Perspectives
Infectious diseases Environmental health
Volume 197 - Issue 10

Learning from journalists’ experiences of the H1N1 pandemic

Authors:  Melissa A Sweet, Kate E Holland and R Warwick Blood

Med J Aust 2012; 197 (10): 544-545. || doi: 10.5694/mja11.11625
Published online: 19 November 2012
Good working relationships with journalists are needed during public health crises but many journalists believe that health departments could do a better job of meeting their information needs, both in content and timeliness.
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Good working relationships with journalists are needed during public health crises

An Australian Government review of the health sector’s response to the H1N1 2009 influenza pandemic identified the importance of communications during times of public health crisis, and made a number of recommendations for improvement.1 Journalists were not listed among the stakeholders consulted for the review, despite the intensive and sustained media coverage the pandemic received.2,3 Given the important role of the media in communicating to the public and health professionals and in influencing attitudes and behaviours about public health advice,4 it is worth considering how journalists’ perspectives can help to refine and shape public health communication practices. As part of a larger study into media reporting and public understandings of the 2009 pandemic,2,3 we interviewed 24 journalists who reported on the pandemic in Australia, and they provided practical guidance for organisations and individuals involved in providing public health advice. The journalists and news managers worked in print and broadcast media, mainstream mass media and specialist medical outlets, and in metropolitan and regional areas.

A common response from journalists was that health departments could do a better job of meeting journalists’ information needs, both in content and timeliness. Many said that a one-size-fit-all approach to communications did not meet their audience’s needs. Several had found it difficult to obtain information they believed crucial to engaging their audiences with the issue, such as local statistics about numbers of cases of pandemic (H1N1) 2009 influenza. Their comments also reflected a widespread frustration with the centralised nature of information provision and having to go through public relations departments. Many felt their coverage of the pandemic was hamstrung by restricted access to appropriate sources and experts. Often, this was because of health department policies restricting who could provide public comment. Journalists wanted access to “a wider field of experts” than simply the Chief Medical Officer. One suggestion was that governments involve a broader range of experts in public communications, for example, through panel discussions or press conferences. The government review also suggested making a wider range of sources available for comment, as a way of better managing the “intense media demand” that occurs at such times. Another suggestion from journalists was that health departments and experts should be more proactive in providing information and background briefings. Given that many journalists are unable to attend physical briefings, the use of webcast briefings and other internet platforms was recommended. The potential benefits of using social media to disseminate health information in a timelier manner have also been highlighted in two resources recently produced by the Centers for Disease Control and Prevention in the United States.5,6 These documents state that social media can increase the potential impact of important messages, enable the personalisation and targeting of health messages, and empower people to make safer and healthier decisions.

Journalists in our study highlighted the importance of trust in relation to their sources and audiences. Maintaining trust is a vital component of good risk management and communication.4 One journalist described the 2009 outbreak of H1N1 “swine flu” as “the worst I’ve come across” in regard to government authorities and agencies holding back information. The journalist added: “When there’s such reluctance to give out such basic information, when information does come out you don’t trust it because you think that it’s been washed and mangled and it’s been used to serve a communication strategy as part of the pandemic plan.”

During large-scale public health events like the 2009 pandemic, one journalist said that it is important for authorities to take some reporters into their confidence and conduct regular briefings. Acknowledging uncertainties was also identified as something that is likely to increase a journalist’s trust in their sources. One said it was useful when sources were “upfront and honest” about what they did not know. Another mentioned the importance of acknowledging differences in opinion, and this was linked to building trust. Journalists also felt their audiences would be more trusting of sources that acknowledged uncertainty. These comments are consistent with previous research showing that communicating the uncertainty inherent in risk assessment is more likely to earn public trust than conveying a sense of certainty and then being proven wrong.7-9

Many comments suggested the pandemic had left journalists and their audiences more sceptical about the motivations of governments, health departments and experts. There was a view that health departments, institutions and experts should be more transparent and upfront in declaring their conflicts of interest publicly and during interviews. A number mentioned a “cry wolf” perception, which could damage the receptiveness of the media and community to future emerging infectious diseases. Future public health responses will have to manage this legacy, and focus on building trust and relationships with journalists. Building trust also requires having mechanisms in place to listen to various audiences,8 both during and after a disease outbreak. Further, there is a view that genuine reasons for lack of consultation are more likely to be respected if there is a track record of consultation.8 Existing literature identifies practical tips for public health and medical professionals communicating with journalists;9,10 our study adds the suggestion that governments, public health authorities and other stakeholders should be more proactive in evaluating their communications strategies and practices and in engaging with journalists about these issues.

