Defining Moments in Risk Communication Research: 1996–2005

Ten years ago, scholars suggested that risk communication was embarking on a new phase that would give increased attention to the social contexts that surround and encroach on public responses to risk information. A decade later, many researchers have answered the call, with several defining studies examining the social and psychological influences on risk communication. This article reviews risk communication research appearing in the published literature since 1996. Among studies, social trust, the social amplification of risk framework, and the affect heuristic figured prominently. Also common were studies examining the influence of risk in the mass media. Among these were content analyses of media coverage of risk, as well as investigations of possible effects resulting from coverage. The use of mental models was a dominant method for developing risk message content. Other studies examined the use of risk comparisons, narratives, and visuals in the production of risk messages. Research also examined how providing information about a risk's severity, social norms, and efficacy influenced communication behaviors and intentions to follow risk reduction measures. Methods for conducting public outreach in health risk communication rounded out the literature.     

Health-Related Disaster Communication and Social Media: Mixed-Method Systematic Review

This mixed-method evidence synthesis drew on Cochrane methods and principles to systematically review literature published between 2003 and 2016 on the best social media practices to promote health protection and dispel misinformation during disasters. Seventy-nine studies employing quantitative, qualitative, and mixed methods on risk communication during disasters in all UN-languages were reviewed, finding that agencies need to contextualize the use of social media for particular populations and crises. Social media are tools that still have not become routine practices in many governmental agencies regarding public health in the countries studied. Social media, especially Twitter and Facebook (and equivalents in countries such as China), need to be incorporated into daily operations of governmental agencies and implementing partners to build familiarity with them before health-related crises happen. This was especially observed in U.S. agencies, local government, and first responders but also for city governments and school administrations in Europe. For those that do use social media during health-related risk communication, studies find that public relations officers, governmental agencies, and the general public have used social media successfully to spread truthful information and to verify information to dispel rumors during disasters. Few studies focused on the recovery and preparation phases and on countries in the Southern hemisphere, except for Australia. The vast majority of studies did not analyze the demographics of social media users beyond their geographic location, their status of being inside/outside the disaster zone; and their frequency and content of posting. Socioeconomic demographics were not collected and/or analyzed to drill deeper into the implications of using social media to reach vulnerable populations. Who exactly is reached via social media campaigns and who needs to be reached with other means has remained an understudied area.     

Just telling and selling: current limitations in the use of digital media in public health: A scoping review

ObjectiveTo undertake a scoping review and to map research in the area of digital media use in public health.Study designScoping review.MethodsPubMed, PsycINFO, Google and major textbooks of public health communication and health psychology were searched for primary studies or systematic reviews examining the use of digital media in a health context. Searches focussed on studies published between the start of 2000 and the end of June 2013. Abstracts of reviews of public health interventions were examined with respect to target groups, health topic, intervention characteristics, media used, study design, issues of quality and ethics, and outcomes. To map this area of work fully, this information was supplemented by adding information from primary studies. Areas were identified where systematic review evidence was scarce or non-existent by comparing the final map with information from the reviews analysed.Results221 systematic reviews related to digital media use in a public health context were included. Most reviews included studies with an experimental design and general ‘at risk’ target populations. Specific settings were not specified in the majority of reviews. A large variety of health topics were covered. About a quarter of reviews did not specify a health topic but were concerned with broader issues of health promotion, disease prevention, or health education. Over half of the reviews focussed on eHealth and telemedicine, and another third were concerned with mass media – social marketing. Reviews most frequently reported behaviour-related outcomes or conducted some form of content analysis or analysis of the use of particular media. Research gaps were identified relating to community-based research, participation and empowerment, active media use (especially with respect to visual media und use of specific visual methodologies), and the use of salutogenic or assets-based approaches.ConclusionThe available research relating to digital media use in public health is dominated by studies relating to eHealth, telehealth or social marketing; emphasising the passive reception of messages and a focus on individual behaviour change approaches. Issues of quality and ethics need to be taken into account more consistently. Further research is needed with respect to more participatory methods, particularly those which would seek to use digital media as a means to harness individual and community assets.     

