New trends and directions in risk communication: combating disease threats at the animal-human-ecosystem interface Keynote presentation by Thomas Abraham Director, Public Health Communications Programme, The University of Hong Kong

1. The Anthropological ImperativeThe Anthropological Imperative
inin ““Risk CommunicationRisk Communication””
Benjamin Hickler, MA, Ph.D.
Tufts University
Cummings School of Veterinary Medicine
Dept. of Environmental and Population Health
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2. ObjectivesObjectives
• Explain why anthropological frameworks and
community participation are particularly relevant
for addressing “One Health” challenges associated
with emerging zoonotic infections.
• Outline potential models for applying
anthropological tools to practical problems of
outbreak prevention and response.
• Outline key concepts for anthropologically
informed strategies for social mobilization and
behavior change communication.
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4. Factors contributing toFactors contributing to
emergingemerging zoonoticzoonotic infectionsinfections
From Marsh Inc. Economic and Social Impact of EIDs, 2010. Derived from Report of the WHO/FAO/OIE
joint consultation on emerging zoonotic diseases. May 2004.

5. • People’s relationships with animals are culturally
and socially mediated, often differ by age, gender,
and socioeconomic status, and in some cases are
characterized by passionate attachment.
• People’s livelihoods are directly affected by efforts
to control zoonotic infections. This recognition
should underpin all “One Health” endeavors.
• Therefore, different stakeholders are likely to have
very different perceptions of the risks associated
with pathogens like H5N1.
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Human behavior is theHuman behavior is the
common denominatorcommon denominator……

6. BeyondBeyond ““Risk CommunicationRisk Communication””
•Risk communication used to be conceived in terms of
a top-down model in which expert consensus is
broadcast to a passive public in order to bring
popular perceptions in line with expert truth.
•Now there is growing recognition that publics are
active participants in sociocultural and political
processes of defining and explaining risk.
•To oversimplify, the top-down broadcast model has
been replaced by a dialogical, participatory model
including an active engagement with publics within a
competitive informational environment.

7. What do we mean byWhat do we mean by
““participation?participation?””
Pretty et al (1995) delineate seven different types of participation.
•Passive participation: People participate by being told what is going to happen or has already happened.
It is a unilateral announcement by an administration or project management without any listening to
people’s responses. The information being shared belongs only to external professionals.
•Participation in information giving: People participate by answering questions posed by extractive
researchers using questionnaire surveys or similar approaches. People do not have the opportunity to
influence proceedings, as the findings of the research are neither shared nor checked for accuracy.
•Participation by consultation: People participate by being consulted, and external agents listen to views.
These external agents define both problems and solutions, and may modify these in the light of people’s
responses. Such a consultative process does not concede any share in decision-making, and professionals
are under no obligation to take on board people’s views.
•Participation for material incentive: People participate by providing resources, e.g. labor, in return for food,
cash or other material incentives. Much on-farm research falls in this category, as farmers provide the fields
but are not involved in the experimentation or process of learning. It is very common to see this called
participation, yet people have no stake in prolonging activities when the incentives end.
•Functional participation: People participate by forming groups to meet predetermined objectives related to
the project, which can involve the development or promotion of externally initiated social organization. Such
involvement does not tend to be at early stages or project cycles of planning, but rather after major
decisions have been made. These institutions tend to be dependent on external initiators and facilitators, but
may become self-dependent.
•Interactive participation: People participate in joint analysis, which leads to action plans and the formation
of new local institutions or the strengthening of existing ones. It tends to involve interdisciplinary
methodologies that seek multiple objectives and make use of systematic and structured learning processes.
These groups take control over local decisions, and so people have a stake in maintaining structures or
practices.
•Self-mobilization: People participate by taking initiatives independent of external institutions to change
systems. Such self-initiated mobilization and collective action may or may not challenge existing inequitable
distributions of wealth and power.
Pretty, J.N., Guijt, I., Thompson, J. and Scoones, I. 1995. Participatory Learning and Action.
A trainers' Guide. International Institute for Environment and Development, London.
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8. Uses of Anthropology in BehaviorUses of Anthropology in Behavior
Change Communication (BCC)Change Communication (BCC)
• Identify the who, what, where, when, and how of risky
practices/behaviors –
o Tools include environmental scans, situational analyses, market and
value-chain studies, structured and unstructured observation, etc.
o Necessary to define behavioral objectives.
• Learn why who does what, where, when and how.
o Tools include participatory learning, focus group discussions, key
informant interviews, rapid ethnographic studies, etc.
o Usually necessary to achieve behavioral objectives.
• Prevent Systemic Insanity – Doing the same thing over and
over again expecting different results.
o Examples include pre- and post-testing, “framing,” cultural competence,
visual literacy, and M+E practices like Participatory Impact Assessment.
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12. WhyWhy people do what they dopeople do what they do……
Whereas psychological frameworks tend to look for
individual motivators, anthropological approaches
emphasize shared cultural, social, political and
structural factors that shape—promote or constrain—
behaviors. (Importantly, not all are comms issues; cf.
Dunn’s framework)
Useful concepts for cultural analysis and comms include:
•Explanatory models and ethnomedical systems
•Illness behavior and “hierarchies of resort”
•Gender and the household production of health
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14. People do whatPeople do what
““makes sensemakes sense””
This is practically an anthropological axiom.
If a behavior or belief does not make sense to the
analyst, then we probably don’t understand the
reasoning behind it.
No behavior or belief should simply be dismissed as
irrational, especially if it seems to resist modification.
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15. Applying Anthropological ConceptsApplying Anthropological Concepts toto
SocialSocial MarketingMarketing
• Social marketing is the process of applying
commercial marketing techniques to social issues in
order to create behavior change (Kotler and
Andreasen 1987)
• Social marketing is consumer-driven - the focus
population or target audience is the central focus
for all steps of a social marketing campaign
• Crucially, each step of the campaign requires
continual input from the focus audi-ence
(recall Pretty’s typology)

