Updated review on contaminant communication experiences in the circumpolar Arctic.

Arctic populations are amongst the highest exposed populations to long-range transported contaminants globally, with the main exposure pathway being through the diet. Dietary advice is an important immediate means to address potential exposure and help minimize adverse health effects. The objective of this work is to enable easier access to dietary advice and communication guidance on contaminants with a focus on the Arctic. This manuscript is part of a special issue summarizing the Arctic Monitoring and Assessment Programme's Assessment 2021: Human Health in the Arctic. The information was derived with internet searches, and by contacting relevant experts directly. Results include risk communication efforts in European Arctic countries, effectiveness evaluation studies for several Arctic countries, experience of social media use, and the advantages and challenges of using social media in risk communication. We found that current risk communication activities in most Arctic countries emphasize the importance of a nutritious diet. Contaminant-related restrictions are mostly based on mercury; a limited amount of dietary advice is based on other contaminants. While more information on effectiveness evaluation was available, specific information, particularly from Arctic countries other than Canada, is still very limited.

On the use of the term "real risk".

The term "real risk" and variations of this term are commonly used in everyday speech and writing, and in the scientific literature. There are mainly two types of use: i) in statements about what the real risk related to an activity is and ii) in statements about the risk related to an activity being real. The former type of use has been extensively discussed in the literature, whereas the latter type has received less attention. In the present study, we review both types of use and analyze and discuss potential meanings of type ii) statements. We conclude that it is reasonable to interpret a statement about the risk being real as reflecting a judgement that there is some risk and that the knowledge supporting this statement is relatively strong. However, such a statement does not convey whether the risk is small or large and needs to be supplemented by a characterization of the risk.

Striving for equitable vaccination coverage: Leveraging rapid coverage and community assessments during the COVID-19 pandemic to reach missed populations in Cambodia.

Amid the global response to the COVID-19 pandemic, Cambodia emerges as a notable exemplar, boasting a remarkable vaccination rate of 91% of its population by the end of 2021. This success can be attributed to a multifaceted approach encompassing strong governmental leadership, robust vaccine management, and effective risk communication. Despite notable success, challenges persisted in reaching unvaccinated segments of the population. Rapid Coverage and Community assessments (RCCAs) supported by UNICEF were deployed in 2022 and 2023 to support Government efforts in expanding vaccination reach to missed populations and bolster COVID-19 booster doses. RCCAs were conducted across 8 provinces, assessing 13,547 individuals from 87 low-coverage communes to identify not vaccinated people and understand their barriers. Overall, only seven percent missed any dose of C-19 vaccine, Disabilities and lack of education correlated with higher rates of zero doses (20.8% and 17.8%, respectively), with concerns about personal health conditions (25%) and adverse effects (10%) cited as top reasons for non-vaccination. RCCAs, differing from routine monitoring, utilized purposive sampling to identify barriers to vaccine access and uptake. Findings informed adaptive strategies by government and partners to enhance outreach in low-coverage areas. The RCCAs played a crucial role at the local level in ensuring vaccinations reached overlooked populations, providing innovative solutions and supporting UNICEF's national strategies. By the end of 2022, Cambodia achieved a high subnational coverage, contributing to a national coverage of 95% for primary doses and nearly 70% for the first booster for everyone above three years old. RCCAs also fostered local coordination, facilitating resource sharing, and coordinated action for more effective local outreach and community trust. Integration of RCCAs into national immunization programs is recommended to develop targeted outreach for underserved populations, including zero-dose children and communities. Cambodia's adaptation of RCCAs during the pandemic offers valuable insights into identifying and engaging missed populations, highlighting the importance of community involvement and targeted interventions for future pandemic preparedness, and achieving more equitable health outcomes in the longer-term.

How do young women approaching screening age interpret the NHS cervical screening leaflet? A mixed methods study of identifying interpretation difficulties, barriers, facilitators, and leaflet interpretation, engagement and future screening behaviour.

