New trends and directions in risk communication: combating disease threats at the animal-human-ecosystem interface

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New trends and directions in risk communication: combating disease threats at the animal-human-ecosystem interface …

New trends and directions in risk communication: combating disease threats at the animal-human-ecosystem interface
Keynote presentation by

Thomas Abraham

Director, Public Health Communications Programme,

The University of Hong Kong




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  • 1. The Anthropological Imperative in “Risk Communication” Benjamin Hickler, MA, Ph.D. Tufts University Cummings School of Veterinary Medicine Dept. of Environmental and Population HealthFooter Text 4/27/2011 1
  • 2. Objectives• Explain why anthropological frameworks and community participation are particularly relevant for addressing “One Health” challenges associated with emerging zoonotic infections.• Outline potential models for applying anthropological tools to practical problems of outbreak prevention and response.• Outline key concepts for anthropologically informed strategies for social mobilization and behavior change communication. Footer Text 4/27/2011 2
  • 3. 4/27/2011 Footer Text 3
  • 4. Factors contributing to emerging zoonotic infectionsFrom Marsh Inc. Economic and Social Impact of EIDs, 2010. Derived from Report of the WHO/FAO/OIEjoint consultation on emerging zoonotic diseases. May 2004.
  • 5. Human behavior is the common denominator…• People’s relationships with animals are culturally and socially mediated, often differ by age, gender, and socioeconomic status, and in some cases are characterized by passionate attachment.• People’s livelihoods are directly affected by efforts to control zoonotic infections. This recognition should underpin all “One Health” endeavors.• Therefore, different stakeholders are likely to have very different perceptions of the risks associated with pathogens like H5N1. 5
  • 6. Beyond “Risk Communication”•Risk communication used to be conceived in terms ofa top-down model in which expert consensus isbroadcast to a passive public in order to bringpopular perceptions in line with expert truth.•Now there is growing recognition that publics areactive participants in sociocultural and politicalprocesses of defining and explaining risk.•To oversimplify, the top-down broadcast model hasbeen replaced by a dialogical, participatory modelincluding an active engagement with publics within acompetitive informational environment.
  • 7. What do we mean by “participation?”Pretty et al (1995) delineate seven different types of participation.•Passive participation: People participate by being told what is going to happen or has already happened.It is a unilateral announcement by an administration or project management without any listening topeople’s responses. The information being shared belongs only to external professionals.•Participation in information giving: People participate by answering questions posed by extractiveresearchers using questionnaire surveys or similar approaches. People do not have the opportunity toinfluence proceedings, as the findings of the research are neither shared nor checked for accuracy.•Participation by consultation: People participate by being consulted, and external agents listen to views.These external agents define both problems and solutions, and may modify these in the light of people’sresponses. Such a consultative process does not concede any share in decision-making, and professionalsare under no obligation to take on board people’s views.•Participation for material incentive: People participate by providing resources, e.g. labor, in return for food,cash or other material incentives. Much on-farm research falls in this category, as farmers provide the fieldsbut are not involved in the experimentation or process of learning. It is very common to see this calledparticipation, yet people have no stake in prolonging activities when the incentives end.•Functional participation: People participate by forming groups to meet predetermined objectives related tothe project, which can involve the development or promotion of externally initiated social organization. Suchinvolvement does not tend to be at early stages or project cycles of planning, but rather after majordecisions have been made. These institutions tend to be dependent on external initiators and facilitators, butmay become self-dependent.•Interactive participation: People participate in joint analysis, which leads to action plans and the formationof new local institutions or the strengthening of existing ones. It tends to involve interdisciplinarymethodologies that seek multiple objectives and make use of systematic and structured learning processes.These groups take control over local decisions, and so people have a stake in maintaining structures orpractices.•Self-mobilization: People participate by taking initiatives independent of external institutions to changesystems. Such self-initiated mobilization and collective action may or may not challenge existing inequitabledistributions of wealth and power. Pretty, J.N., Guijt, I., Thompson, J. and Scoones, I. 1995. Participatory Learning and Action. 7 A trainers Guide. International Institute for Environment and Development, London.
  • 8. Uses of Anthropology in Behavior Change Communication (BCC)• Identify the who, what, where, when, and how of risky practices/behaviors – o Tools include environmental scans, situational analyses, market and value-chain studies, structured and unstructured observation, etc. o Necessary to define behavioral objectives.• Learn why who does what, where, when and how. o Tools include participatory learning, focus group discussions, key informant interviews, rapid ethnographic studies, etc. o Usually necessary to achieve behavioral objectives.• Prevent Systemic Insanity – Doing the same thing over and over again expecting different results. o Examples include pre- and post-testing, “framing,” cultural competence, visual literacy, and M+E practices like Participatory Impact Assessment. 8
  • 9. Footer Text 4/27/2011 10