Formal debriefings with journalists after major public health events would be useful for informing policy and communication strategies. Engaging the media in such processes might also help build more constructive working relationships. Debriefings could enable two-way learning and reflection, and ultimately facilitate a more constructive, engaged and open public debate. In lieu of formal debriefings with journalists, sources could consider engaging in more informal dialogue. Most of the journalists interviewed had not received any direct feedback about their stories from health departments, sources or experts, although most felt this could be useful. Feedback to correct errors was highly valued. One journalist said sources should not be concerned that providing such feedback might damage relationships, suggesting instead that it would earn them added respect from journalists. Another said receiving feedback was important for helping journalists to assess whether they had struck a balance between competing interests and narratives. Contacting a journalist to provide feedback can create an opportunity for two-way learning. One journalist said it could also be helpful to have the chance to explain why a story was done a certain way: “. . . you can defend yourself, you can explain why, because a lot of the times people don’t understand how the media works”.

Most of the journalists were not actively using new media channels such as Twitter at the time of the pandemic, but there was general agreement that these could be useful information sources for both the general public and journalists during future such events. It was suggested that Twitter, for example, could be used to quickly convey messages to key target groups, such as health professionals, in a way that bypassed the media filter. One journalist noted that Twitter was increasingly important, providing access to a wider range of sources and a good way of updating information for people when a story is continually changing. Many journalists felt health departments and other sources of official or expert information about the 2009 H1N1 pandemic had not adapted sufficiently to the changing media environment, which is now a 24-hour news cycle with journalists facing constant deadlines. Asked about the pandemic’s lessons for policy, one journalist said: “I hope that they’ve learned that if there is a pandemic they need to have people available . . . 24/7”. A minority expressed reservations about the use of social media for reasons such as its potential to spread misinformation rapidly. Other comments also indicated the need for sources to tread carefully to ensure that they do not become captive to the media cycle in such a way as to undermine their own credibility.

Efforts to build good working relationships with journalists should not wait until the advent of another crisis.11 Many of the journalists highlighted the need for information sources to adopt a collaborative rather than a combative approach to the media. The kind of dialogue suggested by formal debriefings and informal feedback will be central to ensuring that relationships are established between journalists and relevant experts before future disease outbreaks. Such processes may help all parties to better understand each other’s needs and the constraints of the other’s working environment. Just as journalists face many competing demands — the unrelenting pressure of continuous deadlines versus the need for accuracy and context — so too do public health experts and public officials work under sometimes competing pressures — the need to balance political and public health imperatives, for example. Voluntary guidelines have been released in the US for journalists and public health officials when deciding what information to release or report about deaths, epidemics, emerging diseases or illnesses.12 These were developed by the Association of Health Care Journalists in association with public health officials after concerns were raised about inconsistencies in how state and local public health authorities handled the release of information about H1N1 cases. One journalist in our study suggested the media industry should develop broad-ranging guidelines for how it manages infectious diseases outbreaks or other public health crises. It is clear that such guidelines would need to be developed collaboratively between journalists, public health officials, relevant experts, and citizens.

Authors

  • Melissa A Sweet BA, MA1
  • Kate E Holland PhD2
  • R Warwick Blood PhD2
  • 1. Sydney School of Public Health, University of Sydney, Sydney, NSW.
  • 2. University of Canberra, Canberra, ACT.

Correspondence: Kate.Holland@canberra.edu.au

Competing interests

Melissa Sweet works as a freelance journalist and was employed by the project as a research assistant to interview journalists and to prepare the manuscript. Before this, she had covered the pandemic for various media outlets, in her role as a freelance journalist.

Acknowledgements

Our study is part of a larger project funded by the National Health and Medical Research Council (NHMRC) investigating traditional newspaper and television news portrayal of the H1N1 virus (#628010). All authors are researchers on an NHMRC Capacity Building Grant in Public Health (#571376), “The Australian Health News Research Collaboration”.

References

Provenance: <p>Not commissioned; externally peer reviewed.</p>

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