Key elements to effective communications.

Swine Flu: getting the message through

A study in risk communication

Abstract

This paper investigates public perceptions of risk communication using Swine Flu as a case study.

There has been an increase in the media appetite for stories associated with risk and the management of risk in recent times[1]. Sidell (2000: 196) considers that, “the appetite for health information and programmes is ever growing” but also warns health and risk communicators that with the increased opportunities to address mass audiences, comes potential hazards. Seale (2002: 92) concurs, asserting that, “coverage of [...] infectious disease issues [...] contain considerable potential for creating scares”. Therefore, Sidell (2000: 196) advises that “good communication and an ability to develop a rapport and understand the perspective of the ‘other’” are key elements to effective communications.

Communicating with the media is challenging at the best of times. But when the interview relates to a potential health risk, the stakes are even higher. The ability of a spokesperson to communicate effectively in these circumstances will have a direct effect on whether the public takes the appropriate action and how reassured they feel.

This paper identifies those elements of clear communications to enable spokespeople to better eliminate doubt from their communication of key messages related to health or other risks. The initial evaluation provides a suggestive analysis of the data which identifies a number of characteristics which could be said to connote trustworthiness and reliability, which is particularly important in the delivery of health and risk communication campaigns.

Specifically, the research identified two spokesperson “equations” which are likely to result in either greater reassurance or heightened anxiety among the public:

CS + WA – AA = Anxiety

Where CS is Credible Spokesperson,

WA is Worrying Analysis and

AA is Actionable Advice

Whereas

CS + SA + PA + AA = Reassurance

Where CS is Credible Spokesperson,

SA is Serious Appearance,

PA is Personable Approach and

AA is Actionable Advice

Delivering all of the elements of the reassurance equation is a tough challenge. However, by understanding what the ingredients are, ensuring that nominated spokespeople have the natural ability to deliver them, and providing the right training and preparation for any media encounter, the likelihood of important messages getting through is significantly increased.

Introduction

There has been an increase in the media appetite for stories associated with risk and the management of risk in recent times[2]. Sidell (2000: 196) considers that, “the appetite for health information and programmes is ever growing” but also warns health and risk communicators that with the increased opportunities to address mass audiences, comes potential hazards. Seale (2002:92) concurs, asserting that, “coverage of [...] infectious disease issues [...] contain considerable potential for creating scares”. Therefore, Sidell (2000: 196) advises that “good communication and an ability to develop a rapport and understand the perspective of the ‘other’” are key elements to effective communications. Indeed, The Lancet argues that for any health communication campaign to be successful, the communication strategy must be well thought out from the outset, “by neglecting the urgent need for a well thought out communication strategy, the agency risks undermining the value of their findings right from the start” (The Lancet Oncology, 2003: 519). In this paper we intend to argue that not only does the communication strategy need to be carefully prepared for health and risk communication but so does the spokesperson.

Risk communication is defined by de Sa, Mounier-Jack and Coker (2009) as “the process by which information regarding outbreaks is identified and shared with the purpose of increasing awareness amongst key stakeholders of the threat.” Even in these digital times, the media remains a key stakeholder and so those preparing to use this valuable resource must also be aware of its power. Regester and Larkin (2004: 137) consider that, “By virtue of its ‘believability’ the media acts as the most important conduit to shaping people’s beliefs and behaviour” [emphasis added].

This paper identifies those elements of clear communications to enable spokespeople to better eliminate doubt from their communication of key messages related to health or other risks. The initial evaluation provides a suggestive analysis of the data which identifies a number of characteristics which could be said to connote trustworthiness and reliability, which is particularly important in the delivery of health and risk communication campaigns via the media.

Background

The author was commissioned to undertake a research project on behalf of Insignia Communications. The initial research question was ‘what makes for effective communication of messages via the media in the context of health concerns?’ In simple terms, we were seeking to identify the ingredients that make a media spokesperson credible, trustworthy and effective when communicating about risk through the media.

