Introduction to Crisis & Emergency Risk Communication (CERC)

Moderator: Haley McCalla

Presenters: Kellee Waters, B.A.

Date/Time: May 1, 2018, 2:00 – 3:00 pm ET

Haley McCalla >> Good afternoon, everyone. My name is Haley McCalla, and I’m from CDC’s Office of Public Health Preparedness and Response Division of Emergency Operations. And, I’d like to welcome you to today’s crisis and emergency risk communication webinar titled “Introduction to CERC”. Today, we will hear from CDC’s Kellee Waters who is a Senior Health Communication Specialist. If you do not wish for you participation to be recorded, please exit at this time. You can earn continuing education by completing this webinar. Please follow the instructions linked in the invitation you received. The course access code is CERC0501 with all letters capitalized. To repeat, the course access code is CERC0501, and you must use this to receive continuing education. Today’s webinar is interactive. To make a comment, click the chat button on your screen and then enter your thoughts. To ask a question, please use the Q&A button on your screen. The Q&A session will begin after Kellee has presented. We will now transition to our presenter Kellee Waters. Kellee currently supports the Emergency Risk Communication Branch which oversees the CERC program. Kellee has over 15 years’ experience in public health communication. She has provided communication support during emergency responses to H1N1, Ebola, Zika, the 2017 hurricane season, and others. Previously, she served as an editor, media liaison, and public information officer to internal and external partners including congressional correspondence. She currently leads the CERC program and has conducted numerous international and national trainings on the subject matter. Thank you so much for joining us today, Kellee. Please begin.

