CERC Transcript 06 28 2016

Zika CERC Discussion: Preparing Spokesperson

Presenters: Barbara Reynolds, PhD

Date/Time: June 28, 2016 1:00 pm ET

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Operator:

Welcome and thank you for standing by. At this time all participants’ lines are in a listen-only mode. After today’s presentations you will have the opportunity to ask questions, and at that time you may do so over the phone by pressing Star then 1 at that time.

Today’s conference call is now being recorded. If you have any objections to this please disconnect now. Now I would like to turn the call over to your host for today Ms. Barbara Reynolds. Ms. Reynolds you may begin.

Dr. Barbara Reynolds:

Thank you Brad and welcome everyone to this week’s discussion on Zika and Crisis in Emergency Risk Communication. Last week we had a pretty robust discussion around community engagement and I think that this is just a follow through on some of the things that we talked about there and focusing specifically on our leader's spokesperson and what we can do as communication professionals to prepare our leader to do the best possible communication in a setting where emotions might be high. So for those of you who are following along with slides if you want to just go to the next slide we're going to focus always at the beginning on the fundamentals about why we do what we do here. And we know that the right message at the right time from the right person can save lives and reduce harm. And in today’s presentation - discussion we're going to talk about who is the right person and how do we prepare that person to do their best possible job in that communication?

Next slide, what we know is that when leaders are communicating, when emotions are high, when there is a threat -- the perception of a threat -- by people, that might be imminent and personal, that everything the crisis leader does is scrutinized. And it’s very important that more than anything we help our crisis leader be able to speak to the public in a way that what they’re saying and what they’re believing are consistent because what we know is that everything about that person including all of the nonverbal has a part in helping people determine whether they’re going to trust that leader and the information that they’re sharing in the situation.

Next slide - what we know is that the spokesperson -- the leader spokesperson especially -- is the one who takes the organization from an “it” -- from a bureaucracy of some sort -- to a “we” - to humans. And so the spokesperson humanizes the organization and stands in for that organization in many settings along the way. There is no question that all of us can issue information on a web site or create a public service announcement and there’s some value in that kind of communication. But when emotions are high, when people are feeling threatened or feel like their loved ones are threatened, or their economic security is threatened, it’s really valuable to have a human connection between your organization and the people that you’re trying to influence to do the best things possible to help them through this threat whatever it might be.

One of the important roles of a spokesperson is to remove the psychological barriers within the audience. And when I say barriers there can be a host of different psychological aspects within the audience that may reduce their ability to want to hear the message and then to act on that message.

We’ve talked often in training around crisis and emergency risk communication about how important it is for the crisis leader spokesperson to be able to express empathy. We’ve talked about it in the weeks previous that empathy is incredible, the ability to put into word the feelings that people are experiencing in the moment is vitally important. And I want to stress that we say it’s important not because we want to be popular, not because we want to be seen as caring individuals but because literally the research is telling us that an expression of empathy early on in a crisis situation helps reduce the psychological noise that gets in the way of people hearing what you have to say.

And that psychological noise may be simply that when you show up to start talking to people about a threat that they're receiving as personal and imminent that they're thinking, "Do you get it? Do you understand my perspective? Do you understand that something’s happening here that’s out of my control? I’m worried. I need reassurance. I need something from you, do you get it?" And by us being able to put into words as the leader's spokesperson what people are feeling in that moment not exaggerated but identify it is really critical to help reduce psychological barriers.

The spokesperson leader is also someone who can have a dialogue, can have a discussion can have back and forth between the audience and the organization to show that there is an opportunity for collaboration for input from one side to the other. And spokespersons can be very valuable to us in that kind of situation. And ultimately the right spokesperson again at the right time can help us communicate in a way to reduce the incidence of illness in a situation.

So next slide. Well there are a range of leadership styles that have been studied over time and different leadership styles have different places in the universe were they work well and other places where they may not work so well. And in research around the crisis leader we actually find that an authoritarian approach to leadership and communication may be effective in the initial phases of a crisis but as you go into the crisis situation when people are looking at the sense of the magnitude of just how bad this is and what are we going to do about it, then we may have to have another communication approach in that setting. And the question is what is the best communication leadership style in a crisis situation where hard decisions are being made within the community?

