Warning Fatigue or Cry-Wolf effect is a taken-for-granted phenomenon that can result from being ‘over-warned’. The terms are used to describe situations where individuals who are exposed to recurring warning messages about a disaster which then does not eventuate become cynical, apathetic and ‘tired’ of hearing warnings. They may become desensitised to the risk thereby endangering themselves even more. The assumption by practitioners (emergency managers and governmental policy-makers for example) that warning fatigue is a problem presents emergency agencies with a conundrum: they want to avoid the accusation of panicking the public but worry they may run the risk of under-preparing them at the same time. As a result, they may be tempted to err on the side of caution, delay issuing a warning and downplay the possible severity of a potential disaster. Examination of the literature, and an analysis of presentations and news stories have shown that policy-makers, emergency managers, academics and the public use the term ‘cry wolf’ or ‘warning fatigue’ in everyday life. They regard it as conventional wisdom and believe it can influence risk perception and warning response. Nonetheless it has been presumptively assigned by some disaster theorists to the category of a myth. A limited warning fatigue literature has examined the phenomenon in the context of rapid-onset disasters and has concluded that risk perception is not affected by warning fatigue. However, it also suggests there is a direct relationship between warning time, preparedness and response. This allows for the possibility that warning fatigue may not be a myth, but a function of the type of disaster, the frequency of warnings and warning lead-time. This thesis makes a distinction between rapid-onset and prolonged lead-time disasters and hypothesises that prolonged lead-time disasters are responded to in very differently ways than rapid-onset ones. Australian bushfires provide the context in which this research was conducted because bushfires are repeatedly warned about yet rarely (once every ten or twenty years) result in a major disaster. Using social constructionist and social representation theoretical frameworks, and integrating psychosocial and sociological perspectives, this thesis examines the role that warning fatigue plays in the risk perceptions, warning responses and decision-making processes of people living in bushfire-prone areas of Australia. Utilisation of a mixed methods design, a substantive literature review and two rounds of semi-structured interviews resulted in a conceptualisation of a bushfire warning fatigue measure (BWFM). Application of the measure among at-risk Australian communities validated the measure. Through empirical statistical analysis, this standardised instrument was revised (BWFM-R) and used to measure the change in warning fatigue levels over a fire season (November 2011-April 2012). Analysis showed that warning fatigue appears to be multi-faceted comprising five aspects: Trust and credibility, over-warning, false alarms, scepticism and helplessness. It was also found that warning fatigue responses are contextual and interconnected with ‘unofficial’ warnings (such as media stories). The direction of the change and analysis of the qualitative component of the survey implied that unofficial bushfire rhetoric from the media during the winter months may produce a warning fatigue effect, so that when the official warnings were issued at the beginning of the bushfire season, the public were already ‘tired’ of the message. Trust and credibility, over-warning, false alarms, scepticism and helplessness are not new factors in public warning response to disaster communication, but this research demonstrates that they can combine in a unique way to produce ‘warning fatigue’. It proposes that if emergency and disaster agencies differentiate between rapid-onset and prolonged lead-time disasters, understand the complexities of warning fatigue and design their warnings accordingly, then disaster risk communication will become more effective, increasing public engagement and improving disaster response.

Thesis (Ph. D.)--Texas State University-San Marcos, 2007. / Vita. Appendices: leaves 241-521. Includes bibliographical references (leaves 233-240).

Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.

Thesis (Ph. D.)--Texas State University-San Marcos, 2007. / Vita. Appendices: leaves 241-521. Includes bibliographical references (leaves 233-240).

