|        | **Search**  |         **Index**  |         **Home**  |         **Glossary**  |         **Contact Us**          |
|--------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|        |
|   |
|        |

****Agency for Toxic Substances and Disease RegistryA Primer on Health Risk Communication Principles and Practices****

----

Note: While the original publication dates on some of ATSDR's documents may not appear to be current, the information in the documents is valid and may still provide relevant information.

----

       Barry Johnson, Ph.D.       Assistant Surgeon General       Assistant Administrator       Agency for Toxic Substances and Disease Registry  Public Health Service, US Department of Health and Human Services (1987)

"If we have not gotten  our message across, then  we ought to assume that the fault is not with our receivers."
       Baruch Fischhoff       Department of Engineering and Public Policy       Carnegie-Mellon University       (1985)
CONTENTS-  **Preface** The  ATSDR Mission:  Role  and Importance  of  Community Involvement  in ATSDR Health Risk Communication
-  Overview of Issues and Guiding Principles for Health Risk Communication   - Risk Communication: Myths and Actions Seven Cardinal Rules of Risk CommunicationKnowing Your Publics
-  Factors Influencing Risk Perception Interacting with the CommunitySelecting Channels for Communication
-  Earning Trust and Building Credibility Avoiding PitfallsAssessing your Effectiveness
Presenting Information at Public Meetings
Before the Meeting
-  The Opening Presentation Presentation AidsPlanning and Preparation
-  Design Guidelines Presentation RemindersUsing Risk Comparisons
-  A Presentation Planner Ten Deadly Sins of CommunicationAnswering Questions
-  Sample Questions Some DOs and DON'Ts of ListeningManaging Hostile Situations
Working with the Media
The Media Perspective
-  Preparing a Message Before, During, and After an InterviewIn a Crisis
References

Preface  The public contributes significant information in determining  the public  health  impact of exposure  to toxic substances at  hazardous waste sites. The  public health professional  must understand the needs of  the community andbe  able to facilitate dialogue concerning  the technical issues of  public health  risk  and the  psychological,  political, social,  and  economic needs  of the  community.

  The  purpose  of this  Primer  is to  provide  a framework  of  principles and  approaches for  the  communications  of  health risk  information  to  diverse  audiences. It is  intended for ATSDR staff and personnel from other government  agencies and private organizations who  must respond to public  concerns about  exposure to hazardous substances in the environment.

  The Primer begins  with brief descriptive material about  the mission of ATSDR  and  the  importance  of  local  community  involvement  in  the  health  risk  communication process. The remainder  of the Primer is devoted to a discussion  of issues and  guiding principles for communicating health risk accompaniedby  specific  suggestions  for  presenting  information  to  the  public  and  for  interacting effectively with the media.

  Although  the  Primer   attempts  to  identify  principles  relevant   to  and  consistent  with  effective  health  risk communication  practice,  it  is not  intended  to   suggest  that   a   standard  of   health  risk   communication  effectiveness is  measured  solely  on  the  number  of  principles  that  are  employed. Rather,  the manner  in which  the guidance  should be  applied will  vary from  case to case, based on needs, priorities, and other considerations.  

**US Department Of Health And Human Services                             Public Health Service                Agency for Toxic Substances and Disease Registry                          Division of Health Education**
****[**Table of Contents**]

The ATSDR Mission

 The Agency for Toxic Substances and Disease Registry (ATSDR), created by the   US Congress in 1980, is a federal Public Health Service agency and part of the   US Department of Health and Human Services. The mission of the Agency for Toxic   Substances and disease Registry is to prevent exposure and adverse human health   effects and diminished quality of life associated with exposure to hazardous   substances from waste sites, unplanned releases, and other sources of pollution   present in the environment.

**The Role and Importance of Community Involvement in                        ATSDR Health Risk Communication

****  Health risk communication is an  emerging area of emphasis  and importance  at ATSDR and  in parts of the  broader public health community. Over  the past  decade,  health risk  communication  has played  an  integral part  in ATSDR's  comprehensive  efforts to  prevent or mitigate  adverse human  health outcomes  related to hazardous substance exposure.

  It is ATSDR's responsibility to ensure that decisions  are made using the best  available information.  Community residents,  site personnel, citizen  groups,  health  professionals, and state and local  government representatives are all  unique  sources of  information  needed by  ATSDR  to effectively  communicate  about the public  health risks of  exposure to hazardous substances.  They can  provide information  concerning  site background,  community health  concerns,  demographics,  land and  natural  resource use,  environmental  contamination,  environmental pathways,  and health outcomes.  Information is needed from  the  community  at  several  points  in  the  health  risk  communication  process.  Involving  the community  in  the  information-gathering process  makes  ATSDR  communications  more credible and sets  the stage  for community participation  in helping  to  resolve problems.  Communities need  and want  to be  actively  involved  in identifying,  characterizing, and  solving  problems that  affect  their lives. 
[**Table of Contents**]
Overview of Issues and Guiding Principles                         for Health Risk Communication
  Merely  disseminating information  without  regard for  communicating  the  complexities and uncertainties  of risk does not necessarily  ensure effective  risk  communication. Well-managed efforts will  help ensure that your messages  are  constructively formulated, transmitted, and received and that they result  in  meaningful  actions. Consider  how  the  process  works  and some  general  principles for improving effectiveness.
[**Table of Contents**]
Risk Communication: Myths and Actions                               (Chess et al. 1988)

  Belief in some  common myths often interferes with development of an effective  risk communication program. Consider the myths and actions you can take. 

