Supersize Episode: Dr. Barbara Reynolds on CDC’s Zika Communication Plan

[Intro Music]

[Ryan Weber] Welcome to 10-Minute Tech Comm. This is Ryan Weber at the University of Alabama in Huntsville and as I record today on August 8th, we’re a few days into the 2016 Summer Games in Rio. The Games have raised significant concerns about the Zika Virus, which is transmitted via mosquitos and has made its way recently to the United States. The Center[s] for Disease Control and Prevention has been tasked with preparing Americans for Zika’s arrival. I wanted to get more information bout this strategy for communicating with Americans about this disease and their general strategy for crises and emergency communication overall. So, I brought in an expert.

[Barbara Reynolds] Hi, I’m Dr. Barbara Reynolds with the Centers for Disease Control and Prevention and I’m a Senior Advisor here at CDC on Crisis and Risk Communication.

[Weber] Dr. Reynolds is the author of the book, Crisis and Emergency Risk Communication, and she joins us today to talk about CDC’s communication plan as it relates to Zika and health crises in general.

[Begin Interview]

[Weber] Thank you so much for joining us today Dr. Reynolds. I’m really interested to hear what you have to say concerning the Zika communications plans that you’ve been coming up with. So, I guess if we could start just by talking a little bit, if you can tell us kind of what you have been working on in regard to Zika crisis communications and also the process for developing the plans that you’ve come up with.

[Reynolds] CDC has been involved in a number of high-profile emergency responses in public health over the last few years. I think everybody knows what we went through with Ebola. Every time we go through a public health emergency, we learn something from it in terms of the way we communicate and I think for our Zika response, we’re really benefiting from the more recent Ebola outbreaks and other things, in terms of communication. And one of the things fortunately that we had the possibility to do here is plan more than we have had for some other emergencies that emerged rather suddenly. As we were watching what was happening in Central and South America, we knew the possibility of Zika coming to the United States, the CDC held an important summit back on the first of April of this year and invited public health and other partners from around the country to come to CDC or to join us through media technology.

[Weber] Sure.

[Reynolds] To do the planning and so what was really unique about Zika communication planning is that we had our audiences in mind and we brought representatives from those audiences into CDC to begin the planning process. From that, we developed a number of tools and templates that people could use to start that communication process when they needed it. And it’s not a one-size fits all by no means.

[Weber] Sure.

[Reynolds] I think we’ve allowed for some variation without question, but what we’re trying to do is provide to local and state health departments or hospitals or clinics the content that they can use and adapt as they need to so that they don’t all have to start from zero.

[Weber] Sure, it’s something that they can start working with so that they have some idea of what their message should be and also that messages are somewhat consistent across these different states and local organizations. Is that correct?

[Reynolds] Yes. CDC has a number of crisis and risk communication experts here at CDC, health communications specialists. People who are very creative with images and we bring all of that expertise to bear on this topic and so we’ve been preparing. We have videos, we have infographics, we have images, we have posters, we have a number of both for print and electronic to allow people to zero in on those messages that they think are most important for their audience. And I have to say that we also do this work for technical audiences or professionals, medical professionals, clinical communities, so that they have access to some of these things. I mean talk about the needs from an OB/GYN office for example, they’re going to need specific pieces of information and our-they prepare to create that on their own, no probably not. So, if we can provide it for them we feel we’re doing some service.

[Weber] That’s fascinating. So you’re talking about providing sort of different levels of information or information that’s catered for different types of stakeholders and different sorts of experts and members of the public who might need it. Is that right?

[Reynolds] Yes. If you go to the CDC’s Zika website, we have the information provided there, just basic information for the general public who might be interested, but if you scroll down you’ll see that we are adapting our communication resources by audience needs. So, we have some products that are directed toward clinicians and health care providers, nurses, but then we also have information that is geared toward women who are pregnant or family planning clinics, all kinds of things that people should be able to find something to work with. And I’ve been involved in weekly webinars with communication professionals around the country, well in fact it’s actually international, and each week we take a topic and talk about it in relationship to Zika and talk about the communication resources that are available through CDC.

[Weber] Great and again it sounds like you developed a lot of the materials by meeting with the stakeholders initially, getting some feedback about what they needed. Am I understanding you correctly?

[Reynolds] Yes, absolutely. We’re familiar with the lack of communication resources. I have to say in my long career in risk communication, I have struggled to get people who are planning for crises to think about the importance of communication. Then the event happens and people begin to understand how valuable the communication resources are. So, we always know we’re going into a crisis with a different deficit for communication resources. I shouldn’t complain here at CDC, but when I know I’m working with partners at state and local health departments or in clinics or hospitals, they are not going to have all of the communication resources they need. So, we’re just trying to give them an extra pair of helping hands on the communication front. Taking advantage of what they know and what we know and putting it together

[Weber] Terrific. When I was looking through one of your documents, you had a planning guide for states that was sort of what drew me to you in the first place. One of the things it talks about a lot is maintaining credibility with the public.

[Reynolds] Yeah

[Weber] And what kinds of messaging strategies do you recommend for maintaining credibility? [Reynolds] This is such an important topic for me. I actually want to step back one moment-. [Weber] Sure.