Swine flu was chosen as the vehicle through which to analyse components of effective media communication due to its topical news value as well as its importance as a risk communication campaign. The research team considered that the issue of swine flu was of significant importance to citizens of the UK at the time and therefore the elements of media interview techniques in this scenario were likely to have a more realistic effect on the reactions of the audience.

It was decided that a series of 15 clips featuring a range of spokespeople providing advice and views on the subject of swine flu would be shown to participants. They would be asked to record their thoughts about the spokesperson’s performance after each clip and then take part in a discussion about the interviews after all clips had been shown. The client supplied the clips.

Research methodology

Focus groups were held at a University on 7th and 8th October 2009.

Focus groups are a form of group interview in which participants are asked to explore a particular topic in some depth. One of the characteristics of a group interview is the ability to interview a number of people at one time making it an efficient interview method. However, as Bryman (2004: 346) asserts, it is also concerned with the ways in which people discuss an issue as a group and not merely as individuals. Therefore the technique often seeks to establish how people react to and debate issues within a group situation; Bloor et al point to the use of focus groups to, “throw light on the normative understandings that groups draw upon to reach their collective judgements” [sic] (2002: 4). This was important in this study as we wished to identify the extent to which peer pressure and the power of word of mouth would influence people’s ultimate perceptions of the spokespeople.

A small media campaign was conducted to recruit participants and this, alongside advertising to the specific groups mentioned below, proved effective in recruiting people. Initially it was hoped to attract between 40 and 50 participants to the project; Bloor et al. advise recruiting “more participants than you actually need in the assumption that a number will not turn up on the day” (2002: 36), despite following this advice a number of people still failed to attend and 38 people were recruited overall. The researchers hoped to attract two main groups to the project: parents and young people. While the project succeeded in attracting high numbers of young people (27 people aged 25 and under took part), it was less successful in attracting parents; despite putting on focus groups in the evening, only 13% of participants were parents. The participants broadly fell into three categories: parents, professionals and young people. Of the young people, nearly 80% were in full or part-time study, as such the opinions of this group of people cannot be generalised across the whole UK population, however they do provide an indication of how well messages are received and acted upon by this important group. The professionals and parent groups comprised a broader range of people, of this group only one was involved with higher education, the rest having been recruited via local media coverage and employed in a variety of positions from secretary to teacher, homemaker to lay preacher.

As the topic under consideration was a health scare that could affect all sections of society, the exact make-up of the participant groups was not felt to limit the study at all, as the spokespeople under consideration were seeking to address and reassure the public as a whole and not merely certain ‘at risk’ groups. The main limitation was the potential for different groups to react differently to spokespeople and this is considered in more detail in the discussion section.

To help ensure attendance, reminder calls were issued to all those who had volunteered, and a small payment was made to cover any expenses incurred as a result of attending, which as Bloor et al. (2002: 34) confirm, is a common practice in focus group research.

In this instance, the researcher adopted two approaches to data collection. Firstly, participants were asked to record notes immediately after clips were shown and also to indicate their top three and bottom choices as to the most and least effective spokespeople; secondly, a group interview was carried out after all clips were shown. This approach ensured that initial reactions were recorded, as well as capturing how these opinions were renegotiated and adapted during group discussion. Therefore the study can be said to have taken a blended focus interview and focus group approach.

The research subjects for this exercise were all selected because their role meant that they would be called upon to reassure the general public in the event of a health scare; therefore all subjects work in health or politics. They were:

1) Professor of virology, University of London

2) The Secretary of State for Health

3) Professor, Imperial College, London

4) A doctor from The Cochrane Collaboration

5) Chief Medical Officer

6) A doctor from the Royal College of Obstetricians and Gynaecologists

7) A doctor from the Department of Primary Health Care, Oxford University

8) A representative from the Department of Public Health and Policy, London School of Hygiene and Tropical Medicine

9) Chief executive, National Childbirth Trust

10) Professor of Bacteriology, University of Aberdeen

11) GP and author of The Truth about Vaccines

12) Chair of Royal College of GPs

13) A communications advisor, World Health Organisation

14) Director of the Initiative for Vaccine Research, World Health Organisation

15) Prime Minister

Quantitative data analysis

In total 38 people took part in the focus groups. The majority of the participants were childless females with 13% being parents and 26% being male. The average age of the respondents was 27; with the youngest being 18 and the oldest aged 50. The table below shows the spread of ages among the participants:

The table shows that the mean age of participants was lower than the average age at just 21. The majority of participants were aged below 30 with just 7 people or 18% aged 30 or over. However, those aged over 30 tended to have higher academic qualifications, with two of those participating having a doctoral qualification.

