Risk Communication Process Research Articles

Biological, Chemical, and Nutritional Food Risks and Food Safety Issues From Italian Online Information Sources: Web Monitoring, Content Analysis, and Data Visualization.

BackgroundWith rapid evolution of the internet and web 2.0 apps, online sources have become one of the main channels for most people to seek food risk information. Thus, it would be compelling to analyze the coverage of online information sources related to biological, chemical, and nutritional food risks, and related safety issues, to understand the type of content that online readers are exposed to, possibly influencing their perceptions.ObjectiveThe aim of this study was to identify the types of online sources that are predominantly covering this theme, and the topics that have received the most attention in terms of coverage and engagement on social media.MethodsWe performed an analysis of big data related to food risks by combining web monitoring techniques, content analysis, and data visualization of a large amount of unstructured text. Using a dictionary-based approach, a web monitoring app was instructed to automatically collect web content referring to the food risk and safety field. Data were retrieved from March 2017 to February 2018. The validated corpus (N=12,163) was subject to automatic and manual content analysis. Results were combined with descriptive statistics extracted from Web-Live and processed with Qlik Sense.ResultsNutritional risks and news about outbreaks, controls, and alerts were the most widely covered topics. Thematic sources devoted major attention to nutritional topics, whereas national sources covered food risks, especially during food emergencies. Regarding engagement on social media, readers’ interest was higher for nutritional topics and animal welfare. Although traditional sources still publish a great amount of content related to food risks and safety, new mediators have emerged as alternative sources for food risk information.ConclusionsThis mixed methodological approach was demonstrated to be a useful means for obtaining an accurate characterization of the online discourse on food risks, and can provide insight into how the monitored sources contribute to the process of risk communication.

Professional consensus on orthodontic risks: What orthodontists should tell their patients

Effective communication of risk is a requisite for valid consent, shared decision-making, and the provision of person-centered care. No agreed standard for the content of discussions with patients about the risks of orthodontic treatment exists. This study aimed to produce a professional consensus recommendation about the risks that should be discussed with patients as part of consent for orthodontic treatment. A serial cross-sectional survey design using a modified electronic Delphi technique was used. Two survey rounds were conducted nationally in the United Kingdom using a custom-made online system. The risks used as the prespecified items scored in the Delphi exercise were identified through a structured literature review. Orthodontists scored treatment risks on a 1-9 scale (1=not important, 9=critical to discuss with patients). The consensus that a risk should be discussed as part of consent was predefined as ≥70% orthodontists scoring risk as 7-9 and<15% scoring 1-3. The electronic Delphi was completed by 237 orthodontists who reached a professional consensus that 10 risks should be discussed as part of consent for orthodontic treatment; demineralization, relapse, resorption, pain, gingivitis, ulceration, appliances breaking, failed tooth movements, treatment duration, and consequences of no treatment. A professional orthodontic consensus has been reached that 10 key risks should be discussed with patients as part of consent for orthodontic treatment. The information in this evidence base should be tailored to patients' individual needs and delivered as part of a continuing risk communication process.

Risk communication during the COVID-19 pandemic: lessons for lifestyle interventions in cardiovascular prevention

Lifestyle is a cornerstone of cardiovascular prevention and the process of risk communication constitutes an important step to obtain favorable changes in daily habits. Nevertheless, there is no definite consensus on how health operators should provide information on cardiovascular risk, and several models have been proposed in different settings. The current COVID-19 pandemic - with related communication strategies to reduce the spread of the disease and morbidity - may offer an interesting opportunity to reconsider communication in cardiovascular prevention: even though cardiovascular conditions are not communicable diseases, both COVID-19 and cardiac illnesses force a huge segment of the population to major lifestyle changes. This narrative commentary describes similarities between these conditions, mainly focusing on modalities of risk communication, strategies to counteract fake news, actions to enhance the expertise of health operators, and finally on new skills that could derive as a lesson from COVID-19.

