Literature Review
Public health management is one of the major concerns not just locally but treated as global matter as well. With constant mutations, occurring, new diseases are being produced with higher medical resistance and easier transmission to most types of social communication and interaction. In an editorial by Jay Bernhardt (2004), the demand of having an effective and wide communication system is essential in providing a highly developed public health management. Bernhardt discussed the bioterrorists attacks in 2001 and its impact to social health and preparedness. It was a failure though that anthrax poisoning was able to penetrate U.S. homes and other establishments. Thus, the need of strengthening the public health system can be optimized and achieved with a strong communication and public awareness with relevant and updated information. Mass communication and its relation to public health have developed for the past few years. With modern equipment and technological advances in both media communication and health and medicine, public health has become a vital instrument in improving social and national health as a whole. Public health communication has become an integral part in several medical fields such as epidemiology, risk assessment, microbiology, bacteriology and other specific fields that directly and indirectly create an effect to the overall health conditions of the people. The Centers for Disease Control and Prevention (CDC) recognized the necessity of having an effective public health communication in order to improve American health conditions with the latest health researches, medical and technological advances as well as other innovations in health sciences that can offer greater and effective alternatives in contemporary diseases as well as strengthening the preventive measures initiated by the government. Public health communication must be considered as an art with its several techniques and strategies to inform influence and motivate citizens from the individual up to the organizational and institutional levels with significant exposure to daily varying health conditions and issues. Health should not just be treated in a single perspective but rather consider its overall state in terms of the social, political, environmental, and behavioral aspects with which Americans are exposed. The idea of treating public health in an ecological perspective is rather acceptable as it accepts and follows multilevel communication approaches and interventions such as customized messages for the lower base level, specific point messages at the group level, social marketing at the community level, media advocacy at the policy level and media campaigns at the population level (Bernhardt, 2004). With the multifaceted nature, the idea of ecological perspective in effect, altered orientation and social or audience-oriented and centered philosophy, public health communication has the greater chance of making important and relative contributions and developments in improving the health conditions in the country. The government has a major role in pursuing these innovations with the help of media and other related organizations. With these efforts realized, public health communication is believed to have developed itself as a discipline and field of study as much as it can help improving the lives and health of every American citizen with proper and timely information.
Breakwell (2000) discussed and elaborated on the factors that affect risk communication as well as its impact if the overall system is compromised. Three major components work altogether in forming risk communication. The characteristics of the audience or the public that has to be informed, the source or location of the information or message and the content of such particular message should create a complex interaction to which risk communication is dependent. However, the communication approach must consider the type of people or audience to which it will be addressed. The factors that affects the audiences usually depends on some demographic factors such as their age, gender and ethnicity as well as the personal information, previous health experiences, and ideological orientations, beliefs and traditions. It varies from person to person such that public health communication should be treated with utmost generality and unbiased presentation. Moreover, the overall effect of health communication can be influenced by some cognitive biases such as unrealistic optimism as well as the lay mental models of the poisonous or hazardous substance (Breakwell, 2000). Considering food hazards, the vital dimensions of risk are controllability, novelty and naturalness. The source of information must be reliable and trustworthy in order for the risk or hazard message to be believable and effective. In order to create reliable messages and to build the trust needed, sources must be coming from experts and are significantly impartial, disinterested, and not creating any sensational news. To further strengthen its impact, health risk communications must have the necessary contents that have the capacity to generate and draw wide attention, highly comprehensible and can affect and modify public decision-making. It must be clearly stated in terms of its definitions, goals and objectives and can easily be understood with the ease of interpreting the details, which in some instances is seldom attained due to the shrouded nature of the risk message being relayed in terms of its scientific validity and interpretation. Risk messages should then be able to trigger and start public procedures and processes with a greater effect on amplification and attenuation, with their ramification rarely controllable (Breakwell, 2000).