Kellee Waters >> Good afternoon, everyone. We’re going to discuss the very baics of Crisis and Emergency Risk Communication today. CERC was developed as a framework, initially, for public information officers, but I know we have a lot of people joining us on this call who may not be public information officers. That’s okay. You often get put into different situations in emergency that require communication, and these skill sets, hopefully, will assist you in that process. I’m going to share my slide presentation with you, and this presentation was sent out in the link that you should have accessed to get into this webinar. If you have any trouble accessing it, though, please do send a comment, and we’ll try to assist you. As Haley said, I’ve been with the CDC for more than 15 years and currently work on Crisis and Emergency Risk Communication curriculum. I have been teaching this curriculum for the last three years, and we’re in the process of revising our manual. So, at the end of this presentation, you’ll be directed to a link to our website where you can access additional resources and our updated content as well as our email address if you have any questions, which I’m sure you will. Today, we’re only going to talk about a fraction of CERC. We’re going to talk about the introduction elements that include the six principles of CERC and our CERC rhythm. After I’ve presented, you’ll be able to ask questions, and I’ll be able to provide answers. We’ll discuss the questions and answers after the presentation, but please feel free to continue typing them in as they occur to you. So, let’s get started. CERC was developed, initially, to help people make the best decisions that they can possibly make in incredibly challenging time constraints and with incomplete information. So, basically, Crisis and Emergency Risk Communication principles are used by communicators to help, are used by communicators to help develop messages that help people do the best the best they can in trying times. The reason this is necessary is because the right message, the right information given at the right time from the right person really can save lives. The introduction to Crisis and Emergency Risk Communication gives a little bit of background, gives a little bit of the history on why this is necessary, and then lays out some key principles. So, what I’m going to do is talk to you a little bit first about why Crisis and Emergency Risk Communication was developed. We all know that there are different hazards that people face every day. Infectious disease outbreaks, of course, working at the CDC is something that we come across regularly. Infectious disease outbreaks can mean infectious diseases we’re familiar with or new and unknown infectious diseases that we discover. Natural disasters and severe weather also have a public health component. Bioterrorism is something that people are often concerned with, and it’s something that, initially, when CERC was developed, we had to address. This manual was developed in 2002, shortly after the anthrax attacks in the U.S. And, chemical and radiation exposures are an ongoing concern for many people. As hazards continue, so will communication needs, and we have to adapt to these situations. There are other elements that increase risk to populations. Many areas, as people move into them for work, for other reasons, become highly populated. They become extremely dense, and what this means is as those areas are impacted with any emergency, that just means more people are affected and more people are at risk of injury or life-threatening illness. Technology can be seen two ways. We can think of technology as our, smartphones as our computers as our laptops our iPads, and when emergencies happen, and we lose service or towers go down, our reliance on these methods of communication can feel almost like we’re crippled, like we don’t know quite how to function. We have to come up with new ways of reaching out to people. But, we also can think of technology as infrastructure. If roads are damaged or if, if pathways to get to communities are blocked, needed help can’t get where it needs to go, and neither can information. We also talk about aging populations, whether they need medication, whether that medication needs to be stored at perhaps a room temperature or a refrigerated temperature. If an emergency happens and there is no electricity, we need to be able to communicate alternative means for keeping these special target populations healthy. It’s not just aging populations. And, when CERC talks about messages and audiences in another chapter, we talk a little bit more about how to target special, special segments of the population. And then, international travel. When I was deployed to Africa to help with CDC’s response to the 2014-2015 Ebola outbreak, it took me 24 hours to travel from West Africa back to Atlanta, Georgia, and that’s how fast Ebola could have traveled with me. So, it’s important to consider these things when we’re developing communication messages. In a catastrophe, communication is different. People take in information differently. They take in information in very small bits, and you have to remember that people aren’t just listening to the information that your organization wants to communicate. They’re listening to all kinds of responders. Response organizations from FEMA, response organizations like CDC who want to communicate public health information. They’re listening to doctors. They’re listening to local news. They’re listening to their families and their communities. So, when they’re getting inundated with messages, you want to make sure that what you’re saying is short, clear, and hopefully, memorable. They’re going to process that information differently. People can only remember so much. Again, you want to make sure that it’s short and easily retained, easily repeatable so that the more they hear it, the more likely they are to remember it. Because ultimately, you want them to act on it. If they hear the information correctly and they’re able to process it, they’re going to act on it appropriately, but if they don’t hear it the way that you intend, and they can’t process it appropriately, they may act on it inappropriately. So, communication in a crisis with so much information and so much pressure and so much confusion is very, very different which is why Crisis and Emergency Risk Communication principles are so important to follow. The Crisis and Emergency Risk Communication curriculum for CDC was developed in 2002, and it was developed based on psychological and communication sciences. But, it was also developed on a wealth of experience in the fields of public health emergency response. Which leads us to what ultimately became the six principles of CERC. Fully integrated, CERC helps ensure that limited resources are managed well and can do the most good at every phase of an emergency response. These six principles, used throughout an emergency, can help guide your messages to be clear and concise and, hopefully, actionable. You want to be right. You want to be first and be right. You want to be credible. You want to express empathy, promote action, and show respect. Let’s talk about these in more detail. Be first. Of course, in our 24 hours news world that we live in, it’s hard to be first. With eye reporters and everyone who has a cell phone taking pictures and posting them instantly. What I mean by be first