5. STRATEGIES FOR EFFECTIVE RISK COMMUNICATION

Risk communication occurs in many different contexts and both research and experience suggest that different risk communication strategies are appropriate for these different contexts. Although there are many similarities, the strategies needed during a food safety emergency differ in many respects from strategies needed to engage the public in dialogue about risks and benefits of new food technologies, and from those for communicating about chronic low-level food-related risks. Items to consider when developing strategies for risk communication during a food safety crisis are presented separately here, following a discussion of more general risk communication requirements.

General considerations for effective risk communication

Many considerations for effective risk communication, especially those involving the public, can be grouped in a sequence following the systematic approach of the risk communication process. This starts with gathering background and needed information, followed by the preparation and assembly of the message and its dissemination and distribution, with a follow-up review and evaluation of its impact.

Background/information

• Understand the scientific basis of the risks and attendant uncertainties.
• Understand the public perception of the risk through such means as risk surveys, interviews and focus groups.
• Find out what risk information people want.
• Be sensitive to related issues that may be more important to people than the risk itself. Expect different people to see the risk differently.

Preparation/assembly

• Avoid comparisons between familiar risks and new risks, as they may seem flippant and insincere unless presented properly.
• Recognize and respond to the emotional aspects of risk perceptions. Speak with sympathy and never use logic alone to convince an audience characterized by emotion.
• Express risk in several different ways, making sure not to evade the risk question.
• Explain the uncertainty factors which are used in risk assessment and standard setting.
• Maintain an openness, flexibility, and recognition of public responsibilities in all communication activities.
• Build an awareness of benefits associated with a risk.

Dissemination/distribution

• Accept and involve the public as a legitimate partner by describing risk/benefit information and control measures in an understandable way.
• Share the public's concern rather than deny it as not legitimate or as unimportant. Be prepared to give people's concerns as much emphasis as the risk statistics.
• Be honest, frank, and open in discussing all issues.
• If explaining statistics derived from risk assessment, explain the risk assessment process before presenting the numbers.
• Co-ordinate and collaborate with other credible sources.
• Meet the needs of the media.

Review/evaluation

• Evaluate the effectiveness of risk messages and communication channels.
• Emphasize action to monitor, manage, and reduce risk.
• Plan carefully and evaluate efforts.

Points to consider regarding public concerns

Risks that involve some or all of the following aspects tend to concern the public more than those risks that lack these aspects:

• Unknown, unfamiliar or rare events as opposed to well-known or common hazards.
• Risks that are controlled by others, rather than those where the public or the individual is in control.
• Risks resulting from industry action or from new technology, rather than those perceived as natural.
• Risks where there is significant scientific uncertainty, or where there is open controversy among experts as to the probability and severity of the hazard.
• Risks that raise moral or ethical questions, such as the fairness of the distribution of risks and benefits, or the rights of one group in society to put others at risk.
• The decision-making process by which a risk is assessed is seen as being unresponsive or is unknown.

Therefore, in order to mitigate public concern about risks, the following strategies may be used:

• Make risks voluntary by giving consumers choices, whenever possible;
• Acknowledge uncertainty;
• Show that expert disagreement on an issue is merely uncertainty, by estimating risks as a range that includes estimates from both sides of the debate;
• Determine where control is and look to share it with interested parties;
• Treat all interested parties with courtesy; and
• Always consider concerns and complaints seriously.

Strategies for risk communication in non-crisis situations

Risk communication is obviously very important during a food safety crisis; however, it is equally important when there is no immediate crisis and routine risk analyses are being made to address identified hazards. The following should be considered in preparing risk communication strategies in such situations.

Background/information

• Anticipate emerging public health hazards before they become significant.
• Determine the public's perception of the hazard being considered and their knowledge and behaviour regarding the risks involved.
• Analyze the target audience of a risk communication and understand their motivations. Try to determine the full range of the audience's concerns and their perceived importance.
• Analyze which information channels and messages are best to be used. Use the mass media and other appropriate channels to convey information.

Preparation/assembly

• Describe to concerned groups how risk is determined, how it can be monitored and how an individual can control or reduce risk.
• Identify shared values and help individuals identify an approach to meet their values.
• Make messages interesting and relevant by emphasizing the human rather than the statistical aspects of a story.
• Use extra care to make a message interesting enough for the media to publish. Claims of risk are usually considered by the media to be more newsworthy than claims of safety.

Dissemination/distribution

• Use the mass media where possible to address those consumer concerns which have been identified. For example, public forums with local opinion leaders can be televised.
• Sustain communication, thus enabling the public to make decisions based upon personal values and goals and to gain a greater understanding of the potential risks and benefits involved.
• Make risk communication multi-directional, not just from technical experts to the public, but from the public back to the experts.
• Use participation to sustain efforts. People have to feel that they are at the centre of a health promotion action or decision for the process to be effective.
• Use health education and access to health information to foster effective participation of people and communities.

