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View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Stirling Online Research Repository Proceedings of the Nutrition Society (2009), 68, 135–141 doi:10.1017/S0029665109001153 gTheAuthors 2009 A Meeting of the Nutrition Society, hosted by the Irish Section, was held at the O’Reilly Hall, University College Dublin, Dublin, Republic of Ireland on 18–20 June 2008 Symposium on ‘The challenge of translating nutrition research into public health nutrition’ Session 5: Nutrition communication The challenge of effective food risk communication 1 2 2 3 Aileen McGloin *, Liam Delaney , Eibhlin Hudson and Pat Wall 1National Nutrition Surveillance Centre, UCD School of Public Health and Population Science, 2UCD Geary Institute and 3UCD School of Public Health and Population Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland Society A chronology of food scares combined with a rapid, unchecked, rise in lifestyle-related dis- eases such as obesity highlights the need for a focus on effective food risk communication. However, food risk communication is highly complex. Many factors will affect its success, including the demeanour and conduct of the source, its transparency, interaction with the Nutrition public, acknowledgement of risks and timely disclosure. How the message is developed is also important in terms of language, style and pretesting with target audiences, as is the choice of appropriate channels for reaching target audiences. Finally, there are many personal factors that the may affect risk perception such as previous experience, knowledge, attitudes and beliefs, per- sonality, psychological factors and socio-demographic factors, many of which remain unex- of plored. While there is evidence that campaigns that communicate health risk have been associated with behaviour change in relation to major public health and safety issues in the past, it is unknown at this stage whether targeting risk information based on risk-perception segmentation can increase the effectiveness of the messages. Risk communication: Risk perception: Audience segmentation Proceedings Scientists and regulators have long recognised the need to However, psychological and sociological research has since communicate risk to the public. However, much of the shownthatlayindividualsmayprocessriskquitedifferently early research in this area was focused on issues such as from food experts(6). While the food experts use technical war, nuclear power, road safety, water safety, chemicals quantitative methods of risk measurement to assess risk, and medicines. Only relatively recently have researchers consumers use a broader approach for risk assessments. In a begun to explore the communication of food risks or have recent qualitative study conducted in four European coun- European and national agencies been charged with tries it was found that formal or ‘scientific’ sources of evi- responsibility for food risk communication. This change in dence are rarely mentioned in relation to decisions about (7) approach followed a plethora of food scares, which began food risks . Instead, participants rely on more practical in the late 1980s with the well-publicised occurrence of approaches, including perception of naturalness, taste, smell food poisoning from Salmonella in eggs in the UK and has and appearance. continued up to the present. Taking into account what has been learned from risk- Originally, it was believed that communicating risk perception research, there has been a change in the ap- wouldallowindividuals to process risk more accurately and proach taken to risk communication. In the past, the public (1–5) thus behave more optimally in relation to their health . was perceived as a passive receiver of risk information It was assumed that education was the correct solution and considered to often misunderstand or misinterpret to allow the public to interpret risk more ‘rationally’. risk messages. In contrast, it is now recognised that risk *Corresponding author: Dr Aileen McGloin, fax +353 1 716 3421, email aileen.mcgloin@ucd.ie 136 A. McGloin et al. Voluntariness Immediacy Education Uncertainty Behaviour change Dread Build trust, consensus and confidence The purpose? Controllability Risk characteristics? Raise awareness Catastrophic potential Change perceptions, attitudes Novelty and beliefs Severity of consequence The media Known to science Traditional v. digital media Naturalness The mode? Multi-mode campaigns Group settings Public participation in development Effective food risk Pre-testing Crisis communication? Timing? The message? Language Pre-crisis Style Willingness to take risks Personality Risks v. benefits Future orientation Caring and empathy Existing knowledge, attitudes and beliefs Dedication and commitment Society Previous experience Trust Competence and expertise Self-esteem and self-efficacy Psychological factors The receiver? Honesty and openness The source? Agreement among experts Availability Heuristics Timely disclosure Optimistic bias Transparency Acknowledgement of risks and Gender and age uncertaincies Socio-demographic factors Public participation Nutrition Education and socio-economic status the Fig. 1. Factors affecting risk communication. of