Risk communication and community engagement during COVID-19

"I Didn't Know Him Before the Pandemic… Now He's on My Speed Dial": Strengthening Collaboration Between Infectious Diseases Physicians and State and Local Public Health for Future Public Health Emergencies

BACKGROUND

Infectious diseases (ID) physicians play a crucial role in public health emergencies. Effective collaboration between public health agencies and healthcare providers is essential for a coordinated response. However, there is limited information on how ID physicians and health departments collaborate and which areas need to be improved. Here, we identify ways to enhance public health preparedness through increased collaboration between ID physicians and state, tribal, local, and territorial health departments.

METHODS

We performed a secondary qualitative analysis of 37 telephone interviews conducted using a semistructured discussion guide. Interviews were conducted from July 2023 through September 2023 as part of a pandemic preparedness needs assessment by the Infectious Diseases Society of America's COVID-19 Real-Time Learning Network. Participants included ID physicians (n = 13), public health workers (n = 7), healthcare facility-based pandemic leaders (n = 7), and national stakeholders (n = 10).

RESULTS

While some jurisdictions had robust connections between ID physicians and public health staff, lack of coordination in other areas led to duplication of efforts, confusion, and underutilization of resources. Respondents indicated that collaboration can be strengthened over time. Recommendations included better data systems, standardized reporting procedures, early dissemination of updates, and training of ID physicians in the incident command structure and media communication.

CONCLUSIONS

The opportunity to build on institutional knowledge from the coronavirus disease 2019 pandemic will be lost without a commitment of time, resources, and planning. Public health officials can use this experience as a catalyst for building strong collaborative relationships between ID physicians and public health practitioners, a cornerstone of future pandemic response.

Experiences of Public Health Professionals Regarding Crisis Communication During the COVID-19 Pandemic: Systematic Review of Qualitative Studies

BACKGROUND

The COVID-19 pandemic emerged in the digital age and has been called the first "data-driven pandemic" in human history. The global response demonstrated that many countries had failed to effectively prepare for such an event. Learning through experience in a crisis is one way to improve the crisis management process. As the world has returned to normal after the pandemic, questions about crisis management have been raised in several countries and require careful consideration.

OBJECTIVE

This review aimed to collect and organize public health professionals' experiences in crisis communication to the public during the COVID-19 pandemic.

METHODS

We searched PubMed, MEDLINE, CINAHL, Web of Science, Academic Search Complete, PsycINFO, PsycARTICLES, and Communication Abstracts in February 2024 to locate English-language articles that qualitatively investigated the difficulties and needs experienced by health professionals in their communication activities during the COVID-19 pandemic.

RESULTS

This review included 17 studies. Our analysis identified 7 themes and 20 subthemes. The 7 themes were difficulties in pandemic communication, difficulties caused by the "infodemic," difficulties in partnerships within or outside of public health, difficulties in community engagement, difficulties in effective communication, burnout among communicators, and the need to train communication specialists and establish a permanent organization specializing in communication.

CONCLUSIONS

This review identified the gaps between existing crisis communication guidelines and real-world crisis communication in the digital environment and clarified the difficulties and needs that arose from these gaps. Crisis communication strategies and guidelines should be updated with reference to the themes revealed in this review to effectively respond to subsequent public health crises.

TRIAL REGISTRATION

PROSPERO CRD42024528975; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=528975.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/58040.

Disseminating for Equity and Justice: Findings From the LIGHT Global Crowdsourcing Open Contest to Reimagine Public Health

OBJECTIVES

To describe how crowdsourcing contests soliciting art, letters, stories, and poetry were focused on promoting well-being and health information dissemination from the public to the public.

DESIGN

LIGHT (Leaders Igniting Generational Healing and Transformation) launched three online crowdsourcing open calls that were designed using the World Health Organization Tropical Diseases Research (WHO/TDR) practical guide on crowdsourcing in health and health research, which includes the following steps: convening a steering committee, promoting the open call, receiving and judging entries, recognizing finalists, and sharing solutions.

SETTING

The crowdsourcing open calls were held online via the Submittable platform.