The global health system is ill prepared to handle communicable health crises, much less effectively communicate about them, as evidenced by the West African Ebola outbreak. Although some critics have argued that the delay in international response contributed to the fast spread of the disease, others place greater blame on local cultural practices. The current study investigated how risk/crisis communication was produced, deployed, and received. This is particularly critical as the World Health Organization guidance on crisis/risk communication is not based on systematic evidence-based research Again, risk communication on communicable diseases is still relatively new and the body of research lacks both rigorous empirical evidence and evaluation research on event-specific risk communication efforts. Guided by the protection motivation theory and social mobilization theory, and using a comparative case study approach, this study sought to examine how crisis risk communication was undertaken and received in Liberia and Ghana and the implications for health crisis risk communication. Data was collected via interviews with communication and social mobilization team representatives in the two countries, document reviews, surveys of a cross section of inhabitants in Margibi and Shai Osudoku districts, and focus group discussions with purposively selected participants in the two countries. The study finds that expert-led top-bottom communication interventions used at the start of the outbreak were ineffective in getting target audiences to make the recommended behavior changes in Liberia. Messages developed induced fear rather than action. Furthermore, one in five respondents today, cannot identify the main signs and symptoms of Ebola. Again, the more worried people were about Ebola, the more vulnerable they felt. Finally, respondents moved through a cycle from equilibrium to defense to protection and then back to equilibrium as they sought to make sense of the disease and the communication they received about Ebola. It is recommended that risk communication include bottom-up community-led communication approaches and systems that are embedded within community culture and reality and used by community members. Again, the research challenged the assumption in risk perception studies that increasing knowledge and self-efficacy lowers risk perception thus suggesting the need for further studies in this area. / 10000-01-01

People with psoriasis are known to engage in high levels of unhealthy lifestyle behaviours which may lead to poorer psoriasis outcomes and increase the risk of cardiovascular disease (CVD). Thus, helping individuals with psoriasis understand the link between behaviours and health risks, that is health risk communication, and direct support for lifestyle behaviour change (LBC) are important aspects in optimal management of psoriasis, a long-term inflammatory skin condition. There are two aspects of the literature that remain unclear. First, whether adequate support is given to patients to enable them to understand the links between lifestyle behaviours and health outcomes is part of psoriasis patient management strategies. Second, whether there is agreement around effective health risk communication techniques. This programme of research aimed to examine these gaps in the literature using four related studies. The first study used content analysis to examine general and dermatology-specific healthcare professionals’ core training competencies for evidence of skills relating to LBC. An important finding was the lack of explicit skills relating to LBC and changing understanding of health risks. There was little or no reference to recognised LBC techniques that could be used to support and facilitate LBC with patients. The second study used observational techniques to examine messages about the links between behaviour and health outcomes and LBC signposting (such as leaflets or posters about healthy living) for patients with psoriasis in primary and secondary care patient waiting areas. There was little evidence of psoriasis-specific information about healthy living. Generic information (not specifically about psoriasis) was often of poor quality and was poorly displayed, and did not conform to evidence-based recommendations for effective LBC signposting. The third study combined observational and qualitative techniques to examine how healthcare professionals communicate information about CVD risk to patients and the role of LBC in reducing risk in the context of primary care risk assessments with people with psoriasis. A key finding was that interpretation of risk information was not always linked to specific advice about how to modify each risk factor. Discussion was mostly instructional rather than a shared collaborative discussion about behaviour change and risk reductionThe fourth study used experimental methods to examine the effects of message framing theory as a health risk communication strategy on reported behavioural intentions (BIs) in people with psoriasis. An important finding was that for messages about psoriasis symptom reduction, gain-framed (positively-framed) messages were more effective in increasing BIs for alcohol reduction. Conversely, for messages about CVD risk reduction, loss-framed (negatively-framed) messages were more effective for increasing BIs to reduce alcohol consumption. The body of work presented in this thesis demonstrated that much needs to be done to increase the skill sets of healthcare professionals in order to help people with psoriasis recognise the specific links between their own health behaviours and health outcomes. In addition specific recommendations have been suggested as a way of improving risk communication strategies, such as using theory-based personally-relevant health information for people with psoriasis.

