Cynthia G. Jardine

Development of a Public Participation and Communication Protocol for Establishing Fish Consumption Advisories

Enabling people to make an informed choice on whether to change consumption behavior is ultimately the objective of any fish consumption advisory. This will occur only if people are aware of the advisory, know and understand the advisory information, and believe the information to be true. Interactive, meaningful communication and the opportunity to participate in the process to develop and review advisories are key to achieving these attributes. A case study was undertaken in a community in Alberta, Canada (where an existing advisory was under consideration for review) to determine public awareness, knowledge, compliance, communication effectiveness, information needs, and desire for involvement related to the advisory. The information obtained from this case study was used to develop 14 guiding principles as a foundation for the incorporation of public participation and risk communication into the process of developing and reviewing fish consumption advisories.

Trends in the study of Aboriginal health risks in Canada

Objective. To identify trends in the study of health risk in peer-reviewed and grey literature in Canadian Aboriginal populations from 1960 to 2007. Study design. Systematic literature review and analysis. Methods. Peer-reviewed literature was searched using 5 electronic library databases. The grey literature was searched using 3 online search engines, 4 agency websites and 2 online compiled databases. The search terms used were “Canada,” synonyms for Canadian Aboriginal peoples and “risk.” Citations were screened for relevance to Aboriginal populations and risks to aspects of human health. Results. Both literatures show an exponential growth in risk-focused study of Canadian Aboriginal health issues over time. There is a geographic foci in the North with the Prairies and the West under-represented. Risk is most commonly used in relation to general health, environmental, zoonotic infections and chronic diseases in the peer-reviewed literature, and general health or environment in the grey literature. Most publications in both literatures are on generalized Aboriginal populations. When specified, a larger proportion of the publications relate to First Nations people, followed by Inuit. Little literature exists on Mètis health risks in Canada. Conclusions. There has been an increase in publications about Aboriginal health risk in Canada over time. Trends reflect a research focus on the North and an increased interest in environment and health issues. Greater attention to mental health, addictions and Mètis health is required. The increasing use of a risk-based analytical focus has potential implications for understanding the nature of Aboriginal health today and in the future.

Affect-inducing risk communication: current knowledge and future directions

Affect appears to have a central role in people’s risk perception and decision-making. It is, therefore, important that researchers and communicators know how risk communication can induce affect or more specific emotions. In this paper, several studies that examined affect-inducing cues presented in and around risk communication are discussed. We thereby distinguish between integral affect induction, meaning through the risk message, and incidental affect induction, which occurs unintentional through the risk communication context. The following cues are discussed: emotion induction, fear appeals, outrage factors, risk stories, probability information, uncertainty information and graphs and images. Relatively few studies assessed the effect of their risk communication material on affect or specific emotions. Incidental affect induction appeared to occur more often than expected based on its factual content. Risk communication easily seems to induce affect incidentally and, thus, may be difficult to control. We, therefore, argue that incidental affect induction is more influential than integral affect induction. Implications for further research and risk communication in practice are given. Based on this overview, we strongly suggest considering and empirically assessing the affect-inducing potential of risk communication formats and content during their development and evaluation.

Do the first 10 days equal a year? Comparing two Canadian public health risk events using the national media

It has been suggested that the way in which a risk event is presented within the first 10 days of media coverage provides the major frames that will dominate news media presentations of any new information about the event over time. A media content analysis for two prominent Canadian health risk events (the E. coli water contamination event in Walkerton, Ontario, in 2000 and the discovery of Bovine Spongiform Encephalopathy or Mad Cow Disease in a cow in Alberta in 2003) in a major national newspaper was used to examine this hypothesis. For both case studies, the story frames in the first 10 days of coverage were not significantly different than during a full 1-year period following the event, indicating that a 10 day analysis should be sufficient to determine media presentations of the risk events. The increased accessibility of information during this period (as indicated by the greater number of articles on the front page of the newspaper) reinforces the usefulness of looking at the first 10 days to establish dominant frames. However, the 10 day analysis is only reliable for a risk event that remains relatively constant over time provided that media coverage remains high for an extended period and that no new salient issues emerge.