Qualitative data analysis

In this section we outline the main responses to each of the interviews: spokespeople are ranked in the order of popularity as defined by the individual scores of group members. Their position following group discussion is shown in brackets.

1) Professor of virology, University of London (1)

The professor was filmed in a London street environment providing advice on how people could deal with the swine flu outbreak. This was overwhelmingly considered to be the best interview. Participants warmed to his friendly, calm and informative manner and felt that he was giving practical advice in terms they could understand, without patronising them. The location was broadly welcomed with many respondents identifying it with Harley Street or another medical setting. Participants were generally reassured by the practical advice given and entertained by his exuberant manner and emphatic gesticulation. His appearance also provoked comment, with many considering him to be an eccentric British ‘gent’ which again added to the memorability of his performance. He was considered to be both authoritative and trustworthy and many felt that he communicated in terms that they could understand.

Insights:

- The professor’s style was idiosyncratic. As a result, people remembered him, and remembered what he said.

- Body language used effectively to reinforce verbal messages is incredibly powerful

- A serious appearance – usually implied by clothing – combined with a down to earth, personable style of communication is a very effective combination in risk communication

- The public expects and values practical advice more than just “comment” or generalities

- If you are appropriately entertaining, you are more likely to successfully impart important health advice

2) Secretary of State for Health (2)

The Health Minister was filmed at a health centre commenting on the launch of the swine flu hotline. He came across well, as participants found him clear and confident. They particularly liked his location at a flu centre, which they felt showed that he was ‘involved’ with the situation. They felt that he gave clear and practical advice and liked his manner. He came across as both confident and reassuring in the majority of cases and many participants rated him as convincing. He was also felt to be plain speaking.

Insights:

-Environment is important. People liked the fact that the surroundings for the interview were not only relevant, but also positioned the minister as in touch with the public. Both these factors lent credibility to his performance

-In the event of a health scare, clear, simple, actionable advice must be imparted by spokespeople: this empowers people to take a level of control over the situation

-A down to earth style resonates well with the viewing public

-Politicians are not necessarily distrusted or disbelieved: the actual content and performance of the spokesperson can override stereotypes or negative preconceptions

3) A Professor from Imperial College (4)

The professor was filmed in an academic office: lighting was set up to create a shadowy, almost sombre image. He was talking about the potential impact of swine flu. Many felt this interview to be dramatic. Both the setting and side lighting seemed to increase this sense of drama and many felt that his precise and assertive use of language helped with the delivery of his message. Many found his approach convincing yet pessimistic, which one participant described as ‘scary’. He was largely considered to be authoritative and professional yet many were not reassured by this interview.

Insights:

-A person’s status or profession lends immediate credibility – they are seen to have a right to speak and a right to be listened to

-Well-prepared, clearly communicated messages are a prerequisite for success

-The environment – even the lighting – in which the interview is shot affects how people interpret the message they receive

4) A doctor from The Cochrane Collaboration (3)

This interviewee was filmed outdoors in an unidentifiable location. He was wearing a polo shirt and was commenting on the potential dangers of the swine flu vaccine. This interview led to the most divided opinions; there were those who considered that his tone, delivery and appearance could have been interpreted as scare-mongering, while others felt that his precise language and tone indicated the seriousness of his message. Many misinterpreted the message though, with only the older and more highly educated participants believing that he is trying to calm fears by highlighting the folly of the panic surrounding swine flu.