Screening of COVID-19 suspect cases in a Cargo Ship: A rare field experience

Background: World Health Organization (WHO), China Country Office informed cases of pneumonia of unknown aetiology detected in Wuhan City, Hubei Province of China. On 7th January 2020, Chinese authorities identified a new strain of Coronavirus as the causative agent for the disease. By 1st April 2020, the disease since its first detection in China has spread to over 200 countries/territories leading to a total of 823626 confirmed cases and 40598 deaths. WHO declared the novel Coronavirus outbreak as a Pandemic on 11 March 2020 and named the 2019 novel Coronavirus as COVID-19. As the screening of these suspects in ships is a challenging and novel one, the present study was aimed at identifying the proper and systematic way of screening of these suspects. Screening if done systematically aids in early diagnosis of the COVID-19 suspects and if coupled with pre-arrival preparedness through e-mail follow up helps in proper planning. Proper risk communication can help in alleviating the fears of the stakeholders and public. Aims &amp; Objectives: The primary objective of this study was to screen the COVID-19 suspect cases systematically in the vessels and the secondary objectives were to identify any gaps in the process of collection, transport and receipt of results of samples of COVID-19 Suspect cases, know the process of risk communication &amp; to share the experience to other seaports for duplication. Materials &amp; Methods: Screening was done for all the crew by the Investigators with proper Personal Protective Equipment (PPE) on the Bridge (Navigation Deck) of the vessel mainly for recording the temperature and eliciting other signs &amp; symptoms of COVID -19. It was then followed by sending the samples of the two COVID-19 suspects for testing to the Government approved laboratory in a systematic way. Risk communication was also done to all the stakeholders and media in a well-coordinated manner at the earliest to update them on the facts and to prevent false communication. Results: Pre-arrival preparedness through screening of pre-arrival documents and systematic approach adopted for screening of the COVID-19 suspects led to early diagnosis of the suspects. Samples were collected as per protocol and sent for testing to the laboratory and reports of the same were obtained without any much constraints through proper liaison with Tamilnadu State Health team. Risk communication to the stakeholders and media prevented panic among the public and stakeholders. Conclusions: Pre-arrival e-mail follow-up and arrangements like coordination meeting with the stakeholders led to proper planning. Systematic screening and proper liaison with State Health team helped in the early diagnosis of the suspects. Proper and early risk communication to the stakeholders and media prevents panic, facilitates good support and prevents communication of maleficious information to the public.

Effective Risk Communication for Public Health Emergency: Reflection on the COVID-19 (2019-nCoV) Outbreak in Wuhan, China.

Risk communication is critical to emergency management. The objective of this paper is to illustrate the effective process and attention points of risk communication reflecting on the COVID-19 (2019-nCoV) outbreak in Wuhan, China. We provide the timeline of risk communication progress in Wuhan and use a message-centered approach to identify problems that it entailed. It was found that the delayed decision making of the local government officials and the limited information disclosure should be mainly responsible for the ineffective risk communication. The principles for effective risk communication concerning Wuhan’s outbreak management were also discussed. The whole communication process is suggested to integrate the accessibility and openness of risk information, the timing and frequency of communication, and the strategies dealing with uncertainties. Based on these principles and lessons from Wuhan’s case, this paper employed a simplified Government–Expert–Public risk communication model to illustrate a collaborative network for effective risk communication.

Communicating risk to tourists: A mental models approach to identifying gaps and misperceptions

This study compares the perspectives of government agencies, academic experts, and tourism suppliers on providing tourists with tsunami risk information. Previous studies highlight that government agencies are often in charge of developing tourism-oriented risk communication plans; academic experts are recognized as having a more in-depth understanding of the technical aspects of a risk, as well as the hazard development and potential effects; and tourism suppliers play a fundamental role during the risk communication process, due to direct connection with the tourists. However, tourists are often found to be insufficiently informed about risks and warning systems. We use the Mental Models approach, aiming to analyze the communication between the aforementioned categories of stakeholders. We carried out interviews and conducted field trips in Japan between April and December of 2018. Results highlight an increased general awareness regarding tourists' preparedness, poorly supported by risk-communication gaps, misperceptions, and a lack of efficacy analyses.

