Group Title: BMC Public Health
Title: Effective media communication of disasters: Pressing problems and recommendations
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Title: Effective media communication of disasters: Pressing problems and recommendations
Physical Description: Book
Creator: Lowrey, Wilson
Evans, William
Gower, Karla
Robinson, Jennifer
Ginter, Peter
McCormick, Lisa
Abdolrasulnia, Maziar
Publisher: BMC Public Health
Publication Date: 2007
 Notes
Abstract: BACKGROUND:Public health officials and journalists play a crucial role in disseminating information regarding natural disasters, terrorism and other human-initiated disasters. However, research suggests that journalists are unprepared to cover terrorism and many types of natural disasters, in part because of lack sufficient expertise in science and medicine and training. The objective of this research was to identify solutions to problems facing journalists and public health public information officer (PIOs) of communicating with the public during natural and human-initiated disasters.METHODS:To assist in identifying the most pressing problems regarding media response to health-related risks such as terrorism and large-scale natural disasters, 26 expert advisors were convened, including leaders representing journalists and public information officers, state health officials, experts in terrorism and emergency preparedness, and experts in health, risk, and science communication. The advisory group participated in pre-arranged interviews and were asked to identify and review bioterrorism educational resources provided to journalist. All advisory group members were then invited to attend a day long meeting January 29, 2004 to review the findings and reach consensus.RESULTS:The most pressing problems were found to be a lack of coordination between PIO's and journalists, lack of resources for appropriately evaluating information and disseminating it efficiently, and a difference in perception of PIO's and journalist towards each others role during emergency situations. The advisory board developed a list of 15 recommendations that may enhance communication plans betweens PIO's, journalist and the public. The solutions were meant to be feasible in terms of costs and practical in terms of the professional and organizational realities in which journalists and PIO's work.CONCLUSION:It is clear that PIO's and journalists play crucial roles in shaping public response to terrorism and other disasters. The findings from this formative research suggest that perspectives and organizational processes often limit effective communication between these groups; though practical solutions such as participation of journalists in drills, scenario exercises, sharing of informational resources, and raising awareness at professional trade meetings may enhance the timely dissemination of accurate and appropriate information.
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Research article

Effective media communication of disasters: Pressing problems and
recommendations
Wilson Lowreytl, William Evanst2, Karla K Gowert3, Jennifer A Robinsont4,
Peter M Gintert5,6, Lisa C McCormick*t6 and Maziar Abdolrasulniat5,6


Address: 'Department of Journalism, University of Alabama, Tuscaloosa, USA, 2Department of Telecommunication and Film, University of
Alabama, Tuscaloosa, USA, 3Department of Advertising and Public Relations, University of Alabama, Tuscaloosa, USA, 4Department of Public
Relations, University of Florida, Gainesville, USA, 5Department of Health Care Organization and Policy, University of Alabama at Birmingham,
Birmingham, USA and 6South Central Center for Public Health Preparedness, University of Alabama at Birmingham, Birmingham, USA
Email: Wilson Lowrey wlowrey@bama.ua.edu; William Evans wevans@bama.ua.edu; Karla K Gower gower@apr.ua.edu;
Jennifer A Robinson jrobinson@jou.ufl.edu; Peter M Ginter pginter@uab.edu; Lisa C McCormick* lmccormick@ms.soph.uab.edu;
Maziar Abdolrasulnia maziabdo@uab.edu
* Corresponding author tEqual contributors



Published: 6 June 2007 Received: II December 2006
BMC Public Health 2007, 7:97 doi: 10.1186/1471-2458-7-97 Accepted: 6 June 2007
This article is available from: http://www.biomedcentral.com/1471-2458/7/97
2007 Lowrey et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



