Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-19T05:34:29.516Z Has data issue: false hasContentIssue false
  • English
  • Français

Communicating with the Public Following Radiological Terrorism: Results from a Series of Focus Groups and National Surveys in Britain and Germany

Published online by Cambridge University Press:  21 December 2012

Julia M. Pearce ,
G. James Rubin ,
Piet Selke ,
Richard Amlôt ,
Fiona Mowbray  and
M. Brooke Rogers
Julia M. Pearce*
Affiliation:
King's College London, Department of War Studies, London, UK
G. James Rubin
Affiliation:
King's College London, Department of Psychological Medicine, London, UK
Piet Selke
Affiliation:
University of Stuttgart and DIALOGIK, Stuttgart, Germany
Richard Amlôt
Affiliation:
Emergency Response Department, Health Protection Agency, Salisbury, UK
Fiona Mowbray
Affiliation:
Emergency Response Department, Health Protection Agency, Salisbury, UK
M. Brooke Rogers
Affiliation:
King's College London, Department of War Studies, London, UK
*
Correspondence: Julia M. Pearce, PhD Kings College London Department of War Studies Strand Campus Room K7.05 London, WC2R 2LS UK E-mail [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Incidents involving the exposure of large numbers of people to radiological material can have serious consequences for those affected, their community and wider society. In many instances, the psychological effects of these incidents have the greatest impact. People fear radiation and even incidents which result in little or no actual exposure have the potential to cause widespread anxiety and behavior change. The aim of this study was to assess public intentions, beliefs and information needs in the UK and Germany in response to a hidden radiological exposure device. By assessing how the public is likely to react to such events, strategies for more effective crisis and risk communication can be developed and designed to address any knowledge gaps, misperceptions and behavioral responses that are contrary to public health advice.

Methods

This study had three stages. The first stage consisted of focus groups which identified perceptions of and reactions to a covert radiological device. The incident was introduced to participants using a series of mock newspaper and broadcast injects to convey the evolving scenario. The outcomes of these focus groups were used to inform national telephone surveys, which quantified intended behaviors and assessed what perceptions were correlated with these behaviors. Focus group and survey results were used to develop video and leaflet communication interventions, which were then evaluated in a second round of focus groups.

Results

In the first two stages, misperceptions about the likelihood and routes of exposure were associated with higher levels of worry and greater likelihood of engaging in behaviors that might be detrimental to ongoing public health efforts. The final focus groups demonstrated that both types of misunderstanding are amenable to change following targeted communication.

Conclusion

Should terrorists succeed in placing a hidden radiological device in a public location, then health agencies may find that it is easier to communicate effectively with the public if they explicitly and clearly discuss the mechanisms through which someone could be affected by the radiation and the known geographical spread of any risk. Messages which explain how the risk from a hidden radiological device “works” should be prepared and tested in advance so that they can be rapidly deployed if the need arises.

PearceJM, RubinGJ, SelkeP, AmlôtR, MowbrayF, RogersMB. Communicating with the Public Following Radiological Terrorism: Results from a Series of Focus Groups and National Surveys in Britain and Germany. Prehosp Disaster Med. 2013;28(2):1-10.