Content,Exposure, and Effects of Public Discourses about Marijuana: A Systematic Review

This review presents a comprehensive picture of research studies about marijuana-related content in news, social media, and advertisements. Studies that examined the extent of people’s exposure to the messages and its effects were also included. A total of 27 peer-reviewed journal articles and one thesis were located, of which 16 analyzed the content, four contained information about people’s exposure to the messages, and ten examined the effects. Over time, news coverage shifted from negative to slightly positive toward marijuana use. Social media and advertisements were overwhelmingly favorable toward marijuana use and legalization by claiming social, romantic, and health benefits of marijuana use while completely downplaying risks. A majority of social media accounts were also run by advocacy groups and industry interests, rather than individuals who were simply sharing opinions or experiences. Furthermore, absence of health authorities among the highly popular social media accounts about marijuana was notable. The news, social media, and advertising messages about marijuana were widely used by the members of public, which in turn generated some demonstrable effects on the audience’s marijuana-related perceptions and behaviors. The public and policymakers need to become aware of this information environment for potential marijuana users and take more proactive measures to protect vulnerable populations.     

Propagation of Information About Preexposure Prophylaxis (PrEP) for HIV Prevention Through Twitter

Previous literature has suggested that examining Twitter messages can be productive for studying how the public shares and spreads health information on social media. Preexposure prophylaxis (PrEP) is a promising approach to HIV prevention, yet there are many issues that may influence its effective implementation. This study examined social representations of PrEP on Twitter. One thousand four hundred and thirty-five Tweets were collected and 774 English Tweets were content-analyzed to explore propagation of various issues around daily oral PrEP, as well as characteristics of the sources of those Tweets. We also examined how Twitter message content influenced information propagation. Our findings revealed that PrEP-related information on Twitter covered a wide range of issues, and individual users constituted the majority of the Tweet creators among all the sources, including news media, nonprofit and academic groups, and commercial entities. Using Poisson regression, we also found that a Tweet’s affective tone was a significant predictor of message propagation frequency. Implications for health practitioners are discussed.     

Gesundheitliche Aufklärung als Risikokommunikation

Those seeking to educate the public about health need to communicate health risks effectively. This involves providing evidence-based information about factors and behaviors that are dangerous to people’s health and making recommendations regarding how risks can be avoided or minimized. This communication usually aims to motivate people to act in a way that promotes health or prevents disease. Organized ‘health education’ that seeks to communicate risks is always embedded in a contextual framework that in turn influences the issues and content to be communicated and the form of communication that is chosen. The scope of available scientific knowledge is an important part of this framework as is the extent to which risks are presented in the media as being dangerous. The media’s message has a strong influence on how the public and specific subgroups within it react. The article describes conditions that contribute to successful risk communication based on the example of HIV/AIDS prevention. We chose this particular case because it can serve as an example of how to deal with future epidemics that may potentially generate substantial media coverage. This field report shows how risk communication about HIV/AIDS in the mass media in Germany in the mid-1980s elicited a risk consciousness among the general public that in itself was in danger of becoming a health risk, especially for people affected by the disease, and how ‘health education’ responded to this challenge. It concludes by describing how these experiences with risk communication can be applied to similar types of risk communication today.     

Boundaries and risk: Media framing of assisted reproductive technologies and older mothers

Assisted reproductive technologies (ARTs) have historically been sites of heated public controversy. However, with widespread use, the boundary-challenging risks surrounding ARTs have become less newsworthy. One exception includes their use by "older mothers," particularly postmenopausal mothers. In this paper, I review the social science literature related to the risks of ARTs and the conceptualizations of "older mothers". Next, I move to analyze the specific case of 60-year-old Ranjit Hayer, who gave birth to twins in Calgary, Canada, through the context of the Canadian media coverage the week following the birth, using concepts from cultural approaches to risk perception, constructivist studies of technology, and risk communication theory. I argue that risk discourses emerge when technologies and users expose and challenge the contingent stability of the sociotechnical discourses surrounding them. This leads to a public re-opening of a "closed" technology and user and a reconstruction of the risks associated with them. This case demonstrates how an apparently "settled" sociotechnical network becomes reframed in terms of risk, and how the negotiation of this risk reveals, constructs, and interweaves various boundary discourses.     