I'm kind of tricking you with a slide that I have where I talk about authoritarian, democratic, and laissez-faire because actually what the research tells us is not one of those is the ideal leadership style, that in fact the best leadership style is something that’s called in the literature, transformational leadership. And transformational leadership is really a way of engaging people so that they feel that they are participants in the decision-making process, that they’re not just spectators, that their input is important but there is still somebody who's guiding them, who's taking them along this journey of determining how to protect the community from whatever the threat is. And that could be a community, an organization, it could be a nation.

And frankly the thing that sets the transformational leader apart from someone who's an authoritarian or a democratic leader is this person has the ability through their communication, through their words, to inspire people to act and to act in unison, to act without divisions or fractions are among the groups in the community. And I think the best way to describe the transformational leader is it is the person who can mobilize people’s emotions. And see that’s the difference. It’s not about how well you state the facts, it’s about taking the whole emotional connections that are there in the situation and using those emotions to motivate people to do more and this is the real kick, with less self-interest. Because if you think about it it’s very difficult to find a solution to a problem where everybody's going to equally benefit from that solution. And so the transformational leader has to help people sometimes set their own concerns or their own biases aside so that the people can do the best for the most or the people who are most at risk in that situation. And I think that we can find parallels within the Zika response where our transformational leadership style and the ability to communicate in a way that motivates others, inspires others to do more with less self-interest can be very effective in the situation.

Now I will tell you that today I’m just going to skim through a few concepts and ideas about the crisis leader and spokesperson and some things that we might do initially to get a spokesperson prepared. But what I’m really hoping for is in today’s discussion that you all will join me in having an opportunity for others to hear your perspectives or your concerns about what it's going to take to have good spokespersons in your community at the point where Zika or Zika concerns occur as we move forward.

And the next slide is a reminder that when you are preparing a spokesperson to mirror the transformational leadership style to talk in a way that takes people’s emotions and then uses that connection to motivate them to do more with less self-interest. that we have to keep in mind what does the public see from our communication? I’ve said it before but it’s worth reminding people that yes absolutely they want the facts and we have to be prepared to give people facts. But they also want to empower decision-making. They want to take hold of these decisions so we need to help guide them through the facts with the broader strategy above that of what is the greater good, what is the goal that we're all trying to achieve in that situation? And more often than not you can get agreement on what that end is supposed to look like, what the outcome is, that we want to protect pregnant women from Zika virus infections so that these babies will be born healthy. That is an overall goal.

Now the question is can we motivate people to set aside their own biases or points of view or needs which may not be as great as the needs of this population group in the community? Can we motivate people through our communication to help them do that? And part of the way that we do that is empower their decision-making. So help them who know enough about the situation that they can come to a reasonable conclusion like you. They want to be involved as a participant, not a spectator. I was saying this last week and I think the week before, that frankly it’s pretty exciting that in this instance unlike many others we actually have things that we can ask the community to help participate in the response to help us help them, protect pregnant women and other people from Zika virus infection. So as we think about our communication we must always keep the public’s interests as far as what they want from our communication top of mind. And a leader who does this is going to be more successful as a spokesperson. So just I wish we were all the same room so we could have this discussion in a more robust way. So I’m going to have to substitute for some of you based on trainings that I’ve had in the past I’ll share some ideas with you.

So when I asked the question on the next slide about spokesperson qualities, what makes a good spokesperson or what doesn't make a good spokesperson I think collectively that we’ll come to the same places. I was doing a media trading just yesterday and was asking the group about this. What do you think makes a good spokesperson? And all of us of course think someone who they connect to, that seems authentic, that seems to have their best interest at heart a spokesperson is a good spokesperson who knows the information that they're are supposed to share but is also willing to tell people when they don’t know something so that they don’t bluff their way through it because many of us can see that when it happens and think it’s not a good idea. A good spokesperson is able to make positive eye contact that’s appropriate for the situation as it is that kind of dynamic. So we kind of know what makes a good spokesperson. I should have said what's the ideal spokesperson, because very few of us routinely can be the ideal spokesperson. So I think it’s worthwhile to concentrate just a little bit of time today on what doesn’t make a good spokesperson. And you might be surprised because you’re going to expect me to mention the things that you usually hear in media trading like well you’ll have to eliminate all those verbal hesitations like um, and like, you know, actually -- I’ve heard them all. And that would be good because there is research that suggests the more verbal hesitations you use while you’re speaking to people you kind of lose some credibility. And remember credibility is the combination of trust and expertise. That’s what makes somebody credible.