Youth researching youth: benefits, limitations and ethical considerations within a participatory research process

Objectives. To examine the benefits, limitations and ethical issues associated with conducting participatory research on tobacco use using youth to research other youth. Study design. Community-based participatory research. Methods. Research on tobacco use was conducted with students in the K’àlemì Dene School and Kaw Tay Whee School in the Northwest Territories, Canada, using PhotoVoice. The Grade 9–12 students acted as researchers. Researcher reflections and observations were assessed using “member checking,” whereby students, teachers and community partners could agree or disagree with the researchers interpretation. The students and teachers were further asked informally to share their own reflections and observations on this process. Results and conclusions. Using youth to research other youth within a participatory research framework had many benefits for the quality of the research, the youth researchers and the community. The research was perceived by the researchers and participants to be more valid and credible. The approach was more appropriate for the students, and the youth researchers gained valuable research experience and a sense of ownership of both the research process and results. Viewing smoking through their childrens eyes was seen by the community to be a powerful and effective means of creating awareness of the community environment. Limitations of the approach were residual response bias of participants, the short period of time to conduct the research and failure to fully explore student motivations to smoke or not to smoke. Ethical considerations included conducting research with minors, difficulties in obtaining written parental consent, decisions on cameras (disposable versus digital) and representation of all participants in the final research product.

If they tell me to get it, I'll get it. If they don't...: Immunization decision-making processes of immigrant mothers.

ObjectiveTo understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination.MethodsWe conducted 23 qualitative semi-structured interviews with immigrated mothers from Bhutanese refugee, South Asian and Chinese communities. Participants lived in Edmonton, Alberta and had at least one child under eight years old. Using NVivo™ qualitative software, we generated an inductive coding scheme through content analysis of interview transcripts.ResultsOur three main findings on information gathering and use in vaccination decisions were: 1 ) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants’ recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta.ConclusionOur results highlight the limitations of Alberta’s current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children.RésuméObjectifComprendre les processus de collecte d’information et de prise de décision des mères immigrantes pour la vaccination prévue, la vaccination pendant la grossesse, la grippe saisonnière et la vaccination en période de pandémie.MéthodesNous avons effectué 23 entrevues qualitatives semistructurées avec des mères immigrées des communautés de réfugiés bhoutanais, d’Asie du Sud et chinois. Les participantes vivaient à Edmonton, Alberta, et avaient au moins un enfant de moins de huit ans. Grâce au logiciel qualitatif NVivo™, nous avons généré un schéma de codage inductif au moyen de l’analyse du contenu de la transcription des entrevues.RésultatsNos trois principales constatations sur la cueillette et le recours à l’information dans les décisions sur la vaccination étaient: 1) les participantes des trois collectivités recevaient passivement l’information sur l’immunisation. La plupart des mères obtenaient de l’information sur les pratiques de vaccination exclusivement des professionnels de la santé pendant les visites prévues. Les réseaux sociaux étaient la principale source d’information dans le pays d’origine, mais étaient perdus pendant l’immigration au Canada; 2) les participantes avaient une confiance universelle dans les vaccins (c.-à-d. aucun sentiment antivaccin). Elles se sentaient à l’aise de recevoir des vaccins pour elles-mêmes et leurs enfants, quelles qu’aient été les réactions adverses passées; 3) le souvenir qu’avaient les participantes de la campagne de vaccination Hl NI était presque nul, ce qui illustre l’absence de portée des campagnes de vaccination de la santé publique pour les groupes prioritaires désignés (femmes enceintes et enfants) en Alberta.ConclusionNos résultats soulignent le peu d’efficacité des stratégies de communication albertaines actuelles en matière de vaccination à atteindre les femmes immigrantes. Nos résultats indiquent que les mères immigrantes suivront probablement les recommandations lorsqu’elles reçoivent de l’information sur la vaccination. Mais notre étude montre que les stratégies de communication actuelles ne fournissent pas cette information aux femmes immigrantes, ce qui limite leur capacité de prendre des décisions éclairées sur la vaccination pour elles-mêmes et leurs enfants.

Canadian Media Representations of Mad Cow Disease

A Canadian case of bovine spongiform encephalopathy (BSE) or “mad cow disease” was confirmed in May, 2003. An in-depth content analysis of newspaper articles was conducted to understand the portrayal of BSE and variant Creutzfeldt–Jakob disease (vCJD) in the Canadian media. Articles in the “first 10 days” following the initial discovery of a cow with BSE in Canada on May 20, 2003, were examined based on the premise that these initial stories provide the major frames that dominate news media reporting of the same issue over time and multiple occurrences. Subsequent confirmed Canadian cases were similarly analyzed to determine if coverage changed in these later media articles. The results include a prominence of economic articles, de-emphasis of health aspects, and anchoring the Canadian outbreak to that of Britains crisis. The variation in media representations between those in Canada and those documented in Britain are explored in this study.

