Evaluating Crisis Communication. A 30-item Checklist for Assessing Performance during COVID-19 and Other Pandemics

Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan

In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.

Individualism, economic development, and democracy as determinants of COVID-19 risk information on 132 government websites

Little is known about how governments transparently communicate about COVID-19. This study conducted a content analysis of 132 government COVID-19 websites to identify the salience of health messages (i.e., perceived threat, perceived efficacy, and perceived resilience) and cross-national determinants of information provision. Multinomial logistic regression was used to estimate the relationship between country-level predictors (i.e., economic development, democracy scores, and individualism index) and information salience. The numbers of deaths, discharged patients, and daily new cases were prevalent on the main webpages. Subpages provided information about vulnerability statistics, government responses, and vaccination rates. Less than 10% of governments included messages that may instill self-efficacy. Democratic countries had higher chances of providing threat statistics on subpages, including daily new cases (Relative Risk Ratio, RRR = 1.66, 95% CI: 1.16-2.37), mortalities (RRR = 1.69, 95% CI: 1.23-2.33), hospitalizations (RRR = 1.63, 95% CI: 1.12-2.37), and positivity rates (RRR = 1.55, 95% CI: 1.07-2.23). On subpages, democratic governments emphasized information about perceived vulnerability (RRR = 2.36, 95% CI: 1.50-3.73), perceived response efficacy (RRR = 1.48, 95% CI: 1.06-2.06), recovery numbers (RRR = 1.84, 95% CI: 1.31-2.60), and vaccinations (RRR = 2.14, 95% CI: 1.39-3.30). Developed countries reported the number of daily new cases, perceived response efficacy, and vaccination rates on their COVID-19 main pages. Individualism scores predicted the salience of vaccination rates on main pages and the omission of information related to perceived severity and perceived vulnerability. Democracy levels were more predictive of reporting information about perceived severity, perceived response efficacy, and perceived resilience on subpages of dedicated websites. Improving public health agencies' communication about COVID-19 is warranted.

Assessment of COVID-19 Website Communication in Languages Other than English by Local Health Departments in the United States

Managing the information needs of diverse populations through accessible, high-quality, and evidence-based health communication is critical to controlling the COVID-19 pandemic. Access to comprehensive information is especially important for the >25 million limited English proficient (LEP) individuals in the U.S. who prefer to communicate in languages other than English. We assessed the alignment of COVID-19 communication with LEP constituents' needs by examining multilingual content availability on the health department websites of the largest U.S. cities by population. To guide content analysis, we designed a codebook to evaluate six content types, six delivery modes, and three score measures for each website; for each, we measured Holsti's percent of agreement. We then compared the amount of information provided in all combined content types across cities and languages by delivery mode. We thematically analyzed open-ended responses about users' experiences with each city's webpages. We found that COVID-19 information was not presented consistently across languages: many cities provided less information among several delivery modes in other languages compared to English. We found a discrepancy in the amount of information, presentation quality, and ease of navigability of the information among languages and between cities. Users described having negative experiences with most cities' COVID-19 websites in languages other than English. Our findings indicate a gap in the application of the cultural sensitivity approach by local health departments to address issues related to equitable multilingual, multimodal emergency communication, and underscore the need to improve guidelines for communicating public health information as a component of advancing health equity.

Risk and Health Communication during Covid-19: A Linguistic Landscape Analysis

Since the outbreak of Covid-19 health communicators around the globe have had to reach, urge, and persuade individuals and communities to adopt appropriate health protective behaviors. They have used a mix of communication channels, including outdoor media and public signage which are the focus of this paper. Drawing on a comparative linguistic landscape analysis, this paper critically examined the amount, content, and prominence of Covid-19 signage in Hackney, a London borough severely hit by the first wave of the pandemic. Having analyzed 1288 signs collected between May and July 2020, we found significant differences in Covid-19 signage between deprived and less deprived areas. These differences (e.g., in messaging about staying at home) have created inequalities in access to Covid-19 related health information and guidance. We also explored the changes in Covid-19 signage over time and the tailoring of risk and health messages to minority communities.

Qualitative Insights From Governmental Public Health Employees About Experiences Serving During the COVID-19 Pandemic, PH WINS 2021

OBJECTIVE

The purpose of the current study was to examine governmental public health employee experiences during the COVID-19 pandemic.

DESIGN AND SETTING

A total of 5169 responses to a PH WINS 2021 open-ended question were qualitatively coded. The question asked employees to share their experiences during the COVID-19 response. The 15 most common themes are discussed.