Une des particularités du dispositif de prévention sanitaire est d’incarner une biopolitique au pouvoir faible, au sens où elle doit le plus souvent convaincre, plutôt que contraindre, des individus sains, de se protéger contre un risque potentiel. La vaccination est non seulement le dispositif de prévention sanitaire le plus ancien, mais également celui qui a suscité le plus de controverses. L’enjeu de cette thèse a été de positionner le rôle de la communication au sein de ce dispositif. Plus précisément, notre objectif a été de sérier et caractériser les modalités d’usage discursif qui mettent en croyance le plus grand nombre des récepteurs et favorisent des attitudes de défiance, de confiance ou encore d’hésitation vaccinale au sein des dispositifs médiatiques. Pour ce faire, nous nous appuyons sur une étude de corpus de 386 communications relatives à la vaccination et articulons des savoirs en provenance des champs d’études sur « les médias, la communication et la culture », « le risque » et « la science et ses techniques ». Afin d’optimiser les modalités d’usage discursif les plus en rapport avec la dimension éthique et esthétique des discours sur les vaccins, nous avons amorcé une phase d’expérimentation des variables d’interactions pour les deux modalités discursives en question, ainsi que pour chaque type d’acteurs s’exprimant publiquement sur le sujet. En nous adossant à une enquête par questionnaire et à la méthode des scénarios en ligne, nous testerons la capacité de chaque discours d’acteur à créer du consensus, auprès de la cohorte en santé publique « i-Share », à ce jour, composée de plus de 19 227 étudiants.À titre d’exemple, nous avons choisi de limiter notre étude au vaccin luttant contre les papillomavirus humains (HPV), dont le déploiement, controversé, a pour objectif de prévenir le cancer du col de l’utérus. En effet, depuis sa mise sur le marché européen en 2006, les polémiques sur le coût de ce vaccin, ses effets secondaires et son efficacité n’ont eu de cesse de s’intensifier, allant jusqu’à produire un climat social de méfiance à l’égard des acteurs du dispositif de prévention sanitaire par vaccination. En termes de résultats, nous verrons qu’agir sur les communications de la contre démocratie sanitaire sur l’Internet est une des pistes privilégiées pour optimiser les communications médiatiques sur les vaccins. Dans cette dynamique, et à partir d’une analyse des valeurs qui fondent la mobilisation des modalités discursives les plus représentatives de chaque type d’acteur, selon notre étude de corpus, nous avons mis au jour celles aptes à créer de la reliance entre les différentes croyances vaccinales en action dans l’arène du débat médiatique. Ainsi, nous avons développé à l’attention des acteurs médiatiques online, un tableau d’analyse des variables discursives qui structurent la rhétorique esthétique du discours sur la vaccination, selon les éthiques du Care et de la Justice dans la discussion autour du vaccin anti-HPV. Ces éthiques nous semblent propices à un climat social moins anxiogène et plus reconnaissant de la diversité des opinions sur le sujet, et, dès lors, plus favorables à une réception positive et partagée des informations relatives au vaccin anti-HPV. À la suite, est fourni le protocole d’une étude expérimentale adaptable à l’ensemble des communications du risque, pour permettre la poursuite de ce travail, en ouvrant le mode opératoire de ce processus sociocommunicationnel de captation, de caractérisation, d’analyse, puis d’expérimentation des modalités discursives spécifiques aux vaccins, à d’autres champs d’intervention et/ou d’investigation. / One specificity of the preventive health-care system is to embody a weak-power biopolitics which should convince rather than oblige healthy individuals to protect themselves and their children against potential risks. Vaccination is one of the oldest and most controversial health prevention measure. Our aim was to study the role of communication in this field. More specifically, we have characterized the modalities of discursive usage which induce belief in most receptors and promote distrust, trust or hesitation within media diapositives. To this aim, we have analyzed a corpus of 386 communications related to vaccination using a multidisciplinary approach at the frontier of different field studies: media, communication and culture, risk, and science and technology. To optimize the modalities of the discursive usage in the ethical and aesthetic dimensions of communication, we have analyzed the discursive modalities of different actors who have communicated publicly on the vaccines. We have build a questionnaire which will soon be proposed to the 20.000 young adults of the i-share cohort, a large epidemiological study targeting students in French universities. Volunteers will be invited to participate to an online scenario experimental study to assess the capability of different stakeholders’ discourse to build consensus. We have focused our study on the HPV vaccines which protects against cervix cancer. Since its commercialization in 2006 in Europe, controversies about the cost, possible side effects and efficacy of these vaccines have increased, resulting in general distrust towards actors of the preventive health-care system. We have found that acting on the communications of the health counter-democracy on the Internet could be one efficient method to optimize media communications about vaccines. Based on our analysis of the values underlying the mobilization of the most representative discursive modalities of the actors in our corpus, we have highlighted those that appear to be the more efficient at promoting trust between different vaccine beliefs. We have produced a table describing the discursive variables underlying the aesthetic rhetoric of the discourse on vaccination according to the ethics of Care and Justice. We believe that these ethics could reduce anxiety and promote recognition of opinion diversity on this subject, and therefore act towards a more favorable and shared information reception on the HPV vaccine. Finally, we have described what could be a general method for experimental studies in the field of media, information and communication when risk is at stake. Such a method could provide media emitters with an operating mode to capture, characterize, analyze, and experiment discursive modalities in their field of intervention or investigation.