BACKGROUND: Cervical cancer is a common cancer among young women aged 25-29 in England, and the NHS cervical screening leaflet is the first point of contact for those being invited for their first screening. This study aimed to explore how young women (18-24) understand and engage with the leaflet, as well as the barriers and facilitators associated with its interpretation, engagement, and screening intentions. METHODS: The study used a mixed-methods approach, including a survey (n = 120) to identify interpretation difficulties and how they were affected by different characteristics, and a follow-up interview (n = 10) to assess the utility of the leaflet, identify issues with its practicality, and determine the factors that influence screening intentions. RESULTS: The survey results showed that interpretation difficulties were common, particularly regarding HPV assessment, screening results, additional tests/treatment, and screening risks. Lower interpretation accuracy was associated with lower numeracy scores and non-white ethnicity. Despite these difficulties, participants had high confidence and motivation to engage with the leaflet. The interviews revealed knowledge gaps, issues with the leaflet's practicality, and a preference for digital information. Factors that were identified as barriers and facilitators of leaflet interpretation, engagement, and screening intentions included knowledge, social influence, beliefs about consequences, environmental context and resources, social role and identity, emotions and intentions. CONCLUSION: The current leaflet does not provide enough information for young women to make an informed decision about screening attendance. Implementing a digital invitation featuring simplified gist representation, targeted behaviour change techniques (BCTs), videos, and interactive tools can enhance education and promote screening behaviour. Future research should consider using digital tools and strategies to address existing barriers related to interpretation and engagement.

'Follow the science': Popular trust in scientific experts during the coronavirus pandemic.

The coronavirus pandemic increased the role played by scientific advisers in counselling governments and citizens on issues around public health. This raises questions about how citizens evaluate scientists, and in particular the grounds on which they trust them. Previous studies have identified various factors associated with trust in scientists, although few have systematically explored a range of judgements and their relative effects. This study takes advantage of scientific advisers' heightened public profile during the pandemic to explore how people's trust in scientists is shaped by perceptions of their features and traits, along with evaluations of their behaviour and role within the decision-making process. The study also considers people's trust in politicians, thereby enabling us to identify whether trust in scientists reflects similar or distinctive considerations to trust in partisan actors. Data are derived from specially designed conjoint experiments and surveys of nationally representative samples in Britain and the United States.

Navigating vaccine hesitancy: Strategies and dynamics in healthcare professional-parent communication.

Understanding the communication dynamics between vaccine-hesitant parents and healthcare professionals (HCPs) is vital for addressing parent concerns and promoting informed decision-making. This paper focuses on strategies used by HCPs to communicate with vaccine-hesitant parents. It draws on empirical evidence generated as part of the international project VAX-TRUST. More specifically, 60 hours of observations were carried out in three different pediatric practices during vaccination-related visits, and 19 physicians and nurses were interviewed. We focused on the specific context of the Czech Republic, which represents a country with a mandatory vaccination system and in which children's immunization is the responsibility of pediatric general practitioners. We demonstrate that the dynamics between parents and HCPs and their willingness to invest time in the vaccination discussion are influenced by how HCPs categorize and label parents. Furthermore, we outline some of the different strategies HCPs employ while addressing concerns regarding vaccination. We identified two different strategies HCPs use to manage the fears of vaccine-hesitant parents. The first strategy focused on the communication of risks associated with vaccination (and lack thereof). HCPs used a variety of discursive practices to familiarize the unfamiliar risks of vaccine-preventable diseases (by mobilizing representations that are part of collective memory, incorporating personal experiences to materialize the presence of risk and the confidence in the safety of vaccines and by situating risk as embedded in everyday processes and integral to the uncertainty of the global world). The second strategy involved the conscious employment of medical procedures that may contribute to reducing vaccination fears.

Using Separate Single-Outcome Risk Presentations Instead of Integrated Multioutcome Formats Improves Comprehension in Discrete Choice Experiments.