Abstract
Background: Public health officials and journalists play a crucial role in disseminating information regarding
natural disasters, terrorism and other human-initiated disasters. However, research suggests that journalists are
unprepared to cover terrorism and many types of natural disasters, in part because of lack sufficient expertise in
science and medicine and training. The objective of this research was to identify solutions to problems facing
journalists and public health public information officer (PIOs) of communicating with the public during natural and
human-initiated disasters.
Methods: To assist in identifying the most pressing problems regarding media response to health-related risks
such as terrorism and large-scale natural disasters, 26 expert advisors were convened, including leaders
representing journalists and public information officers, state health officials, experts in terrorism and emergency
preparedness, and experts in health, risk, and science communication. The advisory group participated in pre-
arranged interviews and were asked to identify and review bioterrorism educational resources provided to
journalist. All advisory group members were then invited to attend a day long meeting January 29, 2004 to review
the findings and reach consensus.
Results: The most pressing problems were found to be a lack of coordination between PIO's and journalists, lack
of resources for appropriately evaluating information and disseminating it efficiently, and a difference in perception
of PIO's and journalist towards each others role during emergency situations. The advisory board developed a
list of 15 recommendations that may enhance communication plans between PIO's, journalist and the public. The
solutions were meant to be feasible in terms of costs and practical in terms of the professional and organizational
realities in which journalists and PIO's work.
Conclusion: It is clear that PIO's and journalists play crucial roles in shaping public response to terrorism and
other disasters. The findings from this formative research suggest that perspectives and organizational processes
often limit effective communication between these groups; though practical solutions such as participation of
journalists in drills, scenario exercises, sharing of informational resources, and raising awareness at professional
trade meetings may enhance the timely dissemination of accurate and appropriate information.



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Background
There has been a dramatic increase in the number of nat-
ural and human initiated disasters. From 1900 to 2006
there have been 15,833 reported natural and human ini-
tiated disasters worldwide. One third of all these disasters
have occurred between 2000 and 2006 [1]. Many factors
are contributing to this increase including population
growth, urbanization, increasingly complex technologies,
a rise in world-wide terrorism, social unrest, global eco-
nomic and social interdependence, the emergence and re-
emergence of infectious diseases such as cholera, yellow
fever, diphtheria, malaria, and plague and the emergence
of new infectious diseases including HIV, Ebola, Hepatitis
C, hantavirus, and rotavirus.

Clearly, journalists and news organizations play crucial
roles in disseminating information regarding natural dis-
asters, terrorism and other human-initiated disasters [2].
For example, newscasts were the primary source of infor-
mation for people trapped after hurricanes Katrina and
Rita slammed into to the US Gulf Coast. Similarly, the
media informed the world of the massive destruction, loss
of life, and need for international aid after the 2004 tsu-
nami which killed over 300,000 and left millions home-
less in South Asia, India, Sri Lanka, Africa, Thailand, and
Indonesia.

Most adults in the United States first learned of the Sep-
tember 11, 2001 attacks via mass media. Television was
the primary source of this news, although audiences also
relied on radio, newspapers, newsmagazines, and online
media [3-5]. The bioterrorism-related anthrax outbreak in
fall 2001 generated immense media attention. The emer-
gence of SARS in 2003 was also covered frequently and
prominently in news outlets around the world. Further,
the media played a vital role in informing the public
about the sources and risks of terrorism reporting in 2004
on the four commuter trains that were bombed during
morning rush hour in Madrid, Spain killing 191 people
and injuring 1,200 others and in July 2005's coordinated
attack on London's underground transportation system
which left 56 dead and 700 injured.

News reports of terrorism and natural disasters, however,
sometimes have been faulted for inaccurate, incomplete,
and sensational coverage that may contribute to public
misunderstanding of risks [6-8]. Research suggests jour-
nalists are unprepared to cover terrorism and many types
of natural disasters, in part because journalists lack suffi-
cient expertise in science and medicine [9-11].