**Myth:**We  don't  have  enough  time  and  resources  to  have  a  risk  communication program.**Action:** Train all your staff to communicate more   effectively. Plan projects to include time to involve the public.  
******Myth:**  Telling the  public about  a risk  is more  likely to unduly  alarm people than keeping quiet.**Action:**  Decrease potential  for  alarm by  giving  people a  chanceto  express their concerns.  
**Myth:** Communication is  less important  than education. If  people knew  the true risks, they would accept them.**Action:** Pay as much  attention to your process for dealing  with people  as you do to explaining the data.

**Myth:**  We shouldn't  go  to  the  public  until we  have  solutions to  environmental health problems.**Action:** Release and  discuss information about risk  management options  and involve communities in strategies in which they have a stake.

**Myth:** These issues are too difficult for the public to understand.**Action:**   Separate   public  disagreement   with  your   policies  from  misunderstanding of the highly technical issues.

**Myth:** Technical  decisions should  be left  in the  hands of  technical  people.**Action:**Provide  the  public with  information.  Listen  to  community  concerns. Involve staff with diverse backgrounds in developing policy.

**Myth:**Risk communication is not my job.**Action:** As a public  servant, you have a responsibility to  the public.  Learn  to  integrate  communication into  your  job  and  help others  do  the  same.

**Myth:** If we give them an inch, they'll take a mile.**Action:** If you listen to people  when they are asking for inches,  they  are less likely to  demand miles. Avoid the battleground. Involve people early  and often.

**Myth:** If we  listen to the public,  we will devote scarce  resourcesto  issues that are not a great threat to public health.**Action:**  Listen early  to  avoid  controversy  and  the  potential  for  disproportionate attention to lesser issues.  
**Myth:** Activist groups are responsible for stirring up   unwarranted concerns.**Action:**  Activists  help  to focus  public  anger.  Many  environmental  groups are  reasonable and responsible.  Work with groups  rather than against  them. 
[**Table of Contents**]
Seven Cardinal Rules of Risk Communication                      (Covello and Allen 1988)

- Accept and involve the public as a partner.  Your goal  is  to  produce  an  informed public,  not  to  defuse  public      concerns or replace actions. Plan carefully and evaluate your efforts.
Different goals, audiences, and media require different actions.
Listen to the public's specific concerns.
People  often   care  more  about  trust,   credibility,  competence,       fairness, and empathy than about statistics and details.
Be honest, frank, and open.
Trust and  credibility are difficult  to obtain; once  lost, they are      almost impossible to regain.
Work with other credible sources.
Conflicts and  disagreements among  organizations make  communication     with the public much more difficult.
Meet the needs of the media.
     The media are usually more  interested in politics than  risk, simplicity      than complexity, danger than safety.
Speak clearly and with compassion.
Never  let your  efforts  prevent your  acknowledging  the tragedy  ofan illness, injury,  or death.  People can understand  risk information, but       they may still not agree with you; some people will not be satisfied.

[**Table of Contents**]
Knowing Your Publics

The  likelihood  of  achieving a  successful  risk  communication  program  increases with your knowledge of those with  whom you are communicating. Early  in the process, know who  your publics are, what their concerns are,  how they  perceive risk, and whom they trust.

**Identification**-   Co-workers   Area residents  Elected officials
-   Civic organizations   Health care providers  Media
-   Regulatory agencies   Environmental activists  Contractors
-   Other                    ********Characteristics**-   Concerns   Attitudes  Levels of interest
-   Levels of involvement   Histories  Levels of knowledge
-   Opinions   Reasons for interest  Types of involvement

  Are they potential supporters or potential adversaries?

**Categories of Public Concern**-   Health   Safety  Environment
-   Economics   Aesthetics  Fairness
-   Process   Legalities
[**Table of Contents**]
Factors Influencing Risk Perception                            (Fischhoff et al. 1981)

  People's perceptions of the  magnitude of risk are influenced by factors other  than numerical data.

