SUPPORT-SYSTEMS (28) Building trust in health policy processes and public health communication

15 May, 2022

Civic society participation in health policy.

I wonder whether, although citizens will rarely, if ever, have the knowledge, evidence and understanding to imagine and write expectant new health policy based on complicated science (airborne covid, covid vaccinations, waterborne infection (cholera in the early 19th century), they will have knowledge, evidence and understanding to be persuaded to accept or fund the structure, processes and hopeful outcomes of expectant new health policy.

Persuading citizens of the risks and benefits of expectant public health policy is resource heavy in time and effort. Failure to persuade citizens to support expectant public health measures in a democracy may derail the public health measure.

THE WHO Epi-Win webinar series below [EPIWIN Communicating Risks and evidence in a Public Health Emergency, 14 September 2021] looked at the issues of communicating risks and evidence in a Public Health emergency. If one accepts the advice of University faculties that deal with the theory of communicating risks and benefits of health policies, what a good way to inform citizens and to reduce the time and resources necessary for informing citizens by including citizens right from the start of the conversation about expectant, development and planning the public health measure.

Not only will the process of communicating risk and benefit have started, but the understanding and expression of objections and understanding of public obstacles to implementation of the expectant public health measure will already have begun.



'Communicating Risks and evidence in a Public Health Emergency

'WHO Information Network for Epidemics (EPI-WIN), World Health Organization, Winton Centre for Risk and Evidence Communication Cambridge University, Harding Centre for Risk Literacy Koch University Berlin

'Winton motto - To inform and not persuade

'How to present quantified evidence in different contexts

'There is a spectrum of information that ranges from sharing absolute and complete truth - informed consent in medicine, sworn testament in courts - to pure advertising, sales and PR. Publlic Health has a difficult task deciding where particular messages lie on the spectrum of information to persuasion. Communicating to decision makers may be different to communicating to individuals.

'It is helpful to consider whether the communicator wishes to achieve:

'Does the communicator want the recipient audience to understand or to believe? Does the communicator want the recipient audience to be better informed or to change their behaviour?

Is the communicator giving information or sending a message? Does the communicator want to be a trustworthy source of information or trusted (relied upon?).

'Absolute and relative risks - format of information and how to present figurres

'Numbers mean little to people when stripped of context. What kind of contexts are successful? What are the effects of contexts? The type of person (age, gender, disease group etc) and the level of risk seem to be important. It is important to attempt to discover what kind of context your audience might prefer (see culture later). Audiences prefer visualization.

'Information should be evidence based and transparent. Fact boxes improve knowledge and understanding. They are useful and successful visualization tools and should be informative and not persuasive. Fact boxes are usually embedded in accompanying text.

'Visualization is intended to help low numerate people or people with low literacy skills to help them compare benefits and harms.

'Five rules for evidence and risk communication

'Prevent data fully and clearly. Record risks and benefits, Consider a PROVE matrix

- Pre-empt misinformation and misunderstanding (Think ahead, andd if possible research, about what misinformation and misunderstandings the audience may already have.)

- Reliably inform - Inform and not persuade

- Offer accurate balance and not false balance

- Verify quality - State evidence quality - (a man told me in the lift to 100,000 patient peer reviewed trail etc!)

- Explain uncertainty - disclose uncertainties.

'This will be an iterative process



Below are the resources that were mentioned during the presentations:

- Communicating personalized risks from COVID-19: guidelines from an empirical study:

- Five rules for evidence communication:

- Effect of information about COVID-19 vaccine effectiveness and side effects on behavioural intentions: two online experiments:

- Risk communication in tables versus text: a registered report randomized trial on ‘fact boxes':

HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data

Email address: richardpeterfitton7 AT