TELLME Project - Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence

TELLME worked to achieve its objectives (e.g., collecting and discussing evidence on population behaviour during infectious diseases outbreaks) via 6 work packages (WPs) that correspond to the main lines of research, dissemination, and management of the project. Their strategies and outputs (including 2 resources that can be found summarised under Related Summaries, below) were, in brief:

• WP1 aimed to collect and assess evidence about population behavioural response to infectious diseases outbreaks and how communication may change behaviours. Activities included, for example, reviews of: studies addressing population behaviour during infectious outbreaks, outbreak communication in the 2009 influenza H1N1 pandemic; components and issues of outbreak communication, segmentation and specific communication needs of intended groups, vaccine acceptance/refusal and resistance to vaccination, narratives and urban myths surrounding epidemics and vaccination, and human rights, stigmatisation, and risk of discrimination against specific population segments and intended groups.
• WP2 aimed to identify new challenges and new methods concerning outbreak communication through: stakeholder mapping; exploration of stakeholder communication requirements and health care professional communication requirements; an online course for primary care staff; development of new social media; creation of digital resources for disease detection; and investigation of the "new global health security regime".
• WP3 focused on new communication strategies to support vaccine uptake with special focus on developing new communication strategies for health professionals and agencies to engage with vaccine-resistant groups. This consisted of an "integrated strategy based on the relationships between the various actors involved, the information, belief and opinion flows between these actors, and the effects of the information and belief on actors' behaviour." The approach was intended to be "applicable, with variations, to all epidemics, and will be dynamic, that is, tracing the flows of knowledge and action through time, starting before the epidemic and finishing well after the epidemic." The main outcome of this WP was "an integrated, evidence based, communication workpackage (TELL ME Communication Kit) for outbreak communication."
• WP4 had the purpose of designing, constructing, and testing "a prototype of a computational method for simulating the actions and interactions of autonomous decision-making entities within a virtual environment during an epidemic outbreak, in order to observe the emergence of effects at the macro level (agent based social simulation)." The model included the various actors involved, such as health agencies, government, the media, experts, and the public and, "in coded and simplified form, the content of the 'messages' sent between these actors."
• WP5 sought to communicate the finding and outcomes of the project, coordinate efforts with similar projects, and network with relevant stakeholder organisations and international agencies.
• WP6 reported to and liaised with the Commission.

The TELLME website includes a number of resources that emerged from the project, such as those summarised below, as well a online courses for primary care staff. The first course offers basic health information on infectious diseases such as influenza or severe acute respiratory syndrome (SARS), along with several guidelines on how to talk about these issues with patients and citizens. The second course is specific to Ebola.

Immunisation and Vaccines, Health

TELLME experts have elaborated 10 suggestions for proper and effective risk communication that summarise their results and observations:

• "Organisations cannot afford to simply be reactive; they must build a social media presence before a crisis, to create a sense of online community with the public and develop key followers.
• Health risk communication is NOT a one-way message system. The aim is for an interactive two-way process for the exchange of information and opinions between individuals, groups and institutions.
• Plans must be comprehensive and flexible in order to deal with the unpredictable and changing nature of a pandemic.
• Timing is important. Early communications will help to avoid speculation and false reporting.
• Outbreak communication needs to contain credibility, accountability, transparency and honesty.
• Organisations must take a proactive stance in establishing an authoritative presence on social media sites to build a community presence before a crisis happens.
• Monitoring social media and trending topics allows to ensure you have a stake in the conversation and can adapt to the changing information needs of the community.
• Appealing to healthcare professionals is critical. They need to be targeted not only to pass messages on, but also to act as 'vaccination ambassadors'; if social media is to be adopted as a serious crisis communications tool by them, organisations need to quantify and integrate the value of social media as a mean of spreading public health messages.
• Online communities must be considered as a key resource. Social media appears to encourage pro-social behaviour, which means users share useful information with each other; thus contributing towards the collective body of information and knowledge.
• The effectiveness of outbreak communications relies greatly on meeting the information needs of various key stakeholders, including risk groups such as pregnant women and the elderly."