‘Zika virus alerts spread too much confusion’

Hebrew University study says information on epidemic was at too high a reading level

Information about the 20152016 Zika virus epidemic that was released by the World Health Organization caused confusion and even panic in the world because it was written for people with graduate-school educations rather than the common man.

Also, press releases issued by the US Centers for Disease Control (CDC) were found to be suited for high-school graduates but not people with less education.

These are the conclusions reached by researchers at the Hebrew University of Jerusalem, who studied health monitoring and communication during the recent Zika epidemic and have proposed ways for health authorities to better contain future epidemics.

The researchers studied online trends, incidence and health risk communication during the spread of Zika in South and Central America and East Asia. The epidemic aroused great concern among the public worldwide, especially due to the fear of possible harm to fetuses whose mothers contracted the virus.

The study, just published in BMJ Global Health, was led by international master of public health student Dr. Gbenga Adebayo, under the guidance of Dr. Hagai Levine and Prof. Yehuda Neumark and in cooperation with Wiessam Abu Ahmad, at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine, and Dr. Anat Gesser-Edelsburg of the University of Haifa’s School of Public Health.

Looking at the period between May 1, 2015 and May 30, 2016, the researchers analyzed Google search trends for Zika disease and related concepts, and correlated them with Zika incidence globally, in the US and in the five countries where the epidemic was most severe. They also examined communications from the WHO’s Pan America Health Organization and the CDC, including the contents of press releases, practical recommendations to the public, and how this corresponded to the public’s search for information online.

The authors found press releases from the WHO and the CDC were reactive and hard to read; on average, 17 years of education needed in order to understand WHO press releases but only 12.4 years for CDC statements.

In four of the five countries with the highest incidence, the researchers found very strong correlations between online search trends and the number of suspected Zika cases. This suggests that monitoring online trends can complement traditional surveillance efforts during Zika and other pandemics.

The researchers also found that health authorities’ press releases were reactive in nature: they followed online search trends for Zika-related info, and their timing was delayed. This communication time lag represents missed opportunities for mitigating risk, controlling infection and alleviating anxiety.

The content of press releases was not optimally adapted to the public’s needs and ability to understand. Ideally, materials for the public should have a much lower grade-level score; for example, patient education material should be written at a sixth-grade or lower reading level.

Compared to WHO press releases, CDC press releases were shorter, with significantly lower word counts. Not only were they more readable, but also more likely to provide advice regarding risks, to provide contact details and links to other resources, and to include figures or graphs.

The research has immediate implications for health organizations and reveals gaps in their preparedness for global epidemics. It indicates deficiencies in using the Internet both as a source of information and as a public outreach channel. The consequences can include missed opportunities to better contain the event, improve infection control and reduce public anxiety.

The researchers recommend improving the readability of public health messages, by adding a “layman’s summary” and involving public representatives in assessing readability before releasing documents to the public. Press releases should also reiterate specific steps and behaviors people need to take to mitigate risks, and health communication should make their announcements early. The researchers also conclude that in times of public health emergencies, health authorities such as the WHO could work together with companies like Google to promote reliable sources of health information.

“In the age of social media, press releases remain an important tool for communicating information to the public in times of health crises such as the ongoing Zika pandemic,” said Adebayo, a distinguished graduate of the Hebrew University-Hadassah International MPH program. “Press releases are the initial, and often the only, source of news for health and medical science journalists, and many news organizations reprint health-related and science-related press releases verbatim,” Adebayo said.

“Creating trust between the public and health authorities is a key factor in the public’s perception of risk and the extent to which they are willing to act on official recommendations,” said Levine, the paper’s senior author and head of the environmental health track at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine.

“Mass media tools are continually evolving and public health crises can move with incredible speed. In this fast-paced environment, health authorities need to effectively leverage modern communications platforms in both directions: to communicate effectively with the public, and to monitor epidemiological trends and assess the public’s needs.