PARTICIPANTS

A total of 508 submissions by the public were evaluated with the majority of authors and artists identified as female (25.4%) followed by male (15.4%) and ages ranging from 11 to 82 years old.

INTERVENTION

This study utilized crowdsourcing open call contests to engage the public in generating art, letters, stories, and poetry as strategies to effectively promote well-being and disseminate health information to the public.

MAIN OUTCOME MEASURED

Effectiveness and creativity of the crowdsourced submissions in proposing new strategies for promoting well-being and disseminating health information through art, letters, stories, and poetry.

RESULTS

The three crowdsourcing open calls received 508 eligible entries (Open call 1 = 155; Open call 2 = 191; Open call 3 = 162). Informed by the combined and modified design justice principles creativity, connections, and community, six unique dissemination strategies emerged for dissemination: (a) positive intersectionality, (b) destigmatization, (c) strength-based, (d) collective approach, (e) cultural identity, and (f) unity in healing. Collectively, there was consensus to innovate dissemination strategies to enhance the appeal of research findings and health communication.

CONCLUSIONS

Rebuilding and building public-driven dissemination strategies will involve reimagining and innovating current dissemination approaches. LIGHT shows the feasibility of engaging a diverse broad audience to generate ideas and perspectives on promoting health information dissemination to the public.

Building evidences in Public Health Emergency Preparedness ("BePHEP" Project)-a systematic review

INTRODUCTION

Humanitarian crises exacerbate the vulnerability of already fragile healthcare systems and significantly increase the risk of infectious disease outbreaks in low- and middle-income countries (LMICs). This systematic review aims to evaluate strategies and interventions implemented in LMICs to prevent and manage infectious diseases outbreaks during humanitarian crises from 2018 to 2023.

METHODS

A comprehensive literature search was conducted across Scopus, PubMed, and Web of Science, adhering to the PRISMA guideline and the SPIDER framework to identify relevant studies. The review included studies published between 2018 and 2023 focusing on infectious disease prevention and management in LMICs during humanitarian crises. Study quality was assessed using the Joanna Briggs Institute checklist.

RESULTS

Eleven studies were identified from 1,415 unique articles. These studies addressed diverse interventions, including vaccination campaigns, epidemiologic surveillance, and integrated health services. Cholera outbreaks in Haiti and Mozambique, triggered by gang violence, internal migration, and Cyclone Kenneth, were addressed through epidemiological surveillance, case management, WASH (Water, Sanitation, and Hygiene) service improvements, and oral vaccination campaigns. Mathematical models guided cholera vaccination in Thailand's refugee camps. In India, surveillance and rapid response measures successfully prevented infectious disease outbreaks during the Kumbh Mela gathering. The Philippines improved response times to climate-related disasters using point-of-care testing and spatial care pathways. Despite challenges in Yemen, evaluating malaria surveillance systems led to recommendations for integrating multiple systems. Uganda developed a national multi-hazard emergency plan incorporating vaccination, communication, and risk management, proving useful during the refugee crisis and Ebola outbreak. In South Sudan, integrating immunisation services into nutrition centres increased vaccination coverage among children. Nigeria experienced a rise in measles cases during armed conflicts despite vaccination efforts, while visual communication strategies improved SARS-CoV-2 vaccination rates.

CONCLUSION

These interventions highlight the importance of multimodal, targeted, and collaborative responses to address complex health crises without relying on unsustainable investments. Despite the effectiveness of these interventions, infrastructure limitations, insecurity, and logistical constraints were noted. These findings emphasize the need for adaptable and resilient healthcare systems and international collaboration to safeguard the right to health during complex humanitarian crises.

Challenges of community participation in health emergency and disaster risk management in an Iranian context: a qualitative study

Background

Disasters are considered one of the major threats to the health of communities. Given the global spread of disasters, there has been a renewed emphasis in recent years on using community participation approaches in disaster risk management. Community participation in field of emergency and disaster health in Low and Middle-income countries faces a lot of challenges.