Responding to these concerns and acknowledging that
public health is playing an increasingly important role in
disaster response and communication, The Centers for
Disease Control and Prevention (CDC) has launched sev-


eral ambitious training programs to improve the ability of
public health professionals to communicate through jour-
nalists about terrorism and disaster preparedness. In coor-
dination with the Association of Schools of Public Health,
the CDC supports 27 Centers for Public Health Prepared-
ness that are located within accredited schools of public
health. The project discussed in this paper is a product of
one such partnership, the South Central Center for Public
Health Preparedness, which is based in the Schools of
Public Health at the University of Alabama at Birming-
ham and Tulane University.

These training programs have been informative and past
studies on journalists' decision-making shed light on the
problem. Yet there is still no consensus regarding the most
pressing challenges facing journalists and public health
public information officer (PIOs) as they respond to nat-
ural and human-initiated disasters. This paper identifies
the key challenges and recommends possible solutions.

Public health's expanding role in preparedness
Historically, public health's response to disasters has been
improvised and impromptu. Health departments were
called upon in response and recovery operations as an
afterthought, leaving the medical and health efforts
related to emergencies uncoordinated with the rest of the
emergency response. However, since September 11, 2001
there has been a new emphasis on disaster and emergency
preparedness in public health. Further, there has been a
concerted effort to integrate disaster and emergency pre-
paredness into traditional public health functions and
organizational structures. Today, in most communities,
there is mainstream recognition that public health is a key
player in emergency response.

The public health system is a complex network of individ-
uals and organizations that assure conditions in which
people can be healthy in the community. The "public
health system" is traditionally thought of as being made
up of local and state health departments and laboratories,
the health care delivery system, and the public health and
health sciences divisions of academia. In order to protect
the public's health during crises this network must expand
to include traditional response agencies such as emer-
gency management agencies, fire department, law
enforcement, and other entities with a responsibility to
protect the safety and health of the public. Other volun-
teer and faith-based organizations must be included so
that their resources can be utilized to the fullest extent
during response and recovery operations. Another impor-
tant partner in this network is the media. Public health
officials realize that the media can shape public opinion
and influence decision making that can influence popula-
tion health and welfare. The media can serve as a major
outlet to provide information that the public needs during


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an emergency on personal protective actions and strate-
gies. In 2003, the Institute of Medicine, in its report The
Future of Public Health in the 21stCentury, examined the
lack of understanding that editors and journalists and
medical and public health officials typically have of each
other's perspectives or objectives. A clear need was identi-
fied in both the journalism and public health communi-
ties for training, research, and dialogue to improve this
relationship and their abilities to accurately inform and
communicate with the public during any public health
emergency [12].

Professional and organizational realities
Studies show that to improve journalists' expertise it is
necessary to deal with the organizational and professional
factors that constrain news coverage. For example,
because news events are unpredictable, news managers
encourage reporters to be generalists rather than special-
ists [131. In addition, turnover rates are relatively high
among journalists, who typically advance in their careers
by moving from one news outlet to another. As a result,
relatively few journalists stay in one community long
enough to become well acquainted with its public health
institutions. Because journalists typically work quickly
and under deadlines, they find it difficult to produce rig-
orous, in-depth reports.

Journalists see themselves in multiple professional roles.
For example, they are both channels of information and
"watchdogs" on government institutions [141. Journalists
aim to inform the public about health risks, but they feel
obligated to go beyond passive dissemination of informa-
tion. Journalists may adopt a wary and even skeptical
stance regarding government health agencies and spokes-
persons.

For their part, public health agencies have been faulted for
not preparing in advance information useful in emergen-
cies and for ineffective dissemination of information [151.
Some critics even contend that government health agen-
cies and their PIOs frequently obstruct rather than facili-
tate communication [16,171. But PIOs are also hemmed
in by organizational factors. They have the joint burden of
improving understanding between content experts and
journalists, and ensuring that complex information about
health is communicated accurately [181. PIOs are also
constrained by legal requirements designed to protect cit-
izen privacy.

