Clear communication with the public is a key part of the response to disasters and health emergencies, and the October 2023 update of a rapid review from 2020 investigates this in relation to measures to help to prevent and control COVID-19. Here's lead author Rebecca Ryan from La Trobe University in Australia to tell us more.
Mike: Hello, I'm Mike Clarke, podcast editor for the Cochrane Library. Clear communication with the public is a key part of the response to disasters and health emergencies, and the October 2023 update of a rapid review from 2020 investigates this in relation to measures to help to prevent and control COVID-19. Here's lead author Rebecca Ryan from La Trobe University in Australia to tell us more.
Rebecca: During a public health emergency, clear communication can improve how people follow protective measures to keep themselves safe, and good communication by governments and health authorities is an essential part of the public health response to a pandemic.
When we talk about communication, we don't just mean talking to people or making public announcements. Instead, communication encompasses a whole range of different activities, like providing information or education to people in the community, reminding people of important messages, supporting their decision making or behaviours related to health and wellbeing, and engaging with community members to ensure their voices and perspectives are represented.
With this in mind, our Cochrane review focused on communication about physical distancing measures, sometimes called social distancing. Physical distancing is a set of protective measures that can be used to slow down the spread of infectious diseases like COVID-19, Ebola or the 'flu. They include contact tracing, avoiding crowds, isolating and quarantine. These measures can be especially important for a new disease, such as COVID-19, when vaccines or effective treatments might not yet be available.
Because communication is such a critical part of responding to a pandemic, we wanted to find out which ways of communicating can improve how well people understand and use physical distancing measures to protect themselves. We also wanted to find out whether there were ways of communicating that worked better for certain groups, including people who experience different sorts of disadvantage.
Altogether, this review, which updates a rapid review we did for the World Health Organization in 2020, early in the COVID-19 pandemic, now contains 68 studies. These include guidelines, and reviews and primary studies of quantitative and qualitative research. Although most of the included evidence was of low or moderate quality, studies added in this update fill many of the gaps in the 2020 review; and the studies come from across the world, but with more from high than low- and middle-income countries.
We identified 6 main findings which may help governments and other authorities make decisions about public health communication during a pandemic or other public health emergency.
Firstly, communication must be planned to strengthen and maintain public trust and counter misinformation.
Secondly, people and communities affected by the pandemic need to be involved in planning and delivering the communication, giving them input into how communication can best happen.
Thirdly, communication needs to reach all people across the community, including those who have trouble reading and writing, people who speak languages other than the community's dominant language, and people who face other types of disadvantage. Communication needs to be planned so that it meets the needs of different people within the community and with awareness that some public health measures might worsen inequities that already exist (for example, not all people have homes or housing where they can physically stay apart from other members of their household; and many people earning lower wages cannot work from home).
Fourth, public communication is a public health strategy that can be done poorly or well. Some of the main features of effective communication include using clear language with consistent messages; being up to date; providing a reason for protective measures; and being actionable so that people and populations can protect themselves. To be effective and build public trust in the messages, communication also needs to be delivered in multiple ways and through different channels, so that as much of the community is reached as possible.
Fifth, different supports are needed for people to follow physical distancing measures – including access to the right information, and practical supports like financial support and essential supplies such as food, water and medical care when they are isolating. Monitoring and communicating to prevent stigma associated with measures like quarantine is also needed.
And lastly, sixth, communication needs to be maintained over the whole course of the pandemic - despite pandemic fatigue, misinformation, or loss of trust in authorities. Communication needs to be adapted to changing community needs and use community engagement throughout to help to tailor the communications.
To finish, although there is now a huge amount of research on COVID-19, there are still gaps in the evidence. These include how people at higher risk of getting severely sick or dying from COVID-19 can be communicated with, kept informed and supported; as well as barriers to implementing public communication and protective measures in low and middle-income countries.
As we await such research, all six of our current findings can be used across different settings and countries, and different types of emergency situations. They can be used now and in planning for future pandemics.
Mike: Thanks Rebecca. To read this updated review, you can find it online. If you go to Cochrane dot com and search 'communication physical distancing and COVID-19' you'll see the link to it.