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What have we learned about communication inequalities during the H1N1 pandemic: a systematic review of the literature.

Lin L, Savoia E, Agboola F, Viswanath K - BMC Public Health (2014)

Bottom Line: Consistent results were reported on the association between social determinants of communication inequalities and emergency preparedness outcomes.When addressed in communication interventions, these factors can increase the effectiveness of the response to pandemics.Our findings show the need to include such evidence found in the development of future communication campaigns to ensure the highest rates of compliance with recommended protection measures and reduce communication inequalities during future emergencies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Landmark Center, 3rd Floor East, Boston MA 02115, USA. llin@hsph.harvard.edu.

ABSTRACT

Background: During public health emergencies, public officials are busy in developing communication strategies to protect the population from existing or potential threats. However, a population's social and individual determinants (i.e. education, income, race/ethnicity) may lead to inequalities in individual or group-specific exposure to public health communication messages, and in the capacity to access, process, and act upon the information received by specific sub-groups- a concept defined as communication inequalities.The aims of this literature review are to: 1) characterize the scientific literature that examined issues related to communication to the public during the H1N1 pandemic, and 2) summarize the knowledge gained in our understanding of social determinants and their association with communication inequalities in the preparedness and response to an influenza pandemic.

Methods: Articles were searched in eight major communication, social sciences, and health and medical databases of scientific literature and reviewed by two independent reviewers by following the PRISMA guidelines. The selected articles were classified and analyzed in accordance with the Structural Influence Model of Public Health Emergency Preparedness Communications.

Results: A total of 118 empirical studies were included for final review. Among them, 78% were population-based studies and 22% were articles that employed information environment analyses techniques. Consistent results were reported on the association between social determinants of communication inequalities and emergency preparedness outcomes. Trust in public officials and source of information, worry and levels of knowledge about the disease, and routine media exposure as well as information-seeking behaviors, were related to greater likelihood of adoption of recommended infection prevention practices. When addressed in communication interventions, these factors can increase the effectiveness of the response to pandemics.

Conclusions: Consistently across studies, a number of potential predictors of behavioral compliance to preventive recommendations during a pandemic were identified. Our findings show the need to include such evidence found in the development of future communication campaigns to ensure the highest rates of compliance with recommended protection measures and reduce communication inequalities during future emergencies.

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Proportions of studied determinants of communication inequalities during the H1N1 pandemic in population-based studies.
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Figure 3: Proportions of studied determinants of communication inequalities during the H1N1 pandemic in population-based studies.

Mentions: Most population-based studies (82%, N = 75) looked at the association between specific population characteristics (i.e. sociodemographic as well as interpersonal and psychosocial factors) and H1N1-related communication and/or preparedness outcomes. See Figure 3. Our data show that older age, household income, level of education, and homeownership were positively associated with greater knowledge about H1N1. Studies have shown exposure to media or public health-focused advertising campaigns had a positive impact on not only increasing people’s levels of H1N1-related knowledge, but also their adoption of health behaviors[6,23-29]. A successful example of advertising campaigns was the official public health advertising campaign launched in the U.K., which was accompanied by commercial advertisements of tissues, hand sanitizers, and other related products that regularly repeated the official hygiene messages (i.e. “Catch it, Bin it, Kill it”), that successfully increased the perceived efficacy and adoption of recommended behaviors[26]. Being worried about the disease was identified as an important predictor of compliance with recommended preventive behaviors, and to be associated with the volume of media attention and media reporting on the number of H1N1 cases[18,19,24,26,30-34]. Furthermore, many studies have presented evidence linking H1N1-related knowledge to people’s attitudes (which could be either positive or negative evaluations of particular behaviors or events) such as approval of the governments’ response to the pandemic[20,35-37]. Knowledge and attitudes about the H1N1 pandemic had an impact on people’s adoption of preventive measures[19,24,26,27,29,35,38-43]. Knowing how the H1N1 virus was transmitted and having a good understanding of the symptoms of infection were positively associated with perceived risk and perceived susceptibility to infection, and belief in the effectiveness of recommended behaviors, which affected response efficacy[26,27,35,38-44]. Compliance with social distancing and hygiene measures (i.e. hand washing), was found to be greater in those of older age, in parents of children aged 18 or less, in women compared to men, and in people with higher SEP[18,35,38,39,41,42,45-48].


