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Baruch Fischhoff: the Importance of Testing Messages Why Governments Need to Test Their Messages on Novel Coronavirus Disease (COVID-19) Before Disseminating Them

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Baruch Fischhoff: the Importance of Testing Messages Why Governments Need to Test Their Messages on Novel Coronavirus Disease (COVID-19) Before Disseminating Them News Baruch Fischhoff: the importance of testing messages Why governments need to test their messages on novel coronavirus disease (COVID-19) before disseminating them. Baruch Fischhoff talks to Fiona Fleck. Q: You started studying risk and human behaviour in the 1970s. What sparked Baruch Fischhoff is a psychologist and authority on that interest? the science of decision-making. His research addresses A: I majored in mathematics, with a judgment- and decision-making, with a particular focus secondary major in psychology and then on risk analysis, perception, and communication. He had the extraordinary good fortune to has authored or co-authored over 200 peer-reviewed study and work with pioneers in the field articles and co-authored or edited 11 books. He is the of decision-making, including Daniel Howard Heinz University Professor in the Department Kahneman, Amos Tversky, Paul Slovic, of Engineering and Public Policy and the Institute for and Sarah Lichtenstein. Eventually that Courtesy of Baruch Fischhoff led to the study of the psychology be- Baruch Fischhoff Politics and Strategy at Carnegie Mellon University, in hind judgments and preferences, risk the United States of America (USA). He is also a member analysis, and risk communication. My of the National Academy of Sciences and the National Academy of Medicine. professional entry into the field began He received a Bachelor of Science in mathematics and psychology from Wayne in the 1970s when my colleagues and I State University in 1967 and a master’s and doctorate in psychology from the were approached by technologists and Hebrew University of Jerusalem in 1972 and 1975. engineers trying to understand public resistance to emerging technologies. Initially, they included representatives sentially nothing. All you have to do is of companies promoting nuclear power to ask a diverse group of people to read and biotechnologies based on recombi- a draft message, telling you whatever nant DNA. They would say, “We have It’s a common comes into their minds. There are always this wonderful technology, but people “reaction when we surprises. Things that seemed clear to think it’s too risky because they don’t try to communicate you confuse them. Things that seem understand it. You’re psychologists, do and it doesn’t work: clear to them are being interpreted dif- something about it.” we blame our ferently than the way you intended. Not Q: What did they want you to do exactly? audience. testing messages before putting them out is a kind of public health malpractice. A: Help them make the audience understand the great benefits and low ” Q: How can the study of human behav- risks of their technologies. As they iour in relation to risk support health saw it, the public just didn’t get it. It’s risk communications and messaging a common reaction when people try Q: Can these lessons from the past help regarding preventive measures such as to communicate and it doesn’t work: us in the response to the COVID-19 social distancing, mask wearing and they blame their audience. Drawing on pandemic? handwashing? psychological theories and methods, A: Absolutely. Just as with the A: The discipline of risk commu- we studied how people perceived these technologists in the 1970s, public health nication is straightforward. Gather the new technologies. What we found communicators need to know how their evidence regarding the risk, analyse was that there was very little that the audience thinks about new issues, in- that evidence to determine what people public needed to know that couldn’t cluding the COVID-19 pandemic. One really need to know, draft messages be explained in comprehensible terms. of psychology’s strongest results is that focused on those critical facts, test the However, in order to discover those we exaggerate how well we understand draft messages, and repeat as necessary. terms, you needed to listen to the public one another. As a result, we think we In the United States of America, we have first and then test your draft messages. know what other people want to hear failed on all three fronts. We have not There has been a good deal of work on and we think we are making ourselves tested enough people to know the mag- risk communication since then and that abundantly clear. But we’re just guessing, nitude of the problem – and the risks it work has generated some important based on our intuitive theories about represents. We have not synthesized the insights. For example, the research has what other people know and want to evidence that people need to be aware of found that clearly presented quantitative know. It’s amazing how few messages in authoritative, comprehensible