communication should involve a process of exchange of in- More recently, ‘naturalness’ has also been found to explain (16) formation among all those concerned with the risk at hand. a substantial amount of variation in risk perception . While risk communication has advanced greatly in These factors help to explain why individuals react, or recent years, its complexity means that there is no single fail to react, to different types of food risks. Recent scares set of recommendations to suit all situations. Many pub- include the discovery of BSE in beef in 1996, dioxins in lications and reports have produced guides for best practice animal feed in Belgium in 1999, concerns around acryl- in risk communication(8–14), which provide useful reading. amide in 2002, Enterobactum sakasaki in baby formula in Proceedings However, efforts in food risk communication will vary in France in 2004, polychlorinated biphenyls in Scottish sal- their purpose, timing (crisis and non-crisis) and the attri- monin2004, Sudan Red dye in 2005 and bird ‘flu in 2006. butes of the hazard involved, all of which will impact These risks elicited responses ranging from media frenzy greatly on the communications strategy and its potential to the collapse of production of whole food chains, for success. The effectiveness is further influenced by restriction of trade, limitation of food technology devel- the source of the information, the message, the mode of opment and even government collapse in the case of delivery and the characteristics of the receiver (see Fig. 1). dioxins in animal feed in Belgium. However, given the The present paper will attempt to review and summarise characteristics of these risks and what is known from the some of these influencing factors. psychometric model the public response was somewhat predictable. The changing food environment and the development During the period corresponding to the recent food of food risk communication scares the rates of diet-related diseases such as obesity and diabetes have increased dramatically, tripling in Europe (17) The roots of risk communication lie in risk-perception over the past two decades , with major implications for research. The most widely accepted model of risk percep- human health. While scientists and public health nutri- tion is the psychometric model. It was developed in the tionists describe this situation as a pandemic, studies have late 1970s and uses nine explanatory scales including shown that, for example, neither a high fat intake nor a voluntariness, immediacy, uncertainty, dread, controll- high energy intake(18) score highly in risk perception and ability, catastrophic potential, severity of consequence, the rise in obesity continues unchecked. Whereas techno- known to science and novelty(6). The strongest predictors logical and food safety issues appear to elicit a dramatic of risk have included ‘dread’, i.e. whether individuals can response, healthy eating advice aimed at improving tolerate living with a risk and think about it calmly, and chronic health does not, because the consequences are not (6,15) immediately apparent. ‘novelty’, i.e. how precisely the risks were known . Challenge of effective food risk communication 137 The many purposes of risk communication to communicate about uncertainty increases public distrust in risk-management strategies(28), while acknowledging Given the variety of risks to be addressed, the purpose of uncertainty increases public confidence(29). Authorities that food risk communications can vary greatly and includes are not completely transparent or that over-simplify the building trust and consensus, creating awareness, educat- (30–33) ing, influencing perceptions, attitudes and beliefs, promot- risk messages could also be accused of lying . ing action and changing behaviour. In turn, a variety of strategies will be required to achieve each goal. Pre-crisis communications normally involve proactive strategies to Effective translation of scientific messages call attention to potential and existing risk issues and pro- vide a platform for discussion and information sharing. Equally, the message itself must be clear, easily under- They may also aim to illicit behaviour change in relation stood and take into account the concerns of the public. The to a well-known food risk or one with long-term con- numerical expressions and small probabilities used by risk (19) sequences . Communicating during a crisis presents a assessors can be difficult for non-scientists to understand. particularly difficult challenge for risk communicators in However, translating these terms into every-day language maintaining public confidence. Strong emotions, such as is problematic. A meta-analysis has shown that words such fear, anxiety, distrust, anger, outrage, helplessness and as ‘rare’, ‘unlikely’, ‘frequent’ and ‘probable’ mean dif- frustration(8,20) come to the fore and present serious bar- (34). The effectiveness ferent things to different individuals riers to effective communication(21,22). Convincing the of risk comparisons have also been explored in relation to recipient to accept some level of risk is no easy task. specific risk; for example, what are the risks now com- Useful guidelines have recently