is that you need to be first with what your organization is responsible for. Any information your organization is responsible for sharing, you should be first to share. For CDC, that means public health information. Anything that might help the public protect their safety and wellbeing and their public health. We should be first to respond to this. If you don’t have that information, it’s okay to say what you’re doing to work on getting it. First impressions count. People will remember the first message they hear, and they will compare all other messages to that message. So, it matters that we appear present and ready to respond. Be right. Be right doesn’t mean you have to have all of the facts right out of the gate. Be right means that you share the facts that you know. You can share short statements with the information that you have, and this accuracy does establish credibility. You can tell people what you know, but it’s also okay to tell people what you don’t know yet. And then, tell them what you’re doing to get more information. If you do accidentally give people wrong information based on what you knew then, it’s important that you come forward and say that based on what you know now, this is the correct information. Correcting yourself is being right and will maintain that credibility as well. And, credibility. Well, this is honesty. Tell the truth. Honesty should never be compromised. That doesn’t mean you have to say everything that your organization is doing if you don’t have all the facts yet. But, you should tell people the facts as you know them when you know them. And, be truthful. Uncertainly is worse than not knowing. It’s important that you are present, that you provide a presence to people. And, rumors are more damaging that hard truths. People can handle more information than we’re often willing to give them credit for. Let’s be honest with the information that we have about the situation, and then give people an action step to follow to help them do something about it. It’s also important to express empathy. Suffering should be acknowledged in the words to express what people are feeling. Empathy can help build trust by demonstrating that you really are there for people, that you really understand what they’re going through, that you get it. Examples of empathy are, “During times like these, all of us feel a little uncertain.” As compared to, “We’re thinking of you during this difficult time.” The first statement on the left is an example of sympathy which is nice, but the statement on the right demonstrates that you understand people are feeling uncertain. In words. Again, “Remember that we care about you,” is a statement of sympathy. And, again, that’s nice, but “These are difficult circumstances, and I understand any fear you’re feeling,” acknowledges that this is difficult and fearful, and you get it. And, ultimately, what CERC comes down to is promoting action. What we want to do as communicators is encourage people to take steps that will help protect their wellbeing, that will help protect their health, that will help protect their lives. Giving people things to do also calms anxiety. It’s not going to remove the fear that they’re feeling. That’s not our job. But, what it will do is help distract them a bit and help them manage that fear. It also gives people a sense of control in a really uncertain situation. Promoting action can have benefits for us and for people effected by a crisis. Show respect. This should go without saying, but often, in the urgency of an emergency situation, we forget. We forget to show people the respect that they deserve. They’re not just a statistic of a population that’s been affected. They’re individuals whose world has been turned upside down. So, we want to treat people the way that you would want to be treated, the way that you would want your family to be treated. Even when hard decisions must be communicated. And, recognizing people’s value can help promote their cooperation and build rapport. Just because something has happened to these people, it does not define how they can contribute to their own emergency response. Again, these six principles are critical. If you can remember to use them throughout an emergency response, they can help guide your messaging and help make your emergency communications more efficient. Be first. Be right. Be credible. Express empathy. Promote action and show respect. Which leads us to the CERC rhythm. The CERC rhythm is a cycle that every emergency goes through. In the preparation phase, this is before an emergency happens. Prior to a crisis, this is when you have time to draft messages and host focus groups. And, you have time to start social media accounts and develop a following. And, you have time to build partnerships and foster those relationships. You have time to create a communications plan, outline it, and practice it to exercise how it would go. In the initial phase, this is when an emergency happens, and if you’ll notice some of the bullets below, the initial phase is when the CERC principles come into play. Express empathy promote action. This is when CERC occurs. But, if you haven’t prepared, it’s going to be very difficult to jump right into action with those principles. The maintenance phase of the CERC rhythm is when you have a bit more time. You’re still in an emergency, but there’s a rhythm to it. There’s a sort of pace to this urgent situation. And, you have the opportunity to provide more background information about the incident. You have the opportunity to explain more about the ongoing risks, to address some of the rumors, and to do some targeting of the audiences. Again, in another CERC chapter on messages and audiences, we discuss how to examine and analyze who your audiences are and how to appreciate tailoring your messages to meet their needs. In the resolution phase is when things are beginning to calm down. Whether you’re returning to how things were or whether a community is learning to embrace a new normal. This is an opportunity to motivate people to stay vigilant, to see this emergency through to the end, but it’s also a good opportunity to provide education on how people would respond if a similar emergency happened in the future. Do people need to restock their emergency kits? Do people need to build an emergency kit if they didn’t have one in the first place? Do people need to revise their communication plans? Using that information, you can go back to your preparation phase and make some revisions. However, throughout this entire rhythm, you want to engage with your community. Make them part of the response. You want to empower them to make decisions that affect them, and you want to evaluate the communication efforts of your organization. You want to evaluate the communication response throughout so that you can make improvements as the emergency is going on and so that you can make improvements for future emergencies. The CERC rhythm is something that should be a constant, should be a flowing, living, ongoing process. You never really get to the end of it until you get to the emergency, to the end of the emergency. But, it’s something to keep in the back of your mind, just as the CERC principles, to help guide you through every communications emergency response. That is the end of the very, very basics of crisis and emergency risk communication, and I think we can take several questions now if you guys have them.