Methods
To assist in identifying the most pressing problems regard-
ing media response to health-related risks such as terror-
ism and large-scale natural disasters, 26 expert advisors
were convened, including leaders representing journalists
and public information officers, state health officials,


experts in terrorism and emergency preparedness, and
experts in health, risk, and science communication. The
advisory group members were interviewed via [3] prear-
ranged conference calls, [4] prearranged telephone calls
with individual advisors, and [5] e-mail correspondence.
The advisors were asked to identify what they believed to
be the most pressing problems. They were also asked to
respond to concerns raised in the emerging literature
regarding news coverage of terrorism and other disasters.
The advisors evaluated resources developed to support
journalists, such as A Journalist's Guide to Covering Bioter-
rorism [14] and were invited to nominate resources they
have found helpful. These conversations began in sum-
mer 2003 and culminated in a daylong meeting on Janu-
ary 29, 2004, on the campus of the University of Alabama
at Birmingham. The meeting was attended by 20 of the 26
advisors. During this meeting the advisory group reviewed
and discussed reports in which summarized pre-meeting
interviews. Table 1 presents the advisory group members
and their affiliations.

The advisory group members represent several distinct
constituencies, including constituencies that sometimes
conflict during emergencies related to terrorism and natu-
ral disasters most notably, journalists and public infor-
mation officers. Views across constituencies were
compared, to identify areas of agreement and disagree-
ment regarding pressing problems and likely solutions.
Accordingly, interviews occasionally segregated the advi-
sors, speaking with only one particular constituency (e.g.,
experts in terrorism). During the January 29, 2004, meet-
ing of the advisory group, separate "break-out" discus-
sions were held with advisors who represent two
particular constituencies: journalists and PIOs. The group
was then reconvened as a whole to discussed points and
issues that had emerged from the break-out sessions.

Results
This section addressed what advisors said were the major
problems to be addressed in any effort to improve media
coverage and public understanding of bioterrorism and
emerging infectious diseases.

Problems related to news content
Advisors frequently lodged two complaints regarding
media coverage of health-related emergencies. First, they
complain that stories are too often hectic and breathless,
that the need for journalists to file stories frequently and
quickly leads to stories that focus on details and events
that experts deem to be irrelevant, unimportant, unhelp-
ful, and sometimes inaccurate. Second, they complained
that stories are too often shallow and do not provide
much contextual information, focusing instead on what-
ever details may be new, providing little attention to how



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Table I: Advisory board and affiliations