Stakeholder Participation in Investigating the Health Impacts from Coal-Fired Power Generating Stations in Alberta, Canada

Developing an effective stakeholder participation process and communication dialogue continues to be a challenge in dealing with risk issues, particularly those in which the risk is uncertain and people are fearful about the potential impacts. The complex public stakeholder relations and risk communication issues associated with investigating the potential human health effects associated with exposure to the emissions of coal‐fired power generating stations are discussed. Residents in the area around Lake Wabamun (west of Edmonton, Alberta, Canada) have raised concerns about potential health impacts from four nearby coal‐fired power generating stations. The Wabamun and Area Community Exposure and Health Effects Assessment Programme (WACEHEAP) was developed to look specifically at what people are being exposed to in this area as well as some of the health effects from these exposures. Public stakeholders to this process included the general public, community interest groups and the Paul First Nation. Two surveys were conducted to better understand community concerns, communication and information needs, and desire for involvement. Consultations were also held with the Paul First Nation. The results provided important insights into the risk perspectives of these groups, including communication needs and desired means of participating in the risk assessment process.

The More the Better? A Comparison of the Information Sources Used by the Public during Two Infectious Disease Outbreaks

Recent infectious disease outbreaks have resulted in renewed recognition of the importance of risk communication planning and execution to public health control strategies. Key to these efforts is public access to information that is understandable, reliable and meets their needs for informed decision-making on protective health behaviours. Learning from the trends in sources used in previous outbreaks will enable improvements in information access in future outbreaks. Two separate random-digit dialled telephone surveys were conducted in Alberta, Canada, to explore information sources used by the public, together with their perceived usefulness and credibility, during the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic (n = 1209) and 2009–2010 H1N1 pandemic (n = 1206). Traditional mass media were the most used information sources in both surveys. Although use of the Internet increased from 25% during SARS to 56% during H1N1, overall use of social media was not as high as anticipated. Friends and relatives were commonly used as an information source, but were not deemed very useful or credible. Conversely, doctors and health professionals were considered credible, but not consulted as frequently. The use of five or more information sources increased by almost 60% between the SARS and H1N1 surveys. There was a shift to older, more educated and more affluent respondents between the surveys, most likely caused by a decrease in the use of landlines amongst younger Canadians. It was concluded that people are increasingly using multiple sources of health risk information, presumably in a complementary manner. Subsequently, although using online media is important, this should be used to augment rather than replace more traditional information channels. Efforts should be made to improve knowledge transfer to health care professionals and doctors and provide them with opportunities to be more accessible as information sources. Finally, the future use of telephone surveys needs to account for the changing demographics of the respondents accessed through such surveys.

Risk communication and trust in decision-maker action: a case study of the Giant Mine Remediation Plan.

Background The development and implementation of a remediation plan for the residual arsenic trioxide stored at the former Giant Mine site in the Canadian Northwest Territories has raised important issues related to trust. Social and individual trust of those responsible for making decisions on risks is critically important in community judgements on risk and the acceptability of risk management decisions. Trust is known to be affected by value similarity and confidence in past performance, which serve as interacting sources of cooperation in acting toward a common goal. Objective To explore the elements of trust associated with the development and implementation of the Giant Mine Remediation Plan. Design Semi-structured interviews were conducted with eight purposively selected key informants representing both various interested and affected parties and the two government proponents. Results Five primary issues related to trust were identified by the participants: (1) a historical legacy of mistrust between the community (particularly Aboriginal peoples) and government; (2) barriers to building trust with the federal government; (3) limited community input and control over the decision-making process; (4) the conflicted and confounded role of the government agencies being both proponent and regulator, and the resulting need for independent oversight; and (5) distrust of the government to commit to the perpetual care required for the remediation option selected. Conclusions The dual-mode model of trust and confidence was shown to be a useful framework for understanding the pivotal role of trust in the development of the Giant Mine Remediation Plan. Failure to recognize issues of trust based on value dissimilarity and lack of confidence based on past performance have resulted in a lack of cooperation characterized by delayed remediation and a prolonged and expensive consultation process. Government recognition of the importance of trust to these issues will hopefully improve future communication and public engagement endeavours.