Insights:

-Commentators with strong views or coming from a recognised standpoint can be used to deliberately spark a debate as they are likely to reach some people very effectively, but alienate others

-Casual clothing need not be a barrier to effective communication

-Trust and credibility may be eroded if you are presented as scare-mongering

-Sophisticated or complex messages are hard to communicate effectively to the general public, so keep it simple

5) Chief Medical Officer (= 5)

The medical officer was filmed inside an unnamed and unidentifiable building offering the latest information and advice on the outbreak. While calm and assured in his delivery, some participants felt that his tone was too monotone to maintain their interest. However, his message was overwhelmingly considered to be clear. He is considered by the majority to be reassuring; however his bland delivery style means that he is not the participants’ first choice of interviewee.

Insights:

-Clarity is essential: spokespeople must know exactly what they want to say beforehand and be clear and succinct in communicating it

-Measured delivery adds gravitas and engenders a feeling of reassurance

-Personality and energy should be introduced into interviews if full engagement with the public is to be achieved

6) A doctor from the Royal College of Obstetricians and Gynaecologists (= 5)

The doctor was filmed outside in an unidentifiable location and provided advice on swine flu and pregnancy. This interview was largely considered to be clear and calm with people trusting the interviewee. It was felt that practical advice was offered and an attempt was made to calm people’s fears. This interview featured quite highly in the ranking, with south-east Asian participants, in particular, being reassured by his still and calm delivery. Others thought he displayed a lack of emotion which they felt uncomfortable with. The location of this interview also seemed to reinforce the feeling of calm felt by respondents and many felt he gave sensible advice.

Insights:

-People find the provision of clear and practical advice by spokespeople to be a key factor in reassuring them

-A calm spokesperson is usually a credible spokesperson

7) A doctor from the Department of Primary Health Care, Oxford University (7)

The doctor was filmed in an academic office commenting on the potential effects of the swine flu vaccine on children. This interviewee displayed a much more casual verbal style of delivery which was off-putting to many – there were also comments that his body language seemed unsure. His message was considered to be diffuse, and parents, in particular, were alarmed by his comments. Some participants felt that he was concerned and, rather than feeling more knowledgeable about the treatment, they now felt more worried. While the interviewee’s use of hand gestures maintained some participants’ interest, others were confused by the complexity of the argument and didn’t feel the message was clearly explained. There were also concerns about the fluency of the speaker: hesitation, stammering and change of pitch all contributed to some participants finding the interview hard to follow.

Insights:

-Spokespeople must be capable of preparing and delivering clear messages – complexity should be avoided when communicating to the public about risk

-Being personable engages the public; being casual turns them off

-A spokesperson doesn’t have to be word perfect. But in times of health fears and concerns, a fluent delivery is reassuring and ensures the successful communication of key messages. Organisations should, if possible, avoid putting forward spokespeople who are unable to meet this challenge.

8) A representative from the Department of Public Health and Policy, London School of Hygiene and Tropical Medicine (8)

The spokesperson was filmed on a street outside a building. She commented on plans to deal with swine flu. There was some discrepancy in people’s opinions about the location of this interview – some found it to be more natural while others were distracted by the background. Her manner was found to be calm and questioning yet participants were a little alarmed by her concern that there were no adequate plans in place. Many felt that she was downplaying the consequences and were reassured that she felt the disease would be mild. Others, however, were confused by the message and were unsure whether to feel reassured or alarmed.

Insights:

-This spokesperson had a noticeable French accent: it appeared to have no effect on people’s views of what she said. We can conclude that regional or national accents should not be a barrier to successful communication.

9) Chief executive, National Childbirth Trust (9)

The representative was filmed in an office environment and commented on the potential risks of swine flu for pregnant women. Participants felt that while calm and confident in her delivery, the spokesperson did not offer any useful information. Her use of qualifying phrases such as “might or might not”, and the way she appeared to be ‘hedging her bets’ was seen to be unhelpful and could cause confusion. Many thought her speculative approach could lead to accusations of scare-mongering. Many participants were confused about the level of risk for unborn babies and their mothers at the end of the interview.