So if you’re hesitating a great deal that there could be a question about how trustworthy you are, are you telling me the truth? Why are you editing as you're thinking or it could be does this person have true expertise because they seem to be hesitating about what they should know in the situation? Don’t be too hard on your spokesperson if they do fall into a few verbal hesitations. There is also recent research -- and I have to say I’m skeptical until I see more -- that perhaps a little bit of verbal hesitation just makes you authentic and real so that you don’t seem to polished or over-scripted. So let’s not pick on our spokespersons too much if they fall into verbal hesitations every once in a while but what else doesn't make a good spokesperson?

Well obviously anyone who doesn’t keep the audience in mind as they're speaking, answers the questions that they want to answer, ignores the ones that they don’t want to answer. What doesn't make a good spokesperson more than anything what the research tells us especially when we're in the role of trying to help others, when people are seeking new information from us when they’re feeling threatened in some setting they need our help. And if you think about it when I tell you this think about when you’re in a medical dynamic, in a clinical setting who gets dinged as not being good doctors and who gets praise for being good doctors? Now think about this, what doesn't make a good spokesperson is someone who appears to be arrogant. Now just take a moment and think about that. If you’re in the doctor’s office and you're seeking new information you’re worried because you have symptoms you’re trying to figure out what’s wrong with you or get relief. And if somebody doesn’t want to engage with you or somebody who seems like don’t bother me or I’ll take care this and you don’t have to have any input that sort of arrogance gets in the way of you building rapport with that person and feeling trusted.

Now they might be brainiest they might be really smart and have a lot of expertise but if you can't connect with them it’s all a little harder for you to find them to be a credible source for your medical care. The same is true in these kinds of dynamics whether you’re an emergency response official or public health official or an elected official. If you don’t have the capacity to talk to people in an authentic way where you make them believe that what they’re feeling is important when you act as if you have better things to do with your time than to talk to them, that is the kind of thing that gets you in trouble where you really start to lose credibility, you’re going to lose your community. Spokespersons aren’t going to be able to bring people along in that transformational way that they hope that they can in a dynamic.

So I want to clarify that just a little bit for my colleagues out there who are science experts or emergency response experts. Sometimes I think because we have titles and we have initials behind our names that when we are acting defensive we appear as if we're being arrogant. So I think it's because they don’t - people may not be able to relate to us and really what we are is anxious or defensive because we feel like we're being judged in a way that we don’t want to. And sometimes we get pushed out in front to be a spokespersons and are say really, really does it have to be me in this moment, you know, why me? And we're feeling over-judged in the situation, maybe ill-prepared. And then some of that defensiveness comes across as really arrogance because we are projecting perhaps in that moment that I deal like I’d rather be any place else then be here and so we're not engaging people. We're surviving the communication experience in the situation. So I do in my training sometimes offer to people that I can get you to be a great spokesperson after five minutes of training. But I’m not going to do that right this minute. I'm going to save it for a little later in our discussion today and instead let’s expand on this idea of spokesperson and what’s important about them.

I told you I give you just a few things that I think is worthwhile if I were preparing someone especially my leader or another subject matter expert about getting ready to talk to the community. I would say stay within the scope of your responsibility. And that can be hard for everyone including our elected officials and our leaders because sometimes we take on more than we really should in the crisis situation. And before you know it if you start taking it on your own it. So be sure as we speak to our community for them to understand the scope of our responsibility, what is it that we do in this situation? Because otherwise we’ll set up false expectations and maybe imply promises on areas that we actually cannot accomplish in our role. It may seem so obvious but I do want to reinforce for you and you should reinforce this when you’re talking to your leaders and preparing your spokespersons, tell the truth.