Haley McCalla >> Thank you, Kellee. Yes, we’ll now transition to our Q&A session. Mable, can you read the first question?

Mabel >> Oh, sure I can. So, we have a question from Frank Kenton. He says, “Would it be better to state that you recognize that there is fear rather than understand?”

Kellee W. >> Yes. That’s correct. You can, well, you can say that you understand fear, Frank. It’s actually okay to say that because, for example, even if you haven’t been in the exact same situation that someone in an emergency you’re working on has been in. So, if I haven’t been in a hurricane, which I have not, and I’m speaking to an audience who has just gone through a hurricane. And, I say that I understand that this is a scary situation, I can understand it would be a scary situation because I’ve been scared before. You can understand those emotions because you’re a person, and you have felt fear and you have felt scared and you have felt anxiety. Other emotions. You have felt sad. You have felt angry. You have felt nervousness. All of these emotions are human emotions. So, you can say you understand those things. You can’t necessarily say you understand what someone is going through. “I understand exactly what you’re going through,” might be inaccurate. But, saying, “I understand this is a scary situation. I understand the fear you’re feeling,” would be okay. If it makes you feel better to say, what was? Repeat the, Mable, can you repeat?

Mabel >> The question?

Kellee W. >> Well, yeah. The way that Frank suggested how to say it.

Mabel >> Okay. So.

Kellee W. >> Recognize, that I recognize.

Mabel >> Yeah, recognize. Yeah.

Kellee W. >> Okay. Sorry. Sorry, Frank. If you, if you feel more comfortable saying, “I recognize that you may feel fear,” that’s okay. But, it could be all right as well, instead of assigning it to yourself or to someone else, just to say that this is a scary situation. I hope that helps.

Mabel >> Okay. So, we have another question from Andrew Jokin. He says, “Can I get some credits from this webinar for CPD credits?” And, he’s in Uganda.

Kellee W. >> There is a link in the invitation, and that should provide more information. There’s also email information at the end of this slide presentation, so you guys can send an email, and we can follow up on that later. Are there any more questions relevant to the presentation?

Mabel >> Right. We have one from J. Lenoke. She’s saying she hopes you can elaborate more about how to correct mixed messages on social media without sounding like big government. Sometimes, the locals might seem more familiar and credible.

Kellee W. >> How to correct mixed messages. Let’s see. I’m going to look at this. On social media. So, this is actually a different webinar that we will get to in the future, but I’m happy to try to answer this now. We do get to how to correct mixed messages, and it depends on who is mixing the messages. So, if you’re talking about messages coming from different organizations, we, this is a several part question. So, I’ll answer the first part first. If you’re talking about mixed messages between several organizations. For example, when I was in Sierra Leone, the CDC, WHO, and Médecins Sans Frontières so Doctors without Borders were all saying something different about how long people should use protection after we found out that Ebola could be sexually transmitted. And, that information needed to be corrected from a communicator standpoint and from my personal position that that particular message needed to be elevated to get corrected. But, from our position, we had to stay the course and communication our organization’s message consistently. So, that’s how we did that, but it’s ideal if you can work with those organizations to compromise to come to a consensus. So, that’s how you correct the message is to work together to come to a consensus on it. If you’re talking about correcting mixed messages internally, again, it’s coming together to come to a consensus. And, the second part of that is without sounding like big government, that is another webinar in the future about how to draft messages. When we talk about messages and audience and we talk about making messages simple and short and using plain language which means using the language that people speak every day and avoiding acronyms and large words and large scientific jargon. So, that’s how we try to avoid that big government tone. And then, you say sometimes, the locals might seem more familiar and credible. That is another webinar for future publication on spokespeople and having communication champions. So, working with people who are welcome to share information in the community, and we’ve had this happen in several responses in Africa and in Flint, Michigan where community representatives were much more trusted than government representatives. So, providing our information to faith leaders, community-based organizations, and allowing them to spread the message for us is extremely effective. So, you have a very thorough CERC related, CERC manual question there, and I hope I answered your question. Next question.

Mabel >> Okay. We have one from Timothy. He’s saying, “What are the suggestions for coordinating emergency communications between different stakeholders, for example, international entities, federal and local governments, private sectors, private sector employers, nonprofit or faith-based organizations to limiot confusion and ensure messaging is not contradictory?”