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Advisory Board Member


Robert J. Alvey



C. Kirk Avent, MD

Steven M. Becker, PhD



Eric Braun

Jerdan Bullard
Joy Carter
Vincent T. Covello, PhD

Sharon Dunwoody, PhD

Jamey Durham

David R. Franz, DVM, PhD



Sharon Friedman, PhD

L. Sam Hansen, EMT-P

Captain David K. Hartin

RobertJ. Howard, MS, MPH

Corporal Don Kelly

Donald Koss

Deborah Potter

Scott C. Ratzan, MD, MPA

Thomas E. Terndrup, MD



Laura Tutor
Edward Van Horne



Chris Waddle



Ann Wright


Affiliation


Public Information Officer
Bioterrorism Preparedness Team,
Arkansas Department of Health
Medical Director of Disease Control
Jefferson County Department of Health, Birmingham, Alabama
Associate Professor
University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama;
Member, Scientific Committee 46-14, NCRP
Vice President for Convergence and corporate news director
Raycom Media, Inc., Montgomery, Alabama
Executive Director, Alabama Broadcasters Association, Birmingham, Alabama
Media Relations, University of Alabama at Birmingham, Birmingham, Alabama
Director, Center for Risk Communication,
New York, New York
Evjue-Bascom Professor and Director
University of Wisconsin, School of Journalism and Mass Communication, Madison, Wisconsin
Risk Communication Specialist,
Alabama Department of Public Health, Montgomery, Alabama
Chief Biological Scientist,
Midwest Research Institute, Kansas City, Kansas;
Director, National Agricultural Biosecurity Center, Kansas State University
Professor of Journalism and Communication;
Director of the Science and Environmental Writing Program; Lehigh University, Lehigh, Pennsylvania
Battalion Chief, Vestavia Hills Fire Department, Vestavia Hills, Alabama;
Instructor, Texas A&M University National Emergency Rescue response Training Center
Public Information Officer, Tuscaloosa Police Department and Tuscaloosa County Emergency Management Agency,
Tuscaloosa, Alabama
Consultant. Former press officer and Director of Strategic Communication, National Centers for Infectious disease,
Centers for Disease Control and Prevention, Duluth, Georgia
Baton Rouge Police Department, Office of the Chief of Police, Media Relations Division;
Past President, National Information Officers Association
Instructor, Mississippi Fire Academy, Pearl, Mississippi;
Former Public Information Officer, Hattiesburg (MS) Fire Department
Executive Director,
Radio-Television News Directors Foundation
Editor, Journal of Health Communication;
Vice President, Government Affairs, Johnson & Johnson Europe (Belgium)
Professor and Chair, Department of Emergency Medicine; Director, Center for Emergency Care and Disaster
Preparedness,
University of Alabama at Birmingham, Birmingham, Alabama
Metro Editor, Anniston Star, Anniston, Alabama
Executive Director,
Southern Newspapers Publishers Association,
Atlanta, Georgia
Director,
Ayers Family Institute for Community Journalism;
Vice President for News, Consolidated Publishing; Publisher, Anniston Star, Anniston, Alabama
Public Information Officer,
Arkansas Department of Health;
Regional Representative (Region VI),
National Public Health Information Coalition


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these details may be related to a comprehensive under-
standing of the situation.

Problems related to journalists' work practices
Advisors complain that too many journalists' stories fail
to reflect the complexities of health-related emergencies.
Accordingly, journalists may find it difficult to create sto-
ries about terrorism or natural disasters in which com-
plexity is highlighted rather than minimized. Another
limitation, according to journalism advisors, is the
decreasing commitment by news organizations to staff
development and training in these content areas.

Advisors also perceive that journalists cannot tolerate
uncertainty. They say journalists may mistake experts' typ-
ically cautious and hedging language about health-related
emergencies as evidence of stonewalling or incompetence,
and that journalists too eagerly seek sources sometimes
less reputable sources who will speak with relatively less
caution.

Advisors also perceive that journalists are unreasonably
impatient. Few of the professional groups with which
journalists interact are similarly subject to tight, unyield-
ing deadlines. To PIOs and terrorism experts among the
advisors, it seems that journalists too frequently make
unreasonable demands, looking for instant access to
information that does not yet exist or demanding that
PIOs and experts offer statements on issues that PIOs and
experts feel unprepared to address. Confrontation also
derives from what PIO's perceive as distrust on the part of
journalists. They say many journalists make little effort to
hide their distrust, and many openly profess to be adver-
saries of PIO's, citing their role as "watchdogs" on govern-
ment institutions.

Problems related to PIO work practices
Journalism advisors have several complaints about the
processes and practices of PIO's during health-related
emergencies. Several say PIO's commonly err on the side
of withholding access to information and experts, espe-
cially in situations in which the PIO fears that access will
result in a story that hinders rather than helps emergency
response. When this happens, they say, PIO's become bot-
tlenecks rather than useful gatekeepers, facilitators, and
translators.

The journalism advisors complain that PIO's sometimes
lack the authority to provide access to information and
experts. PIO's may not be permitted by their superiors to
provide access to the information and experts that jour-
nalists seek, and they may not know what information
and experts are [3] available or [4] appropriate and help-
ful. Journalism advisors also complain that PIO's some-
times overlook obvious opportunities to facilitate


information dissemination and access to experts. For
example, online resources could be especially helpful in
emergency situations in which PIO's are deluged with
requests for information.