INTRODUCTION: Despite decades of research on risk-communication approaches, questions remain about the optimal methods for conveying risks for different outcomes across multiple time points, which can be necessary in applications such as discrete choice experiments (DCEs). We sought to compare the effects of 3 design factors: 1) separated versus integrated presentations of the risks for different outcomes, 2) use or omission of icon arrays, and 3) vertical versus horizontal orientation of the time dimension. METHODS: We conducted a randomized study among a demographically diverse sample of 2,242 US adults recruited from an online panel (mean age 59.8 y, s = 10.4 y; 21.9% African American) that compared risk-communication approaches that varied in the 3 factors noted above. The primary outcome was the number of correct responses to 12 multiple-choice questions asking survey respondents to identify specific numbers, contrast options to recognize dominance (larger v. smaller risks), and compute differences. We used linear regression to test the effects of the 3 design factors, controlling for health literacy, graph literacy, and numeracy. We also measured choice consistency in a subsequent DCE choice module. RESULTS: Mean comprehension varied significantly across versions (P < 0.001), with higher comprehension in the 3 versions that provided separated risk information for each risk. In the multivariable regression, separated risk presentation was associated with 0.58 more correct responses (P < 0.001; 95% confidence interval: 0.39, 0.77) compared with integrated risk information. Neither providing icon arrays nor using vertical versus horizontal time formats affected comprehension rates, although participant understanding did correlate with DCE choice consistency. CONCLUSIONS: In presentations of multiple risks over multiple time points, presenting risk information separately for each health outcome appears to increase understanding. HIGHLIGHTS: When conveying information about risks of different outcomes at multiple time points, separate presentations of single-outcome risks resulted in higher comprehension than presentations that combined risk information for different outcomes.We also observed benefits of presenting single-outcome risks separately among respondents with lower numeracy and graph literacy.Study participants who scored higher on risk understanding were more internally consistent in their responses to a discrete choice experiment.

Insufficient evidence for interactive or animated graphics for communicating probability.

OBJECTIVES: We sought to analyze interactive visualizations and animations of health probability data (such as chances of disease or side effects) that have been studied in head-to-head comparisons with either static graphics or numerical communications. MATERIALS AND METHODS: Secondary analysis of a large systematic review on ways to communicate numbers in health. RESULTS: We group the research to show that 4 types of animated or interactive visualizations have been studied by multiple researchers: those that simulate experience of probabilistic events; those that demonstrate the randomness of those events; those that reduce information overload by directing attention sequentially to different items of information; and those that promote elaborative thinking. Overall, these 4 types of visualizations do not show strong evidence of improving comprehension, risk perception, or health behaviors over static graphics. DISCUSSION: Evidence is not yet strong that interactivity or animation is more effective than static graphics for communicating probabilities in health. We discuss 2 possibilities: that the most effective visualizations haven't been studied, and that the visualizations aren't effective. CONCLUSION: Future studies should rigorously compare participant performance with novel interactive or animated visualizations against their performance with static visualizations. Such evidence would help determine whether health communicators should emphasize novel interactive visualizations or rely on older forms of visual communication, which may be accessible to broader audiences, including those with limited digital access.

Trending ticks: using Google Trends data to understand tickborne disease prevention.

Introduction: Ticks and pathogens they carry seriously impact human and animal health, with some diseases like Lyme and Alpha-gal syndrome posing risks. Searching for health information online can change people's health and preventive behaviors, allowing them to face the tick risks. This study aimed to predict the potential risks of tickborne diseases by examining individuals' online search behavior. Methods: By scrutinizing the search trends across various geographical areas and timeframes within the United States, we determined outdoor activities associated with potential risks of tick-related diseases. Google Trends was used as the data collection and analysis tool due to its accessibility to big data on people's online searching behaviors. We interact with vast amounts of population search data and provide inferences between population behavior and health-related phenomena. Data were collected in the United States from April 2022 to March 2023, with some terms about outdoor activities and tick risks. Results and Discussion: Results highlighted the public's risk susceptibility and severity when participating in activities. Our results found that searches for terms related to tick risk were associated with the five-year average Lyme Disease incidence rates by state, reflecting the predictability of online health searching for tickborne disease risks. Geographically, the results revealed that the states with the highest relative search volumes for tick-related terms were predominantly located in the Eastern region. Periodically, terms can be found to have higher search records during summer. In addition, the results showed that terms related to outdoor activities, such as "corn maze," "hunting," "u-pick," and "park," have moderate associations with tick-related terms. This study provided recommendations for effective communication strategies to encourage the public's adoption of health-promoting behaviors. Displaying warnings in the online search results of individuals who are at high risk for tick exposure or collaborating with outdoor activity locations to disseminate physical preventive messages may help mitigate the risks associated with tickborne diseases.

Human exposure to per- and polyfluoroalkyl substances (PFAS) via the consumption of fish leads to exceedance of safety thresholds.