Now I talk about how hard it can be at times to be honest and open but the one thing I am consistent about is that I never want anyone to ever represent their organization in a way that they’re being untruthful. They need to tell the truth. That doesn’t mean you tell people everything that you know in the moment. And I would start with being sure that people know we're going to tell you everything that we can right now. There are some things that just aren’t far enough along that we could share with you but when we have that we’ll share it. And then one of the important things we had to do is be comfortable with the idea that we can repeat ourselves. Repeat, repeat, repeat it’s like advertising sometimes. And it can get tiresome and you may think really do I need to come out here one more time and say the same stuff I said yesterday? Yes. Yes you do. What’s important is that leaders as spokespersons need to reassure their community as they're talking about a crisis threat of some sort. And the way to do that is to start with the foundation and then build on it. There's actually a whole educational process and theory called scaffolding were you say what you have to say and then you add to it. And then you, you know, you add another rung. Well then you do the first rung, the second rung and the third wrong on the third day and you just keep going but you’re constantly building on a basic message because sometimes I think we make the mistake of thinking if we said it one time then everybody's heard us say it. But that’s not true. We need to be willing to repeat our messages and then build on those basic foundational points along the way. And especially if we're trying to counter rumors and misinformation it's worthwhile for the leader spokesperson to repeat basic concepts to remind people who are seeking new information about a new threat what the basics are, what is it that we know in the situation? We have to be able, be ready to follow-up on issues. That means if we're listening to our community we need to respond to them with the things that they’re concerned about.

And this is hands down one of the things that we are going to have to tell our leader spokesperson if they need to expect criticism, expect it. And it’s hard sometimes because we would like not to be criticized. And so I think sometimes people shy away from their role as the leader spokesperson. But if you expect the criticism, I’m not saying that you should ignore criticism, but you should expect it. And at some point you may need a guide from others that you trust around you to say, "Is this legitimate? Should we be thinking differently about this thing or that thing along the way?" But just expected it. It doesn’t hurt quite as much, the sting isn’t quite as bad if we know that some of it's coming our way because we're the people who stand up to try to lead the community through the problem. And if we get defensive about the criticism it’s going to interfere with our authenticity and our ability to connect to the community with their emotions and then therefore we might not be as able to bring them through the crisis with asking them to do more with less self-interest.

We do have some basic risk communication principles that are important for leaders to understand, and so we can talk about creating the spokesperson, the leader spokesperson in terms of their media work but it goes beyond that. So some things that we kind of get wrong that we need to think about and it's the go-to place when there are problems or concerns in the community. Perhaps some of that can be criticism is starting to happen.

First and foremost don’t over reassure. Don’t make promises that we can’t keep. Sometimes our leaders feel like they’re kind of have their backs against the wall and they’re being forced to make promises that they can’t. We have to tell people that we will promise to work towards an outcome but we won’t promise the outcome. The other thing is we don’t want to over reassure as we don’t want to try to make people not be afraid by telling them there is nothing to worry about.

So both of those things can happen with a leader and just know that over reassurance is going to come across for people who are frightened about it as being disingenuous as someone who doesn’t have the sense of the scope of how bad it really is so be careful about statements of over reassure methods. It’s okay to reassure but not over-reassure.

Acknowledge that there is a process in place. This is really fundamental. When all else fails and you don’t have answers to questions explain to people what you’re trying to do to get those answers. And then this is not one that I like to share very widely but it is a very powerful tool. When things are really tough and people are looking for something that goes beyond the scope of anyone to respond in the situation, or if people are upset because things haven’t happened the way they want to and you're again trying to gently guide your community to do more with less self-interest, express wishes. And an example of that would be I wish that there was a fool- proof way for us to overcome the Zika threat but we're going to have to choose among things that with that comes some risk and some benefit. That’s an expression of a wish.

A wish is sort of like I know that none of us are satisfied with the situation the way it is. We would like it not to be here at all. I wish we didn’t have to face the Zika threat in our community. I mean that’s reasonable thinking and a way to connect with people. Whenever possible give people things to do. We talked about that just a little bit more and then asking more of people. I keep talking about this transformational leader who is able to motivate people to do more with less self-interest. The only place you can get people, and the only person who can ask more of people, is the person who's responding as a leader. And it works best if the leader is also sharing the risk in some way. So think of that as you look at some of the things that you’ll be doing in response to Zika up if it occurs in your community.

All right. I promised you that in five minutes or less we could turn someone into a great spokesperson. I hope I didn’t overpromise. But I can tell you that from my experience there’s two things that really are important. One is we need to have that leader spokesperson embody the organization or the community that they represent. And if you think about it, I was just listening to the governor of West Virginia around the horrible flooding that is happening in that wonderful beautiful state, and he, as he was speaking to the community through the media he was explaining to them about what it means to be someone from West Virginia and what they can endure what they’re capable of rebuilding. And it was inspiring in its authenticity of being someone from West Virginia. And so whomever we are, whatever organization we're representing, we should harken back to what makes this organization best, what makes it special and encapsulate that in our communication as a spokesperson so that for me, if I’m acting as a spokesperson it's not me Barbara Reynolds. It’s me CDC, I’m personifying CDC so I need to behave as I would if I were CDC on its very best day and you should do the same.