Risk communication is very essential in protecting public health such that it needs to be highly effective and accessible (Covello et al., 2001). Covello and colleagues (2001) that the intentional or even unintentional introduction of pathogens and other disease-causing organisms in any urban settings or some situations where most people are gathered creates severe considered it and serious challenges to the overall effectiveness of health risk communication. Health risk communication is a scientific approach in properly communicating and disseminating high valued information in risk concern instances or situations. This is attained by providing a set of principles and ideas together with proper tools and equipment to meet the challenges that were laid upon it. The presented a short overview of the effects of risk communication as well as its theoretical perspective including the specific primary risk communication patterns, models and approaches were presented. The effectiveness of risk communication was further assessed using the West Nile virus epidemic in New York City in years 1999 and 2000 as well as further evaluating its effectiveness on possible bioterrorist attacks. Their intention was to provide practical information regarding the possible ways on perceiving and assessing the risks accompanied with an epidemic and disease outbreak considering the best possible ways and means on treating, managing and controlling it as a whole event. As a result, the emerging illness and disorders as well as bioterrorism proved to exhibit uncommon health risk communication challenges. Despite these challenges, the possibility of developing an effective risk communication approach can be done in order to cope and adjust on such events. It would be serious and even disastrous to public health and security if the necessity of developing a stronger health risk communication will be neglected. With the help of the government as well as other public and private health organizations, the final version of risk communication must be created, planned and properly implemented with an accompanying efficient monitoring. It is important to start the creation, planning, preparation and implementation of these risk communication strategies as soon as possible.
Glik (2007) reviewed and further elaborated on the risk communication available during public health emergencies. The paper created a wider perspective and definition regarding health risk communication and traced its beginnings on a number of applied fields in both science and technology. It also showed the processes and events to which these primary principles have made them included in the level of emergency preparedness, information dissemination and risk communication for public health. The paper reviewed four different researches and studies from different fields and has its literature be presented its crisis risk information in different approaches. The paper included environmental risk communication, disaster management, health promotion and communication, and media and communication studies (Glik, 2007). It was further reviewed and studied based on the present curricula and training materials and documents in relation to its updated information flexible enough to adjust and cope with the changing needs of emergency treatment and communication system. Emergencies are different with other health-related situations, as these should be dealt the utmost urgency with appropriate treatment and resolution to every situation. The overall paper review suggested a significant progress in terms of developing faster and more reliable ways to address the public regarding health risks and emergencies as well as incorporating and disseminating messages in crisis risk communication ideas and principles into practice and field of public health. It was further suggested that these developments were achieved with the manifestation of public health workers and medical practitioners with the skills and experiences they have gained, which therefore elevated the level of crisis risk communication as an important field of study. However, crisis risk communication still lack the in-depth analysis, assessment and evaluation needs in order to measure the effectiveness of case-specific crisis risk communication strategies and initiatives. The paper further defined crisis risk communication as the reliable, accurate and effective means of communication to a variety of audiences in emergencies and unusual situations (Glik, 2007). Moreover, risk communication was further identified as the exchange of information regarding the health risks acquired from environmental, industrial, agricultural means, which also includes the processes, policies, or products among individuals, groups, and institutions (Glik, 2007). The practice of crisis risk communication and its significance in with public health risk communication is further established in order to create an emergency responder upon merging the principles, practices and methods that are necessary. Crisis risk communication can greatly help the populace in adjusting and adopting policies and strategies to encounter natural and man-made disasters that can affect both the physical and mental being of each individual. Public health play major role in relaying medical, epidemiological, behavioral, and statistical information and turning it into comprehensible and accurate messages and concepts that the public can understand such that their decision-making can be affected by means of providing better options on dealing with catastrophes and disasters as well making them prepared to overcome the stress and hardships that these may bring upon them. An effective public health risk communication should be constantly be improved and developed in a way that it can cope with the threats of widespread outbreaks such as pandemic flu, industrial accidents, bioterrorist attacks, heavy and damaging tropical storms and other severe health threats. With the use of proper technology as well as the media, risk communication can be a useful field in widening the extent of awareness and level of public preparedness (Glik, 2007).
