July 14, 2022—Elena Savoia is a Principal Scientist in the Department of Biostatistics at the Harvard TH Chan School of Public Health, where he is Deputy Director of Emergency Preparedness Research, Evaluation and Practice Program (EPREP) and co-founder of the IRIS Coalition. She recently co-directed a workshop for public health practitioners in Conference on Global Health Security in Singapore to address misinformation and misinformation in emergency risk communication.
Q: What is EPREP?
A: The preparedness program began in 2002, immediately after 9/11, with initial funding from the Centers for Disease Control and Prevention and a focus on training the US public health workforce. It has grown into a portfolio of national and international workforce development activities and research around key capabilities that governments need to respond to large-scale emergencies such as pandemics, hurricanes and terrorism.
I started working with the program in 2004 while earning my MPH in Quantitative Methods and have been with it ever since.
Q: What are your emergency risk communication workshops like and what do you hope participants get out of them?
A: Our workshops are aimed at people in the public health workforce at various levels, including local and state public health departments or ministries of public health in other countries. They are very practice oriented. We take participants through a simulation exercise, gradually adding more information over the course of about three hours. At the recent workshop in Singapore, participants responded to a scenario involving fictional social media posts questioning the safety of the COVID vaccine in children. The goal was for them to come up with some priorities for actions they can take to improve their emergency communications plans.
During the simulation, the first thing the participants wanted to do was check the facts. You should not assume anything is misinformation. You should see if there is any data to support or substantiate this particular information. Second, they prioritized listening to the public and trying to understand which segments were most concerned. Finally, they wanted to identify people in these communities who could be effective in reaching members of the public who distrusted the government.
Q: You suggested that practitioners “preemptively expose” misinformation, rather than simply trying to debunk it when it’s already there. Why is that and what does it involve?
A: Debunking doesn’t seem to work because there is too much information on social media and elsewhere on the internet. It would be very difficult for an agency to try to debunk all the disinformation that’s out there—or even reach the people who spread it, given the information echo chambers that exist. You are debunking misinformation for people who no longer believe it.
The idea of prebunking is to educate people against misinformation. Instead of trying to convince someone not to believe something, you’re talking about common patterns in misinformation posts and videos and the industry that exists to make money off of it – for example, by selling a bogus drug for COVID-19. You warn people about certain techniques that creators use to manipulate emotions, such as scary music or tone of voice in videos and stories that focus on “corrupt elites” or hurting children. You give people the tools to help them critically evaluate what they see or hear.
We conducted a randomized trial in which we exposed people to a pre-priming video followed by a video that contained misinformation about the COVID-19 vaccine. A control group watches a video on how to clean your washing machine. We found that people who were exposed to the video prior to the vaccine were not only less hesitant about the vaccine, but also less likely to share the misinformation videos with their peers.
Building trust with the public is key to effective communication. Public health practitioners must listen to people and value their emotional experiences and concerns. Otherwise, you may end up alienating people and increasing polarization.
What we are talking about with practitioners is a cultural shift that needs to happen in communication around public health emergencies. For example, during the pandemic we saw that many government agencies around the world have a top-down way of communicating with the public. They push their messages without testing them. But others have had greater success by finding ways to use data—for example from social media and population surveys – to inform their communication strategies.
We interviewed heads of communications from government agencies in multiple countries to understand their approaches to sharing public health messages. Ultimately, we will produce a roadmap for effective communication that will support them in improving their agencies’ ability to communicate vital health information to the public.