Uncertainty handling in estimative intelligence – challenges and requirements from both analyst and consumer perspectives

Important assessments of events and activities relating to military, terrorist and hybrid adversaries and the intentions of foreign governments, are made every day, usually involving subjective or ‘estimative’ probabilities and an associated level of confidence. The way in which these uncertainties are accessed and communicated can potentially have enormous impact and consequences. Challenges are reinforced by increasingly complex intelligence problems for which the contemporary analytic paradigm is not tailored to cope. It is important to better understand how defence intelligence analysts and consumers handle uncertainty in their assessment and decision support activities and what challenges and requirements they face in doing so. This is mainly achieved by the use of semi-structured interviews with a sample of very senior consumers of military intelligence (mostly Flag Officers of the Norwegian Armed Forces) and focus group interviews with groups of Norwegian intelligence analysts. In general, respondents found it difficult or challenging to conceptualize uncertainty analytically. This has implications for the communication of uncertainty and its use in decision-making within the current framework. Secondly, respondents were receptive to suggested potential improvements to the existing framework. One such suggestion involved a differentiated framework, offering different levels of uncertainty resolution in different situations, although none of the respondents had any experience of such a framework for assessing or communicating uncertainty. We conclude with some recommendations to improve the process of uncertainty and risk communication in this important and consequential application area. Having particular implications for policy, we recommend that analysts follow a differentiated approach in handling different situations and problems comprising uncertainty, rather than pursuing a standard solution as is current practice.

RISK COMMUNICATION TO HEALTH AS A COMPONENT OF THE RISKORIENTED MODEL FOR THE PROVIDING MEDICAL CARE TO WORKING POPULATION

Results analysis of the current system of providing medical care to workers of industrial enterprises of the Perm Krai revealed its insufficient effectiveness in terms of risks communication to employees health. The purpose of risk communication to employees is to provide them with reliable and scientifically based information about health risk factors associated with harmful chemical factors, risk levels, necessary and implemented risk management measures, as well as about ways and means of individual prevention of health problems. A survey of enterprises employees, medical staff of health centers and medical organizations showed that more than half of the respondents did not know about the features of the production process of the enterprise, harmful occupational factors at workplaces and occupational risks. It seems expedient to improve the process of risk communication to the health of all interested parties, and when preparing materials about the risks to the workers’ health, one must take into account the peculiarities of perception of this type of information.

A study on local residents' perception in communication process for LNG terminal risks

The objective of this paper is to explore the locals' perception on risk communication process between LNG organisation and local residents. Using a traditional communication model based on the source-message-channel-receiver-effect (SMCRE), the factors of risk communication process were measured to determine the residents' perception of facility risks. The individual factors that influenced SMCRE elements were grouped and analysed by factor analysis. Also, multiple regression analysis was conducted to examine the effect of latter element on former element: the order of elements was S → M, M → C, C → R, and R → E. In terms of the model's final process, an effective pathway had two cases. The first case was the relieving of social conflicts and anxieties through mutual understanding. The second case was the promotion of trust. This study can assist LNG organisations with providing better risk communication to residents and enhance the acceptance of LNG facilities.

A study on local residents' perception in communication process for LNG terminal risks

The objective of this paper is to explore the locals' perception on risk communication process between LNG organisation and local residents. Using a traditional communication model based on the source-message-channel-receiver-effect (SMCRE), the factors of risk communication process were measured to determine the residents' perception of facility risks. The individual factors that influenced SMCRE elements were grouped and analysed by factor analysis. Also, multiple regression analysis was conducted to examine the effect of latter element on former element: the order of elements was S → M, M → C, C → R, and R → E. In terms of the model's final process, an effective pathway had two cases. The first case was the relieving of social conflicts and anxieties through mutual understanding. The second case was the promotion of trust. This study can assist LNG organisations with providing better risk communication to residents and enhance the acceptance of LNG facilities.