form, information can avoid the confusion are empirically tested, however great the so people are buffeted by social media created by vague quantifiers, such as health, economic, and political stakes. rumours and reports of individual stud- “likely,” “rare,” and “possible”. People with enormous responsibility ies, sometimes before they have been just write down something that looks peer reviewed. Our national academies right to them and send it out. Moreover, have a COVID-19 Committee that has the most basic message testing costs es- done a dozen authoritative and peer- 516 Bull World Health Organ 2020;98:516–517 | doi: http://dx.doi.org/10.2471/BLT.20.030820 News reviewed syntheses of the research Communication Advisory Commit- respect to, “How can I control things?”, on topics, such as the vulnerability of tee. We helped the FDA implement its my personal risk analysis is fairly simple: younger people and the effectiveness of strategic plan for risk communication, what can I most easily do to put a barrier handmade fabric face masks. However, proposed fast, efficient messages testing between myself and other people in case the academies cannot track and interpret procedures, and recommended policies they are shedding virus or I am without all of the studies of varying quality that for “emerging events.” I also helped knowing it? People will reach different are coming out. So, we don’t get the evi- the FDA to rework how it reports ap- conclusions, depending on their cir- dence in the form that we need it. Third, proval decisions for pharmaceuticals cumstances. However, they can all use our official communications have often and biologics. The FDA subsequently communications that present the basic been amateurish. created a Benefit-Risk Framework, facts, and uncertainties, in a simple, us- which is an excellent example of how to able, respectful way. Also, I would advise Q: How do you account for these short- communicate complicated decisions. governments to communicate in a way comings? The framework uses a standard format, that takes accounts of people’s beliefs. A: Basically, we know what to do, structured around key issues. It reports People, including experts, process new but haven’t done it. By ‘we’ I mean our evidence and uncertainties, and sets information in terms of their mental official sources, those responsible for out the rationale for its regulatory de- model, which is comprised of their formulating and communicating poli- cisions. It also identifies ways to make assumptions, beliefs, experiences, and cies and recommendations that would approved products even better. There biases about the world. Communica- help us get through crises like the pres- is no reason why we could not use that tors need to be aware of these models ent one. There has been an appreciation kind of framework to organize and com- in crafting their messages. of the need to communicate effectively municate the evidence regarding other during pandemics for some time and ef- health issues. It’s not expensive, it uses Q: How well has the World Health Orga- forts have been made to prepare. For ex- staff time efficiently, and it reduces the nization (WHO) communicated the risks ample, in 2016, our national academies health, economic, and political risks of relating to COVID-19? held a workshop on capacity building in failing to address the public’s concerns. A: WHO, as I see it, treats its audi- communication for pandemics. So, we ence as responsible individuals capable knew what preparations were needed, of understanding things and making but were caught unprepared. responsible choices. When I go to the Not testing WHO website – and I also send people Q: What could have been done differ- messages“ before there – I see pictures of diverse people ently? putting them out is a in settings that would be familiar to A: With a small investment, we kind of public health many. My sense is that someone who could have developed and tested generic malpractice. goes there would say, “The people who messages, ready to adapt to specific situ- put this together care about people like ations. For example, we could have been ” me. They know how we live. They are ready to explain the epidemiological trying to help us solve our problems.” models that are so essential for under- WHO has an advantage in having a very standing what’s happening. We could diverse workforce, and you can tell that have been ready to explain how diseases Q: What is your advice to governments people from different backgrounds have spread, and the risk of transmission, in- when preparing and communicating a hand in the crafting messages. cluding to people we may never even see. their guidance? We could have reduced the confusion A: Avoid long to-do lists with no Q: How has politics informed messaging over mask recommendations meant to organizing rationale. Also, focus on the around COVID-19? protect the people who wear them and decisions that people face in their daily A: As you might expect, it has in- the people who are near them.
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