Objective

The objective of this study is to explore the specific challenges faced by communities in Iran concerning their participation in health emergency and disaster risk management.

Methods

In this study, a qualitative content analysis as research methodology was employed. Purposeful sampling was conducted from June 2023 to May 2024 among community members who were willing to participate and had experience collaborating during disasters. Data were collected through semi-structured in-depth interviews and analyzed using Graneheim and Lundman's method. The rigor of the study was ensured using Lincoln and Guba's criteria. Each interview was recorded, transcribed into a word document, and then uploaded into MAXQDA (2020). A total of 23 interviews were conducted with 20 participants.

Results

There were 15 males and five females participating in the study including healthcare managers, academic people, and laypeople. Data analysis revealed nine distinct categories, which were grouped into three overarching themes based on their similarities. These themes addressed issues of insufficient risk perception, community traumatization, and poor social capital.

Conclusion

This study sheds light on the multifaceted challenges that hinder effective community participation in health emergency and disaster risk management in Iran. Addressing these barriers is essential for enhancing community resilience and ensuring effective disaster preparedness. To overcome these challenges, it is imperative for policymakers, healthcare managers, and community leaders to collaborate and implement comprehensive strategies that foster community participation.

A Survey on Companion Animal Owners' Perception of Veterinarians' Communication About Zoonoses and Antimicrobial Resistance in Germany

The intimate bonds between humans and their pets create favourable conditions that support the mutual transmission of pathogens in either direction. In this context, veterinarians are essential in informing and educating pet owners about health risks linked to zoonotic pathogens and antimicrobial resistance (AMR). To effectively convey this information, veterinarians should have strong communication skills. To gather insights on pet ownership, veterinary consultations, and risk communication, an online questionnaire was used to survey dog and cat owners in Germany. The survey evaluated the frequency and perception of communication concerning zoonotic pathogens and AMR, deriving a communication score. The findings showed that pet owners rated veterinarian communication with a high average score, reflecting a high satisfaction level. The longer pet owners had been clients, the more frequently they received information on zoonoses and AMR, and the better they rated the communication. However, the results also indicated that the amount of information on zoonoses and/or AMR provided by veterinarians was still lower than desired by pet owners. Risk factors, including pathogen detection, vulnerable individuals, owning imported animals, and feeding them raw meat, fish, offal, or uncooked bones, were regularly present. These findings underscore the critical role of risk communication in preventing zoonoses and AMR.

Innovative Regional Services and Heterogeneous Communication Channels: Results from the Nationwide German egePan Project for Pandemic Management

Background: In the COVID-19 pandemic, novel regional services and communication channels emerged across all sectors of the German healthcare system. To contribute to pandemic preparedness, this study aims to describe newly established services in response to the COVID-19 pandemic from a stakeholder perspective and to examine the interprofessional communication channels, applying a nationwide cross-sectional approach. Methods: A nationwide sample of German healthcare stakeholders comprising general practitioners, associations of statutory health insurance physicians, hospital medical directors, local health departments, rescue coordination centres, medical directors of emergency services, outpatient nursing services, nursing homes, community care access centres, and hospital nursing managers was surveyed. A web-based questionnaire asked for their level of participation in newly implemented regional COVID-19 services and communication channels. Stakeholders' level of recommendation was measured using the Net Promotor Score (NPS), a metric that assesses their satisfaction towards the services surveyed. Results: In total, 1312 healthcare stakeholders participated in the survey. Diagnostic centres (23.0-90.9%), COVID-19 wards in hospitals (40.5-92.1%), emergency medical vehicles designated solely for COVID-19 patients (16.5-68.4%), and crisis intervention teams (11.6-30.6%) exhibited the highest rates of engagement. The services receiving the highest recommendation for future use were COVID-19 focus practices (NPS: 33.4-43.7), COVID-19 wards in hospitals (NPS: 47.6-84.4), transportation of COVID-19 patients exclusively by predefined professional groups (NPS: 12.5-36.4), and newly implemented digitally supported nursing services (NPS: 58.3-100.0). Telephones emerged as the most frequently used communication channel (58.0-96.7%), while email was the primary digital channel (23.7-81.5%). Conclusions: During the COVID-19 pandemic, Germany experienced significant variation in the implementation of pandemic-related services across healthcare sectors, with stakeholders prioritising services built on existing healthcare structures. Developing a proactive digital infrastructure to connect healthcare professionals from different sectors is crucial for better future pandemic management.

