Effective responder communication improves efficiency and psychological outcomes in a mass decontamination field experiment: implications for public behaviour in the event of a chemical incident

The risk of incidents involving mass decontamination in response to a chemical, biological, radiological, or nuclear release has increased in recent years, due to technological advances, and the willingness of terrorists to use unconventional weapons. Planning for such incidents has focused on the technical issues involved, rather than on psychosocial concerns. This paper presents a novel experimental study, examining the effect of three different responder communication strategies on public experiences and behaviour during a mass decontamination field experiment. Specifically, the research examined the impact of social identity processes on the relationship between effective responder communication, and relevant outcome variables (e.g. public compliance, public anxiety, and co-operative public behaviour). All participants (N = 111) were asked to visualise that they had been involved in an incident involving mass decontamination, before undergoing the decontamination process, and receiving one of three different communication strategies: 1) Health-focused explanations about decontamination, and sufficient practical information; 2) No health-focused explanations about decontamination, sufficient practical information; 3) No health-focused explanations about decontamination, insufficient practical information. Four types of data were collected: timings of the decontamination process; observational data; and quantitative and qualitative self-report data. The communication strategy which resulted in the most efficient progression of participants through the decontamination process, as well as the fewest observations of non-compliance and confusion, was that which included both health-focused explanations about decontamination and sufficient practical information. Further, this strategy resulted in increased perceptions of responder legitimacy and increased identification with responders, which in turn resulted in higher levels of expected compliance during a real incident, and increased willingness to help other members of the public. This study shows that an understanding of the social identity approach facilitates the development of effective responder communication strategies for incidents involving mass decontamination

Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey

Objective To assess whether perceptions of the swine flu outbreak predicted changes in behaviour among members of the public in England, Scotland, and Wales

Staying ‘Covid-safe’ : proposals for embedding behaviours that protect against Covid-19 transmission in the UK

LB received grants from ESRC and from Ministry of Housing, Communities and Local Government, during the conduct of the study.Objectives The Scientific Pandemic Insights group on Behaviours (SPI-B) as part of England's Scientific Advisory Group on Emergencies (SAGE), were commissioned by the UK Cabinet Office to identify strategies to embed infection control behaviours to minimize Covid-19 transmission in the long term. Methods With minimal direct evidence available, three sources of information were used to develop a set of proposals: (1) a scoping review of literature on sustaining behaviour change, (2) a review of key principles used in risk and safety management, and (3) prior reports and reviews on behaviour change from SPI-B. The information was collated and refined through discussion with SPI-B and SAGE colleagues to finalize the proposals. Results Embedding infection control behaviours in the long-term will require changes to the financial, social, and physical infrastructure so that people in all sections of society have the capability, opportunity, and motivation needed to underpin those behaviours. This will involve building Covid-safe educational programmes, regulating to ensure minimum standards of safety in public spaces and workspaces, using communications and social marketing to develop a Covid-safe culture and identity, and providing resources so that all sections of society can build Covid-safe behaviours into their daily lives. Conclusions Embedding 'Covid-safe' behaviours into people's everyday routines will require a co-ordinated programme to shape the financial, physical, and social infrastructure in the United Kingdom. Education, regulation, communications, and social marketing, and provision of resources will be required to ensure that all sections of society have the capability, opportunity, and motivation to enact the behaviours long term.Publisher PDFPeer reviewe

The role of pre-incident information and responder communication in effective management of casualties, including members of vulnerable groups, during a decontamination field exercise