Communicating risk of medication side-effects: role of communication format on risk perception.

Background:Medication side-effects often arouse fear in the minds of consumers and therefore need to be communicated in a manner such that the intended message is clearly understood, without causing undue fear.Objectives:Considering the message format and contextual factors that influence perceptions of risk, this study aimed at assessing the interaction effects of message format and contextual factors (rate of occurrence and severity) on risk perception of medication side-effects.Methods:Using Rhormann’s risk communication process model, a 2 (message format: words-only vs. words + numeric) X 2 (rate of occurrence: high vs low) X 2 (severity: mild vs severe) experimental factorial study was designed. Participants were presented with four of eight possible combinations of the three factors and were asked to indicate the risk perception with the associated side-effects. Repeated measures analysis was conducted while adjusting for control variables.Results:A total of 196 completed surveys were collected. Communication format did not have significant main effect on risk perception (P=0.4237) but demonstrated a significant interaction with rate of occurrence (P=0.0001). As compared to words-only format, least square means for words + numeric format were lower among low-rate side-effects but were higher among high-rate side-effects. Rate of occurrence (P<0.0001) and severity (P<0.0001) had significant main effects on risk perception as well as interaction effect with each other (P<0.0001).Conclusions:The results indicated that effect of communication format on risk perception of side-effect is dependent on the underlying rate of occurrence of side-effect. Healthcare providers should therefore carefully construct risk communication messages for effective communication with patients.

Emergency Risk Communication: Lessons Learned from a Rapid Review of Recent Gray Literature on Ebola, Zika, and Yellow Fever

ABSTRACTA rapid review of gray literature from 2015 to 2016 was conducted to identify the lessons learned for emergency risk communication from recent outbreaks of Ebola, Zika, and yellow fever. Gray literature databases and key websites were searched and requests for documents were posted to expert networks. A total of 83 documents met inclusion criteria, 68 of which are cited in this report. This article focuses on the 3 questions, out of 12 posed by World Health Organization as part of a Guideline development process, dealing most directly with communicating risk during health emergencies: community engagement, trust building, and social media. Documents were evaluated for credibility using an Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist? and if the document contained a study, a method-specific tool was applied. A rapid content analysis of included sources was undertaken with relevant text either extracted verbatim or summarized and mapped against the questions. A database subset was created for each question and citations were assigned to the subset(s) for which they contained relevant information. Multiple designations per document were common. Database subsets were used to synthesize the results into a coherent narrative.The gray literature strongly underlines the central importance of local communities. A one-size-fits-all approach does not work. For maximum effectiveness, local communities need to be involved with and own emergency risk communication processes, preferably well before an emergency occurs. Social media can open new avenues for communication, but is not a general panacea and should not be viewed as a replacement for traditional modes of communication. In general, the gray literature indicates movement toward greater recognition of emergency risk communication as a vitally important element of public health.

Drug safety in pregnancy: the German Embryotox institute.

Since 1988, the German Embryotox institute combines individual counselling of pregnant women and their health care providers (HCP) with research on drug safety in pregnancy. In addition, Embryotox offers web-based information which covers the most important and most frequently requested pharmaceutical substances. In contrast to ready-made drug risk information in package leaflets and other product information, individual counselling considers different clinical settings such as (1) looking for a drug of choice or planning pregnancy under medication, (2) risk assessment of a particular drug that has already been taken during an (unplanned) pregnancy and (3) evaluation of an adverse pregnancy outcome in association with a particular medication. Using the three established developmental toxicants valproic acid, isotretinoin, and renin-angiotensin-aldosterone system (RAAS) inhibitors as an example, the need of detailed information is illustrated. Through the risk communication process, pregnancy outcome data are routinely collected by Embryotox. This approach uses the advantages of a pre-existing communication structure and of dealing with motivated responders. Engagement in the treatment plan facilitates receiving reliable data on drug exposure as well as detailed follow-up data. Based on these patient records, prospective datasets are evaluated in observational cohort studies in comparison to non-exposed control cohorts. In addition, retrospective datasets received as suspected adverse drug reactions from multiple German sources allow a screening for signals of teratogenicity and distinct patterns of developmental toxicity. Clinical expertise in specialties such as teratology, paediatrics, embryology, obstetrics and human genetics are required to ensure high-quality assessment of drug safety in pregnancy.