PARTICIPANTS

Responses from governmental public health employees in state health agencies (SHAs), big cities (Big City Health Coalition or BCHC agencies), and local health departments (LHDs) across all 50 states were included.

RESULTS

The most frequently identified theme was pride in public health work and/or the mission of public health (20.8%), followed by leadership (17.2%), burnout or feeling overwhelmed (14%), communication (11.7%), and overtime/extra work (9.7%). Among the top 15 themes identified, comments about pride in public health work and/or the mission of public health (95.9%), teamwork (81.5%), and telework (61%) were predominantly positive. Co-occurring themes for responses that expressed pride in public health work and/or the mission of public health were often countered with explanations of why respondents remain frustrated, including feeling burned out or overwhelmed , disappointment with the community's sense of responsibility or trust in science , and feeling unappreciated either by the community or their agency. All of these co-occurring themes were predominantly negative.

CONCLUSIONS

Employees are proud to work in public health and value teamwork but often felt overworked and unappreciated during the COVID-19 pandemic. Reviewing existing emergency preparedness protocols in the context of lessons learned during the COVID-19 pandemic and listening to employees' experiences with teleworking and task sharing may better prepare agencies for future challenges. Creating channels for clear communication during a period of changing information and guidelines may help employees feel more prepared and valued during an emergency response.

Crisis communication strategies for health officials

Background

Mixed messaging among health officials are prevalent amid COVID-19. Crisis communication strategies have the potential to help health officials effectively address issues such as mixed messages and improve their crisis communication efficacy. However, there is a dearth of insights in the literature. Therefore, to bridge the research gap, this study aims to examine practical strategies health officials can utilize to improve their crisis communication efficacy.

Methods

A literature review on effective crisis communication strategies amid COVID-19 was conducted in PubMed, Scopus, and PsycINFO, with a focus on scholarly literature published in English.

Results

The findings of the study identified the following strategies that health officials can utilize to improve their crisis communication capabilities: (1) develop fact-based, transparent, and accountable messaging, (2) utilize people-centered and empathetic persuasive strategies, and (3) leverage international collaboration for consistent messaging and comprehensive crisis communication.

Conclusion

COVID-19 has challenged health officials with unprecedented crisis communication duties and responsibilities. In this study, we underscored the importance of effective crisis communication amid global health emergencies like COVID-19, and identified communication strategies health officials could adopt or adapt to improve their crisis communication efficacy. Future research could explore strategies health officials can use to better communicate with government officials and media professionals to further help health officials improve their crisis communication capabilities, their abilities to avoid preventable miscommunication or mixed messaging, and in turn, society's collective strengthen in curbing and controlling the pandemic.

Trust and Engagement on Twitter During the Management of COVID-19 Pandemic: The Effect of Gender and Position

During the COVID-19 pandemic, health and political leaders have attempted to update citizens using Twitter. Here, we examined the difference between environments that social media has provided for male/female or health/political leaders to interact with people during the COVID-19 pandemic. The comparison was made based on the content of posts and public responses to those posts as well as user-level and post-level metrics. Our findings suggest that although health officers and female leaders generated more contents on Twitter, political leaders and male authorities were more active in building networks. Offensive language was used more frequently toward males than females and toward political leaders than health leaders. The public also used more appreciation keywords toward health leaders than politicians, while more judgmental and economy-related keywords were used toward politicians. Overall, depending on the gender and position of leaders, Twitter provided them with different environments to communicate and manage the pandemic.

Bounded Solidarity as an Asset for Public Health Care Intervention

The relationship between social capital and public health has been extensively analyzed. However, not much has been written about the formation of social capital among citizens and public health workers in times of a pandemic. Our aim is to analyze social capital development through the prism of bounded solidarity and seek its manifestations toward public health workers. A qualitative self-administered survey was used to analyze what actions, practices, attitudes, and reasons inspired citizens to behave as they did with respect to public health workers during the first weeks of lockdown under the COVID-19 pandemic. Respondents, mostly from European countries, reveal that citizens aimed to prevent the collapse of the public health system through reinforcing trust toward institutions, legitimizing health care personnel expertise, practicing reciprocity and altruism, giving recognition to public health workers, and providing them with means. Finally, recommendations for public health communication on risks and crises are discussed.