Insights:

-It is not enough to be a calm and personable spokesperson: successful communication is not just about image – there must be substance and clarity in what is being said

-Speculation is seen to be very unhelpful – the public wants facts and clear guidance

-Spokespeople need to focus on reducing confusion rather than adding to it with equivocal statements

10) Professor of Bacteriology, University of Aberdeen (10)

The professor was filmed outside a hospital talking about the likely development of swine flu. As a person, this interviewee came across as assured and professional. However, many participants found his comments alarming, with one respondent even claiming that ‘he makes me feel really upset and powerless’. Many considered him to be reliable and trustworthy but were concerned about the content of the message which some felt could be interpreted as scare-mongering. His smart appearance and physical movement added interest and gravitas to his presentation but overall, participants still found the content to be worrying.

Insights:

-Worrying facts communicated by a credible spokesperson without accompanying advice on how to address the situation can cause significant public anxiety. Spokespeople need to be aware of this power and responsibility.

11) A GP and author of The Truth about Vaccines (11)

The GP was filmed in a studio, giving his views on the swine flu vaccine. He was generally perceived to be agitated and not confident. His fast speech and tendency to interrupt and overlap the interviewers contrasted with their calm and assured presentation style, all of which contributed to his appearing ‘edgy’ and nervous. Many considered his style to be aggressive and patronising to the interviewer, although the viewers themselves did not feel patronised. Many felt that his intention was good and that he was trying to help people but that his style and manner made him appear to be lacking in confidence. There were also those who felt that he had his position of authority undermined by the presenter. While undoubtedly passionate, many felt that this level of emotion detracted from his main message.

Insights:

-People like passionate spokespeople who come across as real people. But when a spokesperson’s emotions boil over, their ability to communicate effectively is diminished.

-Avoid “taking on” the interviewer – the public reacts badly to this and loses focus on the content of the message.

12) Chair of Royal College of GPs (12)

The representative was filmed sitting in an office, probably at a GP surgery, and commented on the launch of the swine flu hotline. Many participants found this interview worrying and it is also one of the bottom ranked interviews. Two main aspects were identified; firstly, his body language and stance were considered to be arrogant and distant by many participants; and secondly, the language used by the interviewee seemed to be both excessively ‘corporate’ and removed. Respondents felt that he had chosen his words carefully in order to distance himself from any consequences: his use of passive rather than active language, i.e. ‘we have been reassured’, rather than ‘we can reassure you that’, worried participants who felt that he had no faith in the system. Overall people did not find this interviewee trustworthy or reassuring.

Insights:

-Spokespeople need to consider their body language: the public will not empathise with people who appear to be arrogant or distant.

-Spokespeople need to be seen to be part of the solution rather than part of the problem when communicating about risk. Alternative views are acceptable, but they need to be expressed in a constructive way. This can be reinforced both with words and body language.

13) A communications advisor, World Health Organisation (14)

The communications specialist was interviewed in front of computers and screens in a room which resembled “mission control”. This was considered to be one of the worst interviews. Many were distracted by the background, and participants were put off by his casual dress and jerky body language. They were confused by his use of the word ‘event’ to describe outbreaks of the disease: they were not sure if this meant individual cases or localities where cases had broken out. His casual attitude also irritated participants, with many feeling that he didn’t care about what he was saying. Overall participants were not reassured by the interview and found the presentation ‘scary’.

Insights:

-Presentation is important: the environment, personal dress and body language are important elements in how the public views a spokesperson and the messages they communicate.

-In risk communication, avoid jargon at all costs.

-In a serious situation, spokespeople need to be seen to be in control and taking the situation seriously.

-Not all communications people make the best spokespeople; ensure that you have trained professionals representing your organisation.

14) Director of the Initiative for Vaccine Research, World Health Organisation (WHO) (13)

The director was filmed in a dark and uninspiring studio with the WHO logo in the background. She spoke directly to the camera as though she were a newsreader. The setting for this interview was considered to be off-putting. The formal studio, with table and flags was considered old-fashioned and many did not feel that it added anything to the interview. This coupled with a fairly dry and monotone delivery style, led to this interview being in the bottom three interviews. Many were confused by the message and felt that the delivery and relevance of the message was not clear. However she maintains good eye contact and several of the respondents picked up on that. She clearly had notes in front of her and many felt that she was not prepared for the interview: she seemed as though she had just come from a laboratory to speak after little preparation.