Selection of participatory formats as success factor for effective risk communication and decision-making processes. Conclusions from a systematic empirical format comparison

The article contributes arguments to the discussion about the effectiveness of dialogue and participation within the field of risk communication and decision-making, considering the special issue of societal resilience. The contribution summarises selected empirical findings of a systematic comparison of participatory formats based on a multi method and a multi concept approach as well as a comprehensive data base. The analyses detected systematic differences between the formats according to their internal impact on the persons involved and their external impact. These differences can be explained by procedural features of the formats. Appropriate format selection turned out to be an important success factor for developing effective participatory projects. The article sketches the opportunities for synthesising research findings to assess and compare formats. In addition, the potentials of how integrative research can structure and refine the available knowledge are illustrated, so that coordinators and organizers in the field are supported, for instance in selecting formats appropriately. Systematic knowledge of success factors does not only facilitate the practical field work. A couple of arguments from interdisciplinary literature indicate that effective interactive communication and decision-making can be seen as a functional and relevant resource in democratic systems to strengthen the society to react effectively against threats, and to cope with development issues. Effective dialogue and participation, therefore, can be understood as resources for strengthening the social resilience of modern democratic societies.

Medication Risk Communication in Rheumatology: Where Are We and Where Do We Go from Here?

This paper reviews findings from recent research examining issues related to the risk communication process within the context of rheumatologic conditions. Five specific questions are addressed. First, to what extent do patients with rheumatic disorders exhibit adequate knowledge relevant to disease and medication risks and risk management? Second, what sources do patients use when attempting to find information about disease and medication risks and risk management? Third, what types of information about disease and medication risks and risk management do rheumatologists provide during routine office visits. Fourth, what governmental regulations attempt to increase consumer access to information about medication risks and risk management? Finally, what other educational resources are available to facilitate patient-provider communication concerning disease and medication risks and risk management? The findings reported identify gaps in patient knowledge concerning medication risks and risk management, highlight areas for improvement, and identify resources that may enhance medication risk communication.

The electronic medication complete communication (EMC2) study: Rationale and methods for a randomized controlled trial of a strategy to promote medication safety in ambulatory care

BackgroundAdverse drug events (ADEs) affect millions of patients annually and place a significant burden on the healthcare system. The Food and Drug Administration (FDA) has developed patient safety information for high-risk medications that pose serious public health concerns. However, there are currently few assurances that patients receive this information or are able to identify or respond correctly to ADEs. ObjectiveTo evaluate the effectiveness of the Electronic Medication Complete Communication (EMC2) Strategy to promote safe medication use and reporting of ADEs in comparison to usual care. MethodsThe automated EMC2 Strategy consists of: 1) provider alerts to counsel patients on medication risks, 2) the delivery of patient-friendly medication information via the electronic health record, and 3) an automated telephone assessment to identify potential medication concerns or ADEs. The study will take place in two community health centers in Chicago, IL. Adult, English or Spanish-speaking patients (N=1200) who have been prescribed a high-risk medication will be enrolled and randomized to the intervention arm or usual care based upon practice location. The primary outcomes of the study are medication knowledge, proper medication use, and reporting of ADEs; these will be measured at baseline, 4weeks, and three months. Intervention fidelity as well as barriers and costs of implementation will be evaluated. ConclusionsThe EMC2 Strategy automates a patient-friendly risk communication and surveillance process to promote safe medication use while minimizing clinic burden. This trial seeks to evaluate the effectiveness and feasibility of this strategy in comparison to usual care.

