July 14, 2022—Elena Savoy is a Senior Investigator in the Department of Biostatistics at the Harvard TH Chan School of Public Health, where she is Associate Director of the Emergency Preparedness, Research, Evaluation and Practice (EPREP) Program and co-founder of the IRIS Coalition. She recently co-directed a workshop for public health practitioners in Global Health Security Conference in Singapore on countering misinformation and disinformation in emergency risk communication.
Q: What is EPREP?
A: The preparedness program began in 2002, just after 9/11, with initial funding from the Centers for Disease Control and Prevention and a focus on training US public health personnel. It has evolved into a portfolio of national and international workforce development and research activities around the key capabilities governments need to respond to large-scale emergencies, such as pandemics, hurricanes and terrorism.
I started working with the program in 2004 when I was getting my MPH in Quantitative Methods and have been there ever since.
Q: What do your emergency risk communication workshops look like and what do you hope participants take away?
A: Our workshops are aimed at public health personnel at various levels, including local and state public health departments, or public health departments in other countries. They are very hands-on. We walk participants through a simulation exercise, gradually adding more information over the course of approximately three hours. At the recent workshop in Singapore, participants responded to a scenario involving fictional social media posts questioning the safety of the COVID vaccine in children. The goal was for them to leave with priorities for action they can take to improve their emergency communication plans.
During the simulation, the first thing participants wanted to do was check the facts. You shouldn’t assume something is misinformation. You need to see if there is any data supporting or substantiating that particular information. Second, they focused on listening to the audience and trying to understand which segments are most affected. Finally, they wanted to identify people within these communities who might be effective in reaching members of the public who distrust the government.
Q: You suggested that practitioners should “prebunk” misinformation rather than just trying to debunk it when it’s already out there. Why is this, and what does it imply?
A: Debunking doesn’t seem to work because there’s just too much information on social media and elsewhere on the internet. It would be very difficult for an agency to try to demystify all the disinformation out there, or even reach the people spreading it, given the information echo chambers that exist. You end up debunking misinformation for people who already don’t believe it.
The idea of prebunking is to educate people against misinformation. Rather than trying to convince someone not to believe something, you talk about common patterns in misinformation posts and videos and the industry that exists to make money from it, such as selling a fraudulent cure for COVID-19. You alert people to certain techniques that creators use to manipulate emotions, such as creepy music or tone of voice in videos, and narratives centered on “corrupt elites” or harming children. You give people the tools to help them critically evaluate what they see or hear.
We did a randomized trial where we exposed people to a prebunking video, followed by a video with misinformation about the COVID-19 vaccine. A control group watched a video on how to clean your washing machine. We found that people exposed to prebunking video were not only less vaccine hesitant, but were also less likely to share misinformation videos with their peers.
Building trust with the audience is essential for effective communication. Public health practitioners must listen to people and value their emotional experiences and concerns. Otherwise, you can end up pushing people away and increasing polarization.
What we are talking about with practitioners is a culture shift that needs to happen in communicating around public health emergencies. For example, we have seen during the pandemic that many government agencies around the world have a top-down way of communicating with the public. They push their messages without testing them. But others have done better by finding ways to exploit the data—for example, from social media and population surveys, to inform their communication strategies.
We interviewed communications managers from government agencies in several countries to understand their approaches to sharing public health messages. Ultimately, we will produce a roadmap for effective communication that will help them improve their agencies’ abilities to communicate vital health information to the public.