- Risks perceived to be voluntary are more accepted than risks perceived to be imposed. Risks perceived to be under an individual's control are more accepted than risks perceived to be controlled by others.Risks perceived to be have clear benefits are more accepted than risks perceived to have little or no benefit.
- Risks perceived to be fairly distributed are more accepted than risks perceived to be unfairly distributed. Risks perceived to be natural are more accepted than risks perceived to be manmade.Risks perceived to be statistical are more accepted than risks perceived to be catastrophic.
- Risks perceived to be generated by a trusted source are more accepted than risks perceived to be generated by an untrusted source. Risks perceived to be familiar are more accepted than risks perceived to be exotic.Risks perceived to affect adults are more accepted than risks perceived to affect children.
 [**Table of Contents**]
Interacting with the Community(Chess et al. 1988)

Recognize the  importance of  community input.  Citizen involvement is  important because (a) people  are entitled to make decisions about issues that  directly affect their lives; (b) input from the community can help the  agency  make  better  decisions; (c)  involvement  in  the  process  leads to  greater  understanding of - and more appropriate  reaction to - a particular risk;  (d)  those who are affected by a problem bring different variables to the  problem-solving equation; and (e) cooperation  increases credibility. Finally, battles  that  erode  public confidence  and  agency  resources  are  more likely  when  community input isn't sought or considered.

**To  the  extent  possible,  involve the  community  in  the decision-making  process.**- Involve the community at the earliest stage possible. Clarify the public's role from the outset.Acknowledge situations  where the agency  can give the  community only limited power in decision making.
- Find out from the communities what type of involvement they prefer. 
**Identify and respond to the needs of different audiences.**- Try to identify the various interests in a situation at the beginning  and meet with representatives of each informally. Recognize the strengths and weaknesses of citizen advisory groups.Deal with everybody equally and fairly.
 
When appropriate, develop  alternatives to public hearings.  In particular,  hold smaller, more informal meetings.  
If you  cannot avoid a large  public meeting, the logistics  should enable both the agency and the community to be treated fairly.
- Consider breaking larger groups into smaller ones. Be clear about the  goals for the meeting. If you cannot  adequately fulfilla citizen's request for a meeting, propose alternatives.In certain situations, one-to-one communication may work best.

**Recognize that  people's values  and feelings  are a  legitimate aspect of  environmental  health issues  and  that  such  concerns  may  convey  valuable  information.**- Provide a forum for people to air their feelings.   Listen to people when they express their values and feelings.  Acknowledge people's feelings about an issue.
-   When people  are  speaking emotionally,  respond  to  their emotions.  Do  not merely follow with data.   Show  respect  by  developing  a system  to  respond  promptly  to  calls from community residents.   Recognize and be honest about the values incorporated in agency decisions.
-   Be  aware of your own values  and feelings about an issue  and how they affect you. [**Table of Contents**]
Selecting Channels for Communication

Achieving effective communication  with your publics depends  on selecting  methods of  communication that  will reach  them. Consider  your messages  and  your target audiences in  selecting the most appropriate  communication media.  Here are a few suggestions.

- Public:  Coworkers   Channels:               - News releases and fact sheets Site toursMeetings to address questions and concerns
- Hotlines Unit newspaper articles

Public: Area residents  Channels:            
Community meetings
- Newspaper articles and ads Radio and TV talk showsFliers
- Films, videos, and other materials at libraries Direct mailings

Public: Elected officials, opinion leaders, and environmental activists  Channels:
Frequent telephone calls
- Fact sheets Personal visitsInvitations to community meetings
- News releases Advance notices

Public: Media  Channels:
News releases that focus on your message
- Clear, informative fact sheets Site visitsNews conferences
[**Table of Contents**]
Earning Trust and Building Credibility(Covello 1992; Covello 1993)

  Your ability  to establish  constructive communication will  be determined,in  large part,  by whether  your  audiences perceive  you to  be trustworthy  and  believable. Consider how they form their judgments and perceptions.

**Factors in Assessing Trust and Credibility**
  Research conducted by  Dr. Vincent Covello at Columbia University's Center for  Risk Communication shows that public assessment of how much we can be  trusted  and believed is based upon four factors: -  Empathy and caring   Competence and expertise  Honesty and openness
-   Dedication and commitment    Trust and credibility  are difficult to achieve;  if lost, they are  even more  difficult to regain.

[**Table of Contents**]
Avoiding Pitfalls- Pitfall: Jargon **Do:** Define all technical terms and acronyms.**Don't:** Use language  that may not be understood  by even a portion       of your audience.  
Pitfall: Humor
**Do:** If used, direct it at yourself.**Don't:** Use  it in  relation to  safety,  health, or  environmental       issues.
Pitfall: Negative Allegations
**Do:** Refute the allegation without repeating it.**Don't:** Repeat or refer to them.

Pitfall: Negative Words and Phrases
**Do:** Use positive or neutral terms.**Don't:**  Refer  to  national  problems, i.e.,  "This  is  not  Love       Canal."  
Pitfall: Reliance on Words
**Do:** Use visuals to emphasize key points.**Don't:** Rely entirely on words.

