and descriptive data, such as the immediate impact of the risk communication program on the intended audience. This type of evaluation is the first step in determining whether the program achieved its goals, measuring both quantitative (how many people called a hotline number following a television news report) and qualitative data (changes to audience knowledge, perceptions and attitudes).
  • Impact evaluation, the most broad and comprehensive of the evaluation types, identifies long-term results as measured by changes in audience behavior (increase in enrollment of smoking-cessation programs) or improvement in health status (lower rate of childhood lead poisoning). Although impact evaluations can produce valuable information, they are often very expensive and require a generous commitment of time and effort. In addition, it is often hard to isolate results attributable specifically to a risk-communication program because of the influence of other strategies.
  •  

    Elements of Evaluation Design

    There are eight basic elements required of formal evaluation design regardless of evaluation type.

     

    1. Statement of Communication Objectives

    Clear, defined goals must be stated in order for evaluators to measure program effects.

    1. Definition of Data to be Collected

    This determines what is to be measured with respect to the stated program goals.

    1. Methodology

    Study design must be formulated to permit valid, reliable measurement of data.

    1. Instrumentation

    Instruments used in data collection must be designed and pretested. Such instruments can range some simple tally sheets to elaborate surveys and questionnaires.

    1. Data Collection

    This involves the physical process of gathering information.

    1. Data Processing

    This includes converting the collected data into a usable format for analysis

    1. Data Analysis

    This allows discovery of significant relationships through the application of statistical techniques.

    1. Reporting

    This involves compiling and recording evaluation results. From reported results, changes to the existing program can be made. In addition, new programs can be planned using reported results as a guide and benchmark.

     

    (NCI, 1992)

     

    Difficulties in Evaluation   

    A variety of barriers exist in evaluating health-risk communications programs. Awareness of these difficulties assists in anticipating possible roadblocks. Resources are a key constraint to optimal program evaluation. Limitations on funds, staffing, time, equipment and tools can interfere with evaluation. Additionally, when working with a variety of groups or agencies, it may be difficult to agree on program objectives and goals. A lack of clearly defined objectives leads to trouble in creating suitable measures for evaluating a program. Finally, it may be difficult to separate specific program influences when evaluating long-term effects because of the intended audience’s exposure to outside factors (ATSDR).

     

    Conclusions

     

    Effective health-risk communication is crucial to health promotion and disease prevention. The role of risk communication is becoming increasingly important as new threats surface. Recently, public concern about health risks has become heightened because of bioterrorism threats, West Nile virus, SARS, anthrax, dietary supplements, pesticides, mercury in childhood vaccines, and radiation from nuclear weapons testing, to name a few. As a result, health practitioners must learn and exercise effective methods for educating the public, calming fears that may lead to irrational behavior, responding to inquiries, offering resources and using various channels to communicate new information quickly and efficiently.

     

    The following rules provide a brief summary of some topics discussed in the chapter. This list, developed by Covello and Allen (1988), acts as a set of “commandments” for health-risk communications, and neatly summarizes several general rules of thumb.

     

    Seven Cardinal Rules of Risk Communication

    1. Accept and involve the public as a partner.

    Work to produce an informed public, not defuse public concerns or replace actions.

    1. Plan carefully and evaluate your efforts.

    Different goals, audiences, and media require different actions.

    1. Listen to the public’s specific concerns.

    People often care more about trust, credibility, competence, fairness, and empathy than about statistics and details.

    1. Be honest, frank and open.

    Trust and credibility are difficult to obtain; once lost, they are almost impossible to regain.

    1. Work with other credible sources.

    Conflict and disagreements among organization make communication with the public much more difficult.

    1. Meet the needs of the media.

    The media are usually more interested in politics than risk, simplicity than complexity, danger than safety.

    1. Speak clearly and with compassion.

    Never let your efforts prevent your acknowledging the tragedy of an illness, injury or death. People can understand risk information, but they still may not agree with you; some people will not be satisfied.


    References

     

    A.C. Nielsen. http://www.acneilsen.com. Accessed July 12, 2001. In: Nelson DE, Brownson RC, Remington PL, Parvanta C eds. Communicating Public Health Information Effectively: A Guide for Practitioners. Washington, DC: American Public Health Association; 2002.

     

    Agency for Toxic Substances and Disease Registry (ATSDR). A Primer for Evaluating Health Risk Communication. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service. http://www.atsdr.dcd.gov/HEC/evalp1.html

     

    Agency for Toxic Substances and Disease Registry (ATSDR). 2001. A Primer on Health Risk Communication Principles and Practices. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

     

    Allen FW. The government as a lighthouse: a summary of federal risk communication programs. In: Covello V, McCallum D, Pavlova M eds. Effective Risk Communication: The Role and Responsibility of Government and Nongovernment Organizations. New York: Plenum Press; 1989.

     

    Bennett P. Communicating About Risks to Public Health: Pointers to Good Practice. EOR Division, Department of Health. United Kingdom.

     

    Covello V, Allen F. 1988. Seven Cardinal Rules of Risk Communication. U.S. Environmental Protection Agency, Office of Policy Analysis, Washington, DC. In: Agency for Toxic Substances and Disease Registry (ATSDR). 2001. A Primer on Health Risk Communication Principles and Practices. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

     

    Covello V, McCallum D, Pavlova M eds. Effective Risk Communication: The Role and Responsibility of Government and Nongovernment Organizations. New York: Plenum Press; 1989.

     

    Fisher A, Pavlova M, Covello V. interagency Task Force on Environmental Cancer and Heart and Lung Disease, Committee on Public Education and Communication, January 1991, pp. xvi-xvii   http://www.health.gove/environment/Casestudies/csapp3.htm

     

    Glanz K, Rimer B, Lewis FM. 2002. Health Behavior and Health Education: Theory, Research, and Practice. Third Edition. San Francisco: Jossey-Bass.

     

    Lundgren R, Makin AM. 1998. Risk Communication: A Handbook for Communicating Environmental, Safety and Health Risks. Second Edition. Ohio: Battelle Press.

     

    National Cancer Institute (NCI). 1992. Making Health Communication Programs Work: A Planner’s Guide. U.S. Department of Health and Human Services. Public Health Service, National Institutes of Health, Office of Cancer Communications, NIH Publication No. 921493.

     

    Nelson DE, Brownson RC, Remington PL, Parvanta C eds. Communicating Public Health Information Effectively: A Guide for Practitioners. Washington, DC: American Public Health Association; 2002.

     

    Rosenstock L, Cullen MR. 1994. Textbook of Clinical Occupational and Environmental Medicine, Philadelphia: Saunders; 68.