Finally, broadcast journalists complain that PIO's too
often perform poorly on camera and in interviews. This
problem is more common at state and local agencies than
at national agencies, where PIO's are more likely to receive
training in these skills. PIO's may underestimate journal-
ists' needs for PIO's who can themselves become a useful,
visible part of a story, rather than merely serve as an access
point for information.

It should be emphasized that the PIO advisors believe
many of these problems are being addressed. They note
that PIO's at almost every state public health agency have
participated in training that aims to facilitate interaction
with journalists. Since 9/11, the advisors note, PIO's have
become far better prepared to support journalists who will
cover terrorism and other disasters.

Problems with both journalists and PIO's
The advisors complain that in responding to health-
related emergencies both journalists and PIO's frequently
do not understand the likely impact of news coverage.
They may be overly concerned with negative outcomes
that are in fact unlikely, such as public panic so con-
cerned that they withhold helpful information. The PIO
advisors say PIO's have learned that media reports are
unlikely to cause panic and that PIO's must never with-
hold information. But in general, the advisors agree that
journalists and PIO's still have much to learn about the
impact of media coverage.

Both journalists and PIO's profess to be mystified or dis-
mayed by what they believe readers and viewers want to
know about health-related emergencies. They worry about
their ability to convey information about likely risks and
threats in a way that increases audience concern when
concern is appropriate but that does not cause audiences
to discount media reports after long periods in which dan-
ger is covered only as a possibility. In addition, neither
journalists nor PIO's perform well in terms of addressing
the information needs of special populations during
health-related emergencies.

Interaction between journalists and PIO's is another key
issue. The two fields are professionally segregated and
practitioners are typically trained in separate degree pro-
grams in colleges and universities. This segregation has
roots in sensible and important efforts to maintain profes-
sional standards, but it may hinder their interaction in
response to health-related emergencies. Journalists and
PIO's are often on good terms, but they are in fragile, fleet-


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ing relationships. Advisors say journalists can readily
name a PIO whom they trust as an ally in creating respon-
sible coverage of health-related emergencies. Similarly,
most PIO's can identify a journalist whom they consider a
partner in responding effectively to health-related emer-
gencies. Unfortunately such relationships appear to be
exceptional and short-lived due largely to frequent per-
sonnel changes. But according to the advisors, journalists
and PIO's believe it is necessary to build close relation-
ships if they are to respond effectively to health-related
emergencies.

Organizational issues
For decades, television, radio, newspaper, and magazines
have competed zealously against one another. Coopera-
tion became somewhat more common in the 1990s as
media mergers and acquisitions escalated (bolstered by
media deregulation), bringing together one-time foes
who are now expected to realize "synergies" through
cross-media cooperation. Technological convergence now
facilitates cooperation. According to the advisors, journal-
ists who cover health-related emergencies seem increas-
ingly eager to cooperate with colleagues across media;
though to date there have been few efforts. However, the
advisors indicated that journalists learned via the events
of September 11, 2001, that media cross-media collabora-
tion is necessary if media are to respond effectively to
health-related emergencies. Advisors say more coopera-
tion with radio could reap considerable benefits, as
radio's ubiquity and portability may make it the most
effective medium for disseminating news during emer-
gencies. However, as radio station groups become bigger,
fewer in number, and centrally rather than locally pro-
grammed, they employ fewer community journalists. As a
result, unlike other media, radio is becoming less able to
respond to health-related emergencies.