Insights:

-A formal setting conveys a subliminal message that this is a major crisis.

-Dry content and a monotone delivery will fail to connect with the public – even in a crisis, an energetic and animated style engages the public better.

15) Prime Minister (15)

The PM was shown speaking about the outbreak at an international conference: he stood at a podium and had a backdrop of national flags. Overall, participants considered his speech to be too general. The message was not very clear and it failed to reassure them with its lack of real ideas or decisions. Many felt the interview was too dramatic with national flags in the background – it conveyed a national disaster, which participants found unnerving, not reassuring. He appeared vague, as though he didn’t understand the issues very well. Participants were also put off by his refusal to address the audience or look directly at the camera.

Insights:

-Preconceptions of a spokesperson can affect how that individual’s performance is perceived. The prime minister’s lack of popularity at the time of the research is likely to have negatively affected perceptions of his communication effectiveness.

-The speaker’s environment is important in determining how the message is received: the formality of the surroundings implied a major and serious issue.

-When speaking about health risks, the public wants hard information and advice: they are looking for leadership.

-Strong eye contact engenders credibility, trust and confidence; indeed, Fearne-Banks considers eye-contact to be one of the top ten most important factors in a media interview (2007: 27).

Discussion

Following group discussion, participants were asked to re-rank the spokespeople. This resulted in only marginal changes to rankings: therefore, the small shifts in rankings following group discussion seem to indicate that peer pressure has only a limited ability to change personal opinions of a spokesperson’s effectiveness.

Trust the professor

Across all four groups the professor of virology was found to be the favourite and most trusted spokesperson. Almost half the total number of participants rated him as their top communicator, with comments such as “I thought he came across as really friendly and not scary, he just gave the kind of information that you would use”; “I thought he spoke in layman’s terms so everybody at all levels would understand him,” and “[he] was the best communicator because he related to the audience and gave concrete advice on how to treat the illness and what precautions can be taken.”

In total, 25 people or two-thirds of the participants rated the professor of virology in their top three speakers. Reasons indicated for this include:

• His suit implied seriousness and gravitas

• His personable and unique style delivered the memorability factor – he was different from the other spokespeople and so his advice stood out

• His use of gesticulations helped to support his argument and more clearly communicate the advice he was giving

• His calm manner engendered reassurance and confidence in what he said

• He provided concrete advice: this meant there was real value in what he said and offered ways that viewers could take a level of control over the situation

• He seemed ‘like your GP’, a person whom members of the publicly generally recognise, trust and respect

• His location – possibly Harley Street – lent further credibility to his messages

Overall, it appears that it is the combination of all the previous factors that made him the most successful spokesperson. One or two of these attributes are not enough: the most effective spokespeople have the “full package”. With this in mind, it is clear that the most able and competent spokespeople should be used whenever risk communication is required; compromising this can be dangerous if messages are to be effectively delivered.

The only other interview which provoked a similar level of consensus was that of the Prime Minister; 14 people identified him as the worst spokesperson, and double that of his closest rival (Director of the Initiative for Vaccine Research). Comments here included “One of the worst public speakers ever”; “he did seem really unsure about what he was talking about”; and “he’s probably been briefed about thirty seconds before he walked through the door”.

Keeping up appearances

While some participants claimed to be influenced only by the speaker’s content, appearance was important to the majority of respondents, although some felt that this would depend on who was presenting. For instance, one respondent claimed not to have noticed what the interviewees were wearing but asserted that they would be “absolutely disgusted” if the Prime Minister came out wearing a T-shirt and jeans.