Per- and polyfluoroalkyl substances (PFAS) receive global attention due to their adverse effects on human health and the environment. Fish consumption is a major source of human PFAS exposure. The aim of this work was to address the lack of harmonization within legislations (in the EU and the USA) and highlight the level of PFAS in fish exposed to pollution from diffuse sources in the context of current safety thresholds. A non-exhaustive literature review was carried out to obtain PFAS concentrations in wild fish from the Norwegian mainland, Svalbard, the Netherlands, the USA, as well as sea regions (North Sea, English Channel, Atlantic Ocean), and farmed fish on the Dutch market. Median sum wet weight concentrations of PFOA, PFNA, PFHxS, and PFOS ranged between 0.1 µg kg-1 (farmed fish) and 22 µg kg-1 (Netherlands eel). Most concentrations fell below the EU environmental quality standard (EQSbiota) for PFOS (9.1 µg kg-1) and would not be defined as polluted in the EU. However, using recent tolerable intake or reference dose values in the EU and the USA revealed that even limited fish consumption would lead to exceedance of these thresholds - possibly posing a challenge for risk communication.

Severity influences categorical likelihood communications: A case study with Southeast Asian weather forecasters.

Risk assessments are common in multiple domains, from finance to medicine. They require evaluating an event's potential severity and likelihood. We investigate the possible dependence of likelihood and severity within the domain of impact-based weather forecasting (IBF), following predictions derived from considering asymmetric loss functions. In a collaboration between UK psychologists and partners from four meteorological organisations in Southeast Asia, we conducted two studies (N = 363) eliciting weather warnings from forecasters. Forecasters provided warnings denoting higher likelihoods for high severity impacts than low severity impacts, despite these impacts being described as having the same explicit numerical likelihood of occurrence. This 'Severity effect' is pervasive, and we find it can have a continued influence even for an updated forecast. It is additionally observed when translating warnings made on a risk matrix to numerical probabilities.

Pet Owners Risk Perception and Risk Communication in Disasters in Developing Countries.

Disasters can cause great physical and financial damage to pet owners in developing countries. These effects lead to severe psychological side effects on individuals and families. With the tendency of families to keep pets in these countries, many challenges have arisen regarding how to manage these pets before, during, and after disasters. Therefore, mitigation, prevention, and preparedness measures for these families should be prioritized in the disaster management cycle to minimize psychological effects such as posttraumatic stress disorder (PTSD) after losing pets.

Hear me out: the role of competent and warm vocal tones in risk communication.

Risk communication involves conveying potential risks to the audience. It's crucial for shaping behavior and influencing individual well-being. Previous research predominantly focused on verbal and written aspects of risk communication, with less emphasis on nonverbal cues like vocal tone. Addressing this gap, our study explores the impact of competent and warm vocal tones on risk communication across two risky decision-making paradigms, the Balloon Analogue Risk Task (BART) in Study 1 and the Gambling Task in Study 2. Results show that competent and warm vocal tones are more persuasive than neutral tones, and their effectiveness varies in different decision-making scenarios. Additionally, participants' perceived competence and warmth of vocal tones mediate this persuasiveness. This study enhances our theoretical understanding of risk communication by incorporating the impact of vocal tones. Also, it carries practical implications for marketers and practitioners, demonstrating the importance of using voice as a medium to persuade in real-world scenarios.

Risk perception in long-term evacuees of Futaba town, Fukushima: a cross-sectional study reveals greater concerns outside the prefecture, 12 years after the accident.

For over 12 years since the 2011 East Japan Earthquake, the decontamination of radioactive materials is still incomplete. Although evacuation orders had been lifted in ~15% of Futaba town, the site of the Fukushima Daiichi Nuclear Power Plant, by August 2022, anxiety regarding the effects of nuclear radiation persists among evacuees, and their intention to return (ITR) remains low. As of August 2023, only 90 residents lived there. As the only town with government functions relocated outside Fukushima Prefecture, Futaba has more residents who evacuated outside the prefecture. Although numerous factors affect risk perception and ITR to the place of previous residence, the impact of evacuation destination on risk perception remains unknown. Therefore, this study aimed to evaluate the impact of evacuation destination on radiation risk perception. In 2022, a survey was conducted on 404 evacuees aged >18 years. The responses were compared between groups outside and inside Fukushima using the chi-square test and multivariate logistic regression analysis. Significant relationships were found between the evacuation destination and risk perception of genetic effects in the next generation (odds ratio [OR] = 1.92, 95% confidence interval [CI]: 1.15-3.20) and of the health effects of radiation (OR = 1.76, 95% CI: 1.10-2.84), which were both higher in those who had evacuated outside Fukushima. These findings stress the importance of evacuation destination choice and information access for evacuees' risk perception. Enhanced education and support efforts are necessary to help evacuees not only in Fukushima but also throughout Japan.