Problems related to emergency preparedness
Journalists have yet to pursue coordinated, programmatic
efforts to prepare for emergency response. The advisors


identify three key problems in this area. One is that most
media outlets lack routinely-updated, viable emergency
response plans, and in cases where outlets have viable
plans, journalists seldom practice these plans. A second
problem is that too many of the (few) media outlets that
are developing emergency response plans exclude PIO's in
this planning. At the same time, journalists are not fre-
quently invited by public health and emergency manage-
ment agencies to participate in state and local
preparedness drills and simulations. This failure to explic-
itly include both journalists and PIO's in formal emer-
gency planning may doom these plans to failure. The
third problem is that journalists could do a better job of
communicating emergency response plans that have been
developed by government agencies. The advisors agree
that government agencies and news organizations should
work together to publicize emergency response plans.

Problems related to resource development, availability,
and dissemination
The advisors do not believe that journalists and PIO's are
without resources to support them as early responders to
health-related emergencies. However, they deem this a
key problem area, for three reasons. First, such resources
are few, scattered and fugitive. Most journalists and PIO's
can identify a resource (e.g., a simulation, a workshop, a
course, a book) that they have found helpful. However,
few journalists and PIO's nominate the same resource.
Moreover, journalists and PIO's are frequently unaware of
resources that others have found helpful unless and until
a colleague recommends a resource. Second, resources are
needlessly duplicated. There is a dearth of cross-organiza-
tional cooperation in developing and sharing resources.
Third, new technologies such as online media have not yet
been harnessed to effectively develop and disseminate
resources [19]. The barriers to improve journalist and
public health information officer's communication and
their solutions are summarized in Table 2.


Table 2: Barriers and solutions to improve journalist and public information officers (PIO) communication in health-related
emergencies


Barrier


Solution


I. Media stories are too often hectic and do not provide much
contextual information
2. Media stories fail to reflect the complexities of health-related
emergencies
3. Media personnel lack access to information and experts

4. Lack of training to convey information about likely risks and threats in
appropriate manner to the public
5. Journalist lack of cooperation for information dissemination with
colleagues across other media types
6. Lack of government agencies and media organizations in promoting
and publicizing emergency response plans together
7. Lack of consensus between journalists and PIOs related to resource
development, availability, and dissemination for responders


1. Develop case-based learning opportunities to illustrate best practices

2. Invite journalist to participate in emergency and disaster drills and
exercises
3. Facilitate contact and relationship-building between journalists and
PIO's at the local level
4. Provide experiential learning opportunities for both journalist and
PlOs
5. Use the Internet and other mobile technologies to disseminate
information
6. Coordinate with public health and other government agencies in
developing emergency response plans.
7. Bring together the various entities that are developing resources and
publish information through trade publications and professional
meetings


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Recommendations
Below we offer recommended solutions to these and
other problems identified. We are keen to make recom-
mendations that are feasible in terms of costs and practi-
cal in terms of the professional and organizational
realities in which journalists and PIO's work. To support
journalists and PIO's as first responders to terrorism and
other health-related emergencies, it will be useful to:

1. Provide experiential learning. Even the advisors who
lead university degree programs in journalism are quick to
join other advisors in forecasting that journalists and
PIO's can benefit from experiential learning (as opposed
to traditional, formal education).

2. Keep it affordable (cheap, even). Journalists and PIO's
work under organizational constraints and do not enjoy
large budgets for professional development.

3. Keep it brief. Journalists and PIO's find it difficult to
devote more than two consecutive days wholly to learning
opportunities. Even two days may be too much. One-day
and one-half-day programs should be considered when
feasible.

4. Go to them. Journalists and PIO's have professional ori-
entations and long traditions of attendance at annual
meetings of national, regional, and state organizations.
These meetings provide an ideal opportunity for resource
dissemination.

5. Keep it nearby. Other things being equal, journalists
and PIO's are better able to participate in local and
regional events than in national events.

6. Keep it "in-house." Due to clashing professional norms,
as well as a preference for known practices and personnel,
journalists and PIO's will be most responsive to resources
developed and disseminated by their own professional
and trade organizations.

7. Work together. Support journalists in pursuing their
growing interests in, and growing need for, collaboration
across media. Persuade journalists and PIO's to demand
resources designed specifically to support journalist-PIO
interactions.