Pitfall: Temper
**Do:**Remain calm.  Use a  question or allegation  as a springboard to       say something positive.**Don't:**  Let   your  feelings  interfere   with  your  ability  to       communicate positively.

Pitfall: Clarity
**Do:** Ask whether you have made yourself clear.**Don't:** Assume you have been understood.

Pitfall: Abstractions
**Do:**Use  examples, stories,  and  analogies  to establish  a  common       understanding.
Pitfall: Nonverbal Messages
**Do:**Be sensitive  to nonverbal messages  you are communicating. Make       them consistent with what you are saying.**Don't:** Allow your  body language, your  position in  the room, or       your dress to be inconsistent with your message.  
Pitfall: Attacks
**Do:** Attack the issue.**Don't:** Attack the person or organization.

Pitfall: Promises
**Do:**Promise  only  what  you  can  deliver.  Set  and  follow  strict       orders.**Don't:** Make promises you can't keep or fail to follow up.
****
Pitfall: Guarantees
**Do:** Emphasize achievements made and ongoing efforts.**Don't:** Say there are no guarantees.

Pitfall: Speculation
**Do:** Provide information on what is being done.**Don't:** Speculate about worst cases.

Pitfall: Money
**Do:** Refer  to the  importance you  attach to  health, safety,  and       environmental issues;  your moral obligation  to public health  outweighs       financial considerations.**Don't:** Refer to the amount  of money spent as a  representationof       your concern.

Pitfall: Organizational Identity
**Do:**Use personal pronouns ("I," "we").**Don't:** Take on the identity of a large organization.

Pitfall: Blame
**Do:** Take responsibility for your share of the problem.**Don't:** Try to shift blame or responsibility to others.

Pitfall: "Off the Record"
**Do:**  Assume  everything  you  say  and  do  is  part  of  the  public       record.**Don't:** Make side comments or "confidential" remarks.

Pitfall: Risk/Benefit/Cost Comparisons
**Do:** Discuss risks and benefits in separate communications.**Don't:** Discuss your costs along with risk levels.

Pitfall: Risk Comparison
**Do:** Use them to help put risks in perspective.**Don't:** Compare unrelated risks.

Pitfall: Health Risk Numbers
**Do:**Stress  that  true  risk  is  between  zero  and  the  worst-case       estimate. Base  actions on federal  and state standards  rather than risk       numbers.**Don't:**  State absolutes  or expect  the  lay public  to understand       risk numbers.

Pitfall: Numbers
**Do:** Emphasize performance, trends, and achievements.**Don't:** Mention or repeat large negative numbers.

Pitfall: Technical Details and Debates
**Do:**  Focus  your   remarks  on  empathy,  competence,   honesty,  and       dedication.**Don't:**  Provide  too  much  detail  or  take  part  in  protracted       technical debates.

Pitfall: Length of Presentations
**Do:** Limit presentations to 15 minutes.**Don't:** Ramble or fail to plan the time well.

[**Table of Contents**]
Assessing Your Effectiveness

In designing  your communication program, establish measurable objectives.  For  each component, determine  what went well,  what could  have gone better,  and why.

**For each portion of the program, ask the following questions:**

 Were the objectives met?  Were the changes the result of your program?

  What went well? Why?

  What could have gone better? Why?  How can the program be improved?

  What lessons are there to be learned?  With whom should they be shared?

[**Table of Contents**]
Presenting Information at Public Meetings

What you do and how you  do it will affect your audiences'  perceptionsof  you, your organization,  and the information  you are  providing. Prepare  and  present effectively.
[**Table of Contents**]Before the Meeting

**Know Your Audience(s)**- Anticipate interests, concerns, and questions.   Consider them in preparation.
**Prepare Your Presentation**- Develop a strong introduction. Develop a maximum of three key messages.Assemble your supporting data.
- Prepare audiovisual aids. Practice.

**Prepare for Answering Questions**- Anticipate what questions will arise and prepare answers to them. Practice questioning and responding. 

[**Table of Contents**]

The Opening Presentation
  A strong  opening presentation sets a tone  for the meeting and  is crucialin  attempting to establish  trust and build credibility. Its elements include the  following:

**I. Introduction**- A statement of personal concern A statement of organizational commitment and intentA statement of purpose and a plan for the meeting
**II. Key Messages**- A maximum of three take-home points Information to support the key messages

**III. Conclusion**- A summarizing statement  
**I. Introduction**
****Remember  that   perceived  empathy   is  a   vital  factor  in  establishing trust  and  building credibility,  and  it  is assessed  by  your  audience  in   the  first   30  seconds.   Include  the   following  in   your  introduction:

**Statement of personal concern**            e.g., "I can see  by the number of people here  tonight that you are            as concerned about this issue as I am."

**Statement of organizational intent**e.g., "I  am  committed to  protecting the  environment and  the            public. We of the "x" have been involved with  this community            for a long time and want to work with the community on this issue."