Post-tropical cyclone Fiona and Atlantic Canada: Media framing of hazard risk in the Anthropocene.

Post-tropical cyclone Fiona made landfall in Nova Scotia, Canada, in September 2022 with the force of a Category 2 hurricane. Using 'risk society' as an analytical framework, and Thomas A. Birkland's 'focusing event' concept, this paper seeks to understand how publics construct risk in the context of climate change and how institutions engage with those narratives. A qualitative content analysis of 439 newspaper articles from across Canada reveals that most media provide a superficial description of hazard impacts. When media are critical, they connect Fiona to climate change, other extreme events, social vulnerability, and systemic inequality. In response to Fiona and industry trends, insurance representatives indicate a withdraw from covering low-probability, high-consequence events owing to ambiguity in risk analysis and financial interests, complicating hazard relief. Political actors' rhetoric is strong-delivering relief in unprecedented ways and offering new adaptive policy. However, a history of unfulfilled political promises to act on climate change elicits scepticism from media sources.

Verbal Probability Terms for Communicating Clinical Risk - a Systematic Review.

Verbal probability expressions such as 'likely' and 'possible' are commonly used to communicate uncertainty in diagnosis, treatment effectiveness as well as the risk of adverse events. Probability terms that are interpreted consistently can be used to standardize risk communication. A systematic review was conducted. Research studies that evaluated numeric meanings of probability terms were reviewed. Terms with consistent numeric interpretation across studies were selected and were used to construct a Visual Risk Scale. Five probability terms showed reliable interpretation by laypersons and healthcare professionals in empirical studies. 'Very Likely' was interpreted as 90% chance (range 80 to 95%); 'Likely/Probable,' 70% (60 to 80%); 'Possible,' 40% (30 to 60%); 'Unlikely,' 20% (10 to 30%); and 'Very Unlikely' with 10% chance (5% to 15%). The corresponding frequency terms were: Very Frequently, Frequently, Often, Infrequently, and Rarely, respectively. Probability terms should be presented with their corresponding numeric ranges during discussions with patients. Numeric values should be presented as X-in-100 natural frequency statements, even for low values; and not as percentages, X-in-1000, X-in-Y, odds, fractions, 1-in-X, or as number needed to treat (NNT). A Visual Risk Scale was developed for use in clinical shared decision making.

Considerations and challenges in support of science and communication of fish consumption advisories for per- and polyfluoroalkyl substances.

Federal, state, tribal, or local entities in the United States issue fish consumption advisories (FCAs) as guidance for safer consumption of locally caught fish containing contaminants. Fish consumption advisories have been developed for commonly detected compounds such as mercury and polychlorinated biphenyls. The existing national guidance does not specifically address the unique challenges associated with bioaccumulation and consumption risk related to per- and polyfluoroalkyl substances (PFAS). As a result, several states have derived their own PFAS-related consumption guidelines, many of which focus on one frequently detected PFAS, known as perfluorooctane sulfonic acid (PFOS). However, there can be significant variation between tissue concentrations or trigger concentrations (TCs) of PFOS that support the individual state-issued FCAs. This variation in TCs can create challenges for risk assessors and risk communicators in their efforts to protect public health. The objective of this article is to review existing challenges, knowledge gaps, and needs related to issuing PFAS-related FCAs and to provide key considerations for the development of protective fish consumption guidance. The current state of the science and variability in FCA derivation, considerations for sampling and analytical methodologies, risk management, risk communication, and policy challenges are discussed. How to best address PFAS mixtures in the development of FCAs, in risk assessment, and establishment of effect thresholds remains a major challenge, as well as a source of uncertainty and scrutiny. This includes developments better elucidating toxicity factors, exposures to PFAS mixtures, community fish consumption behaviors, and evolving technology and analytical instrumentation, methods, and the associated detection limits. Given the evolving science and public interests informing PFAS-related FCAs, continued review and revision of FCA approaches and best practices are vital. Nonetheless, consistent, widely applicable, PFAS-specific approaches informing methods, critical concentration thresholds, and priority compounds may assist practitioners in PFAS-related FCA development and possibly reduce variability between states and jurisdictions. Integr Environ Assess Manag 2024;00:1-20. © 2024 SETAC.