Integrating mental health and psychosocial support (MHPSS) into infectious disease outbreak response: Results of an expert consensus study

Objectives

Outbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response.

Methods

A participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response.

Results

Systematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing.

Conclusions

Despite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.

Experiences of Governments and Public Health Agencies Regarding Crisis Communication During the COVID-19 Pandemic in the Digital Age: Protocol for a Systematic Review of Qualitative Studies

BACKGROUND

Governments and public health agencies worldwide experienced difficulties with social media-mediated infodemics on the internet during the COVID-19 pandemic. Existing public health crisis communication strategies need to be updated. However, crisis communication experiences of governments and public health agencies worldwide during the COVID-19 pandemic have not been systematically compiled, necessitating updated crisis communication strategies.

OBJECTIVE

This systematic review aims to collect and organize the crisis communication experiences of senders (ie, governments and public health agencies) during the COVID-19 pandemic. Our focus is on exploring the difficulties that governments and public health agencies experienced, best practices in crisis communication by governments and public health agencies during the COVID-19 pandemic in times of infodemic, and challenges that should be overcome in future public health crises.

METHODS

We plan to begin the literature search on May 1, 2024. We will search PubMed, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, Communication Abstracts, and Web of Science. We will filter our database searches to search from the year 2020 and beyond. We will use a combination of keywords by referring to the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) tool to search the abstracts in databases. We intend to include qualitative studies on crisis communication by governments and public health agencies (eg, officials, staff, health professionals, and researchers) to the public. Quantitative data-based studies will be excluded. Only papers written in English will be included. Data on study characteristics, study aim, participant characteristics, methodology, theoretical framework, object of crisis communication, and key results will be extracted. The methodological quality of eligible studies will be assessed using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A total of 2 independent reviewers will share responsibility for screening publications, data extraction, and quality assessment. Disagreement will be resolved through discussion, and the third reviewer will be consulted, if necessary. The findings will be summarized in a table and a conceptual diagram and synthesized in a descriptive and narrative review.

RESULTS

The results will be systematically integrated and presented in a way that corresponds to our research objectives and interests. We expect the results of this review to be submitted for publication by the end of 2024.

CONCLUSIONS

To our knowledge, this will be the first systematic review of the experiences of governments and public health agencies regarding their crisis communication to the public during the COVID-19 pandemic. This review will contribute to the future improvement of the guidelines for crisis communication by governments and public health agencies to the public.

TRIAL REGISTRATION

PROSPERO CRD42024528975; https://tinyurl.com/4fjmd8te.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/58040.

The impact of social cohesion and risk communication on excess mortality due to COVID-19 in 213 countries: a retrospective analysis

BACKGROUND

Tools for assessing a country's capacity in the face of public health emergencies must be reviewed, as they were not predictive of the COVID-19 pandemic. Social cohesion and risk communication, which are related to trust in government and trust in others, may have influenced adherence to government measures and mortality rates due to COVID-19.

OBJECTIVE

To analyse the association between indicators of social cohesion and risk communication and COVID-19 outcomes in 213 countries.

RESULTS

Social cohesion and risk communication, in their dimensions (public trust in politicians, trust in others, social safety nets, and equal distribution of resources index), were associated with lower excess mortality due to COVID-19. The number of COVID-19-related disorder events and government transparency were associated with higher excess mortality due to COVID-19. The lower the percentage of unemployed people, the higher the excess mortality due to COVID-19. Most of the social cohesion and risk communication variables were associated with better vaccination indicators, except for social capital and engaged society, which had no statistically significant association. The greater the gender equality, the better the vaccination indicators, such as the number of people who received all doses.