Review/evaluation

• Add an evaluation component into any risk communication strategy.
• Test the clarity and understanding of the message with a representative segment of the target audience.
• Integrate risk communication with risk assessment and risk management activities, to increase the effectiveness of risk analysis and ensure proper utilization of resources.
• Educate and train risk assessors and risk managers in the principles and uses of risk communication.
• Effective risk communication can break through traditional boundaries within government sectors, between governmental and non-governmental organizations, and between the public and private sectors. Co-operation is essential and this requires the creation of equal partnerships between the different sectors at all levels of governance in societies.

Strategies for risk communication during a food safety crisis

The typical food safety crisis envisioned here is one in which disease-causing organisms are discovered in a widely consumed food. The strategies suggested, however, also will apply to other kinds of crisis situations involving, for example, chemical contamination or physical adulteration of foods.

While the general strategies for non-crisis situations referred to previously still apply, a crisis situation calls for special considerations. Communication strategies should be an integral part of the crisis management plan. Effective crisis management requires a comprehensive plan that can be updated through periodic evaluations. Having good channels of communication to the public during a crisis is extremely important; first to prevent panic and second to provide positive information on the situation to help decide on what course of action should be undertaken. This should include information on:

• the nature and extent of the crisis and the measures taken to control it;
• the sources of contaminated foods and what to do with any suspected foods held in households;
• the identified hazard and its characterization, and when and how to seek medical attention or other assistance as warranted;
• how to prevent further spread of the problem; and
• Safe food handling practices by the population during the crisis.

To achieve these objectives the risk communicator may:

• Manage a series of media communications.
• Establish appropriate mechanisms to deliver information, e.g. local visits, radio announcements, a toll-free telephone help line, etc.
• Arrange for one-to-one advice on infection risk in a special clinic, if a foodborne disease is involved.
• Provide daily updates on the crisis and crisis management activities to all health care and other relevant professionals.
• Hold regular briefings for government officials, and other official representatives as well as representatives of the public. Involve the media.
• Evaluate the effectiveness of the crisis communications and make adjustments as appropriate

Those responsible for managing a food safety crisis should establish a network for interactively sharing information. Central government research institutions, local governments, hospitals and private enterprises should make information accessible to each other in an accurate, concise and usable form.

Crisis Situations: International Responses

Early warning systems in countries or regions should be established to allow rapid communication of emerging crises. Once the cause of a foodborne disease outbreak has been established, action can be taken across international borders. For example, European Sal Net has helped prevent widespread illness due to specific outbreaks.

Member governments should follow the Codex Code for Ethics for International Trade in Food (8) and Guidelines for the Exchange of Information in Food Control Emergency Situations (9) which allows for rapid exchange of information during a crisis situation.

International organizations can serve as neutral fora for risk assessment and the development of appropriate risk management strategies and risk communication messages for national or international dissemination.

Crisis Situations: National Responses

National governments need to be prepared to rapidly disseminate accurate information to the mass media and the public when a food safety crisis arises. Essential steps in preparing for such a crisis include: identifying reliable sources of information and expert advice; arranging an administrative organization to handle communications during a crisis; and developing staff skills in dealing with the media and the public.

A national government might consider opening a Food Safety Information Office which can serve as a crisis centre if needed, while serving as an information centre to receive routine inquiries from consumers about the safety of foods. Food control authorities may also consider developing a home page on the Internet World-Wide Web to provide information on food and food safety including questions and answers about issues of common concern.

Crisis Situations: Industry Responses

When a crisis is emerging or has emerged, the involved industry should assure that the public authorities are fully informed about the potential cause and extent of the problem, and the anticipated effectiveness of any recall of food products already on the market. In dealing with the public during a crisis, consumer safety comes first and company actions and communications should reflect this. The following policies and actions have proven to be effective:

• Assess the problem as if you were the consumer. Take responsibility for finding a solution to the problem and protecting and advising your customers by providing the facts to the public in a clear and reasonable way. This will demonstrate to the public that you are worthy of trust.
• Be certain that any company pronouncements are from a single unified source. Conflicting messages only confuse the issue, erode confidence and disrupt the process of crisis resolution.
• Choose a spokesperson who is trained and skilled in dealing with the media. Make the spokesperson accessible to the media at all times.
• The spokesperson should consider the public, not just the food company. Companies can appear to be impersonal and only concerned about profits and losses whereas an effective spokesperson would express concern for the people and their needs.
• Have an “open door” policy relative to communications with the media. Remember that communication messages must be consistent and should be updated as soon as new information is received.
• Communicate quickly and often. Work with the media using the tools and timetables that work best for them. Communicate with those inside and outside the company who are working on the problem, especially government agencies.
• Inform company employees, especially those in sales and marketing positions, as to progress on the situation, what is being done to resolve it and the risk messages being communicated.
• Establish a mechanism for developing feedback from consumers. Free consumer call-in numbers and survey polls are ways of accomplishing this.
• Know your company's objectives and how they can be used to formulate risk communication messages.

