienceCartoonsPlus.com
Unambiguous information
© 2009 Dave Granlund politicalcartoons.com
Know your audience
Cartoon by Bradford Veley/bradveley.com
Myth #3: Admitting uncertainty undermines credibility
Different demands for certainty
Cartoon by Bradford Veley/bradveley.com
Withholding information
Cartoon by Bradford Veley/bradveley.com
Not saying doesn’t mean people don’t know
Myth #4: Information should be withheld until there is reasonable certainty
Timing matters
www.CartoonStock.com
10 day hypothesis re: timing
ScienceCartoonsPlus.com
5/22/2013 37
10 days to full year - Walkerton
35% 37% 40%
77%
23%
8%
27%
46%
31% 36%
80%
34%
16% 19%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Inquiry Blame Descriptions & control actions
Health Govt. response General (mis)trust
stories
Other
Story Reference Categories
10 days Full Year
5/22/2013 38
10 Days to full year - BSE
81%
27%
64%
31%
22%
3%
27%
80%
14%
2%
20%
37%
66%
26%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Economy Blame Descriptions & control actions
Health Govt. response
General (mis)trust
stories
Other
Story Reference Categories
10 Days Full Year
Myth #5: The media never get it right
The media ‘bad dog’
Cartoon by Bradford Veley/bradveley.com
Need to cultivate media relationships
www.CartoonStock.com
Filling the information void
5/22/2013 42
Time spent dispelling rumours…
…means less time effectively communicating
The spokesperson matters
ScienceCartoonsPlus.com
The spokesperson matters
Take home messages
© Mischa Richter / The New Yorker Collection
Acknowledgements Funded by: Canadian Institutes of Health Research,
Knowledge Synthesis & Knowledge Translation Research Assistants: Alison Watson, Chantal Ritcey,
David Sulz, Darby Love, Andrea Milne, Elizabeth Deblois, Erica Wright, Amanda Boyd, Bhavnita Mistry, Elizabeth Cooper, Stephanie Kowal
Collaborators: Dr. Mike Routledge (Manitoba Health), Dr. Maura Ricketts (Canadian Medical Association), Mr. Alex MacKenzie (Alberta Health and Wellness), Mr. Nelson Fok (Alberta Health Services), Ms. Tamara Magnan (Health Canada)
Questions?
cindy.jardine@ualberta.ca michelle.driedger@med.umanitoba.ca
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