Communication by Key Leaders

With so many changes happening with COVID-19 protocols, it is not surprising that many people are confused or uninformed. This is especially true for individuals with school-aged children as each school is often tasked with coming up with their own safety policies regarding quarantines, masks, and vaccinations. It is important then for schools to understand effective communication strategies to educate families. This article addresses the challenges educators face when trying to communicate timely, transparent, culturally appropriate information in an efficient manner. Here are four suggestions for schools to consider when communicating about COVID-19:

1. Principals should communicate COVID-19 updates to teachers early and often
2. Figure out how parents want to communicate
3. Use translation services to help multilingual families
4. Build communication approaches that will maximize transparency

Developing trust is key for all of these strategies to be effective.

School officials are not the only leaders who need to be communicating with others about COVID-19 protocols. An article published by the American Health Information Management Association (AHIMA) suggests that public health practitioners need leadership training to effectively lead during this pandemic. Effective risk reduction strategies and strong public health leadership are necessary for the global community to navigate COVID-19. Here are four suggestions for assisting with this process:

1. Exceptional communication
2. Partnership and trust
3. Managing fear
4. Focus on infrastructure

Most notable is that communication must be transparent and free from misinformation and disinformation. Educating the public so that they understand (not just know) is imperative, and public health leaders are poised to provide accurate and trusted information.

Finally, scientists also have a responsibility to share their knowledge in understandable ways to help people make sense of research, but for scientists to be effective communicators, they may need to adjust their mindset, according to this article in Vaccine. The commentators argue that scientists need to embrace brevity and clarity (hallmarks of effective communication). It is important to focus on what is known to foster confidence instead of what is unknown, which increases doubt. Particularly as it relates to vaccine communication, the authors suggest the following evidence-based communication principles:

• Empathy
• Brevity
• Clarity
• Not lingering on correcting myths
• Contextualizing vaccine risks with disease risks

Communicating about Vaccines

Much of the communication about COVID-19 now centers on vaccines. In a tweet on September 3, Dr. Monica Gandhi, an infectious-disease specialist, brought to light some of the problems with the communication about vaccination when she stated, “The messaging over the last month in the U.S. has basically served to terrify the vaccinated and make unvaccinated eligible adults doubt the effectiveness of the vaccines.” In her thread, that received nearly 15,000 likes and 1,700 retweets, she explains what she thinks needs to be communicated. She is not alone; several studies this month address communicating about vaccination and vaccine hesitancy with different populations. A common thread among all of them is the need to tailor messages to specific needs and develop trust when communicating with anyone about vaccines.

In this longitudinal, mixed-method study, researchers concluded that health communicators must strategically customize messages based on the target population’s intention and availability as both affected people’s likelihood of being vaccinated. For example, focusing on the safety and effectiveness of the vaccine will likely be more effective in low-accessibility and low-intention groups whereas focusing on cost and logistics may be more effective in high-accessibility and high-intention groups. By strategically tailoring messages, inequalities in vaccine distribution may be able to be addressed.

One particularly vulnerable group with high vaccine refusal rates is incarcerated women. In this qualitative study, researchers interviewed women recently released from jail and determined that interventions targeting this population must address health education to overcome mistrust, misinformation, and conspiracy theories. Without doing so, existing health disparities will only continue to increase. Complacency and lack of confidence were drivers in women’s low levels of intent to be vaccinated, but trust issues were the primary behavioral determinant. Because of all of these detracting factors, the authors argue that interventions will need to be complex and decisive to address the complexity of factors affecting decision making.

Another vulnerable group is nursing home staff and residents. In this brief report, the authors share the results of an intervention to target Black and Hispanic employees of a nursing home after recognizing the paucity at which those employees were being vaccinated. In just a little more than a month, their targeted education and engagement efforts increased vaccine uptake among staff. They specifically engaged in the following strategies:

• DEI (diversity, equity, and inclusion) representatives facilitated culturally sensitive discussion at information sessions, which were offered at various times of day and night and employees’ family members were invited to attend
• Increased availability of multilingual educational materials
• Harnessed the power of social media, paying particular attention to used DEI representatives in all campaigns

They also highlighted the importance of listening to employee concerns with empathy, being respectful of different experiences, answering questions truthfully, maintaining transparency, and communicating clearly to build trust.

In this online experiment, researchers found that individuals’ cultural worldview affects their responses to messages. In general, respondents were more likely to get vaccinated and support vaccine mandates if they were exposed to an individual-centered message as opposed to messages focusing on community or country. However, highlighting different benefits may motivate individuals in different ways as individuals who value individualism were more likely to respond favorably to individual-centered messages than those with communitarianism values. Thus, understanding the values of the target population is important for framing messages to be more effective.

This theoretically informed study provides evidence for framing messages to encourage travelers to be vaccinated. Specifically, messaging should focus on (1) a strong belief in the protection benefits of the vaccine and (2) a higher level of perceived susceptibility to COVID-19, with an anticipation of more severe symptoms. Willingness to vaccinate and beliefs that others should vaccinate predict support for vaccination mandates, leading the authors to encourage the tourism industry to become strong advocates for travel vaccination programs.

In the current issue of Family Doctor, a family physician working at Cornell Health discusses how patients’ personal doctors are highly trusted sources, especially about COVID-19 vaccines. This makes them an essential person to be having difficult conversations with vaccine hesitant patients, in particular. She provides 10 effective communication strategies for health care providers:

1. Take a breath
2. Start the conversation with an open mind
3. Give a strong recommendation
4. Acknowledge concerns
5. Educate yourself
6. Address side effect concerns and offer resources
7. Tell stories in addition to giving data
8. Focus on the freedom the vaccine will give the patient
9. Focus on protection to loved ones
10. Listen and continue the conversation

Finally, one response to vaccine hesitancy is to implement vaccine mandates. This is obviously not without controversy. In just one example, this commentary explores the ethical arguments both for and against mandating vaccination for a particular group of people – U.S. service members. Proponents for the vaccine mandate use the harm principle as justification that without such a mandate, other individuals and the military as a whole would be harmed. Those against the mandate argue that individuals can protect themselves and others in different ways without impinging on one’s autonomy. The authors’ ultimate conclusion is that such a mandate is ethically justified and when communicating the rationale for the mandate, senior leaders should disseminate consistent messaging throughout the military and use the least restrictive justification for overriding individual autonomy.