Abstract
Background: The 2009/2010 A/H1N1 pandemic affected 214 countries and led to ˜18.500 reported deaths. Major communication difficulties within Europe were observed along with a low vaccination uptake and limited public trust in official recommendations. Therefore the overall aim of the EU funded E-com@EU project is to improve risk communication strategies during major epidemic outbreaks in Europe. Within this framework the objective of this study is to analyse the experiences and suggestions of European Public Health Experts who were directly involved in the risk-communication process during the A/H1N1 pandemic. Methods: Semi-structured qualitative interviews with 25 European stakeholders were conducted. The experts came from eight European countries (Germany, Italy, The Netherlands, Poland, Romania, Spain, Sweden and United Kingdom) and three different management levels: Micro level (physicians, health-care staff), Meso level (local public health authorities) and Macro level (national health authorities). The interviews were analysed using Mayrings' qualitative content analysis methodology. Results: During the pandemic some stakeholders were overwhelmed by the sheer amount of daily information and wished for a manageable number of reliable sources that summarize the information precisely. Personal and telephone meetings to exchange information were highly valued. Using new media like short video clips or social media to disseminate relevant information to the public was suggested. The considerable role of influential persons, health care support staff and the media in the decision making process of the public was also pointed out. Discussion: Although recall-bias (pandemic in 2009/10, interviews in 2013/14) and language barriers may have played a role, the results clearly indicate that there is a need to develop evidence-based risk-communication strategies for Europe in preparation for major pandemics. For example establishing better relations between public health and media representatives is required. Investing in measures to increase the society's trust in public health authorities is another area for improvement.
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