**Statement of  purpose and plan  for the meeting.**  (Do not use            the same statement at each meeting.)            e.g., "Tonight, we would  like to share with you the findings of the            report for approximately 15 minutes, then we  would like to open the            floor for discussion, questions, and concerns.  We will be available            after the  meeting for  anyone who wishes  additional informationor            to continue the discussion."

**II. Key Messages and Supporting Data

****      The key  messages are points  you want your  public to have in  mind            after the meeting.  They should address central issues, and be short            and concise.  E.g., "We have extensively tested wells in the area and found that the water   meets all standards for safe drinking."

            To develop your key messages:

- Brainstorm.   Think  freely   and  job  down  all   pieces of            information you wish to communicate.             Select  key  messages.
 Identify  the  most  important  ideas.            Repeat the process until your list is down to three items.  
Identify  supporting   data.
  Other  information  you  listed            probably  provides support  to  your key  messages;  organize it to            reflect this.

**III. Conclusion  
- Restate verbatim your key messages.   Add a  future action statement:  What is your  organization goingto do on this project in the short term? Long term?

[**Table of Contents**]Presentation Aids

Audiovisual aids can make your  messages easier to understand.  People are  more likely  to remember a point  if they have  a visual association  with the  words. More guidance  in preparing quality presentations  can be found in  the  book  *Effective  Business  and  Technical  Presentation*  (Morrisey  and  Sechrest 1987). 

**Some Aids to Understanding**-  Charts   Illustrations  Diagrams
-   Glossaries   Maps  Video/motion pictures
-   35 mm slides   Site visits  Posters
-   Photographs   Examples  Handouts
[**Table of Contents**]
Planning and Preparation
   
**Factors:** Room size,  Audience  size,  Seating  arrangement,  Visual                      obstacles, Lighting, Electrical outlets
**To do:** Set up, focus, test, and arrange equipment beforehand.         Designate someone to help with lights.         Leave equipment intact until audience leaves.  
**Tool kit:**    Spare  bulbs,  3-pronged  adaptor,  Extension  cord,  Duct                      tape, Staff  phone  numbers, Blank  transparencies,  Slide                      tray, Transparencies, Markers/chalk, Back-up notes

[**Table of Contents**]
Design Guidelines
**Effective visual aids:**-   Are able to stand alone.   Illustrate a key concept.  Support only one major idea.
-   Use pictures or graphics rather than words whenever possible.   Conform to six words per line maximum, ten lines per visual maximum.  Feature short phrases or key words.
-   Highlight important points with color or contrast.   Represent facts accurately.  Are carefully made - neat, clear, and uncluttered.
-   Have impact. [**Table of Contents**]Presentation Reminders

When planning, practicing,  and conducting a presentation,  consider these  facets of verbal and nonverbal communication.  
- Volume    The  intensity  of  your  voice  reflects  your  confidence,  competence,  and  openness. Watch your audience for feedback. Adjust to your surroundings.   Enunciation/Pronunciation
Speak distinctly and correctly.  Be careful  with unfamiliar words.  Spell  and define terms as appropriate.  
Pace/Rhythm/Pitch
Vary  your  tempo. Speak  slowly  to  emphasize  key  messages, pause  for  emphasis, vary your voice pattern and length  of phrases. Avoid repeating such  words as "ok," "like," "not," and "uh."  
Facial Expressions/Eye Contact
Eye contact  is most  crucial. Your  mouth, eyes,  forehead, and  eyebrows  also communicate.  
Posture
Posture communicates attitude.  Try to have  a straight  stance with  legs  slightly apart.  
Gestures
  Gestures  can enhance  or detract from  your communication. Be  aware of yours  and make sure they are appropriate.  
Dress/Grooming
Dress  as  your audience  would expect  you to  at your  place of  workor  perhaps slightly less formally.  
Distractions
Avoid repetitive gestures such as  constant throat-clearing, checking your  watch, jingling keys or change, and pacing.  
[**Table of Contents**]
Using Risk Comparisons(Covello et al. 1988; Covello 1989)

  In explaining  risk data, you  may wish  to compare a  risk number to  another  number. 
**Remember:**-  Comparisons can help put risk in perspective.   Benefits should not be used to justify risks.  Irrelevant or misleading comparisons can harm trust and credibility.
   
**Guidelines for Risk Comparisons**- First-rank (most acceptable)     - of the same risk at two different times            with a standard            with different estimates of the same risk
Second-rank (less desirable)
of the risk of doing something versus not doing it            
- of alternative solutions to the same problem             with the same risk experienced in other places
Third-rank (even less desirable)
of average risk with peak risk at a particular time or location            
- of the risk from one course  of an adverse effect with the risk from            all sources of the same effect   Fourth-rank (marginally acceptable)
with cost; or one cost/risk ratio with another            
- of risk with benefit             of occupational risk with environmental risk            with other risks from the same source            
- with  other  specific  causes  of  the  same  disease,  illness, or            injury  Fifth-rank (rarely acceptable - use with extreme caution!)
of unrelated risks (e.g., smoking, driving a car, lightning)
  Remember the factors that people use  in their perception of risk; the more a  comparison disregards these factors, the more ineffective the comparison.