Risk communication and its relevance to health care practice has been reviewed and discussed by Adil (2008). It was stated that considering the art and science of risk communication as essential in providing an effective risk management approach and strategy. It further examined the issues underlying the communications in dealing with public health risks as well as its major role in assisting health care professionals, practitioners and managers to provide the most suitable treatment and approach in the related field as well as providing several examples of situations pertaining to health risk communication. The paper explored the complexity, the multidisciplinary nature, multidimensional perspective of this continuously growing developing field of study. This new and highly dynamic discipline is must be more focused and oriented on protecting and safeguarding public health. For the past years, it has been difficult to separate and segregate several sub processes of health risk communication such risk communication itself from risk assessment and risk management due to their interdependent nature. These areas and disciplines are treated in different ways but must be convergent with one another, having a contribution to the success of each process. By doing so, health risk communication, in terms of traditional messages regarding health threats create a one way flow in motivating personal behavior by means of changing it among the medical practitioners and the government health officials. It was established that modern and considerably effective means of risk communication must be a two-way process due to its needed consideration and treatment at every stage of risk management. A proactive and systematic risk communication approach must be based on the understanding of the public perception and interpretation of risk beforehand. The paper further stated that risk communication as well as the overall process is facing significant challenges in terms of relaying the information to the public, which includes the overall organizations performance, availability and presence of experts in the specific fields, and the establishment of regulators, institutions, and government trusts. Dealing with these factors can create a way in providing an effective and workable risk management in the health care industry. It was concluded that having a poor and ineffective risk communication could create emotional as well as other financial costs. Moreover, it can lead to public disorder through panic that can exhaust and even waste vital resources upon addressing unnecessary risks at the expense of other vital departments and areas. It can further result in exposing the people in riskier rather than safer circumstances. Upon showing the importance of an effective risk communication, it has been advisable to consider other weaker means and strategies of risk communications and from there creating and devising new methods in improving the old systems and protocols followed by weaker processes. It is established that if risk communication is not workable, the other two processes, risk and crisis management, is affected and even hindered. It can elevate to a disastrous situation wherein the affected population will refuse to adhere any recommended preventive methods and treatment procedures (Adil, 2008). Balance should be made on each stakeholders and policy-makers part such as regulating the information and the process in which these are being relayed and disseminated.
Maibach and colleagues (1991) discussed and elaborated on the changes in self-efficacy and health behavior in response to a minimal contact community health campaign. It created the suggestion that the baseline levels and the alterations and modifications in the perceived personal efficacy are both essential in mediating the adoption and acceptance of health behaviors in the ideals and principles of long-term community health advocacy. Creating a pre- to post evaluation pattern and model, they used path models in establishing the relationships and connections between the self-perceived self-efficacy, the level of campaign exposure, and the four different and separate health behaviors. It was then found out that exposure to health campaigns and advocacy programs as well as keeping the public properly informed about the latest health issues increased the level of perceived self-efficacy. Moreover, the baseline and alterations in the perceived self-efficacy contribute to the general adoption and acceptance of health characteristics and behaviors and that these baseline and changes in health behavior further provide an overall development and improvement of the perceived self-efficacy. A negative correlation has been established between self-efficacy and the changes that accompany it, which can further explain the results from previous researches and studies that show baseline self-efficacy alone cannot predict the following behavioral manifestations. The paper also reported the initial investigations that show the relationship between self-efficacy and health behavior in terms of discussing and evaluating a health information campaign. Researches that employ and required longitudinal experimentation and a minimum of three points of observation can be of great help in improving how medical professionals and the people understand the reciprocal interaction between self-efficacy and behavior. Additional researches and studies should also divert to the identification and evaluation of public messaging system and strategies that has the ability to increase health-related self-efficacy. By doing so, self-efficacy can be a great factor that affects the overall effectiveness of public health risk communication with the accompanying perception and attitude towards the different approaches applied in disseminating the necessary and needed information (Maibach et al., 1991).
