A literature review on effective risk communication for the prevention and control of communicable diseases in Europe.

Executive Summary This review examines the current body of literature on risk communication related to communicable diseases, focusing on: (i) definitions and theories of risk communication; (ii) methodologies, tools and guidelines for risk communication research, policy and implementation; and (iii) implications, insights and key lessons learned from the application of risk communication principles in real-world settings. Effective risk communication is essential to limiting morbidity and mortality caused by communicable diseases, in addition to minimising the damage that communicable diseases can cause to national economies and public health infrastructure. The aim of the review was thus to uncover the general principles of effective risk communication that can assist with the prevention and control of communicable diseases in the European context, as well as specific examples of good practice that can be built on in future risk communication policies, guidance, research and implementation scenarios. The review brings together the current body of literature on risk communication on communicable diseases in a concise reference document that can be used to inform the development of evidence- based risk communication strategies and approaches. To conduct the review, various databases were searched to locate published academic literature on the topic of risk communication for communicable diseases. In addition, both general and targeted internet searches were undertaken to locate relevant unpublished literature on the topic, such as conference presentations, reports and other technical documents. The literature search prioritised documents produced over the past ten years and relevant to the European context. Following the collection of relevant literature, key themes were identified and analysed and findings synthesised for the production of this report. The review revealed that the multi-cultural and multi-lingual environment of Europe presents a unique set of challenges to effective risk communication on communicable diseases to which the most promising solutions include: (i) collaboration of an international coordinating body with both national and local non-governmental organisations; and (ii) focusing on the development of cross-sectoral and cross-national risk preparedness, surveillance, response and monitoring strategies in the region. In addition, both quantitative and qualitative studies on risk communication have brought valuable insights to light on the topic, but there is an important need for evaluation research to better understand the effectiveness of risk communication as it unfolds during real-life events. In terms of risk communication practice, there are various resources available to risk communicators today (for example, toolkits, training modules, guidance frameworks), but when tested, challenges, gaps and limitations have been exposed. The review indicates that risk communication resources need to be continuously updated to meet new and developing needs (for example, strategies for effective web-based and social networking communication are notably absent yet highly relevant in todays world); and the scope of the resources must be broadened beyond the current focus on risk communication in the context of emergency and outbreak situations. Other principal conclusions of the review are that risk communication messages often fail to reach the intended communities, including those people most at risk of the disease. Similarly, despite the availability of planning tools and pre-crisis event and readiness efforts, many countries in the European region still need to concentrate on advanced risk communication planning efforts at all levels of public health, such as needs assessments and public engagement plans.