CONCLUSION

Public trust in politicians, trust in others, equal distribution of resources and government that cares about the most vulnerable, starting with the implementation of programs, such as cash transfers and combating food insecurity, were factors that reduced the excess mortality due to COVID-19. Countries, especially those with limited resources and marked by social, economic, and health inequalities, must invest in strengthening social cohesion and risk communication, which are robust strategies to better cope with future pandemics.

"Spine to the future"-A narrative review of anatomy engagement

Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.

Are self-test kits still relevant post COVID-19 pandemic? Qualitative study on working adults' perceptions

BACKGROUND

Other than self-isolation measures, self-testing is likely to reduce the transmission of COVID-19 and may become a valuable approach in future outbreaks of infectious diseases. This study delves into the perceptions and experiences of working adults who utilised COVID-19 self-test kits in Singapore during the post-pandemic period.

METHODS

Employing a qualitative descriptive design, in-depth interviews were conducted with 40 working adults from diverse occupations, with a median age of 35 years. Thematic analysis of transcribed interviews was carried out by two independent qualitative research-trained researchers.

RESULTS

Facilitators included personal motivations like safeguarding vulnerable individuals and the convenience of user-friendly self-test kits. Proximal environmental factors encompassed situations involving close contacts and large gatherings, while distal factors involved workplace regulations, public health campaigns, mass media influence, and trust in authorised kits. Nonetheless, barriers include discomfort, cost, uncertainty about proper technique, and evolving testing requirements. Positive test results prompted participants to notify contacts and self-isolate, whereas negative results encouraged a return to normalcy. Participants recommend sustained testing for new variants and vulnerable groups, though some view it as unnecessary due to pandemic normalisation.

CONCLUSIONS

Self-testing emerged as a social phenomenon influenced by societal obligations and relationships across multiple levels. Effective communication strategies may play a role in fostering trust and ensuring that working adults sustain the practice of self-testing; therefore, further research is needed to explore their potential impact. Such efforts could be valuable for maintaining vigilance and achieving effective disease control in the post-COVID-19 pandemic landscape.

COVID-19 preventive measures in Rohingya refugee camps: An assessment of knowledge, attitude and practice

BACKGROUND

Although many studies were conducted on COVID-19 knowledge, attitude, and practice (KAP) among the general population in many countries, very little is known about refugees, particularly Rohingya refugees in Cox's Bazar. A vast array of risk communication and community engagement (RCCE) interventions were implemented in Cox's Bazar with the intent of reducing disease transmission by empowering the community to adopt public health measures.

OBJECTIVES

The study aimed to assess the level of knowledge, attitude and practice (KAP) of COVID-19 preventive measures among the Rohingya refugees in Cox's Bazar, and to identify their socio-demographic determinants.

MATERIALS AND METHODS

A cross-sectional study was conducted with 500 Rohingya individuals. Participants in the study were Rohingya refugees residing in five randomly selected camps where International Organization for Migration (IOM) Health was operating. Using a structured questionnaire, skilled community health workers surveyed the Rohingya population. In addition to the survey on knowledge, attitude, and practice, the study gathered information on the perspectives and relevance of sociodemographic factors that influence KAP.

RESULTS

The study findings indicate that the mean scores for knowledge, attitude, and practice were 9.93, 7.55, and 2.71 respectively. Association was found between knowledge and practice level and age group-the elderly age group (>/ = 61 years) had less level of knowledge (AOR 0.42, P value = 0.058) and the late mid-age group (46-60 years) had better practice level (AOR 2.67, P value <0.001).

CONCLUSIONS

Our study found that the Rohingya refugee community in Cox's Bazar has improved knowledge and attitude toward COVID-19 preventive measures. However, the practice level of these measures remains low compared to the knowledge and positive attitude. The reason behind the poor practice of preventive measures needs to be identified and addressed engaging the community in similar future outbreaks.