Keywords

emergencyhealth behaviorpersuasive communicationradiation protectionterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 2 , April 2013 , pp. 110 - 119
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Slovic, P. Perception of risk. Science. 1987;236:280-285.CrossRefGoogle ScholarPubMed
2.Bromet, EJ. Lessons learned from radiation disasters. World Psychiatry. 2011;10(2):83-84.CrossRefGoogle Scholar
3.Vyner, HM. The psychological dimensions of health care for patients exposed to radiation and the other invisible environmental contaminants. Soc Sci Med. 1988;27:1097-1103.CrossRefGoogle ScholarPubMed
4.Acton, JM, Rogers, MB, Zimmerman, PD. Beyond the dirty bomb: re-thinking radiological terror. Survival. 2007;49(3):151-168.CrossRefGoogle Scholar
5.Becker, SM. Emergency communication and information issues in terrorist events involving radioactive materials. Biosecurity and Bioterrorism: Biodefense Strategy Practice and Science. 2004;2(3):195-207.CrossRefGoogle ScholarPubMed
6.Lasker, RD. Redefining Readiness: Terrorism Planning Through the Eyes of the Public. New York: New York Academy of Medicine; 2004.Google Scholar
7.Williams, MT, Saathoff, GB, Guterbock, TM, MacIntosh, A, Bebel, R. Community Shielding in the National Capital Region: A Survey of Citizen Response to Potential Critical Incidents. Charlottesville, Virginia USA: University of Virginia, Critical Incident Analysis Group; 2005.Google Scholar
8.Stone, FP. The “Worried Well” Response to CBRN Events: Analysis and Solutions. Alabama: USAF Counterproliferation Center; 2007.Google Scholar
9.Rubin, GJ, Amlot, R, Wessely, S, Greenberg, N. Anxiety, distress and anger among British nationals following the Fukushima nuclear accident. Br J Psychiatry. 2012;201:400-407.CrossRefGoogle ScholarPubMed
10.Lemyre, L, Turner, MC, Lee, JEC, Krewski, D. Differential perception of chemical, biological and nuclear terrorism in Canada. Int J Risk Assessment and Management. 2007;7(8):1191-1208.CrossRefGoogle Scholar
11.Taylor, M, Joung, W, Griffin, B, et al. The public and a radiological or nuclear emergency event: threat perception, preparedness, and anticipated response - findings from a preliminary study in Sydney, Australia. Aus J Emerg Manage. 2011;26:31-39.Google Scholar
12.Glik, D, Harrison, K, Davoudi, M, Riopelle, D. Public perceptions and risk communications for botulism. Biosecur Bioterror. 2004;2:216-223.CrossRefGoogle ScholarPubMed
13.Henderson, JN, Henderson, LC, Raskob, GE, Boatright, DT. Chemical (VX) terrorist threat: public knowledge, attitudes, and responses. Biosecur Bioterror. 2004;2:224-228.CrossRefGoogle ScholarPubMed
14.Wray, R, Jupka, K. What does the public want to know in the event of a terrorist attack using plague? Biosecur Bioterror. 2004;2:208-215.CrossRefGoogle ScholarPubMed
15.Marshall, RJ, Petrone, L, Takach, MJ, et al. Make a kit, make a plan, stay informed: using social marketing to change the population's emergency preparedness behavior. Social Marketing Quarterly. 2007;13:47-64.CrossRefGoogle Scholar
16.Gibson, S, Lemyre, L, Clement, M, Markon, MPL, Lee, JEC. Terrorism threats and preparedness in Canada: The perspective of the Canadian public. Biosecur Bioterror. 2007;5:134-144.CrossRefGoogle ScholarPubMed
17.Santos, SL, Helmer, DA, Fotiades, J, Copeland, L, Simon, JD. Developing a bioterrorism preparedness campaign for veterans: using focus groups to inform materials development. Health Promot Pract. 2007;8:31-40.CrossRefGoogle ScholarPubMed
18.Rinchiuso-Hasselmann, A, Starr, DT, McKay, RL, Medina, E, Raphael, M. Public compliance with mass prophylaxis guidance. Biosecur Bioterror. 2010;8:255-263.CrossRefGoogle ScholarPubMed
19.Chesser, A, Ablah, E, Hawley, SR, et al. Preparedness needs assessment in a rural State: themes derived from public focus groups. Biosecur Bioterror. 2006;4:376-383.CrossRefGoogle Scholar
20.Glik, DC, Drury, A, Cavanaugh, C, Shoaf, K. What not to say: risk communication for botulism. Biosecur Bioterror. 2008;6:93-107.CrossRefGoogle ScholarPubMed
21.North, CS, Pollio, DE, Pfefferbaum, B, et al. Concerns of Capitol Hill staff workers after bioterrorism: focus group discussions of authorities’ response. J Nerv Ment Dis. 2005;193:523-527.CrossRefGoogle ScholarPubMed
22.Clarke, CE, Chess, C. False alarms, real challenges - one university's communication response to the 2001 anthrax crisis. Biosecur Bioterror. 2006;4:74-83.CrossRefGoogle Scholar
23.Stein, BD, Tanielian, TL, Ryan, GW, Rhodes, HJ, Young, SD, Blanchard, JC. A bitter pill to swallow: nonadherence with prophylactic antibiotics during the anthrax attacks and the role of private physicians. Biosecur Bioterror. 2004;2:175-185.CrossRefGoogle ScholarPubMed
24.Blanchard, JC, Haywood, Y, Stein, BD, Tanielian, TL, Stoto, M, Lurie, N. In their own words: lessons learned from those exposed to anthrax. Am J Public Health. 2005;95:489-495.CrossRefGoogle ScholarPubMed
