Communicating during a crisis: the public health lessons learned from COVID-19

Mireia Yter
David Murillo

How can health institutions improve their communication policies during times of public health risks and crises?

Esade researchers have explored the issue and published their findings in the peer-reviewed journal Qualitative Health Research. The study was carried out during COVID-19 and its authors—Mireia Yter, David Murillo, and Andreas Georgiou—examined how society responded to the new circumstances in the given situation focusing on the increase in ‘social capital’—observable through some concrete manifestations of solidarity, mutual trust, participation in social groups, and a sense of belonging, among others.

The researchers conducted a qualitative survey of 375 respondents, the majority from Europe but some from as far afield as the Americas, Africa, Asia, and Oceania. Questions focused on the actions and practices of, and attitudes towards, public health workers, and the reasons behind them.

The results revealed five key common areas for the overwhelmingly positive public response: trust in health institutions; the legitimacy of health professionals, scientists, and researchers; altruism, gratitude, and reciprocity; the recognition of public health workers' endeavors; and support provided in the form of donations and other material resources.

Four paths to positive responses

Analysis of these key areas allowed the researchers to make four main recommendations to be implemented in public health risk communication strategies and encourage positive responses.

1) Healthcare institutions should lead public health communication

The survey revealed that healthcare institutions were seen as more trustworthy agents during the early days of the pandemic. “The results of our fieldwork suggest that for effective communication to be achieved, this should be led by legitimated healthcare institutions,” say the researchers. “Our data confirms previous research suggesting that credible sources can play a key role when it comes to effectively promoting public health behavior.”

2) Focus on experts

Individual experts and their visibility, as well as the institutions they represent, are key in helping to spread the word. “Our data revealed that experts were seen as legitimate representatives,” say the researchers. “The findings suggest that media exposure should be given to scientific experts, rather than leaving them as invisible expert figures behind the government’s institutional messages.”

3) Make altruism, gratitude, and reciprocity central to communication messages

The survey revealed that “abundant instances of bounded solidarity” played a major part in the combined social efforts of individuals in protecting healthcare workers and institutions.

“Bounded solidarity is a tool that, similarly to what happens in other major crises like wars or natural disasters, provides an actionable reserve that becomes operative with or without institutional direction,” explain the researchers. “Finding synergies between this untapped social potential and governmental policies should be a priority of any public communication effort.”

4) Emphasize individual efforts

Healthcare workers and other medical professionals face a precarious employment situation that requires greater recognition for their work. “Survey respondents expressed their support for healthcare personnel and also expected specific actions to be taken by the authorities to significantly increase their status as essential workers,” explain the researchers. “Communication campaigns that reveal the travails of health personnel—such as continuous overwork or poor working conditions—seem bound to create empathy while increasing effectiveness and compliance of public health regulations.”

Public health implications

Crisis communication is an essential way for public health institutions to inform and advise on necessary measures to minimize the impact of risk.

The European Centre for Disease Prevention and Control says that “research shows that properly designed behavior-based health communication activities can have a significant positive impact on health-related attitudes, beliefs, and behaviors (of the recipients).”

“Our aim with this research is to show how, drawing from the data we collected and working around the concept of social capital, governments can improve public policy interventions,” explain its authors. “And our results suggest some key learning points that confirm or build accumulated knowledge to develop a public policy communication strategy in a crisis mode setting.”

There are, they acknowledge, some limitations to the research.

“Respondents spent the lockdown in different parts of the world, experiencing different stages in the development of the pandemic, so biases may exist. Although we observed a certain level of homogeneity that impelled us to treat the sample as one common pool, future research could examine the possible differences between different stages in the pandemic and the citizens’ responses to that in terms of bonded solidarity and social capital in a broader sense.

 “However, our main contribution is to show how the findings of our research can be used in the field of communication in times of pandemic from a public health perspective.”

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