The Risk Perception of the Chinese Diaspora during the COVID-19 Pandemic: Targeting Cognitive Dissonance through Storytelling.

The global COVID-19 pandemic in 2020 required risk communications to mitigate the virus' spread. However, social media not only conveyed health information to minimize the contagion, but also distracted from the threat by linking it to an externalized 'other'-primarily those appearing to be of Chinese descent. This disinformation caused the attribution of blame to Chinese people worldwide. In Canada's Greater Toronto Area, Chinese individuals reported widespread public stigma that compounded their risk of contagion; to the degree that it was driven by cognitive dissonance, it generated experiences of social and cultural vulnerability. In this paper, we draw on the aforementioned study's findings to explain how the risk perception and threat appraisal of Chinese diaspora individuals were impacted by different cognitive dissonance pathways. These findings explore how storytelling is a viable intervention with which to target and mitigate cognitive dissonance. Indeed, the mechanisms of cognitive dissonance can modify risk perception and mitigate social and cultural vulnerability, thereby averting potential long-term negative consequences for one's mental health and well-being. We hope our guidance, training educators to target pathways of cognitive dissonance by drawing on storytelling (with humour), can assist them to better convey information in ways that are more inclusive during public health emergencies.

Assessment of coping capacity of public health facilities with health emergency situations during an event of flood in Mumbai.

BACKGROUND: Floods had been a repeated phenomenon in India, causing considerable losses to properties, life and infrastructure, and public utilities. Floods are found to be a common natural disaster occurring not only in developing countries but also in developed nations. Hospital preparedness against disaster could help in the management of the surge of patients in an effective manner. This study aims to assess the capacity of public health facilities for coping up with health emergency situations during an event of flood in Mumbai. MATERIALS AND METHODS: A cross-sectional study was conducted among 38 public health facilities in Mumbai. A purposive sampling technique was used for the selection of the health facilities. Administrative staff, medical officers, and pharmacy in charges were included in the study. RESULTS: The study revealed that surge capacities in hospitals were adequate as they had additional beds for monsoon-related diseases for the preceding flood situation. There was a triage policy, and the staff were trained on the same. Procurement of drugs was easy because of a good networking system between hospitals. Due to this networking system, patients were also transferred to the nearest healthcare facility in a short span of time. CONCLUSION: The response during an event of a flood in the health facilities of Mumbai city was good as they have regular training sessions to be prepared for the emergency situations during monsoon as they have repeated exposure to floods.

Consumer knowledge, attitudes, and behaviour regarding food safety - A perspective from Laos.

Primary research data on food chain safety at consumer level is needed to help policymakers to decrease the risk of foodborne infections in the Lao People's Democratic Republic. Therefore, the objectives of this study are to 1) determine Lao people's food safety knowledge, attitudes, and intentions and identify the most influential factors that shape their food safety behaviour, and 2) to support the government in the development of more efficient risk communication programmes. A paper-based consumer survey was implemented to collect quantitative data on the selected topics about Laotian consumers, as well as on the equipment of households regarding the conditions and tools necessary for safe food preparation and storage. A model was developed based on the extended Theory of Planned Behaviour (TPB), and partial least squares structural equation modelling (PLS-SEM) was applied to analyse the factors that affect food safety behaviour. The elements of Knowledge and Perceived Behavioural Control positively influence behaviours, such as using separate chopping boards for raw and ready-to-eat foods. According to the model, only 10 % of the Intentions would be translated into Behaviours, which gap can be explained by the lack of a hygienic environment. Although the survey indicated that Laotian people intend to follow food safety guidelines, participants felt they lacked sufficient knowledge. This perception was validated by the knowledge test and behavioural part of the study. In the light of these findings, it is essential to raise awareness and promote food safety knowledge and interventions, such as enhancing food safety education in childhood. This would help to facilitate and encourage adopting safe practices to improve overall food safety at the consumer level, delivering positive impacts also to the food business sector.