Social agents and news media as risk amplifiers: a case study on the public debate about the E. coli outbreak in Germany 2011

The social amplification of risk framework highlights the role which the news media play in risk communication by interacting with other agents in amplifying risk. However, the precise ways in which the media and other social agents actually amplify risks in public debates are unclear. In this article we draw on insights from the sociology of news to examine whether and to what extent social agents and news media amplify an emerging health risk. We use the debate about the Escherichia coli outbreak in Germany in 2011 to examine three issues: the amount of risk reporting by news media and social agents in their function as news sources; their evaluation of risk; and how they contribute to the escalation of risk, also known as ripple effects. In this article we draw on data from a content analysis of press releases from public health authorities and affected stakeholders and of news items in leading German news media. We found that the affected stakeholders were amplifying the risk to the greatest extent. We also found that there was a shift over time in the use of dominant frames. At the start of the debate the risk was framed as a public health issue and linked to medical-scientific progress. As the debate developed, more attention was given to political and economic consequences of the outbreak and the original health risk event was layered by other risk-related events.     

Communicating About Cancer Through Facebook: A Qualitative Analysis of a Breast Cancer Awareness Page

Social media channels are increasingly being used for health communication and promotion. Social networking sites such as Facebook have become popular platforms for organizations to communicate health messages and encourage user participation around health topics. While the evaluation of social media's effectiveness in health promotion is beginning to emerge in the literature, few studies have examined actual interactions and user behaviors on Facebook Pages hosted by health organizations. The authors present a qualitative case study of a popular Facebook Page from a nonprofit organization devoted to raising awareness about breast cancer. With the goal of identifying the functions and uses of the Page, our study analyzes the content of Wall posts during Breast Cancer Awareness Month, October 2010. Common themes and characteristics are identified, including open mic communication, scarcity of health information, the commodification of breast cancer, unpredictable locations of conversation, and the use of gendered images and language. The findings have potential implications for health promotion efforts using social media platforms.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Mediatised risk culture: News coverage of risk technologies

In this article, we examine if and how a particular risk culture emerges as mediated and mediatised for a number of diverse technological risks. Modern news reporting is increasingly preoccupied with representing risk events in order to show how technological lifestyles affect our human and natural environments. In this article, we draw on data from project which used a comparative research design to investigate media coverage of four contemporary risks, in order to show how public risk communication contributes to the establishment of a broader mediatised risk culture. The project combined a quantitative content analysis with a qualitative study of a sample (n = 344) of news items across three different Danish media platform. We found that risk reporting varied substantially depending on dominant news themes, cultural resonance and media platform. However, within these variations we also found common elements such as the discursive representations of risk as contested and/or manageable. Based on the aggregate picture of the four risk studied, we argue that the media risk discourse takes a particular form that is different to risk discourse in other social arenas. Media risk discourse, therefore, tends to share certain cultural traits which results in the representation of risks as either (un-)manageable or (un-)controllable according to the level of public or elite disagreement in public debate.     

Health risk communication and amplification: learning from the MMR vaccination controversy

Immunisation is the cornerstone of childhood disease prevention. In this context the combined measles, mumps and rubella vaccination (MMR) has proved a world-wide success, although in the UK it has been at the centre of public controversy since 1998. Through the media, the public domain has witnessed contestation among expert views about the relative risks associated with the diseases vs. the potential side-effects of the vaccination. Attainment of health protection targets has been compromised. The UK Department of Health sought to redress this through a major communication exercise. This paper reports the findings of a study of information strategies that parents use to make sense of health risk issues, particularly MMR. The findings identify the importance of social networks in reinforcing parental understanding and beliefs. While the media are identified as important sources of information, there is no evidence to suggest that parents passively receive and act upon such risk messages. Official information has been able to capitalise on the strong social normalisation of vaccination, but has not responded fully to the evolving social interpretation of risks. The study reveals a preference for personal and face-to-face engagement with health professionals, stressing the importance of user-centred health risk communication.     

Media advocacy and underage drinking policies: a study of Louisiana news media from 1994 through 2003

The communications literature firmly establishes the significant role of media advocacy in setting public agenda and influencing the direction of public opinion on social issues. Recent public health campaigns embrace media advocacy as an integral part of efforts to change public health policies, yet further studies are needed on the best strategies to promote legislative action. This article examines press coverage in the Baton Rouge Advocate and the New Orleans Times-Picayune newspapers and Louisiana State legislation pertaining to underage drinking from January 1994 to June 2003 and focuses on evidence of media priming and framing of underage drinking and four related legislative policies. High press coverage of alcohol bills during the legislative process was associated with defeated legislation, whereas little or no press coverage was associated with bills successfully passed into law. The authors conclude that more work is needed to understand how media advocacy strategies may hinder enactment of bills.     

