Boil water notices as health-risk communication: risk perceptions, efficacy, and compliance during winter storm Uri.

Winter Storm Uri was a disaster that impacted much of the United States during February of 2021. During and after the storm, Texas and Oklahoma experienced massive power grid failures. This led to cascading impacts, including water system disruptions and many boil water notices (BWNs). The breakdown of some communication channels and the inability to enact protective actions due to power outages, as well as travel limitations on public roads, complicated the dissemination and implementation of notifications. This research examined individuals' perceptions of risk, water quality, and BWNs during Uri. Additionally, this study sought to understand if previous experience with a BWN influenced compliance during Uri and how perceived efficacy impacted these variables. Surveying 893 Texans and Oklahomans revealed that most Uri-affected respondents believed the risks associated with BWNs were severe. Income and race were two factors that influenced BWN compliance. Age, gender, and level of education did not influence compliance. Previous experience with BWNs did not increase risk perceptions. Higher levels of perceived efficacy correlated to higher levels of compliance, perceptions of risk, and water quality, much of which support propositions of the Extended Parallel Process Model. Results suggest that pre-disaster planning and communication are imperative to helping reduce risk(s) and enhancing efficacy during a disaster, especially for novel disasters that have cascading risks, like Winter Storm Uri.

Boil Water Advisories as Risk Communication: Consistency between CDC Guidelines and Local News Media Articles.

The Safe Drinking Water Act Public Notification Rule requires that customers of public water systems (PWS) be informed of problems that may pose a risk to public health. Boil water advisories (BWA) are a form of communication intended to mitigate potential health risks. The Centers for Disease Control and Prevention (CDC) developed guidance for BWAs. We examined how local US news media incorporate the CDC's guidelines when reporting on BWAs. A content analysis of 1040 local news media articles shows these reports did not consistently incorporate CDC guidelines. Overall, 89% of the articles communicated enough information for readers to determine if they were included in the impacted area. Articles that included at least some of the CDC's instructions for boiling water were likely (p < .001) to include other risk information, such as the functions for which water should be boiled (e.g., drinking, brushing teeth) and that bottled water could be used as an alternative source. However, this information was included in only 47% of the articles evaluated. Results suggest public notifications often do not serve the public need for clear risk communication.

Resilience of Communities in Puerto Rico Following Hurricane Maria: Community-Based Preparedness and Communication Strategies.

OBJECTIVE: This study aimed to examine factors that may have contributed to community disaster resilience following Hurricane Maria in Puerto Rico. METHODS: In April 2018, qualitative interviews (n = 22) were conducted with stakeholders in 7 Puerto Rican municipalities (9% of total). Transcripts were deductively and inductively coded and analyzed to identify salient topics and themes, then examined according to strategic themes from the Federal Emergency Management Association's (FEMA) Whole Community Approach. RESULTS: Municipal preparedness efforts were coordinated, community-based, leveraged community assets, and prioritized vulnerable populations. Strategies included (1) multi-sectoral coordination and strategic personnel allocation; (2) neighborhood leader designation as support contacts; (3) leveraging of community leader expertise and social networks to protect vulnerable residents; (4) Censuses of at-risk groups, health professionals, and first responders; and (5) outreach for risk communication and locally tailored protective measures. In the context of collapsed telecommunications, communities implemented post-disaster strategies to facilitate communication with the Puerto Rican Government, between local first responders, and to keep residents informed, including the use of: (1) police radios; (2) vehicles with loudspeakers; (3) direct interpersonal communication; and (4) solar-powered Internet radio stations. CONCLUSIONS: Adaptive capacities and actions of Puerto Rican communities exemplify the importance of local solutions in disasters. Expanded research is recommended to better understand contributors to disaster resilience.

The Communicative Relationship between the Socioeconomically Disadvantaged Stakeholders and the Reproductive Healthcare Nonprofit Organization.

As the third largest employment sector in the United States, nonprofits work to fill gaps left by the government and for-profit sectors. Because they work with disadvantaged populations, mission-driven nonprofits are afforded an opportunity to empower clients. This study uses Planned Parenthood as a point of entry for interrogating the role of service-oriented nonprofits. Grounded in a feminist approach to stakeholder theory, this study assesses how socioeconomically disadvantaged women experience their relationship with Planned Parenthood, and how they negotiate this relationship to meet and become better informed about their reproductive healthcare needs. Twenty women who use Planned Parenthood as their primary reproductive healthcare organization were interviewed. Findings highlight the organization's ability to meet needs and make clients comfortable in healthcare interactions, as well as barriers women experience as part of the organizational relationship. Conclusions demonstrate the importance of engaging client perspectives as nonprofits to carry out their mission.

Informational Sources, Social Media Use, and Race in Flint, Michigan's Water Crisis.

Safe, clean water is necessary for health and wellbeing. Water issues affect minority and vulnerable populations at disproportionate rates, including the poor and racial and ethnic minorities. An investigation of the relationships of race, social media use, and informational sources during the municipal water crisis in Flint, Michigan reflects an instrumental view of communication and uses and gratifications theory in this study. Data from 208 Flint residents in 2016 indicated that African American respondents favored interpersonal networks and resources and were more likely than other racial groups to obtain current information about the water crisis via Instagram. Preferred channels and sources to receive additional crisis information varied on the basis of race.

A Conceptual Model for Evaluating Emergency Risk Communication in Public Health.

Public health threats, such as emerging infectious diseases, terrorism, environmental catastrophes, and natural disasters, all require effective communication. Emergency risk communication is a critical component of public health emergency planning and response. It is a complex process involving a variety of constructs that interact in dynamic ways over time. While emergency risk communication is generally recognized as an important tool for risk management and emergency response, the specific elements, processes, and outcomes are not well described and have not been systematically assessed. In this article, we describe a conceptual model for public health developed in collaboration with the Centers for Disease Control and Prevention (CDC). We propose using this model to inform practice and to guide evaluations of emergency risk communication. The model was informed by an extensive review of the emergency risk communication literature, interviews with researchers, and discussions with CDC stakeholders. This model can be adapted for a wide range of emergency events and incorporates key constructs to assess internal processes, as well as outcomes of emergency risk communication on audiences. Evaluating internal processes can help identify and correct messaging deficiencies. Outcome constructs describe expected target audience responses to emergency risk communication, such as changes in knowledge, attitudes, beliefs, and behaviors that may occur over time. This can help public health communicators learn how their various activities contribute to emergency risk communication outcomes.

CERC as a theoretical framework for research and practice.

Health communicators at the Centers for Disease Control and Prevention (CDC) have developed an integrated model titled Crisis and Emergency Risk Communication (CERC) as a tool to educate and equip public health professionals for the expanding communication responsibilities of public health in emergency situations. This essay focuses on CERC as a general theoretical framework for explaining how health communication functions within the contexts of risk and crisis. Specifically, the authors provide an overview of CERC and examine the relationship of risk communication to crisis communication, the role of communication in emergency response, and the theoretical underpinnings of CERC. The article offers an initial set of propositions based on the CERC framework and concludes with a discussion of future directions.

Media use and information needs of the disabled during a natural disaster.

This study examined differences in evacuation, crisis preparation, information-seeking patterns, and media use among the communities of disabled and non-disabled evacuees in the aftermath of Hurricane Katrina. Surveys were collected from 554 Katrina evacuees temporarily relocated in different areas of the United States. Results indicate differences in crisis preparation and evacuation plans, with disabled subpopulations being more likely to prepare emergency supplies but less likely to have an evacuation plan. Differences between the disabled and non-disabled subpopulations also existed in information-seeking habits. Media use was similar between disabled and non-disabled respondents.