[Reynolds] -and define credibility.

[Weber] Yeah, absolutely.

[Reynolds] Because I know I throw that word around a lot when I’m talking to people, that it’s important we have our credibility, and this is how I define it when I’m talking to professionals in the public health arena. Credibility is combination of two things: trust and expertise. Because someone might trust someone else but they may recognize they don’t have any expertise in the area. Someone may recognize someone has expertise but because of one reason or another they may not be a trusted source for that expertise. So, to be credible in this arena means bringing trust and expertise together in one package. CDC works really hard to do that but to develop credibility means that you need to be accurate. It also means you have to share information openly with people. It’s the trust and the accuracy going together that makes a difference. I think sometimes we stumble, all of us do in that arena, and we have to work really hard to gain back trust and to ensure that we are as accurate as possible so that we don’t lose that part of credibility, which is expertise. One of the things that we learned years ago, and have tried to practice, is the idea of interim guidance when we have an emerging public health emergency. When we just don’t have all the answers and at the summit I was talking to leaders across the country about their communication going forward and I said, “There are six words you need to know and those six words are: Based on what we know now,” and the reason I say that is we have to have room and we have be humble enough to recognize that when something’s unfolding, when it’s something we’ve never faced before, or haven’t faced for many, many years, we have to be prepared to tell people, “We’re going to give you the best advice we have with the information that we have right now. We’ re still digging. We’ re still learning and we’re going to study this even more and if we change something understand it’s because we have gained some knowledge we didn’t have previously.”

[Weber] You know that’s great. It sounds like part of credibility is admitting what you don’t know or admitting where the gaps in the knowledge are.

[Reynolds] Yes. I would say that history has taught us that not being humble in our communication is probably the biggest mistake that we can make and in fact if we want to speak with certainty because people are seeking a reduction of uncertainty in a crisis situation. And so there’s this yen or yang thing going on here of, “Well want to speak in absolutes when we can, but we also need to recognize that there are some things that may change.” I think Zika has shown us this. We have had to recognize the greater role of sexual transmission in Zika than we had expected previously and then just within the last two weeks, we updated our guidance to indicate sexual transmission can go from not just man to woman from woman to man or from woman to woman, man to man, that we have to think in all of those ways. But that comes from learning and then sharing and we used the word interim I think sometimes it’s not recognized as much as we would like to that we’re going to come back and change it. A dose of humility in an ongoing crisis is really smart.

[Weber] Certainly, certainly. The same document mentions some principles for crisis emergency risk communication. Are there any others you’d like to mention, principles for crisis communication that have informed the work that you’ve done with Zika?

[Reynolds] So, crisis and emergency risk communication is actually an integrated model of communication, which is now recognized as a theory that I can claim for CDC. We are the ones who developed this.

[Weber] Oh wow, great. Okay.

[Reynolds] Yeah. I actually wrote the first book on it. I will tell you that I went to Hong Kong in 1997 for the first human cases an outbreak of HSNl Influenza HSNl, the Bird Flu, and I was there as a communications professional and I realized that I felt wholly inadequate to the task of talking to people if this had become the severe pandemic that it had the potential to be at the time.

[Weber] Sure.

[Reynolds] And so my quest from that time forward has been, how do we talk to people when their lives have been turned upside down? When there’s a great deal of uncertainty? And so those principles you’re talking about is a part of that framework and it’s be first, meaning you increase your credibility by getting out there quickly to people with information. Be right, we talked about the importance of accuracy. Be credible, what that means, but express empathy, promote action, and show respect are the other three of those principles. That encompasses a lot of different concepts but the idea honestly comes down to talk to people as they deserve to be spoken too. Don’t talk down to them and recognize the emotional component of your communication when you’re talking to people. And I have spent hours and hours and hours across the country and internationally working to convince professionals who are responding to crises that it is incumbent on them to recognize the emotional component and to address it.

[Weber] Right, that’s great. It’s so important because this stuff is, it’s scary and people are concerned and it’s not processed like say dispassionate scientific knowledge or medical knowledge might be so.

[Reynolds] Yes. When we put on our professional scientific or operational response role, we sometimes think that it’s taboo to even speak to the emotions that are occurring in the community. We went through an Anthrax even back in 2001 where Anthrax letters were being mailed and we lost some of our postal workers during that time and there was a strong research that there was a level of mistrust in the messages that we were providing. We as in the whole community of response and that they told us that they needed to know that we understood what they were going through emotionally for them to have accepted our messages. And my motto in all of this is, “The right message at the right time from the right person can save lives and reduce harm,” and each of those components are really important and so I work hard to try to get our messengers to do a better job of it and we at CDC, I think, have been leaders in the field of crisis and emergency risk communication because of this.

[Weber] Excellent. Well hey thank you so much for joining us. Good luck with your continued efforts with Zika communication and with whatever the next thing is. We really appreciate the work that you’re putting in.

[Reynolds] Thanks Ryan.

[Weber] Great, thanks so much Dr. Reynolds.

[Reynolds] Alright, bye-bye.

[Weber] Bye.

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