Research in action – learning lessons from COVID-19

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In December, 2022 I found myself sitting in a hotel bar in Almaty, Kazakhstan talking with a friend and colleague who works for the World Health Organization about the importance of building communities of knowledge, practice, and experience to tackle global problems like COVID-19. Practitioners and politicians get the benefit of research-informed decision-making and academics get the benefit of seeing research in action. We learn from one another.

Within the context of risk and crisis communication we can create better interventions to save lives, mitigate risk, and help improve crisis response. At least these are the aspects of risk and crisis communication that motivate me.

Why was I in Kazakhstan in December? I was there to participate in the WHO’s workshop on risk communication and community engagement for Central Asia. Aside from offering a keynote address on lessons learned from COVID-19 in Europe as a way of sharing best practice, I was also there to better understand new or different approaches to risk communication and community engagement in different cultural, political, and social contexts.

Much of the material that I presented in Kazakhstan was my contribution to an EU-COVI funded report on communication strategies enacted across EU countries from 2020-2022. On Monday (30 January, 2023), I had the opportunity present these findings to the COVI Committee in the EU.

Pre-recorded presentation. For the live hearing, click the link in the paragraph above.

Key Lessons Learned for Governments About Communicating During a Health Crisis

This research summarizes 236 scientific publications and institutional reports related to the COVID-19 pandemic between 2020 and 2022, including an exhaustive search for English-language resources on the 11 countries included – 9 as the countries of focus (Bulgaria, France, Germany, Hungary, Italy, Lithuania, the Netherlands, Portugal, and Sweden) and 2 countries for comparison (UK and US).

Summary of Communication Best Practices During Health Crises

Let’s briefly talk about the highlights from these lessons learned:

  • Effective pandemic communication strategies should focus on explaining to citizens what self-protective behaviours should be taken and why, within each country’s national contexts.
  • Research suggests that in a pandemic, governments should adopt a positive tone supporting citizen confidence in taking action, communicating engagement and responsiveness because defensive messages are simply less effective.
  • There is an overall citizen preference for transparency and a constructive management of fear and anxiety. 
  • Additionally, two-way communication or citizen engagement was crucial in their relative communication success. Governments must also actively listen and respond to their citizens’ needs.
  • It was also recognised across countries that tailoring the messages to meet different demographics’ information needs and attitudes about government was essential. For example minority communities within countries often have different information and communication needs.
  • Finally, regardless of relative success in managing the pandemic, trust in the communicating institutions is a central – if not the central feature of communication success.

A Contingency Approach to Responding to Health Crises

Overall, the literature analysing COVID-19 communication supports the need for an effective stakeholder relationship management framework. This framework focuses on the interactions between the institutions managing COVID-19, citizen interests, and COVID-19-related issues that lead to self-protective behaviours being enacted.

Research finds that issue-related, institutional, citizen, and information factors all affect message acceptance.

This framework is meant to be used as a contingency approach to building communication strategy. A contingency approach argues that agile crisis response using research-informed message design and evaluation is especially important in complex situations like COVID because it allows governments and public health authorities to diagnose the key communication challenges within a population and then design messages to meet those citizen information needs – reflecting one of the best practices learned from COVID-19.

Let me summarize some key findings for each of these factors:

Issue-Related (COVID-19) Factors

Across the EU, UK, and US literature, citizens’ knowledge of the disease, their own perception of risks, and the amount of control they feel like they have directly affect their willingness to take behaviors to protect themselves.

Issue-related factors influence strategy in several ways. For example, within the context of the COVID-19 pandemic, people were already afraid. Therefore, it makes more sense within this context to focus on building positive messages about reducing risk rather than fear-based messages. For example, countries like England and Hungary that used fear-based messaging or emphasised punishment for non-compliance had lower levels of citizen compliance with instructional messages.

Institution-Related Factors

No matter whether research was analysing the high-trust environments in Sweden or explaining why political polarisation eroded institutional trust and correlated with a low level of adoption of self-protective behaviours in countries like the US, UK, Bulgaria, and Hungary, institutional trust emerged as central to citizen behaviour. In short, building and maintaining a good reputation and trust – especially related to health issues – is an essential tool for governments and public health to effectively manage future pandemics.

Citizen-Related Factors

Citizen-related factors highlight the demographic and attitudinal predispositions for people to enact self-protective behaviours. Demographic factors matter depends on location, culture, and timing.

But a more universal citizen-factor is efficacy – or our confidence in our ability to enact behaviors AND have those behaviors lead to positive outcomes. The evidence from across the countries clearly concludes that as governments and public health authorities should: (1) explain what people should be doing, (2) provide clear instructions on how to perform the behaviour correctly, and  (3) provide evidence that there is a benefit for them in performing the behaviours.

Finally Information-Related Factors

Popular media and scientific research widely recognise that the COVID-19 ‘infodemic’ poses a serious threat persuading citizens to adopt self-protective behaviours. The bottom line is that when citizens feel they do not have enough quality information from their governments and public health authorities they will fill perceived information gaps by relying on other sources of information, opening the door to mis and disinformation.

Additionally, in such a prolonged crisis, several pieces of research also identified a new challenge related to information fatigue. Information fatigue emerged as a prominent factor in countries like Germany, Italy and Lithuania. Finally, when there are lower levels of information literacy – that is being able to discern good and back information, citizens are more resistant to adopting self-protective behaviours recommended (or required) by governments and public health institutions.

While it is obvious to say that ‘good pandemic communication practice’ is necessary, good pandemic communication practice requires planning, adaptability, and a strong understanding of citizen attitudes.

Link to EU Report: https://www.europarl.europa.eu/RegData/etudes/STUD/2023/740063/IPOL_STU(2023)740063_EN.pdf