Communicating health information to an alarmed public facing a threat such as a bioterrorist attack

Considerable literature exists on the communication of risk to the public through channels such as television, radio, and newspapers. However, little has been written on the communication of risk through less traditional communication forms, such as the Internet. The purpose of this study was to investigate the role of the Internet as an additional source of health information to that provided by the traditional news media in managing the public's response to an emerging health risk such as a bioterrorist attack. Despite some of the Internet's advantages over traditional media, including the depth and speed in which information can be conveyed to different audiences, the Internet was underutilized during fall 2001, when it became important to convey information on the risks of anthrax. A number of developments are required if the health care system is to capitalize on the Internet's potential as a risk communication device. These developments include research into public Internet searching behavior and further development in the role of search engines and government agencies in organizing quality health information.     

Comparison of Child Obesity Prevention and Control Content in Mainstream and Spanish-Language US Parenting Magazines

Mass media coverage of child obesity is rising, paralleling the child obesity epidemic's growth, and there is evidence that parents seek parenting advice from media sources. Yet little to no research has examined the coverage of child obesity in parenting magazines or Spanish-language media. The purpose of this study was to use qualitative and quantitative content analysis methods to identify, quantify, and compare strategies for child obesity prevention and control presented in mainstream and Spanish-language US parenting magazines. Child obesity?related editorial content in 68 mainstream and 20 Spanish-language magazine issues published over 32 months was gathered. Magazine content was coded with a manual developed by refining themes from the sample and from an evidence-based child obesity prevention action plan. Seventy-three articles related to child obesity prevention and control were identified. Most focused on parental behavior change rather than environmental change, and only 3 in 10 articles referred to the social context in which parental behavior change takes place. Child obesity?focused articles were not given high prominence; only one in four articles in the entire sample referred to child obesity as a growing problem or epidemic. Key differences between genres reflect culturally important Latino themes, including family focus and changing health beliefs around child weight status. Given mass media's potential influence on parenting practices and public perceptions, nutrition communication professionals and registered dietitians need to work to reframe media coverage of childhood obesity as an environmental problem that requires broad-based policy solutions. Spanish-speaking media can be an ally in helping Latina women change cultural health beliefs around child weight status.     

The silent killer in media stories: Representations of hypertension as health risk factor in French-language Canadian newspapers

The media is recognised as an increasingly important source of information about health risk and disease for non-professionals. The issue for public health actors is the accuracy and objectivity of such information. But the media do not neutrally transmit expert information on health risk; they also contribute to shaping it. Media studies show that the media have their own modus operandi and produce content that satisfies the criteria of newsworthiness and media-value. The objective of our research was to analyse how newspapers represent hypertension as a health risk factor, to examine how these representations relate to media-value characteristics, and to reveal differences between serious, popular, and tabloid newspapers. Our findings show that, in their coverage of hypertension, the newspapers we analysed accentuate features that come closest to media-value characteristics of health risk. The magnitude and undetectable nature of hypertension, and the severity and unpredictability of its consequences, are accentuated in media discourse through various rhetorical devices. Exacerbation of fear is most prevalent in the tabloid newspapers, with more use of scary metaphors and personifications.     

The fukushima nuclear crisis reemphasizes the need for improved risk communication and better use of social media

ABSTRACT: The potential of social media has expanded far beyond the initial function of social communication among a network of friends. It has become an increasingly important tool in risk communication to allow the dissemination of timely and accurate information to global citizens to make more informed choices regarding a particular crisis. The Fukushima nuclear crisis is an example where the potential of social media was not fully tapped. This caused undue stress and distrust of authorities. While the use of social media in this crisis could have altered significantly the level of trust in authorities and others, two additional points should be considered. One point is the use of plain language versus scientific language in order to reach a wider audience. The other is an urgent need to improve public information especially in the event of a nuclear emergency and to enhance educational efforts and action by improving radiological protection communication from regulatory bodies and international agencies. These are points that also play a large role in the use of social media.