Public health officials have found ways to address the public misinformation, disinformation and distrust that originally coalesced around COVID-19 vaccines but spread to challenge their ability to educate people about other important issues, such as maternal health, medical screenings and influenza.
They told attendees of a Public Health Communications Collaborative webinar that engaging their communities with consistent, relevant and easy to understand messaging, being persistent in their efforts, and finding ways to accept feedback that do not lead to personal harassment and threats are keys to creating trust between public health agencies and the public.
“Trust is relational; trust requires risk,” Sehat said. “And to ask for trust is potentially to ask for a lot.”
Trust is easier with repeated interactions, Sehat added, making developing trust with online information difficult. Online information is premised on two-way communications so the public can respond, but they may not do so in generally expected ways.
The ARTT was developed as a response model to engage people and have constructive conversations. It addresses key trust issues by focusing on understanding what people want, seeing situations from their viewpoint, signaling to people you are listening, helping them become knowledgeable, debunking rumors and verifying information.
Sehat said research suggests that when someone shares misinformation, it is a good idea to respond by including the source of that information, helping people understand why it is incorrect and providing an explanation.
On the other hand, there is the option of not responding, and public health agencies may have good reasons to go that route. The challenge is that it can create a misinformation environment and lead to poorer understanding of generally accepted information, Sehat added.
Building community trust
Brett Morrow, chief communications officer for the Los Angeles County Department of Public Health, said his team decided to shut down the comment section on their social media sites because the conversation had become too hateful. The department ended up in a First Amendment lawsuit and won through a decision that said a designated public forum could be open and shut down at any time.
The ramification of shutting off comments was that people went after Morrow and his staff, with bullying, personal threats and hacking of personal information. He said his team “never took their eyes off the goals” they had for educating and informing the public about health issues. They did not let the harassment affect their work and implemented a bidirectional feedback mechanism that included emails, surveys, meetings with partner organizations, open forums and social media messaging.
The WNC Health Network in North Carolina supports people and organizations in their efforts to promote community health. Communications specialist Adrienne Ammerman brought health communicators in the region together in 2019 to build relationships, and the group then raised funds to support COVID-19 communications. Lessons learned from those efforts are being applied now, including the launch of a public health advertising campaign last spring to connect with residents.
Listening sessions with experts to ensure communications reflected the information needs of communities, working with local storytellers and shared performance measures to gauge impact were key to developing the program. They found that people wanted them to focus on Western North Carolina; use clear, relevant messages; evoke feelings of hope, strength and resiliency; highlight local stories; provide inclusive visuals; and engage various communities, among other things.
Ammerman said about half of the region’s population saw the ads and there was a 133% engagement rate.
“People who report engaging with our materials are more likely to say that the materials had an impact on their knowledge seeking or other types of behavior change,” Ammerman said.
After the first ad cycle, 86% of survey respondents said they had some trust in the source of information, and that increased to 94% after the second ad cycle. Consistently seeing messages from local health departments that tied in with high-priority issues helped build trust.
“When we have the trust of our communities, it stands to reason that they’ll be more likely to engage with and listen to the health information that we share,” Ammerman said.
Simple, succinct messaging
Keeping department goals at the forefront, maintaining transparency and promoting key public health programs help build trust for the L.A. County department.
Morrow said it is important to keep messaging simple and easy to understand. “That concept to me is probably the single most important consideration for building trust, not just online in general, (but) in regards to the work that we do,” he said.
That means messages that do not include a lot of jargon, which the general public may not understand and can be used by bad actors who want to take advantage of people. The department uses limited text, graphics that are engaging and information that relates to different communities or people.
Finally, Morrow said, departments can increase engagement by being visible at community building and outreach events, such as town hall meetings, and sharing highlights from them across social media.
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