Pathogen inhibition and indication by gelatin nonwoven mats with incorporation of polyphenol derivatives

There is a need for non-pharmaceutical intervention methods that can prevent and indicate the risk of airborne disease spread. In this study, we developed a nonwoven mat based on the polyphenol gallic acid, which can inhibit pathogens growth and also indicate pathogen levels in the surrounding environment. Using nuclear magnetic resonance, Fourier-transform infrared spectroscopy, and high-performance liquid chromatography, we characterized this novel gelatin-based nonwoven mat and investigated the mechanism governing its ability to indicate pathogen levels. We demonstrated that the incorporation of gallic acid serves a vital role in indicating the presence of bacteria, causing the nonwoven mat to change in color from white to brown. We have proposed a plausible mechanism for this color change behavior based on a reaction of gallic acid with components excreted by bacteria, including glutamate, valine, and leucine. The concentrations of these components reflect the bacterial counts, enabling a real-time indication of pathogen levels in the surrounding air. In summary, the nonwoven mat presented herein can serve as an excellent antibacterial agent and as an indicator of nearby bacteria for fabricating personal protection equipment like filtration mask.

Risk communication and community engagement with vulnerable groups: Perceptions of social-services CSOs during Covid-19

Risk communication enables people to be prepared, respond and recover from public health risks which can only be realized with a considerable amount of community engagement. Enabling community involvement is necessary in order to reach and protect vulnerable people during epidemics. In situations of acute emergency, it is difficult to reach everyone, which makes it necessary to work with intermediaries such as social and care facilities and civil society organizations (CSOs) who work to support the most vulnerable in our societies. This paper analyses the perceptions of experts working in social facilities or CSOs of Covid-19 RCCE efforts in Austria. It starts from a broad understanding of vulnerability which combines medical, social and economic determinants. We conducted 21 semi-structured interviews with CSO and social facility managers. The UNICEF core community engagement standards (2020) were used as a framework for qualitative content analysis. The results show that CSO's and social facilities were essential for allowing community involvement of vulnerable people in Austria during the pandemic. For the CSO's and social facilities participation of their vulnerable clients was a real challenge especially because direct contact was difficult and public services were switched to digital only. Nonetheless, they all put a lot of effort into adapting and discussing Covid-19 regulations and measures with their clients and employees which in many cases led to acceptance of public health measures. The study gives recommendations on how community engagement could be enhanced especially from government actors and how CSO's could be addressed more as essential partners.

Health risk communication and infodemic management in Iran: development and validation of a conceptual framework

OBJECTIVE

The COVID-19 pandemic exposed significant gaps in Iran's and other health systems' risk communication. The accompanying infodemic undermined policy responses, amplified distrust in government and reduced adherence to public health recommendations among the Iranian population. This study aimed to develop a conceptual framework for health risk communication and infodemic management (RCIM) during epidemics and health emergencies in Iran that could have potential applications in other contexts.

DESIGN

This study was designed in two phases. Phase 1 involved semistructured qualitative interviews with key informants to explore effective RCIM strategies across public health settings in Iran and to develop a conceptual framework. Phase 2 involved revising the framework based on feedback from an online expert panel regarding its comprehensiveness and validity.

SETTING

Provincial/national public health settings in Iran.

PARTICIPANTS

Twenty key informants from provincial and national public health authorities who contributed to COVID-19 response programmes participated in interviews. Nine experts from diverse academic disciplines, provincial and national settings, and geographical locations participated in an online expert panel.

RESULTS

The conceptual model was created based on qualitative interviews and expert panel discussions and was structured according to six pillars of the WHO health system framework: leadership and governance, information, health workforce and financial resources, along with media and community. Leadership and governance, including trustworthy leaders, were recommended as the foundation for developing RCIM in Iran. Developing an official strategy with information infrastructures, including high-quality surveillance systems, identified personnel and training for specialists among the health workforce, financial resources, communication channels and community engagement were recognised as other dimensions for developing health risk communication in Iran.

CONCLUSION

The proposed framework represents a step toward establishing a national RCIM strategy in Iran. Further validation of the conceptual framework and experiments on how it could potentially influence policy and practice is recommended. This model has the potential to be applied in other contexts in its current form or as the foundation for customised local versions.