been issued by the WHO pared with 10 years ago or what are the risks compared Society in the Sixth Futures Forum on Crisis Communication, with a better-known risk(35). However, these comparisons which deal with preparedness, infrastructure, timing, do not take into account the complexity of decision making (10). for an individual. availability, transparency, honesty and media relations Research on the use of appropriate language and style of the communication is limited in relation to food risks. The Trust, transparency and uncertainty in effectiveness of using verbal expressions compared with Nutrition risk communication numerical expressions has been examined in relation to Rn (36) Increasingly, the risk communications strategies of health gas . Also compared was understanding of messages that the and regulatory authorities, often the source of risk com- were conveyed using a ‘command’ or directive approach v. munications efforts, have come under intense scrutiny, a ‘cajole’ or persuasive approach. It was found that the of particular during crises. Disasters such as the BSE crisis in command approach using verbal expressions increases the UK and the dioxin scandal in Belgium have focused learning and the numerical expressions result in greater attention on the causes of public distrust in these institu- consistency between perceived and objective risk, while tions and their risk-management practices(23). Mistrust in a the ‘cajole’ verbal version increases the probability of communicator is a major barrier to effective risk commu- making an appropriate recommendation to a neighbour. nication(24) and may render the source less credible than Thus, no method was found to be best and the commu- (25) nications format will depend on the aim of the risk com- other sources such as the mass media . Only when trust munication. It is unknown whether this result is specific to Proceedingshas been established can other goals, such as raising communication about Rn gas or whether it is transferable awareness and behaviour change, be achieved. to food risks. Again, this uncertainty highlights the need Four important determining factors have been observed for pre-testing messages with key audiences. in establishing trust and they include: caring and empathy; dedication and commitment; competence and expertise; honesty and openness(26). On the other hand, trust is decreased by perceived disagreement among experts, lack Communicating both benefits and risks of coordination among risk-management organisations, failure to incorporate public participation, an unwillingness The scenario in which a certain behaviour presents both to acknowledge risks, delay in disclosure of information risks and benefits presents an interesting case study. Such a and irresponsibility or negligence in fulfilling risk- situation has recently been reviewed in relation to oily fish, (12,27) management responsibilities . For these reasons, which provide the benefit of n-3 fatty acids, but may also measures such as increased transparency in risk-assessment be contaminated with heavy metals(37). Exposure to the and -management processes, widespread consultation and benefit-only message was found to result in an increased stakeholder engagement are now viewed as important intention to eat fish (+21%), while the risk-only message (38,39) aspects of risk communications practice. translates into an 8% decrease in intention to eat fish . The demand for transparency and the focus on the needs Balanced messages that include both risks and benefits do of the recipient have had an impact on how messages about not significantly change intention to consume fish. How- food risk are developed and on what is communicated. The ever, other research has shown that negative information need to communicate uncertainty is now an important has more impact than positive information(29,38–41) and that consideration. In the past, scientific experts have worried consumers value information that has potential negative that communicating uncertainty would result in public health effects more than information that conveys positive distrust. In fact, the opposite was found to be true; failure health effects(42). 138 A. McGloin et al. Choosing the best medium for communication Characteristics of the recipient of risk messages In relation to the use of appropriate channels for commu- Finally, understanding the characteristics of an individual nication, risk communicators normally rely on their public that influence how he or she will receive and act on risk relations, advertising and media-buying partners for advice information presents perhaps the most complex challenge. on targeting specific audiences. However, these data are Past experience, existing knowledge, attitudes and beliefs, rarely captured in the scientific literature. A useful review socio-demographic factors, personality factors, psycholo- of elements of successful mass-media campaigns for gical variables, self-esteem, perception of vulnerability and behaviour change, including use of appropriate channels, affect heuristics such as optimistic bias may all influence (43) has been published . Evaluation studies indicate that how risk messages are accepted and whether an individual individual