Predicting Response to Reassurances and Uncertainties in Bioterrorism Communications for Urban Populations in New York and California
Biosecurity and Bioterrorism
Recent national plans for recovery from bioterrorism acts perpetrated in densely populated urban areas acknowledge the formidable technical and social challenges of consequence management. Effective risk and crisis communication is one priority to strengthen the U.S.'s response and resilience. However, several notable risk events since September 11, 2001, have revealed vulnerabilities in risk/crisis communication strategies and infrastructure of agencies responsible for protecting civilian
... ations. During recovery from a significant biocontamination event, 2 goals are essential: (1) effective communication of changing risk circumstances and uncertainties related to cleanup, restoration, and reoccupancy; and (2) adequate responsiveness to emerging information needs and priorities of diverse populations in high-threat, vulnerable locations. This telephone survey study explored predictors of public reactions to uncertainty communications and reassurances from leaders related to the remediation stage of an urban-based bioterrorism incident. African American and Hispanic adults (N = 320) were randomly sampled from 2 ethnically and socioeconomically diverse geographic areas in New York and California assessed as high threat, high vulnerability for terrorism and other public health emergencies. Results suggest that considerable heterogeneity exists in risk perspectives and information needs within certain sociodemographic groups; that success of risk/crisis communication during recovery is likely to be uneven; that common assumptions about public responsiveness to particular risk communications need further consideration; and that communication effectiveness depends partly on preexisting values and risk perceptions and prior trust in leaders. Needed improvements in communication strategies are possible with recognition of where individuals start as a reference point for reasoning about risk information, and comprehension of how this influences subsequent interpretation of agencies' actions and communications. Recent assessments of the bioterrorism threat anticipate that a significant incident could occur in the near future. 1-3 Since 2001, considerable resources have been devoted to improving preparedness, response, rapid recovery, and resilience with the goal of minimizing the societal impact and damage should a biological attack occur. 2,4,5 Effective risk and crisis communication during an incident is a core component of strategic planning and is a priority to strengthen the U.S.'s capacity to mitigate consequences. 6-9 Yet, since September 11, 2001, several extreme risk events in the U.S. and in other countries have demonstrated an urgent need to update and improve the risk/crisis communication infrastructure and strategies of government agencies and organizations responsible for the safety and security of civilian populations. 9-12 Terrorist attacks on the London, Mumbai, and Madrid public transportation systems; Hurricane Katrina; the December 2008 multisite terrorist attacks on "soft targets" in Mumbai, India, over a 60-hour period; the anthrax attacks of 2001; and the H1N1 influenza pandemic of 2009-10 all revealed weaknesses in crisis, risk, and public health communication planning and operations. Despite some notable successes, gaps between communication needs of affected populations and actual practice included: less than optimal, timely adaptation to unforeseen circumstances; 9,11-15 difficulties in interagency response coordination and cooperation; 9,12-16 inadequate or delayed acknowledgment and correction of errors that had appeared in previous public communications about the event; 13,17-20 inadequate uncertainty communication; 11, 13, 16, 18 limitations in predicting, assessing, and responding to changing or ongoing critical information needs of affected populations;    18, 19, 21 and less than desired effectiveness in risk/crisis communications for certain socially vulnerable and ethnically diverse groups. 11,17,21-24 Some gaps were historic and reflected longstanding deficiencies, such as limited communications about risk uncertainties and significant social disparities in the success of risk management strategies, with less desirable outcomes for those most vulnerable to adverse consequences of a public health emergency. 11,25-28 Other risk/crisis communication missteps resulted from the changing characteristics of modern risks and limited intelligence about planned attacks, leading to uncertainty about the scope and methods of future extreme risk incidents. 2, 4, 6, 10, 13, 15, 19, 29 Despite significant recent improvements in strategic communication approaches, 2,18,30 ongoing critical vulnerabilities in ways of thinking about and preparing for risk/ crisis communication call for increased responsiveness to changing risk scenarios, evolving communication goals, and growing scientific evidence about the dynamics of public risk perceptions and behaviors during unfolding extreme risk occurrences. 31 Even more critical is communication preparedness for extreme acts like biological terrorism or other weapons of mass destruction (WMD) attacks that can display high levels of uncertainty as events progress, demand ongoing timely reevaluation of response effectiveness, present a good likelihood of unexpected developments, and reflect an ongoing potential for catastrophic Vaughan et al.