16. The 4Ps of Social MarketingThe 4Ps of Social Marketing
• Product is the goal or behavior we would like to
change or maintain.
• Price is what people must give up in order to receive
the product’s benefit.
• Promotion is the overall strategy (messages and
media, content and channels—think MS CREFS) used
to persuade people to accept the “price” for the
“product.”
• Place is the setting in which an audience encounters
the social marketing strategy. “Place” includes both
the communication channel (e.g., mass media,
schools, village council meetings, etc.) as well as the
setting in which the targeted behavior occurs.

17. Challenges of Social MarketingChallenges of Social Marketing
• Each step of the campaign requires input from the focus audi-ence. This can
be time-consuming and labor-intensive.
• The “product” must be presented in a way that rein-forces core needs and
values.
• Cannot stop only at process evaluation, for example counting the number of
times a person saw a message or assessing whether the audience liked a
message. It can be challenging to evaluate the impact of social marketing
cam-paigns on attitudes or behavior.
• The effectiveness of social marketing is primarily demonstrated when it is
combined with other strategies. Because social marketing focuses on
individual and collective behavior rather than policy and envi-ronmental
conditions, social marketing campaigns need to be implemented along with
other strategies that impact policies, laws, and norms at institutional,
environmental, and political levels.
• Social marketing has been challenged by some researchers. Wallack (1990)
argues that it promotes dependence on experts and diverts attention from
public policies and structural factors. For example, in less developed
countries, social marketing strategies have focused on changing habits
instead of working to ensure clean and healthy water supplies (Wallack, et al.,
1993).
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18. Thank You!Thank You!
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19. • What is the purpose of the message?
• What techniques are used to attract your
attention?
• What lifestyles, values and points of view are
represented?
• How might different people interpret the
message differently?
• What is omitted from this message?
Dr. Renee Hobbs,
Clark University Media Literacy Project
Deconstructing Media MessagesDeconstructing Media Messages

20. Culture is an integrated pattern of human behavior
which includes but is not limited to:
thought
languages
values
beliefs
customs
practices
courtesies
rituals
communication
roles
relationships
expected
behaviors
… of a racial, ethnic, religious, social, disability or political group;
ability to transmit the above to succeeding generations;
dynamic in nature.
manners of
interacting
Slide Source: National Center for Cultural Competence,2008

21. • Are based on fact and focus on immediate
consequences
• Clearly state the desired behavior and its benefits
• Use positive emotional appeals and/or humor
• Appeal to logic and reason
• Show desired behavior
Effective MediaEffective Media
MessagesMessages

22. Finding Information AboutFinding Information About
CommunitiesCommunities
• Consulting the “Experts”
o Individuals and groups in the community
o Similar communities
o Academicians
• Gathering “Data”
o Census data, maps, and other “data”
o Epidemiological data/trends and articles related to identified problem
o Behavior and social science literature
o Local newspapers

23. Cultural CompetencyCultural Competency
• The understanding and appreciation of cultural
differences and similarities within and between
groups.
• A willingness and ability to draw on community-
based values, traditions, and customs and to
work with knowledgeable persons of and from
the community in developing prevention
strategies (programs, policies, and practices).

24. An Iceberg Concept of Culture
Dress age
gender language
race or ethnicity
eye behavior
facial expressions
body language sense of self
gender identity
concept of justice value individual vs. group taste and style
notions of modesty concept of cleanliness
emotional response patterns rules for social
interaction child rearing practices
©decision-making processes
©approaches to problem solving
perceptions of mental health, health, illness, disability
patterns of superior and subordinate roles in relation to status by age,
gender, class sexual identity & orientation
and much more…
Slide Source: The National Center for Cultural Competence, 2008
physical characteristics

25. 30
Community Prevention Design
Entity B
Strategy 1
Entity C
Entity A
Strategy 2
Strategy 1
Strategy 2
Strategy 1
Strategy 2
Inputs Outputs Short Term
Outcomes
Intermediate
Outcomes
Long Term/
Community
Change
Program Measures
Incidence &
Prevalence of
Problems
Behavior Outcome
Measures

26. 26 30
Community Prevention Design
Entity B
Strategy 1
Entity C
Entity A
Strategy 2
Strategy 1
Strategy 2
Strategy 1
Strategy 2
Inputs Outputs Short Term
Outcomes
Intermediate
Outcomes
Long Term/
Community
Change
Program Measures
Incidence &
Prevalence of
Problems
Behavior Outcome
Measures