or small-group settings, such as information is likely to change related risk behaviour. Thus, audience exchanges and public workshops, are the most effective segmentation has become increasingly important when (21,44) venue for communicating trust factors . The effec- crafting risk messages. tiveness of written (i.e. brochure) v. computerised com- munication has been tested and no significant differences (45,46) in learning outcome were found . Thus, at this stage it Previous experience, existing knowledge, attitudes is not known whether there is an optimal mode for com- and beliefs municating risk. If an individual, or someone known to them, has experi- enced the outcome of a risk (e.g. food poisoning) this The role of the media in risk communication factor will clearly intensify its personal relevance(52).In Society contrast, the extent to which an individual is knowledge- The media influence on risk perception is also still very able about the topic or familiar with it may result in much under debate. Media exposure would seem a logical overconfidence or complacency(53). Existing beliefs and influence of risk perceptions, especially given the vivid attitudes have also proved to be important predictors of language, narratives and imagery often accompanying news risk perception and to influence acceptance of risk mes- stories. For example, the terminology ‘mad cow’ evoked sages; for example, in relation to GM foods previous atti- Nutritionhigh emotion. However, it is difficult to measure the social tudes has been shown to be the strongest predictor of amplification of risks, i.e. why hazards or risk events with variance in perceived risk (86–90%) and benefit (92– minor physical consequences frequently elicit strong public 95%)(54). Also, more extreme or well-crystallised attitudes the response and result in extremely severe social impacts. could influence perceptions of the information source, of There is widespread perception that media reporting is causing mistrust rather than perceptions of the risk being biased; for example, in a review of UK and Swedish media (54) communicated . In short, if a message is not in line with reporting it was found that reports tend to be negative and what an individual already believes it is likely to be dis- (47) (53) use alarmist headlines rather than reassuring ones . missed or neglected . However, other reviews have suggested that reporting of (31) food risks is more neutral or moderate . Media reporting of risk may or may not provide the kind of information, Socio-demographic factors e.g. statistics, that would allow an individual to assess their Proceedingsown risk. However, it has been suggested that the media Socio-demographic factors such as age, gender, socio- may have an influence on the public’s risk perception economic status, religious beliefs and world views also because the media express themselves in a way that the appear to be important in risk perception. It has been (31) public can understand . In relation to media coverage of shown that men, particularly white men, view risks to be GM foods it has also been shown that changes in the smaller when compared with women(55). A similar obser- (48) volume and content of risk reporting can alter attitudes . vation has been reported more recently, with women who The growing reach and sophistication of digital com- have children and are full-time home makers rating risks (56,57) munication is largely unexplored in relation to food risk more highly . Older individuals also perceive greater communication. Certain subsets of the population now risk(57) and are more likely to avoid risk(56). Results relat- favour the internet, and especially social networking sites, ing to education level are equivocal. Higher education along with mobile phone technology, as their preferred levels have been found to lead to less risk aversion(57), media channels and attempts to communicate with them while subjects with a higher education worry more, feel using conventional media channels may fail. The influence less confident about the effectiveness of measures to pre- of the internet on the rapid global spread of information on vent themselves from falling ill, feel less able to take such a food risk has recently been reviewed(49) following the measures and have a lower level of trust in the safety of (56) publication of a report on the level of contamination in food products . Socio-economic differences may also (50) farmed salmon in Science . The widespread publicity be important. Subjects with higher incomes have been (57) that followed had immediate negative implications for the shown to have higher risk avoidance , while those with farmed salmon industry. It has also been demonstrated lower incomes being less likely to engage in the risk from the European Food Safety Authority’s monitoring of communications process, particularly non-nationals who media reporting of semicarbazide in baby food in 2006 that may have language barriers. global coverage is expanded by the internet, with the Cultural theory proposes that ‘worldviews’ such as (51). highest publicity outside the EU noted in the USA fatalism, individualism, hierarchicism and egalitarianism
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