I don’t know if any of you have been through media training or have done media training but somewhere along the way people will say well the important thing is to just act natural. And I suggest for some people it may not be really a good idea to just act natural. What we really need them to do is act like their organization or their community on its best day and that gives us a place to start from a foundation. It sort of centers us into we are and perhaps takes away a little bit of that defensiveness that can creep in because we’re feeling judged as a human being and we should know we're not being judged as a human being. We're being judged as the organization or the community that we have to represent our organization and our community in that situation. So that’s step one.

But there are two steps to the five minute training and this one oh it's going to seem so obvious but I will tell you people miss this quite often. Step two is if you’re going to speak out, if you’re going to be a leader spokesperson or going to address the media in any situation, understand that you half to define your audience. And again I told you I was doing media training yesterday I will tell you the audience is not the general public. You must be if you want to be a good spokesperson be more specific about who you’re speaking to. I am talking to a woman who is in her first trimester of pregnancy. That’s who I’m speaking to when I’m talking about Zika risks and the steps that we need to take to protect our community from Zika. Know your audience. Who is that? Who's most affected by the threat that you’re addressing, and do I have to say, "Now I’m only talking to the women who are in their first trimester of pregnancy," no. What I’m saying is that if the spokesperson keeps that person in their mind, has that focus that’s who I’m speaking to is going to alter the approach that they take to the communication.

And here is what’s really important because oftentimes we get distracted by the approaches and the questions that reporters ask who are interviewing us. And we begin to think that the reporter is our audience. And if the reporter is asking us mean questions we might get defensive as we're talking to that reporter. Forget the reporter as nothing other than the conduit for you to talk to your audience and your authenticity, your sincerity your empathy will come across if you keep that audience in mind.

And the other thing I have to say for our expert is that you’re not talking to your scientific peers because sometimes we carry them around in our head and we feel so judged by them. We recognize the perhaps we made a little mistake here or there. We beat ourselves up internally and it starts to deflate our ability to be sincere and authentic in the situation itself. So be your organization or community on its best day and have your audience, those people who most desperately need the information and support that you’re willing to offer in that situation. Have those two things going for you. And I suggested that some of the problems that we find in our leaders, spokespersons are just spokespersons generally will fall away in that setting.

I also want to share with you on the next slide this is something that we talked about in the Zika Summit so this may seem like a repeat for some of you who may have participated either here personally or through web-casting these are lessons that we’ve learned at CDC that might benefit your leaders as they prepare to be spokespersons around the Zika situation and that is be prepared to answer with I don’t know. If we don’t have an answer it’s reasonable the process but it’s okay to say I don’t know, counterintuitive but it’s very valuable.

Try to speak at all times in plain language. I know we're throwing around and I - words that probably don’t need to be thrown around, new tech, you know, new jargon. And Dr. Bauer talked a few weeks ago about plain language and made a case for it and offered tools. And I just want to remind you how important it is just say it as plainly as possible. And if you keep your true audience in mind, those people who really need to hear from you you're going to talk in a language that they can understand. When things are uncertain -- and uncertainty is not easy for any of us to deal with -- when we have to be prepared that something might change along the way we need to be able to build in the potential for change by acknowledging it. And one of the ways we do that is to use the phrase based on what we know now.

If there is a question out there that is vital for everybody, everybody's wanting the answer to it and there isn’t an answer raise that question, acknowledge people, just be real, acknowledge to people that, you know, we know everybody's wanting to learn fill and the blank we don’t have that answer to that right now, raise the question. That means that you’re in touch with those people along the way. And then some of the others that we talked about we were discussing on earlier slides, share more as a leader and as a spokesperson. Expect the criticism and don’t let it get you down so you remember who your audience is and try to inspire others to come with you to fix the situation.