Nelson, Lurie and Wasserman (2007) made as assessment on the extent of public health emergency awareness and preparedness considering the current concepts, technological advancement in tools as well as the challenges that the current system faces. The governments effort, especially the legislative body, has been a major consideration in terms of assessing the overall effectiveness of public health risk communication for the past few decades. Their increased determination in the specific duties and responsibilities of the federal government in terms of its current increased investments in public health preparedness system has created any significant improvement especially when called to respond to larger-scale public health emergencies. They are measuring the governments success rate in terms of its ability to be more prepared and aware in responding to medical emergencies. The current public health system needs an overall modification in its ability to respond and act upon specific types of emergencies depending on the situation and manner on how it will be treated and resolved especially when it involves public health, safety and security. However, the question remains on how to define public health emergency preparedness as well as the acceptable level of preparedness as to how well one can consider that there was sufficient preparedness made and how one can measure the extent of preparedness needed on a certain type of emergency or urgent situation. The paper further identified and evaluated the major challenges that are associated with the measurement of public health sufficiency and preparedness level as well providing a deeper review on the approaches that are currently used. Also, Nelson and colleagues (2007) identified and cited some currently developing and emerging new measurement approaches and methods that have the potential of addressing some of the major challenges that public health emergency preparedness and health risk communication system is facing. For the past years, the United States have been susceptible to various public health threats and attacks such as the anthrax bioterrorists attacks and other viral and bacterial outbreaks such as SARS, West Nile Virus and Monkey pox as well as the governments responses to natural calamities such as the Hurricanes Katrina and Rita. Questions and more disputes regarding the general government preparedness will arise upon anticipating the possibility of having a pandemic outbreak of the H5N1 influenza virus (Nelson et al., 2007). Using several parameters in measuring the overall preparedness level and the ability to address major public health concerns, they have found out that written assignments such as checklists, progress reports and surveys can be applied and implemented to a wider set of health departments and offices. However, they usually have a poor job in measuring the effectiveness of the preparation process and may suffer reliability and accuracy issues. Exercises on the other hand, have a greater potential providing observable results from direct jurisdictions ability to impose their authority and capabilities, commonly in responding to contrived situations. However, this process is usually costly and not related to provide clear performance standards and metrics. It is through proper embedding procedure that exercise-based evaluations in regular activities that the costs can be reduced and yet increasing the frequency on which they are administered or implemented. Furthermore, having sound structural look-back strategies can help the decision-making and the authorities in getting more achievable events and learning from their routine and non-routine activities. Further researches and studies should focus on means of developing several performance qualities that are reliant on process-mapping procedures. It can also be helpful if one will be exploring the evaluations embedded that can address cost issues and that mathematical patterns can be used in providing more ways to write standards that can lessen the variations degree of preparedness thus, eliminating the boundaries of helpful variation approached in public emergency preparedness.
From the past years of experiences with bioterrorist attacks and other public health threats, the government has been capitalizing on the learning that has been gained. Tinker (2002) from the U.S. Public Health Service made some recommendations to improve health risk communication as it is believed to be a vital part in addressing serious public health and safety threats as well as decreasing casualties and number of affected people in these situations. Furthermore, tinker established the major role that the government plays in terms of informing and addressing the public with latest advances and information, mobilizing resources and work force during crises and developing rehabilitative plans for post crises. The ever-growing public concern and awareness for the past years coming from a variety of environmental health and safety risks have created new requirements, demands and responsibilities on the U.S. Public Health Service (PHS) departments, agencies and offices. They are then mandated to provide updated information that creates a clear, comprehensible and publicly understandable definition, description and explanation on the nature of risks that can pose serious threat to human lives. Using previous experiences, it has been observed that simply and plainly disseminate and relay information without any reliability or application of communication principles can lead the public to ineffective and inadequate health messages further causing unreliable public health actions. Tinker (2002) then studied and evaluated the results provided by the Subcommittee on Risk Communication and Education of the Environmental Health Policy Committee (EHPC) of the PHS. He focused on the way, methods and approaches that these agencies are using in communicating and relaying information regarding health risks. Moreover, the paper evaluated the efficacy and overall effectiveness of these communications and what particular principles, approaches, strategies and practices would be suitable enough to promote effective health risk communication. The Subcommittees report paper focused on the development of specific recommendations and areas of improvement regarding the effectiveness of the public health information dissemination that has been provided to, and received from, the public. It also provided several suggestions on the basic and primary principles created from a series of case studies coming from PHS agencies pertaining to plans and suitable actions to be carried out in providing efficient and effective risk communication activities (Tinker, 2002). At the end of the study, the Subcommittee EPCH provided several endorsements that creates the baseline and idea of identification of some specific strategies that can be considered for implementation by EPCH in order to address their four other recommendations. It has been observed that the strategies being implemented by PHS agencies have been coming from the following areas developing and improving programs, building and strengthening partnerships, developing and conducting trainings, expanding information, and continuous conduction of research and evaluation. Moreover, the PHS has described the ideas and strategies in sufficient detail in order to provide the needed guidance to establish priorities and practicality in terms of implementing them among PHS agencies (Tinker, 2002).