[**Table of Contents**]
A Presentation Planner

**Project:**
******Time:**
**Place:
  Date:

  Publics - Names: Concerns:
  Introduction - Statement of personal concern: Statement of organization commitment:Purpose and plan for the meeting:
  Key Messages  - Content: Supporting data:
  Conclusion  - Summary statement     Questions and Answers - Anticipated questions: Responses:
  Presentation Materials  - Audiovisuals: Handouts:
[**Table of Contents**]
Ten Deadly Sins of Communication
-  Appearing unprepared.   Handling questions improperly.  Apologizing for yourself or the organization.
-   Not knowing knowable information.   Unprofessional use of audiovisual aids.  Seeming to be off schedule.
-   Not involving participants.   Not establishing rapport.  Appearing disorganized.
-   Providing the wrong content.  [**Table of Contents**]
Answering Questions

****As  with  presentations,  your responses  to  individual's  questions  and  concerns  will affect  your  success. Prepare  and  practice. Consider  howto  answer questions in general and how to respond to specific inquiries.

**Guidelines****-  Be  prepared.   If you  know  your  subject and  know  your audience,  most  questions can be anticipated. Develop and practice responses. **Track  Your  Key  Messages.**  Use  your   responses  as  opportunity to reemphasize your key messages.Keep Your Answers Short and Focused.
 Your answer  should be less than2 minutes long.
- Practice  Self-Management.  Listen.  Be confident  and factual.  Control your emotions. **Speak and Act  with Integrity.** Tell the  truth. If you don't  know, sayso.  Follow  up as  promised.  If you  are  unsure of  a  question, repeat or paraphrase it to be certain of the meaning.

[**Table of Contents**]
Sample Questions

****The following  sample  questions  illustrate  what you  are  likely to  encounter, along  with suggested key messages and tips for responding to them.  For   a   discussion  of   different   types  of   tough   questions,  consult  *Communicate  with  Power:  Encountering  the  Media*,  Barry  McLoughlin  Associates, Inc., 1990.- You  are here as a representative of "x."  Why doesn't "x" have a program to investigate hazardous waste sites?

**Key  Message:** We  do  have a  policy  to investigate  hazardous waste  sites. In fact, we...  
           - State in a  positive manner that you  do not agree with  the questioner'sstatement. Do not try to ignore it. Be polite but firm.Take the opportunity to restate your position or message.
Your boss said that he was confident that there would be no   problems found at this location. Doesn't  he know that dumping 1,000  gallons  of  oil, paint thinner,  and solvent near the  vehicle shop  can cause serious  public health problems? Or is he trying to sway the results of the study?  
**Key Message:** Evaluating the safe  disposal of these products  is part  of  the overall investigation that  we are conducting  to ensure the continued  safety of the public.  
           - Do   not   repeat   the  negative   words.   Refute   without   repeatingallegations. Return to your message.
You've told us about the agency's position on  water quality. But would you  drink the water?

**Key Message:** I'm also concerned about the quality of drinking water-   not only as an agency representative but  also as a fellow citizen. Given all  I know about the issue and  given the type of person I am,  yes, I would drink  the water.  
- Be prepared for personal questions.        If you do not agree with the agency's  position, you should not act as a spokesperson.  Does EPA agree with what you are doing here?  
**Key Message:** We follow EPA guidelines and send EPA copies of all  our  studies.  
- Refer questions to the appropriate person or organization. Speak  only to  what  you know  and  on behalf  of  the organization  yourepresent.
Do you know the exact  figure on how much  money has been spent to date on this problem?
**Key Message:** I don't know  the exact figure. But if you  will giveme  your name and number, I will get that information for you by...  
- Say you don't know. Offer to get the information by a specified time.Don't lie or make up an answer.
- If you promise to get the information, follow up.  We've heard that your agency and  the state regulators have made a  dealto clean up heavy  contamination quietly and not  to do a proper  hazardous waste  investigation because it would be  embarrassing to admit this area  was missed  earlier. Why is your  agency being  insensitive by dragging  its feet on  this  environmental issue?

**Key Message:**Our goal is to fully protect the safety and   health  of the  community and  to do  so  in compliance  with all  applicable  federal and state laws and regulations.  We have issued several news  releases  on the study.  
               - Respond with a straightforward statement of theme. 
What do you  plan to do about the  lawsuit that a local business  has filed  against your agency claiming compensation for loss of business?

**Key Message:** That's a legitimate  question. But while the case is in  progress, I am not able to discuss this.  
- Give a reason why you can't answer.     What are your qualifications to run this program?