Kellee W. >> And, this is where, when I talked about the preparation phase of the CERC rhythm, I talked about building relationships. This is where we are, we have the opportunity to identify who some of the players in an emergency will be, who the people who are counterparts might be who we might work with and trying to draft those messages and test those messages to make sure that we would all be on the same page. When we’re developing communication plans at whatever level, at the local level, at the state level, at the national level, we have some idea of who the players will be. We also have some idea of what kinds of emergencies we’ll be asked to work on. So, like I said, for CDC, we will work on public health related elements to emergencies. So, for us, we have experienced working with FEMA. We have experienced working with our partners at HHS, and we know who our counterparts are. So, we build those relationships, and we foster those relationships. We also have had experience working with some partners at WHO, and we do the same thing. We try to make sure that we stay connected. We share our information. We share our messaging. We try to work together throughout the year, not just when something happens. And then, as far as making sure that our messaging is on the same page, in a communication plan, we plan out a clearance process. And, everyone’s role is pretty clear. So, when the emergency happens, we know who we want to review our messages to make sure that we’re saying the right things, to make sure that we’re not contradicting their science, to make sure that we’re not contradicting their expertise. Next question.

Mabel >> So, this question is from Nicki. She’s asking, “For those of them who are new public health communicators, how do they, how do you recommend that they become intentional about the things, about all the things and maintain the CERC rhythm during the public health emergency even though they have never worked in an emergency operation center or a joint information center until the very moment?” And, all kind of chaotic, you know.

Kellee W. >> It’s practice, and quite honestly, the CERC manual, as I said, is going to be some revisions. The first chapter is going from 30 pages down to 10 pages for this very reason. Because nobody has time during an emergency to read a novel and figure this stuff out. And, we’re trying to make this all as user friendly and as accessible as possible. That said, it is practice, and it’s something, again, that in the preparation phase, you can do to study it, to read this, to try and keep things in mind. How would you incorporate this? How would you implement it? And, when it happens, hopefully, you’ve sort of thought about it and you’ve sort of practiced it in your head. You’ve sort of kept it in your consciousness. And then, as you get more experience in the field, it will become a bit more second nature. But, to be honest, every emergency is different, and every emergency is chaotic. If there is no chaos, there is no crisis.

Mabel >> So, this next question is from someone who’s anonymous, and they’re asking, “When addressing rumors, should the speaker refer to them in specific or simply refer to rumors in general?”

Kellee W. >> When you’re addressing rumors, you do not repeat the rumor. When we talked about be first, and I said that that first message is what people remember, that applies to addressing a rumor. If you repeat the rumor and then you address it, what people are going to remember is what you repeated. They’re going to remember that first part of your statement where you reiterated the rumor. So, you address a rumor by simply restating your message without repeating the rumor.

>> And so, we have another one who’s asking, “How does the message depend on the media? For example, mass emails versus television. Presumably, the basics are the same, but the skills of the messenger may be greater for television. For example, the appearance of the person that’s professionalism comes into play.”

>> Yeah. So, the message is obviously going to have to be tailored for different dissemination channels, and mass emails are going to have a different feel and a different tone to them than television. Television is going to, obviously, need a spokesperson with some experience in front of the camera and some experience speaking through media. But, the, this is where, again, we get into a different chapter of CERC, a different section of CERC where we talk about spokesperson. And then, there’s another section of CERC where we talk about media and social media, that there are different dissemination channels, different communication channels, and they each have different techniques for how you develop messages for them. While CERC does address how to use media as a tool, it is not a media training. So, I do want to be clear about that for everyone participating. CERC is not a media training, and I do highly encourage any of you who may anticipate dealing with the media to get media training if that’s something you think you need.

>> Thank you, Kellee. So, we have a question from Sharon, and she says, “In an era where everyone with a mobile phone can be an immediate source of news or information, how do you think about being both first and right?”

>> That’s a good question, Sharon. That’s exactly the kind of question we get every time we say be first. Be first is tricky, generally since even news media uses social media as their headlines these days. If you ever watch any major news channel, you’ll see that they have, you know, come twitter feed popped up where they’ve got people’s comments on a current situation on screen. The way that we frame be first is be first in your lane. So, whatever information your organization is responsible for sharing. And, that said, you want to definitely not be talking about information that is someone else’s responsibility to share. When the Flint water crisis happened, when Flint, Michigan experienced contamination of their water supply, several federal agencies were sent to respond to assist the local community in responding to the situation. And, the Environmental Protection Agency and the CDC and the Department of Health and Human Services and the Federal Emergency Management Agency were all together working on this response, but we were all working on different types of messages. And, we all stayed in our lane. When there were overlaps, we all worked together, but we all stayed true to our expertise. And, that’s what you want to do when you’re being first is when you have information related to your expertise, you want to be first to share that.