Defining health risk communication in a comprehensible and understandable manner especially for the nonprofessionals is a task initiated by Kreps (1998). Health risk communication or health communication has been treated as a mechanism through which health-related messages and information are being communicated and relayed from the scientific and medical experts and public health agencies to the people who are affected by this information. It has been more focused on the parameters of health communication as having a major role in human performance and mediation of communication for the proper delivery of health care assistance and services as well as promoting good health and lifestyle to the public. Having a clear and concise communication system is very essential and vital to the success of public health practice considering the ecological perspective. They must provide a variety of communication pathways at every level of the organization, which may probably consider individual to mass communications. Social behaviors are also considered on the way these sets of information are being communicated at home, in schools, medical offices and hospitals as well as the workplace. With modern equipment and technological advancements especially in communications, public health risk communication can be made easier and more accessible to public. Television, radio, cellular phones, other major telecommunication developments, and even the Internet can be utilized and maximized in order to make timely and updated information, which in return, can help public health agencies in increasing the effectiveness of health risk communication. Current developments in the field of public health communication are the involvement of other field of studies and disciplines such as communication, social sciences such as sociology, psychology and public health as well as medicine. These made a significant step in making these professionals focus on more specialized fields such as health or communication making them equipped with the necessary skills and knowledge needed to apply effective health communication (Kreps, 1998).
Currently, the U.S. as well as the global public health sector has been alarmed and threatened by the rapid outbreak of Influenza A (H1N1). In an article by Parry (2009), risk communication has been a vital instrument in keeping the mortality rate from Influenza A (H1N1) at a lower level. Hospitals and other medical institutions in cooperation and intervention of the government, preparedness measures and reliable risk communication are important to reduce and lessen death cases from H1N1 influenza. It can be noted as an example that Mexico, by doing influenza surveillances from April to July 2009, has been able to assess and evaluate the total admission of influenza patients and the mortality rate from them. With proper and reliable risk communication, the survival rate for H1N1 influenza has been greatly affected with a 92 confirmed recovery, 7 have survived with cautious treatment and less than 1 have been recorded as cases of death. Mexican health professionals and experts stated that a seasonal influenza vaccine can be helpful in reducing the threats if H1N1 infection. It has been further believed that with the present information available, the virus will not cause a pandemic in some other future however, it has been observed as well that the virus is continuously evolving and is becoming a major threat to other countries (Parry, 2009).
Influenza A (H1N1) has become a serious threat to U.S. public health and safety. In a study conducted by the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM), several tips or strategies can be applied in order to have an effective risk communication as what have been observed and applied to Army Preventive Medicine agencies as well as their medical staff in relation to H1N1 influenza (USACHPPM, 2009). With the rapid spread of H1N1 influenza throughout the United States and other countries, army personnel, as well as civilians will seek advice from health care professionals for information and answers to major inquiries or even turn to traditional personal preventive medication. The Army has initiated its efforts in identifying the possible trends in terms of disease manifestations and symptoms such that its medical staff can provide sufficient guidance, advice and even medical treatment. They can also share some opinions and insights regarding the seriousness of the situation with the use of their considerable knowledge, training, and experiences. Risk communication is an effective way of handling such outbreaks and infections. It has the greatest capability of increasing public awareness, concern and understanding of the situation and can reduce and alleviate negative reactions such as unnecessary fear and anxiety but rather trigger timely actions that can create prevention rather than chaos and panic (USACHPPM, 2009).
Risk communication is an essential part of securing public health and safety. It has to be always clear and concise with faster and wider means of being disseminated to the public. Moreover, health risk communication should address major concerns that in return, can increase and improve the level of public preparedness and timely response to most situations.
Categories:
0 comments:
Post a Comment