**Key Message:**  I have  several years' experience  in managing programs  of  this type, and  I have a team  of professionals working with  me to ensure  that all aspects of the program are carried out with quality.  
- Don't respond with hostility or emotion. Remove emotional words.

Don't  you know that you cannot  make final decisions without providing for  public comment, you idiot?
**Key  Message:**  All final  decisions  must take  public  comments very  seriously.  
- Restate, removing hostile or negative tone. 
It must be really hard to deal with all of your environmental problems.
**Key  Message:**My  training  and experience  prepare  me to  deal with  environmental, safety, and health problems, and  I am here to do the best  job  I can for the community.  
- Don't  buy into  the sympathetic approach.  You may  end up  agreeing and destroy your credibility. 
In reference to  groundwater contamination, why  do you  think your  agency  doesn't care about the health of its neighbors?
**Key  Message:** We  are very  much concerned  about the  health  of our  neighbors.  
Then why does it take  over 5 years of study to come up with  a solutionto  remediate your contamination of our groundwater?
**Key Message:**  I want to make sure that  it is clear that we take care  of  any situation  that poses  an immediate  danger without delay.  During our  study, which for  many reasons is an  extensive and expensive process,  we did  not find an immediate health threat. If we had, we  would have taken immediate  action. Public health is always our top concern.  
               - Be polite but firm. Return to your message.Repeat your statements.
- Be careful  not to  repeat negative  words like   contamination of  thepublic groundwater.         What is the worst-case scenario?
**Key Message:** I  would not want to  speculate. We are working  hardto  ensure the health  and safety of this  community. The study we  are conducting  will include testing of soil, groundwater... ******-   Don't speculate. If you do speculate, categorize it as such.
We have heard a rumor that  there are serious groundwater problems at  this  site.
**Key Message:**This is the first  time I've heard this rumor. The  data  I have seen indicate that no groundwater problems exist at this site.  
- Don't respond to rumor. Do tell the truth.

Why do you want  to expand? And did  you send an  undercover employee to a  private meeting and what information did he gather?
**Key Message:** Let  me respond to your first question. The community       has legitimate concerns about...  
- Choose the easiest to answer first. Don't answer them all at once.
What would you recommend that your boss  do to address the concerns of  the  public on these contamination problems?  
**Key Message:**  My boss  can request  advice and  guidance from  anyone  concerning  safe environmental  practices. When I'm  asked, I provide whatever  assistance I can.  
- Don't give this kind of advice when talking to the public or media.  
[**Table of Contents**]
Some DOS and Don'ts of Listening        (Atwater 1989)

**Do:**-  Become aware of your own listening habits.   Share responsibility for the communication.  Concentrate on what the speaker is saying.
-   Listen for the total meaning, including feelings.   Observe the speaker's nonverbal signals.  Adopt an accepting attitude.
-   Express empathic understanding.   Listen to yourself.  "Close the loop" of listening by taking appropriate action.
**Don't:**-   Mistake not talking for listening.   Fake listening.  Interrupt needlessly.
-   Pass judgment too quickly.   Make arguing an "ego-trip;" don't argue.  Ever tell a speaker, "I know exactly how you feel."
-   Overreact to emotional words.   Give advice unless it is requested.  Use listening as a way of hiding yourself.
[**Table of Contents**]
Managing Hostile Situations
Issues of health and environment can arouse strong anger and hostility. Consider some things you can do to diffuse anger and re-direct hostile energy.
**Remember**- Environmental issues can arouse strong emotions, including anger and hostility. Hostility is usually directed at you as a representative of an organization, not you as an individual.Dealing ineffectively with hostility can erode trust and credibility.
**Some Things You Can Do**
- Acknowledge the Existence of Hostility.    - You are sending the message that you are in control. The worst thing you can do is pretend it's not there. 
Practice Self-Management.
Control your apprehension.
- Anxiety undercuts confidence, concentration, and momentum. Listen.
Be Prepared
Plan, prepare, and practice your presentation and anticipated questions and answers.
Communicate Empathy and Caring.
Recognize people's frustrations.
- Use eye contact. Assume a listening posture.Answer questions carefully and thoughtfully.
**Track Your Messages.**- Turn negatives into positives. Bridge back to your messages.
[**Table of Contents**]
Working with the Media
Because working  with the media is  one of your  primary opportunities for  communicating with the  public, your positive relationships with the media are  crucial. Consider  what to do before, during, and after an interview, and ina  crisis.  
[**Table of Contents**]The Media Perspective

In general, the media is interested in the following:  
-   Human interest stories   Bad news more than good news  People's perspectives
-   Yes or no/safe or unsafe answers   Front-page news stories
[**Table of Contents**]Preparing a Message

  The  media  will be  seeking  information on:  Who?  What?  When? Where?  Why?  How?  
  To maximize your  impact, prepare and  practice delivering  your key  message.- For broadcast media: a 10- to 12-word "soundbite" For print media: 1- to 3-line quote

[**Table of Contents**]
Before, During, and After an Interview(Donovan and Covello 1989)

Before
**Do:**-   Ask who will be conducting the interview.   Ask which subjects they want to cover.  Caution them when  you are not the  correct person to interview  because thereare topics you cannot discuss (because lack of knowledge, etc.)
-   Inquire about the format and duration.   Ask who else will be interviewed.  Prepare and practice.

