It has been said that when public health works, nothing happens — and it’s hard to get excited about nothing.
With no end in sight to the COVID-19 pandemic, the world might welcome a moment of boredom as a result of effective public health planning. What has never been more clear is the need for effective communication about the virus, which has thrown the world’s experts curveballs at every turn.
The authors of a 2009 World Health Organization bulletin on health communication noted that “communication is at the heart of who we are as human beings ... (and) intervention efforts to change behaviors are communicative acts” (https://www.who.int/bulletin/volumes/87/4/08-056713/en/).
Public health messaging aims not just to inform but also to persuade, ideally leading to sustainable, beneficial change. Decades of research on tobacco cessation have shown that merely providing information about harm is rarely enough to change behavior. This acknowledgment has given rise to motivational interviewing, a technique physicians are implementing as part of one-on-one counseling for health promotion and risk reduction.
But how can skills used in the exam room translate to messaging to the public?
Pediatricians who have dealt with anti-vaccine campaigns can tackle new public health communication opportunities by building on their experience in combating misinformation (defined as false information that is spread, regardless of intent to mislead) and disinformation (deliberately misleading or biased information; manipulated narrative or facts; propaganda).
K. Vish Viswanath, Ph.D., of Harvard T.H. Chan School of Public Health, pointed out that COVID-19 is the first pandemic in the social media age, which presents new challenges (https://bit.ly/2XvoXbe).
Worldwide connectivity can send a single statement, accurate or not, across oceans and continents in less than a second. With the right amplification, it can become viral within minutes. This can be lifesaving during crises when time is of the essence. If the information is inaccurate or designed to mislead, however, it can cause irrevocable damage.
While it is nearly impossible to control a rumor, it is important to present consistent, factual information that resonates with the public.
Here are some tips:
- Focus on the facts. Check and double-check. Do not exaggerate the potential impact of data or diminish its importance. Doing either can hurt the credibility of the message and messenger.
- Illustrate the evidence. People cannot comprehend large, impersonal numbers. Instead, use personal anecdotes to create emotional resonance and make your message stick.
- Build trust. Whether you have an audience of one or 1 million, people will not believe you if they do not trust you. Show why you care and that you have learned about the issue and the communities it affects.
- Remain objective and maintain a neutral tone. In a world where the loudest pronouncements often are most amplified, it can be challenging to remain a calm, consistent voice. Keep in mind that public health is nonpartisan, data-driven and population-oriented.
- Understand your audience. According to Jay M. Bernhardt, M.P.H., Ph.D., “information from and about the intended audience should inform all stages of an intervention.” This two-way communication allows for community investment and modification of methods to optimize reception of the message (Am J Public Health. 2004;94:2051-2053).
- Engage your audience. Using humor and other unique techniques to connect with your audience can help ensure they understand and remember a critical message. But don’t let the message get lost in the packaging. Make sure it is in good taste, not off-putting and does not misrepresent or unintentionally disparage anyone.
- Acknowledge limitations and uncertainty. Be upfront that newer information from larger or better designed studies may overturn previous information, and recommendations can change. Avoid speaking in absolutes, knowing that credibility rests on both the integrity of the information and communicating effectively.
Former AAP Executive Vice President/CEO Karen Remley, M.D., M.B.A., M.P.H., FAAP, shared timeless advice from the Centers for Disease Control and Prevention that should serve as a guiding principle for pediatricians communicating public health information: “Be first. Be right. Be credible.”
Dr. Ameenuddin is chair of the AAP Council on Communications and Media Executive Committee.