The Relationship between Government Information Supply and Public Information Demand in the Early Stage of COVID-19 in China-An Empirical Analysis

Accurate and effective government communication is essential for public health emergencies. To optimize the effectiveness of government crisis communication, this paper puts forward an analytical perspective of supply-demand matching based on the interaction between the government and the public. We investigate the stage characteristics and the topic evolutions of both government information supply and public information demand through combined statistical analysis, text mining, text coding and cluster analysis, using empirical data from the National Health Commission's WeChat in China. A quantitative measure reflecting the public demand for government information supply is proposed. Result indicates that the government has provided a large amount of high-intensity epidemic-related information, with six major topics being the medical team, government actions, scientific protection knowledge, epidemic situation, high-level deployment and global cooperation. The public's greatest information needs present different characteristics at different stages, with "scientific protection knowledge", "government actions" and "medical teams" being the most needed in the outbreak stage, the control stage and the stable stage, respectively. The subject of oversupply is "medical team", and the subject of short supply is "epidemic dynamics" and "science knowledge". This paper provides important theoretical and practical value for improving the effectiveness of government communication in public health crises.

Content and Communication of Inpatient Family Visitation Policies During the COVID-19 Pandemic: Sequential Mixed Methods Study

BACKGROUND

Inpatient health care facilities restricted inpatient visitation due to the COVID-19 pandemic. There is no existing evidence of how they communicated these policies to the public nor the impact of their communication choices on public perception.

OBJECTIVE

This study aims to describe patterns of inpatient visitation policies during the initial peak of the COVID-19 pandemic in the United States and the communication of these policies to the general public, as well as to identify communication strategies that maximize positive impressions of the facility despite visitation restrictions.

METHODS

We conducted a sequential, exploratory, mixed methods study including a qualitative analysis of COVID-19 era visitation policies published on Pennsylvania-based facility websites, as captured between April 30 and May 20, 2020 (ie, during the first peak of the COVID-19 pandemic in the United States). We also conducted a factorial survey-based experiment to test how key elements of hospitals' visitation policy communication are associated with individuals' willingness to seek care in October 2020. For analysis of the policies, we included all inpatient facilities in Pennsylvania. For the factorial experiment, US adults were drawn from internet research panels. The factorial survey-based experiment presented composite policies that varied in their justification for restricted visitation, the degree to which the facility expressed ownership of the policy, and the inclusion of family-centered care support plans. Our primary outcome was participants' willingness to recommend the hypothetical facility using a 5-point Likert scale.

RESULTS

We identified 104 unique policies on inpatient visitation from 363 facilities' websites. The mean Flesch-Kincaid Grade Level for the policies was 14.2. Most policies prohibited family presence (99/104, 95.2%). Facilities justified the restricted visitation policies on the basis of community protection (59/104, 56.7%), authorities' guidance or regulations (34/104, 32.7%), or scientific rationale (23/104, 22.1%). A minority (38/104, 36.5%) addressed how restrictive visitation may impair family-centered care. Most of the policies analyzed used passive voice to communicate restrictions. A total of 1321 participants completed the web-based survey. Visitation policy elements significantly associated with willingness to recommend the facility included justifications based on community protection (OR 1.44, 95% CI 1.24-1.68) or scientific rationale (OR 1.30, 95% CI 1.12-1.51), rather than those based on a governing authority. The facility expressed a high degree of ownership over the decision (OR 1.16, 95% CI 1.04-1.29), rather than a low degree of ownership; and inclusion of family-centered care support plans (OR 2.80, 95% CI 2.51-3.12), rather than no such support.

CONCLUSIONS

Health systems can immediately improve public receptiveness of restrictive visitation policies by emphasizing community protection, ownership over the facility's policy, and promoting family-centered care.

An Appraisal of Communication Practices Demonstrated by Romanian District Public Health Authorities at the Outbreak of the COVID-19 Pandemic

Communication during an ongoing crisis is a challenging task that becomes even more demanding during a public health crisis. Early in the start of the pandemic, global leaders called upon the public to reject infodemics and access official sources. This article focuses on the communicative aspects of health services management, with a particular focus on the communication strategy of the Romanian district public health authorities during the COVID-19 lockdown, as seen on official websites and social networks. The 15 most affected districts were selected, according to the officially reported health cases. The issued press releases and the posts on Facebook pages show an uneven experience on the part of district authorities in dealing with public information campaigns. In addition, the results of the study indicate a lack of sustainable communication approaches as well as the need of professional training and strategy in dealing with the public health crisis. From a communication point of view, a strategic approach on behalf of the public health sector is crucial to enhance the preparedness of appropriate institutions to act during emergencies and to respond to the needs of the media and the public with timely, correct, and meaningful information.