**Don't:**-   Tell the news organization which reporter you prefer.   Ask for specific questions in advance.  Insist they do not ask about certain subjects.
-   Demand your remarks not be edited.   Insist an adversary not be interviewed closeup.  Assume it will be easy.

During
**Do:**-  Be honest and accurate.   Stick to your key message(s).  State your conclusions first, then provide supporting data.
-   Be forthcoming to the extent you decide beforehand.   Offer to get information you don't have.  Explain the subject and content.
-   Stress the facts.   Give a reason if you can't discuss a subject.  Correct mistakes by stating you would like an opportunity to clarify.

**Don't:**-   Lie or try to cloud the truth.   Improvise or dwell on negative allegations.  Raise issues you don't want to see in the story.
-   Fail to think it through ahead of time.   Guess.  Use jargon or assume the facts speak for themselves.
-   Speculate, discuss hypothetical situations.   Say, "No comment."  Demand an answer not be used.

After
**Do:**-   Remember you are still on the record.   Be  helpful. Volunteer  to get information. Make yourself  available. Respectdeadlines.  Watch for and read the resulting report.
-   Call the reporter to politely point out inaccuracies, if any. 
**Don't:**- Assume the interview is over or the equipment is off.   Refuse to talk further.  Ask, "How did I do?"
-   Ask to review the story before publication or broadcast.   Complain to the reporter's boss first.

[**Table of Contents**]
In a Crisis
 A threat to health, safety, or the environment - actual, perceived, or       potential - can pose both danger and opportunity in risk communication.       Consider some DOS and Don'ts    

**Do:**-   Plan now.   Respond immediately - the first 24 hours are critical.  Respond straightforwardly.
**Don't:**-   Hope a crisis never comes.   Let the issue be defined by someone else.  Think  that keeping a  lid on the story  will prevent the  public from seeking
-   information. 
[**Table of Contents**]
References

Atwater  E. 1989.  In  E. Donovan  and  V. Covello.  *Risk Communication  Student Manual*. Chemical Manufacturers' Association, Washington, D.C.  
  Barry McLoughlin Associates 1990. *Communicate  with Power: Encountering the  Media*, New York.

  Chess C,  Hance BJ, Sandman PM 1988. *Improving Dialogue with Communities:A  Short Guide  to Government  Risk Communication*. New  Jersey Department of  Environmental Protection.

  Covello  V.  1983.  The  perception   of  technological  risks.  *Technology  Forecasting  and   Social  Change:  An  International  Journal*  23:285-297  (June).

  Covello et al. 1988.

  Covello  V.  1989.  Issues  and   problems  in  using  risk   comparisons  for  communicating right-to-know  information on  chemical risks.  *Environmental  Science and Technology*, 23 (12):1444-1449.

  Covello  V. 1992.  Risk communication, trust,  and credibility.  *Health and  Environmental Digest* 6(1):1-4 (April).  

  Covello V. 1993.  Risk communication,  trust, and  credibility. *Journal of   Occupational Medicine* 35:18-19 (January).

 Covello V, Allen F. 1988. *Seven Cardinal Rules of Risk Communication*.       US Environmental Protection Agency, Office of Policy Analysis, Washington,       DC    

  Covello V, McCallum D, Pavlova  M. 1989. *Effective Risk  Communication: The  Role  and Responsibility  of Government  and Nongovernment  Organizations*.  New York: Plenum Press.

 Donovan E, Covello V. 1989. *Risk Communication Student Manual*. Chemical       Manufacturers' Association, Washington, DC    

  Fischhoff   B,  Lichtenstein  S,  Slovic  P,  Keeney  D.  1981.  *Acceptable  Risk*. Cambridge, Massachusetts: Cambridge University Press.

 Morrisey G, Sechrest T. 1987. *Effective Business and Technical Presentation       (Third Edition)*. New York: Addison-Wesley Publishing Co., Inc.     
 

[**Table of Contents**]

 This page last updated on June 25, 2001  Contact Name: Wilma López/ WLopez@cdc.gov
ATSDR Home  |  Search  |  Index  |  Glossary  |  Contact UsAbout ATSDR  |  News Archive  |  ToxFAQs  |  HazDat  |  Public Health AssessmentsPrivacy Policy  |  External Links Disclaimer  | AccessibilityU.S. Department of Health and Human Services************