A Textual Processing Model of Risk Communication: Lessons from Typhoon Haiyan

Abstract As the world’s urban poor increase in numbers, they become acutely vulnerable to hazards from extreme weather events. On 8 November 2013, Typhoon Haiyan struck the province of Leyte, Philippines, with casualties numbering in the thousands, largely because of the ensuing storm surge that swept the coastal communities. This study investigates the role and dynamics of risk communication in these events, specifically examining the organizational processing of text within a complex institutional milieu. The authors show how the risk communication process failed to convey meaningful information about the predicted storm surge, transmitting and retransmitting the same routine text instead of communicating authentic messages in earnest. The key insight is that, rather than focus solely on the verbatim transmission of a scripted text, risk communication needs to employ various modes of translation and feedback signals across organizational and institutional boundaries. Adaptation will require overcoming organizational rigidities in order to craft proportionate responses to extreme weather events that may lie outside personal and institutional memory. Future work should build upon the textual processing approach to risk communication, expanding it into a comprehensive relational model of environmental cognition.

Health risks from environmental degradation in the Niger Delta, Nigeria

Local communities within oil producing countries in Africa often face formidable environmental challenges that generate conflicts and concerns around exploitation, environmental impact, and health risks. A key feature of these concerns has been the paucity of effective risk communication mechanisms and the impact this has on the public understanding of risk. Risk communication has been identified as a significant factor in explaining why the health consequences of environmental degradation remain unabated in oil producing communities. This paper evaluates health risk communication in the oil rich Niger Delta region of Nigeria. The study is based on 69 interviews conducted in the Niger Delta region. The paper argues that the health of the local population is being impaired by risk incidences relating to oil and gas exploration activities, the effects of which are amplified by inadequate communication of health risks to the public. The study argues for and suggests ways in which health risk communication processes can be improved in the Niger Delta. A multi-dimensional framework for public health risk communication is developed as a means of advancing understanding, practice, and policy.

Shared Decision Making and Effective Risk Communication in the High-Risk Patient With Operable Stage I Non-Small Cell Lung Cancer

Shared decision making is a dynamic clinical process by which the provider assists the patient in choosing between more than one treatment option for a given condition. Here, we explore what the shared decision making and risk communication process could look like in the setting of a high-risk patient with clinical stage I non-small cell lung cancer who is potentially eligible for either segmentectomy or stereotactic body radiation therapy. We highlight clinical tools that can be used during the shared decision making and risk communication process in a stepwise manner to identify patient preferences and values to assist in making a tailored treatment decision.

Stakeholders' perceptions, attitudes and practices towards risk prevention in the food chain

An online survey was conducted to describe stakeholders' perceptions, attitudes and practices towards risk prevention in the food chain and to explore if common features could be extracted from different fields of competency or groups of stakeholders. Out of 80 participants, 60% believed that pathogenic microorganisms were the main hazard to prevent. Twenty-four percent perceived climate change as the main risk factor. Seventy-three percent believed that hazards in the food chain are preventable and they often showed a positive attitude towards risk prevention measures. The opinion of 75% of stakeholders was that prevention measures should be compulsory and under the shared responsibility of both food business operators and competent authority. Seventy-five percent of the respondents had recent experience with particular hazards and declared to have undertaken risk reduction measures. Incentives to implement measures were policy obligation and public health consequences whereas barriers were budgetary reasons and doubts about their effectiveness. However, there was not always a complete agreement between the perceived usefulness of risk prevention measures and their effective implementation, and conversely. No significant difference could be observed in the perceptions, attitudes and practices towards risk prevention between neither groups of stakeholders nor their fields of competency. The results are important for improving the risk communication process because the same issues can be emphasized when promoting risk prevention in the food chain regardless of the type of food sectors and the groups of stakeholders.