Communicating with the Public in an Emergency Lessons

Communicating with the Public in an Emergency: Lessons from Rapid Polling During H 1 N 1 Robert Blendon, Sc. D Gillian Steel. Fisher, Ph. D, MSc Harvard Opinion Research Program Harvard School of Public Health Funded as part of a cooperative agreement between HSPH, the National Public Health Information Coalition, and the CDC

Emergency Polling • Technology transfer from politics • Support communications and material response in an emergency • Telephone polls using randomized samples (landline/cell) • Conducted at baseline, mid-crisis and aftermath • 14 Polls during H 1 N 1: http: //www. hsph. harvard. edu/research/horp 2

What Communications did the Public See and Hear? 3

Public’s Exposure to H 1 N 1 Flu Communications % saying since April 2009, they have seen advertising that provides information about ways to keep them and their family safe from H 1 N 1 Yes, have Very often Somewhat often Not very often Not at all often Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 4

Public’s Assessment of State and Local PHD Communications Concerning the H 1 N 1 Outbreak % saying state or local public health departments did an… Excellent job Good job Fair job Poor job Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 5

Public’s Exposure to H 1 N 1 Flu Communications in Different Locations % saying, since the beginning of the H 1 N 1 outbreak in April 2009, they have seen or heard advertising that provides information about ways to keep them and their family safe from H 1 N 1… On television On the radio In newspapers At schools, colleges, or daycares On billboards On websites At work At airports Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 6

Public Efforts to Get Information on H 1 N 1 From Their Local or State Public Health Department’s Website Got all information needed at website or had to go elsewhere** Gone to website for information about staying healthy from H 1 N 1 Got all 73% Did not get all 27% No 89% Yes 11% Easy or difficult to understand information from website** Easy 93% Difficult 6% **n = 296 Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 7

What non-pharmaceutical flu-prevention behaviors did people adopt? Did communications play a role? 8

Adoption of Key Flu Prevention Behaviors Among the Public % saying, since the beginning of the H 1 N 1 outbreak in April 2009, they have, at any point, done the following in response to H 1 N 1 Washed hands more frequently Used hand sanitizer more frequently Taken any steps to avoid being near someone who has flu-like symptoms More frequently covered mouth and nose with tissue when coughing or sneezing More frequently coughed or sneezed into elbow or shoulder Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 9

Public’s Exposure to H 1 N 1 Flu Messages % saying, since the beginning of the H 1 N 1 outbreak in April 2009, they have seen advertising suggesting that they should… Wash their hands or use sanitizer frequently Stay home from work, school, or other outside activities if sick with H 1 N 1 Cover mouth and nose with tissue when coughing or sneezing Cough or sneeze into elbow or shoulder Clean or disinfect their surroundings Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 10

Flu Prevention Behaviors Among the Public: By Exposure to Specific Messages % saying, since the beginning of the H 1 N 1 outbreak in April 2009, they have, at any point, done the following in response to H 1 N 1 * Wash hands more frequently Used hand sanitizer more frequently * More frequently covered mouth and nose with tissue when coughing/sneezing * * More frequently coughed or sneezed into elbow or shoulder More frequently cleaned or disinfected home or workspace * *Statistically significantly different from respondents who say they did not see an ad recommending that they do this Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 11

What percentage of people got vaccinated? Did communications play a role? 12

H 1 N 1 Vaccination Among the Public % saying, since a vaccine to protect specifically against the new H 1 N 1 flu first became available in October 2009 Got the H 1 N 1 flu vaccine for self Did NOT get H 1 N 1 flu vaccine for self Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 13

Public’s Exposure to the Message: Take the H 1 N 1 Vaccine % saying, since the beginning of the H 1 N 1 outbreak in April 2009, they have seen advertising suggesting that they should get the H 1 N 1 flu vaccine Yes No Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 14

H 1 N 1 Flu Vaccine Uptake Among Adults: By Exposure to Ad Saying Get the H 1 N 1 Flu Vaccine % saying, since the beginning of the H 1 N 1 outbreak in April 2009, they have gotten the H 1 N 1 flu vaccine Saw the message * Did NOT see the message *Statistically significantly different from respondents who say they did not see an ad recommending that they get the vaccine Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 15

H 1 N 1 Vaccination Among the Public: By Concern About Illness % saying they have gotten H 1 N 1 vaccine for themselves Among those who say they were very concerned they or family member would get sick 38% Among those who say they were somewhat concerned they or family member would get sick Among those who say they were not concerned they or family member would get sick * ** 27% 16% *Statistically significantly different from respondents who say they have been “somewhat concerned” and not concerned (including “not very” or “not at all” concerned) at the 95% confidence level **Statistically significantly different from respondents who say they have been not concerned (including “not very” or “not at all” concerned) at the 95% confidence level Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 16

Public Concern About Getting Sick with H 1 N 1 Over Time % saying they are concerned that they or someone in their immediate family may get sick from H 1 N 1 during the next 12 months… 12/17: Sebelius Announcement Vaccine Released More Generally 40% 12/17/09 NOTE: Timeline not to scale Harvard Opinion Research Program, Harvard School of Public Health, April 29, 2009, June 22 -28, 2009, September 14 -20, 2009, December 16 -17, 2009 and January 20 -24, 2010. 17

H 1 N 1 Vaccination Among the Public: By View of Safety of H 1 N 1 Flu Vaccine % saying they have gotten H 1 N 1 vaccine for themselves 46% * Among those who say the H 1 N 1 flu vaccine is very safe Among those who say the H 1 N 1 flu vaccine is somewhat safe Among those who say the H 1 N 1 flu vaccine is NOT safe 15% ** 4% *Statistically significantly different from respondents who say that the H 1 N 1 flu vaccine is “somewhat safe” and “not very” or “not at all” safe generally for most people to take at the 95% confidence level **Statistically significantly different from respondents who say that the H 1 N 1 flu vaccine is “not very” or “not at all” safe generally for most people to take at the 95% confidence level Harvard Opinion Research Program, Harvard School of Public Health, March 17 – April 11, 2010. 18

Public Views of H 1 N 1 Vaccine Safety Over Time % saying they believe the vaccine is very safe… NOTE: Timeline not to scale Harvard Opinion Research Program, Harvard School of Public Health September 14 -20, 2009, January 20 -24, 19 2010 and March 17 -April 11, 2010.

Lessons from Polling During H 1 N 1 • Exposure to public health messaging was widespread • Traditional media plays a critical, primary role in getting the message out, while online and social media are an important support • Many people followed key recommendations pertaining to NPI behaviors, and those who did were more likely to have seen relevant messages • Although most people saw vaccine-specific messages, most people did not get vaccinated • Vaccine messaging faced key challenges related to lack of concern about the seriousness of the illness and concern about the safety of the vaccine 20

Communicating with the Public in an Emergency: Lessons from Rapid Polling During H 1 N 1 gsteel@hsph. harvard. edu http: //www. hsph. harvard. edu/research/horp 21