Social innovation in health and community-driven engagement as a key strategy for addressing COVID-19 crisis challenges: insights and reflections from the multicultural society of Iran

BACKGROUND

Social innovation is one of the strategies for appealing to people and encouraging social cooperation and engagement in interventions during crisis periods. In this regard, community engagement is an operative and innovative community health approach for achieving successful health outcomes. There is limited information about the role and operational impact of social innovation on community engagement during the challenges posed by the COVID-19 crisis. In this study, we aim to contribute to the understanding of innovative social strategies to attract social participation in crises such as the COVID-19 pandemic by highlighting the experience of social innovative strategies based on community-driven engagement in Iran.

METHODS

This qualitative study was conducted in seven provinces of Iran-Mazandaran, Zanjan, Golestan, Lorestan, Tehran, Kurdistan, and Khuzestan-from 4 September 2021 to 1 March 2022. A sample of Iranians (15-71 years) was selected by purposeful and snowball sampling methods to participate in the study, and 187 semi-structured telephone interviews were conducted. Participants were recruited from three levels of the community: community leaders, healthcare providers, and laypeople. The data collection tool was an interview guide, which was designed based on a review of the literature. The data were analyzed using conventional content analysis. Exploratory analyses were performed to identify social innovative strategies based on community engagement used during the COVID-19 crisis in Iran. The interviews continued until data saturation was reached.

RESULTS

Based on our findings, we distilled innovative strategies into 6 main themes and 37 categories: (1) information giving/sharing, (2) consultation, (3) involvement/collaboration, (4) health education and prevention, (5) empowering, and (6) advocacy. The results revealed that the participants were very driven to engage in the management and control of the COVID-19 crisis, even though they faced significant challenges.

CONCLUSION

The spread of the COVID-19 pandemic required social- and community-based responses. These reactions increased the possibility of fair access to health services, especially for vulnerable groups and minorities. As with other epidemics, applying the experience of the comprehensive participation of communities played an important and active role in the prevention and control of COVID-19. In this regard, giving and sharing information, consultation, involvement/collaboration, health education/prevention, empowerment, and advocacy are the most important innovative strategies that might encourage the community to perform COVID-19 crisis management and control.

Community pandemic prevention and control measures and their influence on citizen satisfaction during the COVID-19 pandemic in China

At the forefront of the fight against the pandemic, the community' s measures and services would have a greater impact than ever before on citizen satisfaction. However, the influence of citizen satisfaction on community pandemic prevention and control measures (CPPCM) during the pandemic is poorly understood. This study aims to investigate the allocation of CPPCM and its impact on CS. The Chinese national data was analyzed for the outcome. (1) Pandemic prevention propaganda (PPP), disinfection (DT), and body temperature tests (BTTs) were the primary measures taken by the Chinese community. (2) The CS for pandemic prevention and control is high, and urban and central Chinese communities express greater satisfaction. (3) The impact of disinfection, body temperature tests, free supplies, and assistance purchasing supplies on CS was greater in rural areas than in urban areas. (4) Regional variations exist in the impact of CS on CPPCM. (5) The number of measures has an inverted U-shaped relationship with citizen satisfaction. This study also suggests that the government should disseminate information about pandemic prevention in a timely manner, provide basic health and medical services, and evaluate the measures taken to avoid the discount effect.

Participatory action research to co-design a culturally appropriate COVID-19 risk communication and community engagement strategy in rural Pakistan

Background

Community engagement has shown to be fundamental component of the response to previous disease outbreaks. This study aimed co-design and implement a culturally appropriate COVID-19 risk communication and community engagement strategy with a resource-poor rural community in Northwest Pakistan.

Methods

Participatory Action Research (PAR) was conducted from January 2021 to March 2022. Five PAR meetings took place with community members (n = 30) to: (1) explore how the COVID-19 pandemic impacted on the community; (2) identify challenges to limit the spread of the virus; (3) identify and implement solutions to these challenges; and (4) highlight the enablers, challenges and knowledge of the cultural context needed to optimize safety during emergencies. Focus group discussions (N = 6) with community members not involved in the PAR meetings (N = 50) and children of the community (N = 26) were conducted following the PAR meetings. Thematic analysis of the PAR and focus group data was conducted.