The role of the interviewee was also important when making judgements about clothing: less consideration was given to appearance where the interviewees’ job didn’t normally involve presentation. For example the participants were less concerned about the appearance of doctors such as the GP, the representative from the Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, and the director of the Initiative for Vaccine Research. However those people whose job was seen to involve presentation (politicians and communications advisors, for example) were judged more harshly on their appearance. The communications specialist suffered particularly badly on this criterion, with a high number of participants criticising his casual appearance, which seemed to them to be indicative of a ‘disinterested’ attitude. It is, perhaps, for this reason that, following group discussion, he displaced the director of the Initiative for Vaccine Research to take second last place.

Content is king

The main characteristic shared by the interviewees in the bottom three places was that none of them seemed to have anything useful or concrete to say. The director of the Initiative for Vaccine Research suffered from a perceived lack of expression; her statement was delivered very precisely but in a monotone and this was seen as unconvincing’ by the participants who placed her in the bottom three. The Prime Minister provoked the most vehement response on this matter as it was felt that he was ‘shifty’ in his delivery and that he had nothing useful to add. The WHO communications advisor also suffered from a perceived problem with his attitude, coupled with the use of words described by one participant as ‘meaningless’.

The chief executive of the National Childbirth Trust (NCT) was judged by almost a third of the respondents to be ‘scare-mongering’ and yet more considered that she had nothing ‘useful’ to add to the debate. Conversely the doctor from the Royal College of Obstetricians and Gynaecologists was found to be calm and reassuring as almost a third of participants rated him in the top three of all interviewees. The contrasting interview styles of these two presenters could be said to contribute to the differing opinions, for the NCT representative, although confident and assured, seemed to give little concrete advice, whereas the doctor was perceived as calm and more considered and offered useful advice to viewers, according to participants.

A question of trust

The risk of ‘scare-mongering’ was a concern raised about a number of the interviews. Despite this, the doctor from the Department of Primary Health Care, Oxford University and the representative from The Cochrane Collaboration succeeded in presenting alternative and even controversial views, and on the whole, participants still considered them to be trustworthy. Accent and dress seem to have an effect on perception here, although a number of participants were put off by the casual appearance of the latter. One person even said that he was a conspiracy theorist because of his approach and appearance, although this view was not echoed by other participants. The chair of the Royal College of GP’s was generally considered to be off-putting because of his physical position, leaning back in his chair with one leg casually thrown across the other.

The politicians split the voters

Contrary to popularly held belief, politicians were not automatically mistrusted. Indeed, although The Prime Minister did fare badly in terms of his presentation style, the Health Minister, by contrast, was widely considered to be reassuring and informative. His interview was rated as one of the best interviews in the focus group and people appreciated his delivery and presentation style. Again, contrary to popular opinion that politicians deal only in spin, it was also one of the few interviews perceived to have provided concrete advice – meaning that the substance of the interview was also considered to be useful and important.

Implications for risk communication

Key insights from the research indicate that the following factors are most important when communicating about risk via the media:

Personal style

• ‘Likeability’ is a key factor: participants were more likely to respond positively to those who came across as warm and approachable

• Tone of voice is important: participants were put off by monotone delivery, irritated by over-confident or patronising tones and reassured by friendly, down-to-earth, animated styles

• There is a thin line between the interviewee coming across as confident or arrogant: spokespeople should be aware of their physical stance during an interview; too relaxed a position can be perceived as arrogance

Credibility

• Spokespeople should dress appropriately: on the whole, participants considered that interviewees should dress formally to deliver important or risk-related information

• Suitability of interviewee is an important factor: the participants were concerned with the perceived relevance of the interviewee; this was a key factor in engendering respect

Content

• Content is king: it is important that there is a correlation between content and presentation; participants were quick to spot when interviewees had little of substance to say

• Clarity of language is vital: participants were confused or annoyed with jargon, which prevented them from understanding the message, as Regester and Larkin assert, “The avoidance of complex language and statistics is essential” (2004: 62)

• Clarity of message: as far back as 2003, The Lancet was warning that “uncertainty brings with it risks of misinterpretation, manipulation, and confusion.”