Kekllee W. >> Thank you, Kellee. So, we have one last question. Someone is asking, “How can we address cultural differences in risk communication management?”

>> You guys are wanting a whole day CERC training all today. Again, this will be another webinar in the future, so I’m really glad there’s so much interest. There will be a community engagement chapter actually released soon, and this should, this should develop, this should highlight how to address some cultural differences, how to engage with communities. This information is also available in the currently posted manual on our website at, and I’ll show you our website in just a moment under messages and audiences and how to consider the cultural differences between your audiences. I did see a question about when the, when the next manual will be released, and what we’re doing is posting chapter by chapter updates. So, it’s just a matter of keeping tabs on our website. We also are going to have a LinkedIn site going live soon, so you’ll be able to see our updates there when, as we have new chapters available, we’ll make announcements about that. But, cultural differences are very important. Understanding demographics, religious, community, history, all kinds of differences are addressed in these other chapters.

Mabel >> Thank you, Kellee. So, we have one more question. Alison says, “How do you address language and functional concentration in messaging?”
Kellee W. >> This is something that we’ve actually come across quite often in our responses recently. We’ve been translating so many of our resources, if I’m reading your question right. We’ve been translating so many of our resources into different languages to suit our audience needs. I think for zika we ended up translating our key messages into 11 different languages with the different countries and areas that were affected by zika. And, other needs. The, having, making sure that all of our information what we call 508 compliant. So, people who are hard of hearing, people who are visually challenged, making sure that we’re reaching out to these specific audiences. When I am not training CERC, I work on a team called Emergency Partners Information Connection. It’s called EPIC, and it’s our regular job to build partnerships in the preparation phase that can help us reach these special target populations during an emergency to make sure that they’re getting the information that they need that they wouldn’t necessarily get through mass media traditional channels.

Mabel >> Thank you, Kellee, and TJ here, she’s asking, “Is there a shuttle for the CERC webinars?”

Kellee W. >> There will be, TJ. There isn’t right now. I wish I could share that with you. I’m hoping the next one will be on June 1st. I’m hoping the first of every month we’ll, but we’ll have to look at a calendar because if that’s a weekend, I could be inaccurate. So, my goal would be the first week of every month.

Mabel >> And then, someone is asking, “Based on your experiences, how far into an expected crisis do you prescript messages?”

Kellee W. >> We have some crises that we’ve experienced so often. So, for example, these recent hurricanes. We, we’ve been through so many hurricanes that we had several messages already prepared, but this was such a unique experience for the Virgin Islands and for Puerto Rico that we had several messages develop we couldn’t have anticipated needing and had to be really creative about dissemination because so many traditional channels were unavailable with power outages. So, like I said, every crisis is unique. Every situation is different. We plan for the worst and hope for the best. That is typically how crisis communication planning goes. If your organization is in the process of developing a crisis communication plan, ideally, you want to think about the types of crises that you’re likely to experience, the types of emergencies you’re likely to have to respond to and anticipate the things that you may have to address. And then, and then, ask yourself the question that you may want to know. Ask yourself the obvious questions. Are my family safe? What can we do? There are actually some CERC resources on the website. Again, I’ll share that slide in just a moment that, that will give you some examples of how to start that messaging process.

Haley M. >> Hi, Kellee. I have a question for you. This is from Cheyenne. “Can you talk more on any issues you have come across using the CERC principles or the rhythm at the CDC and how you were able to overcome them as an organization?”

Kellee W. >> Sure. Haley, can you just repeat the question one more time?

Haley M. >> Yes. So, “Can you talk more on any issues you have come across using the CERC principles or the rhythm at the CDC and how you were able to overcome them as an organization?”