Results

Delivery of messages on how to keep families safe, provision of personal protective equipment and improved water systems were part of the strategies taken by the community to create awareness and reduce the spread of COVID-19. Nine themes were identified: Attitudes to the pandemic: From skepticism to acceptance, Changing attitudes about vaccination: rumors and trust, COVID-19 and Faith, Social impact of the pandemic, Access to water, Resource mobilization: personal protective equipment, Spaces where collaborative effort can bring to solutions, Agents of change, and Empowerment of women.

Discussion

The participatory approach of this research allowed understanding of the challenges faced by the community to engage in behavior change strategies to reduce the spread of COVID-19 and enabled the community to find sustainable solutions. Engagement with the community empowered men and women to be agents of change and promoted necessary precautionary actions to reduce the risk of infection within their community.

Conclusion

Participatory approach highlighted the importance of engaging with and integrating to local culture and values to overcome challenges such as gender imbalance and distrust. Findings of this study are relevant to others working in diverse cultural settings in similar crises events regardless of particular cultural variations.

The Impact of COVID-19 Pandemics on the Development of Health Risk Communication: Challenges and Opportunities

Starting from an analysis of communication in Italy during the COVID-19 emergency period (February-June 2020), this paper provides an overview of the main challenges and opportunities for communication during pandemics. The purpose of this study is to perform a literature review contributing to the identification of practical recommendations for the improvement of current risk communication strategies. Given the variety of the parties involved in communication and the peculiarity of the theme, an integrated analysis approach was adopted, based on the connections between institutional, scientific and mass communication. On one hand, the "emotional" character of Italian institutional communication aimed at promoting solidarity and unity among citizens. On the other hand, scientific communication played a key role both as a technical and scientific consultation for the policymaker, and as a guide for mass communication. Nevertheless, a lack of awareness emerged from the institutional and scientific side of the importance of an interface between science and effective, transparent policy. It thus becomes necessary to develop new and effective communication strategies aimed at facing uncertainties and the challenges of risk communication in epidemics and pandemics. Such strategies should consider interaction between public health, human and social sciences, political science, law, ethics, communication and media studies, as each of these areas may give an important contribution to the understanding of the context in which communication occurs.

Interpersonal risk communication matters more than media risk communication in its impact on individuals' trust and preventive behaviors during COVID-19

A cross-sectional survey study from 1496 respondents was conducted to investigate how interpersonal risk communication and media risk communication foster individuals' interpersonal trust and trust in scientists during the ongoing COVID-19 pandemic. Findings reveal that interpersonal risk communication is significantly related to interpersonal trust and trust in scientists, but have no direct association with preventive behaviors. Media risk communication is significantly associated with preventive behaviors and increases individuals' trust in scientists while having no effect on interpersonal trust. Preventive behaviors are significantly influenced by both interpersonal trust and trust in scientists. In addition, trust mediated the association between risk communication and preventive behaviors.

Source Credibility and the Information Quality Matter in Public Engagement on Social Networking Sites During the COVID-19 Crisis

During the coronavirus disease 2019 (COVID-19) pandemic, people use social networking sites (SNSs) to seek social support, ease the move toward the social distance, and communicate and engage with one another. However, there is growing evidence that trustworthiness and quality of information can affect individuals' online engagement behaviors. This study proposes a theoretical model to test people's online engagement during the COVID-19 pandemic by applying the elaboration likelihood model (ELM). Through a questionnaire survey of 630 SNS users, the study examines whether and how source credibility and information quality affect people's online engagement during the COVID-19 pandemic. The model was tested using structural equation modeling. The findings show that source credibility and information quality have a significantly positive relationship with perceived benefit, while negative and significantly associated with perceived risk. Furthermore, perceived benefit is a stronger predictor of online public engagement than the perceived risk. To improve online public engagement as a crisis response strategy, careful source selection and careful generation of online crisis information should not be overlooked.