And I just want to give an example of an issue where the way we address a question can make a real difference. And have your leaders think this through. A question that might come up to you when we're at the point where we have mosquitos circulating, there’s the possibility that Zika is on the move in your community or on the way to your community and there may even be some local transmission and somebody has to energize that community in a way that they’re going to manage it with all of the tools available to help someone. And in that course it may be that the question comes up to the leader, "Are insecticides more of a risk than Zika itself? I mean how can you recommend spraying chemicals in our community?" That would be a question that could occur. And I suggest when you get that question when your leader gets a question that's one of the important things that we need to do is unpack it one is anticipate it, but then unpack it. What are people looking for in their community when they asked the question? Are they looking for reassurance? Are they looking to have their beliefs confirmed about dangers of chemicals? Are they concerned that decisions outside of their control are being made and they want to participate in that process? Are they truly concerned about Zika as an exotic risk or are they looking at insecticides as an exotic risk? And more than anything are they asking to be included in the process? And those are legitimate things. What’s the motivation behind that question because oftentimes there’s a question behind the question. There's a point of view behind that question and it may not be the obvious. So if I were asked that question as a leader spokesperson I might answer it this way. And I think this - I’m going to throw this out as a potential answer and then I want you all to discuss what we talked about as far as preparing our leaders spokespersons in this potential topic and see where we can go on it. So I might start with some empathy.We would all like a foolproof way to avoid Zika transmission. And unfortunately only one - no one strategy is going to protect all of us. Our approach has to work for this community and it has to be based on the best science available. We know that mosquitoes that carry virus can be resistant to some insecticide. And so what we use, when we use it, and how we use it should all be carefully considered. Insecticides are available and can be used effectively to protect our community.
Most importantly we want to share information with you as we learn it. We know for example that in New York City when it faced the introduction of West Nile Virus they used insecticide successfully as part of their control effort and did so with community support. They also made it a priority to share information with neighbors before doing spraying including aerial spraying. That’s a respectful approach I believe we should follow.

So that’s a long answer but if you take that answer and put it into the words of your leader you can see that I’m taken the time to express empathy, to acknowledge people’s concerns, to talk about the benefit and that a deliberate activity has to happen for us to make the decision to do it, that we need to keep people informed and gave an example of where it has worked effectively in the past.

That’s the kind of answer where you have a transformational leader trying to motivate others to do more with less self-interest. So I’m going to leave it there for now. Of course you know I could go on and on about crisis and emergency risk communication principles. And if all else fails I’ll talk to you again about building trust. But Brad could we opened it up for discussion now?

Operator:      

Certainly. At this time if you’d like to ask a question or make a comment you may press Star then 1 on your phone’s keypad. Please keep in mind to unmute your phone when recording your name. If it anytime your question has been answered you may remove your request from the queue by pressing Star then 2. Once again that is Star 1 if you like to ask a question or make a comment at this time.

Dr. Barbara Reynolds:

So while we're waiting for someone to join the discussion about preparing the leader spokesperson I just want to remind you that especially as you’re preparing your community for the possibility of Zika and looking at alternatives of ways to combat mosquitoes that could carry Zika that it’s important we share information early. We talked about this last week in community engagement and I just want to say again, start the conversation. Don’t surprise people with the alternatives that might be in play. And then acknowledge the concerns of other people and be sure not to overpromise and then under deliver. So Brad do we have anyone who's willing to join the discussion this afternoon?

Operator:

We do have one response so far from (Nicole). Your line is open.

Nicole:

Thank you. This is  representing the Kleberg County South Texas Mexico Corpus Christie. Tomorrow I’m having a Zika forum at the Texas A&M University in Kingsville. And we have several representatives from the Texas Department of Health and Human Services coming, the Navy, Border Patrol and so forth. And the reason we are doing this is because as you mentioned we want to be prepared, but also kind of as leaders to prepare ourselves on how we are going to deliver the message to our community and help our population to become ready for anything that may be associated with Zika epidemic.

So my question is the following. If we were to present tomorrow -- I’m actually the main speaker -- if we are to present all the background facts and now I want to engage say several units especially the Border Patrol who is one of the first units coming in contact with, you know, water, mosquitos close to the Mexican border we want to engage the commissioners from surrounding counties as well as the medical corps and so forth what is the best approach to get those individuals engaged? Do we give them, you know, time to present their own concerns or do we give them the opportunity to ask, you know, questions and see how they would resolve it? Thank you.

Dr. Barbara Reynolds:

(Nicole) that - one I just want to congratulate you for pushing forward to have this really important meeting with people who will be responding to Zika if it does come to your community and doing this now before it's there is really valuable without question. And I also appreciate how concerned you are that you want to make sure not only that they get the facts but that they engage in a way that when they leave they feel some level of empowerment within the community to do the things that need to be done as officials. And I understand that based on the group who are invited.

