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Crisis Communication University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 6-20-2014 Crisis Communication: Sensemaking and Decision-making by the CDC Under Conditions of Uncertainty and Ambiguity During the 2009-2010 H1N1 Pandemic Barbara Bennington University of South Florida, [email protected] Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the Communication Commons Scholar Commons Citation Bennington, Barbara, "Crisis Communication: Sensemaking and Decision-making by the CDC Under Conditions of Uncertainty and Ambiguity During the 2009-2010 H1N1 Pandemic" (2014). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/5181 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Crisis Communication: Sensemaking and Decision-Making by the CDC Under Conditions of Uncertainty and Ambiguity During the 2009-2010 H1N1 Pandemic by Barbara Bennington A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Communication College of Arts and Sciences University of South Florida Major Professor: Eric M. Eisenberg, Ph.D. Ambar Basu, Ph.D. Kenneth N. Cissna, Ph.D Stephen Turner, Ph.D Date of Approval: June 20th, 2014 Keywords: sensemaking, crisis communication, uncertainty, CDC, H1N1 Copyright ©2014, Barbara Bennington ACKNOWLEDGMENTS My first thank-you goes to Dr. Marsha Vanderford who had the idea to develop an oral history of the CDC’s response to H1N1 and who offered me the opportunity to participate in the project. Being part of the Oral History project and having the opportunity to meet and interview so many extraordinary members of the CDC leadership team was truly an honor. I would also like to recognize Dr. David Sencer, M.D. for making the H1N1 Oral History a reality. Without his dedicated support and the extensive network of personal relationships he developed as the longest serving CDC Director (1966-1977), the H1N1 Oral History Project would very likely not have happened. Dr. Sencer’s dedication to assisting the CDC during the H1N1 response was also remarkable. Although well into his retirement at age 84 when the H1N1 virus first appeared, he volunteered his time and expertise to support the response. The CDC Director, Dr. Thomas Frieden, commented on this when Dr. Sencer passed away in 2011, saying, “Dave Sencer was a public health giant. And until the end he continued to be a thoughtful and vibrant member of the public health community. At the height of the H1N1 pandemic of 2009, he was here full time, and I said, ‘Can I pay you?’ He said, ‘No, this is a labor of love.’ Finally, I would like to thank Dr. Eric Eisenberg for his thoughtful guidance, brilliant advice, and unending patience. Without his support this dissertation would most certainly not have been written. I am very fortunate and so grateful to have had the privilege of working with him. TABLE OF CONTENTS Chapter One: Introduction and Statement of the Problem ..............................................................1 Focus and Rationale of the Study .......................................................................................4 Organization of the Study ...................................................................................................7 Statement of the Problem ....................................................................................................7 Government Responsibilities ...............................................................................................8 Defining Public Health ......................................................................................................10 Mission and Organization of the United States Public Health System ..............................12 Public Health Law..............................................................................................................14 Department of Health and Human Services (DHHS) ........................................................15 Centers for Disease Control and Prevention (CDC) ..........................................................17 CDC Organization .............................................................................................................17 Surveillance............................................................................................................20 Epidemiology .........................................................................................................21 Laboratory Research Services ................................................................................22 Response Capability...............................................................................................23 Public Health Crises ...........................................................................................................23 Pandemic Flu .........................................................................................................24 Chapter Two: Review of the Literature .........................................................................................29 Crisis Communication .......................................................................................................29 Defining Crisis Communication ............................................................................30 Differences between Risk and Crisis Communication .........................................31 Practicing Crisis Communication ......................................................................................34 Crisis Communication Models and Approaches................................................................35 The CERC Model ..................................................................................................35 EIDC ......................................................................................................................36 Crisis Communication and Public Health: The CDC’s Response to the Anthrax Attacks .....................................................................................................38 The 2001 Anthrax Attacks ....................................................................................39 Impact of the Anthrax Response: A Paradigm Shift ..............................................43 Evaluating Organizational Crisis Response .......................................................................44 Sensemaking .........................................................................................................44 Sensemaking Properties .........................................................................................45 Framing ..................................................................................................................47 Transparency .........................................................................................................49 Components of Organizational Crisis Response ...................................................................52 Organizational Processes .......................................................................................52 Organizational Practices .......................................................................................55 i Organizational Culture ......................................................................................... 57 Research Goals and Questions ..........................................................................................60 Chapter Three: Methods and Data ................................................................................................63 Case Study: The 2009-2010 H1N1 Virus Pandemic ........................................................64 The 1918 Flu Pandemic ........................................................................................64 The H1N1 Threat Significance .............................................................................65 Confirming H1N1/A .........................................................................................................66 CDC’s Response to the H1N1 Pandemic ..........................................................................69 The H1N1 Oral History Project ........................................................................................70 Oral History Project Interviews ............................................................................71 Selection of Data ...................................................................................................72 Data Gathering ......................................................................................................74 Research Site .............................................................................................74 Interviews ..........................................................................................................................75 Interview format ................................................................................................................75 Interview questions ...........................................................................................................77 Final Interview Questions .....................................................................................77 H1N1 ..........................................................................................................79
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