Body language

• Movement is an advantage: participants were attracted to those interviewees who displayed a passionate delivery style; gesticulation for emphasis was appreciated (although there are risks in taking this too far)

• Interviewees must address the camera or interviewer: participants were wary of those who did not directly address the audience

Environment

• Location is important: contrived settings were not as popular with participants as those interviewed in more natural or relevant locations

Conclusions

If, as Weaver, Sargent Weaver & DiClemente (2008: 601) argue, “Increasingly, risk communication concepts are proving instrumental to pursuits in noncrisis contexts such as health care and health promotion”, then it is vital that risk communicators are adequately prepared and setting the right example.

It is clear that while individuals may react differently to individual spokespeople, there are a clear set of criteria for ensuring effective communication of risk or health issues. This paper identifies five key areas for communicators to concentrate on:

• personal style

• credibility

• content

• body language

• environment

Beyond this simple list, we are also able to create two spokesperson “equations” which are likely to result in either greater reassurance or heightened anxiety among the public:

CS + WA – AA = Anxiety

Where CS is Credible Spokesperson,

WA is Worrying Analysis and

AA is Actionable Advice

This equation represents the worst possible combination of factors in risk communications. Based on the research undertaken, these factors are likely to lead to confusion, mistrust and panic in target publics. Whereas:

CS + SA + PA + AA = Reassurance

Where CS is Credible Spokesperson,

SA is Serious Appearance,

PA is Personable Approach and

AA is Actionable Advice

The combination of concrete advice, professional appearance, credible background and a personable approach offers the best possible chance of messages of reassurance being received and understood by target audiences. It seems that it is not enough for one or two of these factors to be present but they must all be used simultaneously to achieve maximum effect.

As Brecher and Flynn (2002: 447) argue, “Communicating sensitive, technical information to the public can be one of the most difficult challenges that a scientist faces today”, it is therefore crucial that for risk to be clearly communicated and messages to be accurately received, communicators should take steps to ensure that they satisfy as many of the key criteria as possible.

Future developments

This paper provides an initial suggestive analysis of the data. The nature of the topic under study and the data collected would suggest that a social semiotic analysis may lead to more nuanced findings being uncovered as the investigation goes deeper.

It is therefore recommended that the study continues with a more profound examination of the data considering social semiotics and visual analysis as theoretical lenses through which more meaningful insights can be uncovered.

A number of participants identified ‘giving good information’ as a key quality for a good interview. Future critical discourse analysis should be carried out on the interviews in order to establish what information is being given, if any, and how this correlates to audience perceptions of information being given.

Bibliography

Bloor, M. Et al. (2002) Focus Groups in Social Research, London: Sage

Brecher, R. and Flynn, T. (2002) Principles of Risk Communication: Building Trust and Credibility with the Public, in Handbook of Toxicologic Pathology, 447-457 Amsterdam: Elsevier.

Bryman, A (2004) Social Research Methods, Oxford: OUP

De Sa, J., Mounier-Jack, S., and Coker, R. (2009) Risk Communication and management in public health crises. Public Health, 123 (10), 643-644

Fearn-Banks, K. (2007) Crisis Communication: A Casebook Approach, New Jersey: Lawrence Erlbaum Associates (3rd Edn.)

Regester, M. And Larkin, J. (2004) Risk Issues and Crisis Management: A Casebook of Best Practice London: Kogan Page

Seale, C (2002) Media and Health, London: Sage

Sidell, M in Katz et al. (eds.) (2000) Promoting health: knowledge and practice, London: The Open University

The Lancet, O. (2003) Communicating risk: an impossible task? The Lancet Oncology, 4(9), pp.519-519.

Weaver III, J.B., Sargent Weaver, S. and DiClemente, R.J. (2008) Risk Communication in International

Encyclopedia of Public Health, 601-606 Amsterdam: Elsevier.

[1] See Beck, U (1992), Klein, N (2007), Giddens, A (1990 and 1991) and Brooker, C & North, R (2007) to name but a few authors writing on the subject of risk in society and the media. [2] See Beck, U (1992), Klein, N (2007), Giddens, A (1990 and 1991) and Brooker, C & North, R (2007) to name but a few authors writing on the subject of risk in society and the media.