Westat’s Simani Price on Assessing the Effectiveness of Risk Communications During a Pandemic

Simani Price, Ph.D., an Associate Director for Public Health and Epidemiology, has more than a decade of experience conducting research and evaluation studies related to risk communication and public health emergencies for the Centers for Disease Control and Prevention (CDC). During the 2009 H1N1 influenza pandemic, she directed a nationally representative survey of U.S. households to assess people’s beliefs about their risks and preparedness for public health emergencies. Following the 2015 Zika outbreak, she directed a project for CDC to develop a conceptual framework and measures to assess the effectiveness of CDC emergency risk communications (ERC).

Q: Simani, with the rapid spread of COVID-19, effective communication about its risk to the public is critical to help people protect against it and prevent further community infection. You conducted an evaluation of CDC’s ERC during the Zika outbreak. What methods did you use to assess the quality, effectiveness, and impact of CDC’s messages, and would these be the same methods you would use to evaluate the same for COVID-19?

A: We developed a conceptual framework and measures to assess both internal processes at CDC and the impact of ERC on multiple target audiences. The framework and measures were informed by an extensive review of the ERC literature, interviews with leading academic researchers, and small group discussions with CDC stakeholders. Then we conducted a pilot test of these new measures on populations affected by the domestic Zika response. The framework and measures were designed to be adaptable to a range of public health emergencies and can certainly be used to assess the efficacy of CDC’s ERC regarding COVID-19.

Q: Which populations did you study and why?

A: We conducted research with health care providers because they are both a target audience for CDC ERC and also a channel for reaching another important CDC audience, pregnant women. Pregnant women are particularly vulnerable because of the potential for serious birth defects associated with Zika.

With Zika, our key communication message was protect your baby through prevention of mosquito bites by covering up, using insect repellent, eliminating standing water, using window screens, and not travelling to areas with known Zika outbreaks.

Q: What kinds of things did you look for regarding people’s awareness of the Zika virus?

A: We looked at the target audiences’ knowledge and awareness of CDC’s messages and also at purchase behaviors. Was there an increase in sales of netting and mosquito repellents, for example. We also looked at Google search patterns and CDC web metrics.

Q: What kinds of measures would you be looking at now with regard to COVID-19 messages?

A: The CDC ERC measures that were developed for Zika are very relevant for the current pandemic. The current CDC message is to prevent exposure by maintaining social distance, not gathering in large groups, use of handwashing and hand sanitizers, and staying home when ill. Therefore, we could assess the implementation of social distancing policies (closing schools, universities, businesses, and retail) as obvious short-term outcomes. Similarly, changes in purchase patterns—increases in purchase of hand sanitizers, cold and flu medicines, and, of course, toilet paper—are also outcomes.

Q: What might be some new ERC challenges confronting the CDC with the COVID-19 that did not exist with Zika?

A: Information spreads much more quickly now, especially on a wide variety of social media sites. This means that misinformation can spread just as quickly if people aren’t getting information from credible sources like CDC. And because COVID-19 has triggered an international crisis, it demands continual and frequent communication with countries worldwide.