During a CBRNe incident, it is essential that those affected are decontaminated as quickly as possible. Factors which may enhance the speed with which decontamination can be carried out include the provision of pre-incident information to members of the public, an effective responder communication strategy, and consideration of the needs of all those affected. In the current study, we ran a field exercise involving mass decontamination in response to a simulated chemical incident. The study aimed to understand the role of responder communication, the needs of vulnerable individuals, levels of compliance, and the impact of pre-incident information, during decontamination. Eighteen participants took part in the exercise with nine participants having vulnerabilities. Participants completed pre-exercise and post-exercise questionnaires and took part in a post-exercise focus group. Participants' and responders’ behaviour was also observed during the exercise. Results showed that participants reported issues associated with both practical aspects of responder communication (e.g., background noise) and overall responder communication strategy and stated that poor communication from responders would have led to less compliance in a real incident. Vulnerable individuals reported that their needs were not always met, with issues including poor physical and communication-related support, and a lack of consideration for functional aids. However, participants reported positive perceptions of the actions in the pre-incident information. Overall, this research suggests that effective management of a chemical incident must include an effective communication strategy (both before and during an incident) and consideration of the needs of vulnerable individuals

The role of pre-incident information and responder communication in effective management of casualties, including members of vulnerable groups, during a decontamination field exercise

During a CBRNe incident, it is essential that those affected are decontaminated as quickly as possible. Factors which may enhance the speed with which decontamination can be carried out include the provision of pre-incident information to members of the public, an effective responder communication strategy, and consideration of the needs of all those affected. In the current study, we ran a field exercise involving mass decontamination in response to a simulated chemical incident. The study aimed to understand the role of responder communication, the needs of vulnerable individuals, levels of compliance, and the impact of pre-incident information, during decontamination. Eighteen participants took part in the exercise with nine participants having vulnerabilities. Participants completed pre-exercise and post-exercise questionnaires and took part in a post-exercise focus group. Participants' and responders’ behaviour was also observed during the exercise. Results showed that participants reported issues associated with both practical aspects of responder communication (e.g., background noise) and overall responder communication strategy and stated that poor communication from responders would have led to less compliance in a real incident. Vulnerable individuals reported that their needs were not always met, with issues including poor physical and communication-related support, and a lack of consideration for functional aids. However, participants reported positive perceptions of the actions in the pre-incident information. Overall, this research suggests that effective management of a chemical incident must include an effective communication strategy (both before and during an incident) and consideration of the needs of vulnerable individuals

A systematic review of the use of mobile alerting to inform the public about emergencies and the factors that influence the public response

During an emergency, it is necessary to quickly disseminate messages to the public. These communications often provide information about the emergency as well as guidance or advice aimed at ensuring the safety of the population. Successful emergency communication depends upon how rapidly and reliably a message can be disseminated, but also on how people respond to the message that they receive. To assist emergency planners tasked with developing message sets for future incidents, in this paper we report a systematic review of all studies that assessed the impact of mobile telephone alerting systems on intended and actual behaviour, to identify factors that affect their likely impact. We searched multiple databases and conferred with topic experts, resulting in a total of 22 studies which met the inclusion criteria. Our results indicate that limited data exist on how people respond to text-based warning messages and that much of the data is poor quality, indicating a need for more real-world studies

Do members of the public think they should use lateral flow tests or PCR tests when they have COVID-19-like symptoms?

Objectives: This study aimed to investigate public use of lateral flow tests (LFT) and polymerase chain reaction (PCR) tests when experiencing key COVID-19 symptoms. Study design: In this study, data from two waves of a cross-sectional nationally representative online survey (data collected 1 and 2 June, and 14 and 15 June 2021; n = 3665 adults aged ≥18 years living in England or Scotland) were used. / Methods: We report data investigating which type of test, if any, the public think Government guidance asks people to use if they have COVID-19 symptoms. In people with key COVID-19 symptoms (high temperature / fever; new, continuous cough; loss of sense of smell; loss of taste), we also describe the uptake of testing, if any. / Results: Ten percent of respondents thought Government guidance stated that they should take an LFT if symptomatic, whereas 18% of people thought that they should take a PCR test; 60% of people thought they should take both types of test (12% did not select either option). In people who were symptomatic, 32% reported taking a test to confirm whether they had COVID-19. Of these, 53% reported taking a PCR test and 44% reported taking an LFT. / Conclusions: Despite Government guidance stating that anyone with key COVID-19 symptoms should complete a PCR test, a significant percentage of the population use LFT tests when symptomatic. Communications should emphasise the superiority of, and need for, PCR tests in people with symptoms