What have we learned about communication inequalities during the H1N1 pandemic: a systematic review of the literature.

Lin L, Savoia E, Agboola F, Viswanath K - BMC Public Health (2014)

Proportions of studied determinants of communication inequalities during the H1N1 pandemic in population-based studies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4048599&req=5

Figure 3: Proportions of studied determinants of communication inequalities during the H1N1 pandemic in population-based studies.
Mentions: Most population-based studies (82%, N = 75) looked at the association between specific population characteristics (i.e. sociodemographic as well as interpersonal and psychosocial factors) and H1N1-related communication and/or preparedness outcomes. See Figure 3. Our data show that older age, household income, level of education, and homeownership were positively associated with greater knowledge about H1N1. Studies have shown exposure to media or public health-focused advertising campaigns had a positive impact on not only increasing people’s levels of H1N1-related knowledge, but also their adoption of health behaviors[6,23-29]. A successful example of advertising campaigns was the official public health advertising campaign launched in the U.K., which was accompanied by commercial advertisements of tissues, hand sanitizers, and other related products that regularly repeated the official hygiene messages (i.e. “Catch it, Bin it, Kill it”), that successfully increased the perceived efficacy and adoption of recommended behaviors[26]. Being worried about the disease was identified as an important predictor of compliance with recommended preventive behaviors, and to be associated with the volume of media attention and media reporting on the number of H1N1 cases[18,19,24,26,30-34]. Furthermore, many studies have presented evidence linking H1N1-related knowledge to people’s attitudes (which could be either positive or negative evaluations of particular behaviors or events) such as approval of the governments’ response to the pandemic[20,35-37]. Knowledge and attitudes about the H1N1 pandemic had an impact on people’s adoption of preventive measures[19,24,26,27,29,35,38-43]. Knowing how the H1N1 virus was transmitted and having a good understanding of the symptoms of infection were positively associated with perceived risk and perceived susceptibility to infection, and belief in the effectiveness of recommended behaviors, which affected response efficacy[26,27,35,38-44]. Compliance with social distancing and hygiene measures (i.e. hand washing), was found to be greater in those of older age, in parents of children aged 18 or less, in women compared to men, and in people with higher SEP[18,35,38,39,41,42,45-48].

Bottom Line: Consistent results were reported on the association between social determinants of communication inequalities and emergency preparedness outcomes.When addressed in communication interventions, these factors can increase the effectiveness of the response to pandemics.Our findings show the need to include such evidence found in the development of future communication campaigns to ensure the highest rates of compliance with recommended protection measures and reduce communication inequalities during future emergencies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Landmark Center, 3rd Floor East, Boston MA 02115, USA. llin@hsph.harvard.edu.

ABSTRACT

Background: During public health emergencies, public officials are busy in developing communication strategies to protect the population from existing or potential threats. However, a population's social and individual determinants (i.e. education, income, race/ethnicity) may lead to inequalities in individual or group-specific exposure to public health communication messages, and in the capacity to access, process, and act upon the information received by specific sub-groups- a concept defined as communication inequalities.The aims of this literature review are to: 1) characterize the scientific literature that examined issues related to communication to the public during the H1N1 pandemic, and 2) summarize the knowledge gained in our understanding of social determinants and their association with communication inequalities in the preparedness and response to an influenza pandemic.

Methods: Articles were searched in eight major communication, social sciences, and health and medical databases of scientific literature and reviewed by two independent reviewers by following the PRISMA guidelines. The selected articles were classified and analyzed in accordance with the Structural Influence Model of Public Health Emergency Preparedness Communications.

Results: A total of 118 empirical studies were included for final review. Among them, 78% were population-based studies and 22% were articles that employed information environment analyses techniques. Consistent results were reported on the association between social determinants of communication inequalities and emergency preparedness outcomes. Trust in public officials and source of information, worry and levels of knowledge about the disease, and routine media exposure as well as information-seeking behaviors, were related to greater likelihood of adoption of recommended infection prevention practices. When addressed in communication interventions, these factors can increase the effectiveness of the response to pandemics.

Conclusions: Consistently across studies, a number of potential predictors of behavioral compliance to preventive recommendations during a pandemic were identified. Our findings show the need to include such evidence found in the development of future communication campaigns to ensure the highest rates of compliance with recommended protection measures and reduce communication inequalities during future emergencies.

Show MeSH
Related in: MedlinePlus