Inconsistent crisis communications during the COVID-19 pandemic led to an erosion of public trust and hardened vaccine hesitancy among some Canadians, according to studies by University of Guelph researchers.
Although some public health experts have effectively shared messages and information during the pandemic, many authorities failed to consistently apply guiding principles for effective crisis communication, said Dr. Melissa MacKay, a post-doc researcher in the Ontario Veterinary College’s Department of Population Medicine.
In several studies led by MacKay and published this year and in 2021, researchers, including population medicine professors Drs. Andrew Papadopoulos and Jennifer McWhirter, called for more consistent use by public health experts of guiding principles for crisis communications during health emergencies.
“There were a lot of examples of excellent crisis communication during COVID-19,” said MacKay, who completed her PhD studies this past summer. “There were also instances where the public perceived public health communication as conflicting or untrustworthy or maybe not targeted appropriately.”
The group has assembled its recommendations into a social media crisis communication guidebook for public health practitioners and authorities.
MacKay said she hopes more experts will pay closer attention to these guiding principles, which she calls key to maintaining and building widespread trust in public health communication.
Public trust ‘hard to earn, easy to lose’
Trust is key for combatting a pandemic or other public health emergency, she said.
“Trust is so predictive of how people are going to take in information and act on that information,” said MacKay. “Trust is incredibly difficult to earn but so easy to lose.”
Referring to the COVID-19 pandemic, Papadopoulos said, “Trust will encourage the public to act upon public health measures in the current crisis. Maintaining trust will have the public listen to and act upon future public health messages during the next crisis.”
The researchers compiled a list of guiding principles for crisis communication:
- Clear use of language and visual information targeted to specific audiences
- Compassion shown through emotion and concern
- Conversational language including the use of first and second person and informal language
- Correction of misinformation including rumours, myths and conspiracy theories
- Timely dissemination of information and decisions
- Transparency, including honest, accurate information about uncertainty and decisions
For social media especially, MacKay said, best practices also include use of conversational tone as well as a call to action – say, asking the public to do something or inviting users to visit a website, share a post or watch a video.
“If a public health official is speaking to you like a friend or a neighbour, you may accept the message more readily,” said Papadopoulos.
The group looked at social media to assess adherence to these principles and to learn more about what aspects of crisis communications affected public trust. In one paper in the International Journal of Environmental Research and Public Health, they looked at tweets between March 2020 (the initial lockdowns in Canada) and January 2021.
Overall, public health experts adhered inconsistently to the guiding principles in their tweets. Tweets using a combination of guiding principles were more likely to encourage higher public engagement.
Influencers, family doctors seen as trustworthy communicators
Another paper in BMC Public Health looked at effects of Instagram posts by so-called “influencers” between December 2019 and March 2021. Politicians, celebrities and science communicators had above-average engagement with their posts; public health, government and media had lower engagement.
According to a paper in the Journal of Community Health in fall 2021, members of the public assess the trustworthiness of crisis communication based on such factors as consistency, reputation, timeliness and transparency.
People tend to trust public health when the spokesperson is a health official providing non-political, timely information, said MacKay. Community members such as family doctors are more trusted for crisis communication than media and governments, which are often perceived as using sensationalism or unreliable information.
Yet another paper in the International Journal of Environmental Research and Public Health in 2021 looked at Facebook use of key guiding principles for crisis communication early in the pandemic. The team’s analysis of more than 400 posts and more than 26,000 comments showed inconsistent use of those principles.
“Public health needs to use these guidelines more consistently to increase public trust,” said MacKay. “The more guiding principles you’re using, the better your engagement will be.”
Vaccine hesitancy strengthened by inconsistent crisis communication
The group also interviewed 12 Canadian adults who were not fully vaccinated against COVID-19. They found that perceived low use of guiding principles for crisis communication led to lower trust and to continued vaccine hesitancy.
“Talking to vaccine-hesitant individuals was eye-opening for a number of reasons,” said MacKay. “I was mainly struck by how much this group felt coerced by public health and how that degraded trust in public health. They felt like they didn’t fit anywhere in society.”
Said Papadopoulos, “We wanted to better understand why people were to receive the COVID-19 vaccine. We felt this information could illuminate why public health messaging was ineffective on a portion of the population and how we may approach crisis communication during the next public health emergency.”
Among MacKay’s own trusted information sources during the pandemic were two U of G professors.
- Early in the pandemic, she attended a talk by philosophy professor Dr. Maya Goldenberg on the importance of trustworthiness in ensuring compliance with public health measures. Goldenberg wrote about trust in scientific institutions in her 2021 book, Vaccine Hesitancy: Public Trust, Expertise, and the War on Science.
- Also in the early months of COVID-19, psychology professor Dr. Kieran O’Doherty studied trust in vaccination programs, research intended to help policy makers and public health to address concerns about inoculation.
MacKay and her co-authors teamed up with the Canadian Public Health Agency and the National Collaborating Centre for Methods and Tools to produce the Social Media Crisis Communication Guidebook for Public Health. Published this year, the handbook is intended to help public health ensure effective communication not just during COVID-19 but for future emerging infectious diseases.
“We assembled all of our research to create the guidebook for public health practitioners to understand what the research says about maintaining trust and demonstrating trustworthiness though social media crisis communications,” said MacKay.
She said the guidebook is being well-received among public health experts in Canada. Funding for the resource came from a Social Sciences and Humanities Research Council Partnership Engage grant.
Dr. Melissa MacKay