25.Miro, S, Kaufman, SG. Anthrax in New Jersey: a health education experience in bioterrorism response and preparedness. Health Promot Pract. 2005;6:430-436.CrossRefGoogle ScholarPubMed
26.Quinn, SC, Thomas, T, Kumar, S. The anthrax vaccine and research: reactions from postal workers and public health professionals. Biosecurity Bioterrorism. 2008;6:321-333.CrossRefGoogle ScholarPubMed
27.Jefferds, MD, Laserson, K, Fry, AM, et al. Adherence to antimicrobial inhalational anthrax prophylaxis among postal workers, Washington D.C., 2001. Emerging Infectious Diseases. 2002;8:1138-1144.CrossRefGoogle ScholarPubMed
28.Keselman, A, Slaughter, L, Patel, VL. Toward a framework for understanding lay public's comprehension of disaster and bioterrorism information. J Biomed Informatics. 2005;38:331-344.CrossRefGoogle Scholar
29.Fischhoff, B, Gonzalez, RM, Small, DA, Lerner, JS. Evaluating the success of terror risk communications. Biosecur Bioterror. 2003;1:255-258.CrossRefGoogle ScholarPubMed
30.Blendon, RJ, Desroches, CM, Benson, JM, Herrmann, MJ, Taylor-Clark, K, Weldon, KJ. The public and the smallpox threat. NEJM. 2003;348:426-432.CrossRefGoogle ScholarPubMed
31.Marshall, KM, Begier, EM, Griffith, KS, Adams, ML, Hadler, JL. A population survey of smallpox knowledge, perceptions, and healthcare-seeking behavior surrounding the Iraq invasion--Connecticut 2002-03. Biosecur Bioterror. 2005;3:246-255.CrossRefGoogle ScholarPubMed
32.SteelFisher, G, Blendon, R, Ross, LJ, et al. Public response to an anthrax attack: reactions to mass prophylaxis in a scenario involving inhalation anthrax from an unidentified source. Biosecur Bioterror. 2011;9:239-250.CrossRefGoogle Scholar
33.Rubin, GJ, Page, L, Morgan, O, et al. Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis. BMJ. 2007;335:1143-1146.CrossRefGoogle Scholar
34.Renn, O. Public Responses to the Chernobyl Accident. Journal of Environmental Psychology. 1990;10(2):151-167.CrossRefGoogle Scholar
35.Gaskell, G, Bauer, MW. Towards Public Accountability: Beyond Sampling, Reliability and Validity. In M.W. Bauer and G. Gaskell (eds.), Qualitative Researching with Text, Image and Sound. London: Sage Publications Ltd.; 2007:336-350.Google Scholar
36.Galea, S, Tracy, M. Participation rates in epidemioligic surveys. Annals of Epidemiology. 2007;17:643-653.CrossRefGoogle Scholar
37.Aronson, J. A pragmatic view of thematic analysis. The Qualitative Report. 1994;2(1):1-3.Google Scholar
38.Boyatzis, RE. Transforming Qualitative Information: Thematic Analysis and Code Development. London: Sage Publications Ltd.; 1998.Google Scholar
39.Braun, V, Clarke, V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.CrossRefGoogle Scholar
40.Moss-Morris, R, Weinman, J, Petrie, KJ, Horne, R, Cameron, LD, Buick, D. The revised Illness Perception Questionnaire (IPQ-R). Psychology & Health. 2002;17(1):1-16.CrossRefGoogle Scholar
41.Rogers, MB, Amlôt, R, Rubin, GJ, Wessely, S, Krieger, K. Mediating the social and psychological impacts of terrorist attacks: The role of risk perception and risk communication. International Review of Psychiatry. 2007;19(3):279-288.CrossRefGoogle ScholarPubMed
42.Wray, RJ, Kreuter, MW, Jacobsen, H, Clements, B, Evans, RG. Theoretical perspectives on public communication preparedness for terrorist attacks. Family & Community Health. 2004;27(3):232-241.CrossRefGoogle ScholarPubMed
43.Rubin, GJ, Amlôt, R, Carter, H, Large, S, Wessely, S, Page, L. Reassuring and managing patients with concerns about swine flu: qualitative interviews with callers to NHS Direct. BMC Public Health. 2010;10:451.CrossRefGoogle ScholarPubMed
44.Wray, RJ, Becker, SM, Henderson, N, et al. Communicating with the public about emerging health threats: lessons from the pre-event message development project. American Journal of Public Health. 2008;98(12):2214-2222.CrossRefGoogle ScholarPubMed
45.Pandey, A, Patni, N, Singh, M, Sood, M, Singh, G. YouTube as a source of information on the H1N1 influenza pandemic. American Journal of Preventive Medicine. 2010;38(3):e1-e3.CrossRefGoogle ScholarPubMed
46.Morgan, DL. Focus Groups as Qualitative Research, 2nd Edition.London: Sage Publications Ltd.; 1997.CrossRefGoogle Scholar
47.Sussman, S, Burton, D, Dent, CW, Stacy, AW, Flay, BR. Use of focus groups in developing an adolescent tobacco use cessation program - collective norm effects. Journal of Applied Social Psychology. 1991;21(21):1772-1782.CrossRefGoogle Scholar
48.Bishop, GF. The Illusion of Public Opinion: Fact and Artifact in American Public Opinion Polls. Oxford: Rowman & Littlefield.; 2005.Google Scholar
49.O'Cathain, A, Knowles, E, Nicholl, J. Testing survey methodology to measure patients’ experiences and views of the emergency and urgent care system: telephone versus postal survey. BMC Medical Research Methodology. 2010;10:52.CrossRefGoogle ScholarPubMed
Supplementary material: File

Pearce Supplementary Material

Appendix

Download Pearce Supplementary Material(File)
File 26.9 KB