I was going to share a little bit with you and then, you know, perhaps someone else who's listening will also have an idea and we can get them as part of the discussion too. I would say that there are some things and some steps that you do when you want to empower group decision-making. And so it’s one thing to give the facts. But facts are facts. And then there are choices that sometimes need to be made in crisis situations. And there might be more than one alternative. And so one of the things that might be useful to do is as you’re providing facts or listening to people to identify alternatives what are some options that might be available unless all those decisions have already been made and you’re just reporting it out. But if all the decisions haven’t been made and there might be different alternatives or different ways to approach the concerns that you’re facing with Zika identify alternatives. And then it’s a good idea to analyze those alternatives. What are the pluses and minuses of that? And if you’ll remember if you were joining us a few weeks ago I talked about the four questions that individuals ask and I think that organizations will ask it too. And that is, what’s the benefit of going in this particular direction, what’s the cost, you know, so what’s the downside of going in this direction? What do people who are important to us think we should be doing in this situation? And then the big one for most organizations can I actually carry it out?

So you could actually use that same approach as you're starting the conversation with people. And it may be that since you’re taking on a heavy responsibility to be the key speaker in this study is that you might want to tell them as they're listening to you about the facts that you want to engage them in decision-making. You want them to look at alternatives and think through the questions what’s the risks, what's the benefits, do they think people important to them and the organization want this, and can they carry it out? You want to make sure that you share all the scientific information that you have to help people make the best possible decisions.

I don’t know about you but there are times when I interact with someone and they'll ask me to make a decision and they'll give me some information. So then I make the decision based on that information they gave me and then they counter that decision by saying, "Oh yes but you need to consider blah, blah, blah." And it's like, "Well then why didn’t you tell me that before so that I could make a better decision?" So that means present all the information that you can about Zika and Zika response understanding that we don’t know everything. There's still some questions out there.

And then to really engage a group and empower the decision-making as a group let them think through what are wants and what are must-haves so what do we want to have but what must we have? And that helps to narrow down some of the alternatives and move through a decision. And then at some point we would hope that everyone who's engaged and is willing to come and have this discussion about the Zika response will find some commonalities, again some overarching goals and some consensus towards the actions that need to be taken in the community. That was a quick summary of what could be a very difficult process in some settings but it might be worthwhile. And I really appreciate (Nicole) that you’re willing to ask that question at all. If you’re still online if you have a follow-up please do.

Nicole:

I had just one more short question. Now I have going through the Centers for Disease Control, the NIH and also the Texas Department of Human Health Services but I have also gotten information from the DynaMed Class, the medical repository so I can get all of the facts that I can. Do you advise me to go and get that scientific information from any other source?

Dr. Barbara Reynolds:

I think that it’s reasonable to present credible information and it’s also important -- and I’ve learned this and focus groups -- to be sure to share the source for that information. Sometimes we make the mistake of weighing one piece of information we see on the internet as heavily as we do another. And so it’s up to you to decide if you believe this information is coming from a credible source or not.

Nicole:

Okay, thank you. That is it. I appreciate your input.

Dr. Barbara Reynolds:

Thank you (Nicole). And I'd really love to hear how things go after this meeting. I'm really, really excited for you and very proud that you’re taking this step.

Nicole:

I will follow-up in writing certainly. Thank you.

Dr. Barbara Reynolds:

Thanks. Brad do we have any other questions or comments?

Operator:

One moment. At this time once again if you would like to ask a question please press Star then 1. And our next is from Chris. Your line is open.

Chris Merkel:

Yes, hi, good afternoon. Chris Merkel, Mammoth County Health Department, New Jersey. Quick question for you in regards to advice you may have for public health officials that are responding to media requests for information in regards to human exposures, not only Zika but other vector borne diseases like West Nile Virus? Thank you.

