The Risk Communication Advisory Committee to the Food and Drug Administration (FDA) met on February 16-17, 2016 to discuss recent developments in risk communication and related sciences, and possible approaches and applications in the context of FDA communications. Twelve guest speakers presented information to the Committee on the latest science in communication in a series of six sessions. After each session, the Committee discussed and provided recommendations on how FDA communicators can apply the information presented by the guest speakers.
Guest speakers included:
- Dr. Benjamin Chapman, North Carolina State University
- Dr. Timothy Coombs, Texas A&M University
- Dr. Isaac Lipkus, Duke University
- Dr. David Broniatowski, The George Washington University
- Dr. Jennifer Lerner, Harvard University
- Dr. Carl Botan, George Mason University
Session 1: Strategies and Tactics for Effective Communication about Risks and Health
Dr. Chapman presented on “Emerging and Novel Food Safety Risk Communication Tools and Approaches: Social Media and Secret Shopping” and Dr. Coombs presented on “The Recommendations, Reality, and Potential Benefits from Using Social Media in Food Recalls.”
Following the presentations, the Committee discussed how the FDA can apply the information that was presented by Dr. Chapman and Dr. Lipkus and provided the following recommendations to the FDA:
- Conduct an audit of FDA’s communication guidelines to determine how messages should be communicated
- Identify credible sources that can help deliver messages to different audiences
- Identify opportunities to communicate risk to the public before recalls are issued
- Encourage companies to develop and submit communication plans to FDA
- Research the effect social media has on delivering messages to audiences
The Committee also discussed important considerations when the FDA does communicate through social media. Such considerations included: identifying the target audience(s) across the various social media accounts; interfacing with individuals within the health profession as well as other professions that can communicate risk; and ensuring the language used in a message is appropriate for the audience.
Session 2: Effective Risk Communication – Audience Engagement for Change
Dr. Lipkus presented on “The Promise of Biomarker Feedback as a Risk Communication Strategy to Promote Health Behavior Change” and Dr. Broniatowski presented on “Germs are Germs and Why Not Take a Risk? Perception of Bottom-Line Gists and the Relationship to Antibiotics Prescribing Behavior.” The Committee discussed how FDA communicators can apply the information presented by Dr. Lipkus and Dr. Broniatowski. During this discussion, the Committee provided the following recommendations to the FDA:
- Conduct case studies to demonstrate how tailoring messages can be scaled up to be applied to larger populations
- Enhance FDA’s risk communication to include information on how the public can apply the information
The Committee acknowledged that just providing information to a patient is insufficient and additional information is needed to make informed decisions and facilitate behavior change. Information related to patient values and stages of change are important factors when communicating to patients.
The Committee also discussed methods of how the FDA can communicate to patients and physicians. Suggestions included establishing licensing agreements with patient portals and social media sites to communicate messages to patients, utilizing electronic medical records and public service announcements.
Session 3: The Effects of Emotion on Risk Perception and Implications for Risk Communication
Dr. Lerner presented on “Beyond Valence: Emotion-Specific Influences on Citizens’ Perceptions of Risk and Implications for the Design of Effective Risk Communication” and Dr. Botan presented on “Message-Centered vs. Publics-Centered Campaigns: The Cocreational View on Health Communication Campaigns.” Following the presentations, the Committee provided the following recommendations:
- The need to implement user testing of Medication Guides with patients
- Consider the affective state of the target audience when framing messages
- Consider how a message is co-created by the receiver when message testing
- Develop a series of campaigns to reinforce the message rather than relying on one-time messaging
Guest speakers included:
- Dr. Christopher R. Trudeau, Western Michigan University
- Dr. Lauren McCormack, RTI International
- Dr. Nathan Dieckmann, Oregon Health & Science University
- Dr. Timothy Sellnow, University of Central Florida
- Dr. K. Viswanath, Harvard School of Public Health
- Dr. Linda Aldoory, University of Maryland
Session 4: Strategies for Making Messages More Effective
Dr. Trudeau presented on “Risky Business: Prioritizing Risk Information in FDA-mandated Documents” and Dr. McCormack on “Best Practices in Risk Communication and Communicating Uncertainty: Application to FDA Regulated Products.” Following the presentations, the Committee discussed and recommended the following:
- Prioritize information to determine what information needs to be presented first
- Provide patients a condensed version of information along with a more detailed version for patients that prefer more detailed information
- Define audience segmentation and communicate this segmentation throughout the agency
- Identify technographics along with demographics and psychographics as a way of understanding the audience
Session 5: How Audiences Negotiate Multiple Messages
Dr. Nathan Dieckmann presented on “Public Perceptions of Expert Disagreement” and Dr. Timothy Sellnow presented on “Comprehending the Role of Message Convergence for Consistently Effective Message Design in Pre-Crisis and Crisis Situations.” Following the presentations, the Committee recommended the following:
- Design messages for convergence. This design will include collaborating with other agencies to ensure consistent messaging.
- Communicate the same message through multiple messages, multiple channels, and multiple agencies
- Be proactive in communication approaches with the public during times of crisis and non-crisis
Session 6: Techniques for Reaching Underserved Populations
Dr. K. Viswanath presented on “Communication, Health and the Urban Poor” and Dr. Linda Aldoory on “The Role of Health Literacy in Mobile Health and Text Messaging Campaigns.” Following the presentations, the Committee discussed the challenges in communicating with vulnerable populations given that they require a different message and different channels when receiving messages due to their availability of resources. Based on the discussion, the Committee recommended the following:
- Identify community based organizations that service vulnerable populations and work with these organizations to help communicate messages to individuals within these populations
- Develop an online training tool to help health practitioners and other front line workers in the community reach members in the community that are limited in their communication reach
- Incorporate plain language in patient materials, such as the Risk Evaluation and Mitigation Strategies (REMS) to assist patients and those that are communicating with patients. The Center for Disease Control and Prevention’s Clear Communication Index was discussed as a possible framework for creating standards for patient materials
- Conduct or facilitate communication research with academic and nonprofit institutions
- Develop a checklist to use at every stage of message development. The checklist would include evidence based items such as: message convergence, visuals, affective science, and use of narratives.
- Consider the user experience when framing messages and understand that providing information does not always lead to behavior change
- Conduct an environmental scan of all current risk communication to assess the strategies used within each communication
- The Committee would like to review FDA’s strategic plan for communication at a future meeting. The review would consist of identifying gaps within the plan and ways to improve the plan.