No description available.

A review of the literature regarding risk management and effective risk communications identified that very few researchers have addressed risk assessment confidence levels when using risk scoring methods. The focus of this research is to develop a definition of risk assessment confidence levels for use in internal project management communications and to evaluate its usefulness. This research defines risk assessment confidence level as "The degree of certainty that the likelihood or consequence score (assigned by the risk assessor) reflects reality." A specific level of confidence is defined based on the types of analyses that were conducted to determine the risk score. A survey method was used to obtain data from a representative sample of risk assessment professionals from industry and academia to measure their opinion on the usefulness of the defined risk assessment confidence levels. The survey consisted of seven questions related to usefulness--four questions addressed the importance of stating confidence levels in risk assessments and three addressed the usableness of the proposed confidence level. Data were collected on the role and experience level of each of the respondents and the survey also included a comment section to obtain additional feedback. The survey generated 364 respondents representing a broad variety of roles associated with decision making and risk management with experience levels from fairly new to experienced risk assessors. The survey data were analyzed by calculating the proportion of respondents who gave negative, neutral and positive responses to the survey questions. An examination of the roles of the survey respondents indicated that no single group was dominant. A non-parametric Kruskal-Wallis test generally failed to reject the hypothesis that the means of the survey response distributions were identical. There was one exception which indicated that there are differences based on role and by inspection of the responses, it appears that decision makers, academics, and others more strongly support the need for confidence level information to reduce the difficulty in making risk based decisions in projects. The survey responses at a confidence level of 95% have a range of errors from 3.84 to 4.97%. Based on the results of the survey, 77 - 83% of those surveyed indicated agreement that knowing the confidence the assessors have in their assessment is important and would improve a management decision. The survey showed that 60 - 86% of the respondents agreed that the confidence levels and their definitions as presented in the survey were usable. The question with the lowest agreement (60%) was related to the way in which the individual levels were defined. The ad-hoc comments provided in the survey were divided into eleven groups based on similarity of the subject of the comment and then examined for common themes. These added additional insight into the results and useful information for future research efforts. This research validates that the use of risk assessment confidence levels is considered to be useful in project risk management. The research also identified several potential areas for future work, including determining the appropriate number of confidence levels that should be defined, refining the definition of the individual confidence level definitions, examining historical perspectives of whether the risk assessments were accurate, examining the concept of shiftability of risk assessments, further research on communication of variability of risk assessments, and research into the usefulness of risk matrices.