Crisis Situations: Local Responses

The first lines of contact in a crisis are usually the local officials. It is critical that they communicate conditions to the appropriate authority quickly so a crisis can be contained and appropriately managed.

• Provide complete, up-to-date and accurate information. When the situation is resolved, tell the public that “it is over”.
• Keep your message simple. Too many facts are overwhelming. If appropriate, use videotape or other communication means to emphasise your point.
• Chose a media-trained spokesperson. During a crisis, consumers should know who is responsible for information and updates. Make the trained spokesperson accessible to the media at all times.

Specific guidelines for communication within the risk analysis process

Risk communication about food safety within the risk analysis process is carried out on an ongoing basis from the local through the international levels. While many of the strategies presented above also apply in the risk analysis process, there are additional considerations that can help frame those risk communication strategies that are part of risk analysis.

Specific Guidelines: International Considerations

Communication can be considered at two levels in the international context. The first level involves international organizations like FAO and WHO, and intergovernmental organizations like Codex. The second level involves national governments on bi-lateral and multi-lateral bases. At both levels, effective internal and external risk communication requires development and documentation of a comprehensive risk analysis policy. Matters of concern include:

• Continuing efforts to refine the concepts and understanding of food safety risk analysis in general and risk communication in particular;
• Improving the organizational infrastructure for internal and external risk communication to meet emerging situations;
• Addressing the critical role of effective risk communication in determining the equivalence of food control measures in different countries; and
• Establishing credible sources for risk assessments and technical advice.

In regard to the latter point, a joint FAO/WHO expert committee for food microbiological hazards (as is now the case for food additives, veterinary drug residues, pesticide residues and other food contaminants) would provide internationally recognized microbiological risk assessments for member governments and for Codex. The Consultation was aware that at its 22nd Session, the CAC recognized this problem and requested FAO and WHO to convene an international expert advisory body similar to JECFA and JMPR, to specifically address microbiological risk assessment in food.

Advice and assistance from international organizations may be sought when local authorities wish additional technical information and support. This may lead to specific international development projects. In such situations it would be necessary to maintain continuity in the composition of national counterpart staff. Co-ordination within such projects is essential.

Specific Guidelines: National Considerations

National Codex Co-ordinating Committees should have responsibility and appropriate support to communicate issues involving risk to consumers, local food industry and those national authorities involved in risk analysis.

International organizations like WHO and FAO have, over the years, developed documentation related to risk assessment and management. National organizations should make use of this information. National organizations should integrate food safety into primary health care for the public. This should penetrate down to the local marketplace.

It was previously suggested that national governments consider opening a Food Safety Information Office to address routine food safety inquiries as well as serving as a crisis centre when needed. Governments may wish to consider establishing a Food Safety Council comprised of microbiologists, physicians and toxicologists and other scientists with appropriate public health and food control expertise, as well as representatives of consumer organizations and industry, to evaluate and advise government officials regarding food safety. The Council's deliberations and recommendations could be made available to the public through official bulletins or administrative notices as well as through the mass media. It could also provide input for national delegations to Codex meetings.

Specific Guidelines: Industry Considerations

Industry should be more proactive and establish or strongly support non-profit information centres to provide science-based information on food safety and nutrition to the public, educators, health professionals, government officials and the media.

If consumer food handling, storage, or other practices can assist in controlling a food-borne illness or disease outbreak, then the industry should communicate clearly what actions the consumers should take. This communication should be based on a realistic estimate of the level of knowledge of the consumers. Safe handling, preparation and storage instructions should be presented in clear and unambiguous language, using graphics and pictograms when and where appropriate.

Judicious use of labelling holds promise as a risk management/risk communication strategy but its effectiveness needs further study. Labelling has been extensively used to convey certain types of information to the consumer, e.g., product composition, nutrition, weights and measures, and warnings on certain health issues. Labelling should not be used as a substitute for consumer education. In assessing the use of food labels in risk communication, it is essential that the public's concerns be identified and addressed.

Specific Guidelines: Local Considerations

Experience has shown that local government, being closer to the local population, is often more likely to be regarded as a trustworthy and credible source of risk information. Therefore local officials should be involved as key participants in ongoing risk communication activities.

Local bodies should be encouraged to integrate food safety information into primary health care which should also include key risk communication messages using appropriate delivery systems (e.g. mass media, street plays, posters, leaflets, video, etc.).

The need for evaluation of communication activities

Risk communication efforts and programmes need to be evaluated both regularly and systematically to determine their effectiveness and to provide for change where needed. Communication aims and objectives need to be clearly stated if an evaluation is to be effective. This could include the proportion of at-risk population to be reached, adoption of appropriate risk reduction practices, and the extent of resolution of the crisis. It is important to learn from both positive and negative risk communication experiences, in order to adjust and improve ongoing communication activities. Only through systematic evaluations, which are performed throughout the communication process, can that process be strengthened.