Dr. Barbara Reynolds:
     
Sure. So you are in a part of the country where you are going to be challenged with more than one vector control issue. And it’s going to be hard I think for any spokesperson to flow back and forth between West Nile and Zika. We're talking about different mosquitoes, we're talking about different health risks for different population groups. And so I would say that that is a challenge. If I were setting up an interview for my leader spokesperson I would suggest that if I couldn't limit it to one or another I might. It may be that the community actually needs a little bit of education about the differences. And if that’s the case I would want to provide them my spokesperson with a table that would be easy for them to see the differences between the two and share that with the reporter too. And I wasn’t sure if you were talking about a print interview, or a press conference, or a television interview. Obviously it's mosquito season. Zika is getting some amount of interest in the media. So you could expect that that might be an entrée for you to also talk about other problems. And I realize that it could be ticks or other things that are of concern so a lot to digest. I would say if and perhaps you need to ask to limit the interview because otherwise you put someone on the spot who doesn’t do this exclusively as needing to know a lot more perhaps than they can at any one time. Does that answer the question or am I just making it harder for you?

Chris Merkel:
    
I was looking for more specific information. As you know members of the media can be a little aggressive. So just in terms of human exposure I was talking more your question, I was talking more about actual, on camera interviews, and spokesperson interviews, not printed.

Dr. Barbara Reynolds:

So can you give me an example of the kind of question that you're worried might come up in terms of human exposure because I’m - I’d love to help if I could understand exactly what it is that you’re looking for?

Chris Merkel:

Well some of it is going to be HIPAA related in terms of the human exposure.

Dr. Barbara Reynolds:

Oh, oh, oh I see. So…

Chris Merkel:

I wanted - yes.

Dr. Barbara Reynolds:

When you’re saying if you have an actual case.

Chris Merkel:

Yes.

Dr. Barbara Reynolds:

So we've lived through that with West Nile.

Chris Merkel:

And Zika is not in New Jersey as we know but I’m just thinking we have dealt with West Nile Virus in this part of the country. So, you know, well tell me, you know, tell me where the case is, what’s the person’s name, how old are they? And, you know, obviously we can't answer that but I wanted to see if you had any specific strategies on information we could provide, you know, in benefit of the community while not providing the sensitive information that we can’t provide based on the law?

Dr. Barbara Reynolds:

Right. If I were doing a television interview and the reporter pushed me to divulge, you know, which house was this case of Zika in that we're now wanting to do aerial spraying or larvacides around, I would say it is our duty to not share information that would violate the privacy of the individual. But it is also our duty to make sure that we inform the public in a way that they can do what they need to do to protect themselves from the risk. And then I would explain what we’re doing and the geographic boundaries in which this effort is being done. And I would go on to say that it is not a clear cut line. You’re on one side of the line there is no risk, you’re on the other side there is a risk. So we have to blur the lines a little bit here as we talk about this. And that’s what’s important for your viewers. They want to know what they need to do and the area in which we’ve identified the risk and then go on to explain that anyone who has concern about exposure to Zika or other mosquito-borne diseases can take certain steps to protect themselves. That’s kind of how I would go with it. And I would also suggest that you go on to the CDC web site as we start to talk about, we're not there yet, but as we start to have maps drawn out about where Zika may be occurring that you'll know that we don’t do it in hard lines. We kind of do it in sweeping circles or swooshes or whatever to give the impression that it can happen in more than one place or another because anyone who's legitimately concerned about their risk related to Zika don’t need to know whether it was their neighbor or not. They can still take steps to protect themselves and we would encourage people to do that.

Chris Merkel:

Thank you.

Dr. Barbara Reynolds:

That was a long answer too. Did that help at all?

Chris Merkel:

Yes thank you.

Dr. Barbara Reynolds:

Okay good. Brad I think we have time for one more question if there is anyone wants to jump in.

Operator:

Once again if you do have a question or comment please press Star 1. One moment ma’am.

Dr. Barbara Reynolds:

And while we're waiting to see if anybody else wants to jump in and I just want you to know that our next Zika crisis and emergency risk communication discussion will be July 12.,  and you will have Dave Daigle will be the speaker. And he is going to talk about those, you know, first hours the days when there's been local transmission in your community and the CDC search team that will be coming to help and how he’ll he has volunteers. He goes in all kinds of interesting places but he’ll be sharing some tips on how the health communications media person on the team can interact with you in that setting so I really look forward to Dave Daigle on July 12. Brad is there anyone else that wants to jump in?

Operator:

We’ve had no further responses Miss.

Dr. Barbara Reynolds:

Good. Okay well I look forward to hearing Dave Daigle on July 12th. And always if you have any questions or concerns about the topic that we talk about you can reach us at CDC at email which is cercrequest@cdc.gov. Thanks Brad and thank everyone else for joining.

Operator:

Thank you for your participation on today’s conference call. At this time all parties may disconnect.