  • 10. Why people do what they do…Whereas psychological frameworks tend to look forindividual motivators, anthropological approachesemphasize shared cultural, social, political andstructural factors that shape—promote or constrain—behaviors. (Importantly, not all are comms issues; cf.Dunn’s framework)Useful concepts for cultural analysis and comms include:•Explanatory models and ethnomedical systems•Illness behavior and “hierarchies of resort”•Gender and the household production of health Footer Text 4/27/2011 12
  • 11. Footer Text 4/27/2011 13
  • 12. People do what “makes sense”This is practically an anthropological axiom.If a behavior or belief does not make sense to theanalyst, then we probably don’t understand thereasoning behind it.No behavior or belief should simply be dismissed asirrational, especially if it seems to resist modification. Footer Text 4/27/2011 14
  • 13. Applying Anthropological Concepts to Social Marketing• Social marketing is the process of applying commercial marketing techniques to social issues in order to create behavior change (Kotler and Andreasen 1987)• Social marketing is consumer-driven - the focus population or target audience is the central focus for all steps of a social marketing campaign• Crucially, each step of the campaign requires continual input from the focus audi-ence (recall Pretty’s typology)
  • 14. The 4Ps of Social Marketing• Product is the goal or behavior we would like to change or maintain.• Price is what people must give up in order to receive the product’s benefit.• Promotion is the overall strategy (messages and media, content and channels—think MS CREFS) used to persuade people to accept the “price” for the “product.”• Place is the setting in which an audience encounters the social marketing strategy. “Place” includes both the communication channel (e.g., mass media, schools, village council meetings, etc.) as well as the setting in which the targeted behavior occurs.
  • 15. Challenges of Social Marketing• Each step of the campaign requires input from the focus audi-ence. This can be time-consuming and labor-intensive.• The “product” must be presented in a way that rein-forces core needs and values.• Cannot stop only at process evaluation, for example counting the number of times a person saw a message or assessing whether the audience liked a message. It can be challenging to evaluate the impact of social marketing cam-paigns on attitudes or behavior.• The effectiveness of social marketing is primarily demonstrated when it is combined with other strategies. Because social marketing focuses on individual and collective behavior rather than policy and envi-ronmental conditions, social marketing campaigns need to be implemented along with other strategies that impact policies, laws, and norms at institutional, environmental, and political levels.• Social marketing has been challenged by some researchers. Wallack (1990) argues that it promotes dependence on experts and diverts attention from public policies and structural factors. For example, in less developed countries, social marketing strategies have focused on changing habits instead of working to ensure clean and healthy water supplies (Wallack, et al., 1993). 17
  • 16. Thank You! 18
  • 17. Deconstructing Media Messages • What is the purpose of the message? • What techniques are used to attract your attention? • What lifestyles, values and points of view are represented? • How might different people interpret the message differently? • What is omitted from this message? Dr. Renee Hobbs, Clark University Media Literacy Project
  • 18. Culture is an integrated pattern of human behavior which includes but is not limited to: roles values rituals communication languages relationships courtesies thought beliefs practices customs manners of interacting expected behaviors… of a racial, ethnic, religious, social, disability or political group;ability to transmit the above to succeeding generations;dynamic in nature. Slide Source: National Center for Cultural Competence,2008
  • 19. Effective Media Messages• Are based on fact and focus on immediate consequences• Clearly state the desired behavior and its benefits• Use positive emotional appeals and/or humor• Appeal to logic and reason• Show desired behavior
  • 20. Finding Information About Communities• Consulting the “Experts” o Individuals and groups in the community o Similar communities o Academicians• Gathering “Data” o Census data, maps, and other “data” o Epidemiological data/trends and articles related to identified problem o Behavior and social science literature o Local newspapers
  • 21. Cultural Competency• The understanding and appreciation of cultural differences and similarities within and between groups.• A willingness and ability to draw on community- based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing prevention strategies (programs, policies, and practices).
  • 22. Dress age An Iceberg gender language race or ethnicity Concept of Culture physical characteristics eye behavior facial expressions body language sense of self gender identity notions of modesty concept of cleanliness emotional response patterns rules for social interaction child rearing practices ©decision-making processes ©approaches to problem solving concept of justice value individual vs. group taste and style perceptions of mental health, health, illness, disability patterns of superior and subordinate roles in relation to status by age, gender, class sexual identity & orientation and much more…Slide Source: The National Center for Cultural Competence, 2008
  • 23. Community Prevention Design Inputs Outputs Short Term Intermediate Outcomes Outcomes Strategy 1 Long Term/Entity A Community Change Strategy 2 Strategy 1Entity B Strategy 2 Incidence & Strategy 1 Prevalence ofEntity C Problems Strategy 2 Behavior Outcome Measures Program Measures 30
  • 24. Community Prevention Design Inputs Outputs Short Term Intermediate Outcomes Outcomes Strategy 1 Long Term/Entity A Community Change Strategy 2 Strategy 1Entity B Strategy 2 Incidence & Strategy 1 Prevalence ofEntity C Problems Strategy 2 Behavior Outcome Measures 30 Program Measures 26