Kellee W. >> Sure. So, we have been a bit challenged with our maintenance phase during the last couple of responses. When I showed you the rhythm, CERC was initially developed with the thought that an emergency would be two to three days long and then would begin recovery. That was, that was the initial thought process. Responses adhere to the rhythm whether they are three days long, three weeks long, three months long, or three years long. But, what’s interesting about the last couple of responses for the CDC where we’ve worked on Ebola for two years, where we worked on zika for a year and a half, is that the maintenance phase just gets, it just offers more opportunity. It just offers more opportunity to provide background information and to address rumors. The rumors get more interesting, and we have to continually decide whether we have manpower and the staff to address all of them or some of them. A key with addressing rumors is are they catching hold? Are they taking, are they seeming believable? Are people starting to follow them, and are they harmful? That’s a good litmus test of whether you want to respond to a rumor or not. Also, with the length that these, of these maintenance phases is keeping people vigilant. It’s been a real challenge. That’s been the hardest issue, I think, with the maintenance phase is that these long responses has been while people want to be over the emergency, the emergency isn’t over them. And, their lives are continuing. People in West Africa still dealing with Ebola also still had to go to work and get their kids to school and, you know, still had holidays. When I arrived there, it was just before Christmas. Still had to do Christmas shopping and church and, you know, life was still going on around this emergency. So, keeping people vigilant throughout these circumstances is a challenge, particularly when people are, quite honestly, sick of them. They’re sick of hearing the messages. As far as what did we do? Sorry. I’m not sure if I answered your question. What did we do? We kept pestering, and we remained vigilant to try to keep them vigilant.

Mabel >> One more question from Cheyenne. She’s asking, “What type of creative messaging methods did you use in Puerto Rico and U.S. VI with the recent hurricanes and problems posed with using traditional methods went without power for extended periods of time?”

Kellee W. >> A lot of what was done in Puerto Rico and in the Virgin Islands was flyers, doing handouts, taking things door to door, doing large printouts of fact sheets, which, you know, normally would be sent via link or a poster. It was, it was a whole lot of footwork on the ground distribution of messaging. I guess that’s not as creative, but it is in this day and age when we don’t have access to our social media which is our standard. Creative goes back to old school. So, that’s what we did. One thing that, you know, we heard was pretty interesting when people were able to charge their cell phones, when people were able to get access to electricity, people were using social media to communicate back and forth to people stateside and our messages were being shared. So, that was good.

Mabel >> Thank you. And then, we have another question from P. Carver. He says, “In a situation like zika, when we need to continue to give public health messaging about a potentially critical health threat, how do we continue to maintain the public’s interest without sounding like we are crying wolf?”

Kellee W. >> This is often something that people ask in trainings, and it’s not, it’s not that we, that we’re trying to create fear. That’s a question, that’s another way of framing your question. It’s more that we’re trying to help educate people to understand the risk. So, in a different section of CERC, we talk about the psychology of a crisis and we talk about people’s perception of risk. We talk about their, the real risk which is the hazard, and the outrage, which is not grr, the anger outrage that we typically think of. But, outrage any emotion, anger or sadness or fear or scared or any emotion. So, we talk about how the hazard, the scientific risk puts the outrage, the emotional risk equals people’s perception of risk. And, if the scientific risk is saying there’s a real threat and people’s outrage, their emotional risk isn’t very high, it’s a matter of educating them to understand that they need to be a bit more cautious. They need to be a bit more vigilant. That the real risk is this. It’s not about creating fear. It’s about helping them understand.

Haley M. >> Let’s see. Let’s do one more question. How can we address cultural differences in communication management?

Kellee W. >> So, cultural differences would be addressed, again, when I talked about the chapters on community engagement and also messages and audiences that are on our website. They get into this a bit, but they, they talk about how understanding your audience, understanding your audience’s needs, understanding your audience’s background, languages spoken, their education levels. Understanding who you’re talking to affects your messages. So, for example, if you’re talking to an audience that has a low literacy level, are maybe pictures more appropriate? Sometimes, we don’t even use words in our messages. Sometimes, just drawings because that’s what’s most appropriate. Understanding that even if something is translated into Spanish, it might not be the right dialect. So, in Puerto Rico, there’s a very different dialect of Spanish, and we have come across that in both our zika and our hurricane responses recently. Where we want to make sure that we’re talking to the, directly to the audience that we need to hear our message. Because it’s ineffective to share information that isn’t speaking to the people you need to hear you.

Haley M. >> Thank you so much, Kellee. And, I’d like to thank all of you for joining us for today’s webinar. If you have any additional questions, you may email them to That’s As a reminder, today’s presentation has been recorded, and you can earn continuing education for your participation. Please follow the instructions linked in the invitation you received. The course access code for this presentation is CERC0501 with all letters capitalized. Thank you so much for your time, and everyone please have a good afternoon.


Page last reviewed: May 25, 2018