Public experiences of mass casualty decontamination

In this article, we analyze feedback from simulated casualties who took part in field exercises involving mass decontamination, to gain an understanding of how responder communication can affect people’s experiences of and compliance with decontamination. We analyzed questionnaire data gathered from 402 volunteers using the framework approach, to provide an insight into the public’s experiences of decontamination and how these experiences are shaped by the actions of emergency responders. Factors that affected casualties’ experiences of the econtamination process included the need for greater practical information and better communication from responders, and the need for privacy. Results support previous findings from small-scale incidents that involved decontamination in showing that participants wanted better communication from responders during the process of decontamination, including more practical information, and that the failure of responders to communicate effectively with members of the public led to anxiety about the decontamination process. The similarity between the findings from the exercises described in this article and previous research into real incidents involving decontamination suggests that field exercises provide a useful way to examine the effect of responder communication strategies on the public’s experiences of decontamination. Future exercises should examine in more detail the effect of various communication strategies on the public’s experiences of decontamination. This will facilitate the development of evidence-based communication strategies intended to reduce anxiety about decontamination and increase compliance among members of the public during real-life incidents that involve mass decontamination

Tiered restrictions for COVID-19 in England: knowledge, motivation to adhere and self-reported behaviour

Objectives: To test whether public knowledge and confidence in one’s understanding of the local restrictions, motivation to adhere, and self-reported behaviour differed according to tier level. / Design: Cross-sectional nationally representative online survey of 1728 participants living in England (data collection: 26 to 28 October 2020). / Methods: We conducted logistic regression analyses to investigate whether knowledge of restrictions, confidence in knowledge of restrictions, motivation to adhere to restrictions, and self-reported behaviour were associated with personal characteristics and tier. / Results: Between 81% (tier 2) and 89% (tier 3) of participants correctly identified which tier they lived in. Knowledge of specific restrictions was variable. 73% were confident they understood which tier was in place in their local area, while 71% were confident they understood the guidance in their local area. Confidence was associated with being older and living in a less deprived area. 73% were motivated to adhere to restrictions imposed for their local area. Motivation was associated with being female and older. People living in tiers with greater restrictions were less likely to report going out to meet people from another household; reported rates of going out for exercise and for work did not differ. / Conclusions: While recognition of local tier level was high, knowledge of specific guidance for tiers was variable. There was some indication that nuanced guidance (e.g. behaviour allowed in some settings but not others) was more poorly understood than guidance which was absolute (i.e. behaviour is either allowed or not allowed)

Holding a stigmatising attitude at the start of the COVID-19 outbreak (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] study)

Objectives: To identify the prevalence of a stigmatising attitude towards people of Chinese origin at the start of the COVID-19 outbreak in the UK population and investigate factors associated with holding the stigmatising attitude. Design: Online cross-sectional survey conducted 10 to 13 February 2020 (n=2006, people aged 16 years or over and living in the UK). / Methods: We asked participants to what extent they agreed it was best to avoid areas heavily populated by Chinese people because of the COVID-19 outbreak. Survey materials also asked about: worry, perceived risk, knowledge, information receipt, and perception of government response to COVID-19, and personal characteristics. We ran binary logistic regressions to investigate associations between holding a stigmatising attitude, personal characteristics, and psychological and contextual factors. / Results: 26.1% people (95% CI 24.2% to 28.0%, n=524/2006) agreed it was best to avoid areas heavily populated by Chinese people. Holding a stigmatising attitude was associated with greater worry about COVID-19, greater perceived risk of COVID-19, and poorer knowledge about COVID-19. / Conclusions: At the start of the COVID-19 pandemic, a large percentage of the UK public endorsed avoiding areas in the UK heavily populated by people of Chinese origin. This attitude was associated with greater worry about, and perceived risk of, the COVID-19 outbreak as well as poorer knowledge about COVID-19. At the start of future novel infectious disease outbreaks, proactive communications from official sources should provide context and facts to reduce uncertainty and challenge stigmatising attitudes, to minimise harms to affected communities