8. Make local connections. Facilitate contact and relation-
ship-building between journalists and PIO's at the local
level, helping the personnel who will interact in emergen-
cies anticipate and respect the professional needs of one
another.

9. Use scenarios and cases. The rapidly growing interest in
and use of, scenario- and case-based learning should be


embraced as an especially effective and seemingly popular
form of experiential learning. Develop innovations in sce-
nario-based learning that invite journalists to learn liter-
ally to work as PIO's, and vice-versa.

10. Participate in drills and exercises. Gain standing for
journalists and PIO's to participate routinely in disaster
response drills and exercises. Assess the effectiveness of
drills in part based on how well journalists and PIO's per-
form and how well other agencies perform in interacting
with journalists and PIO's.

11. Use the Internet and other mobile technologies to
develop and disseminate resources.

12. Take advantage of existing programs and publications.
Make effective use of trade publications and professional
meetings to provide information about available
resources

13. Translate and disseminate the work of experts in
health and risk communication. There is an already large
and steadily growing body of research in health and risk
communication that addresses several of the problems
identified above, especially the problems related to audi-
ence interest, attention and understanding and the impact
of news coverage. This research is underutilized by jour-
nalists and PIO's who shape media coverage of terrorism
and other disasters but who have an inadequate under-
standing of the nature and needs of audiences.

14. Get on the same page. Bring together the various enti-
ties that are developing resources, or at least ask them to
better coordinate efforts and more effectively disseminate
resources. Establish more effective channels of communi-
cation not just across resource providers but also between
resource providers and the journalists and PIO's they aim
to support.

15. Plan. It is crucial that news organizations develop
emergency response plans. Moreover, this planning
should be done in coordination with public health and
other government agencies. This planning should be
informed by the growing literature on emergency plan-
ning [20].

Discussion and conclusion
The recommendations listed offer no guarantee of
improvement. Much will depend on the specific details of
resources developed. Effective solutions will require care-
ful planning, ongoing evaluation and a continuing reali-
zation of the larger organizational, professional and social
factors that shape the problems being addressed. Many of
the recommendations are consistent with recommenda-
tions emerging from recent conferences [21] and publica-


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tions [10]. With this manuscript we contribute to the
process of building consensus regarding pressing prob-
lems and likely solutions.

It is clear that journalists and public health spokespersons
play crucial roles in shaping public response to terrorism
and other disasters [2]. Journalists and PIO's are profes-
sionals who frequently interact in covering health-related
emergencies. Unfortunately, they are often inadequately
prepared for this interaction, and they rarely coordinate
efforts to become better prepared. As mentioned, there is
a host of organizational, legal and professional con-
straints that play a role in this inadequacy. Nevertheless,
legislative bodies, public health agencies, and media
organizations should deem it a high priority to improve
dissemination of information regarding terrorism and
other disasters. Reliable and responsible news coverage
should be seen as integral part of preparedness.

Competing interests
The authors) declare that they have no competing inter-
ests.

Authors' contributions
WL conceived of the study and participated in the design
and coordination and helped to draft the manuscript. WE
conceived of the study and participated in the design and
coordination and helped to draft the manuscript. KKG
participated in the design and coordinated activities and
helped to draft the manuscript. JAR participated in the
design and coordinated activities and helped to draft the
manuscript. PMG coordinated activities related to the
study and helped to draft the manuscript. LCM coordi-
nated activities related to the study and helped to draft the
manuscript. MA coordinated activities related to the study
and helped to draft the manuscript. All authors read and
approved the final manuscript.

Acknowledgements
This research was supported under a cooperative agreement from the
Centers for Disease Control and Prevention (CDC) through the Associa-
tion of Schools of Public Health (ASPH). The contents of this manuscript
are the responsibility of the authors and do not necessarily represent the
official views of CDC or ASPH.

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