Tackling Public Health Communication Conundrums: Rumors and Public Trust

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MARGAUX HAVILAND:
Good afternoon and or good morning wherever you are today, and thank you for joining us for today's important conversation on communication conundrums, rumors and public trust.

I'm Margo Haviland, the director of Preparedness and Response coordination here at ASTHO I will moderate today's session, which will be recorded and distributed to participants in the coming weeks. 

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Landscape, misleading rumors and health related myths are more than just nuisances, they pose a real threat to public health. These false narratives can weaken, trust in health institutions, slow down response efforts, and ultimately put lives at risk. while rumors and myths in public health are not new, how they spread and who spreads them has evolved rumors are moving faster, amplified by social media and other digital platforms, and they're often endorsed by individuals in roles that were once seen as trusted messengers. The shift has created greater public confusion and frustration and complicated our ability to respond effectively.

Today we'll explore strategies to not only respond to misleading rumors, but to proactively build trust. strengthen communication frameworks, and reinforce public confidence in some settings of these approaches may be referred to as readiness activities or community planning, but at their core they are the same critical actions designed to build a strong foundation before a crisis hits. Our discussion is about equipping you, our public health colleagues with real world strategies to meet challenges head on whether you're involved in emergency preparedness, health, promotion, communications, or community engagement. This conversation is about readiness. It's about the foundational work we can do now to prepare for when misleading rumors become a true crisis. With the right planning, collaboration, and communication, we can protect the public's health and restore the trust that is so essential to our mission.

Thank you for the essential work that you do, and for being here to strengthen your readiness to meet one of the most pressing challenges facing public health. Today we're looking forward to a thoughtful and practical discussion and hearing your questions as well. The chat box has been disabled, but the Q and A box is available for your questions. So let's go ahead and get started. And I'd like to introduce today's panel 1st off Tara Kirksell, our senior scholar from John Hopkins Center for Health Security. Tara.

TARA KIRK SELL: 
Well, thanks so much. I really appreciate being here today and getting the opportunity to talk about our work. I'm going to do a brief overview here of some of our work that forms the foundation of a few efforts around the country to counter rumors, build trust, and move forward our work and preparedness. 

So, just want to start with a disclaimer that our work was supported by centers for Disease Control and Prevention of the US. Department of Health and Human Services. But the contents of this presentation, and those of the authors and me presenting here today don't represent, don't necessarily represent the official views of, nor constitute or imply endorsement by CDC, HHS, or the US Government. 

But here I'm here to talk to you today about the playbook for health, for addressing health rumors. And so really, this is guidance for addressing rumors. It provides tools and templates, but I want to sort of caution to say, like these are pieces to start you going on. This process, or sort of, you know, give you another step if you're already moving on it.

But it's not a perfect solution. You know, this is a big problem, and we can only sort of make, you know, step by step, progress on this. You'll see some photos on my slides, and these are part of my team, who are, you know, very much involved in these pieces of work. So if you have someone come present to you more specifically about the playbook. You might see Ashwari or Vanessa, or if you look at some of my other work, you might see our other team here. So for if we think about rumors and the rumor types we see in emergencies, you know, it always feels crazy.

And in the moment you're like, how do people think of this? But if you think back over the course of your careers and the rumors you've had to deal with, you probably can say like, Oh, wait they. There are a lot in common amongst these rumors. Sometimes it even feels like copy and paste, so you can think all right. Maybe I can actually look to see what my community has been saying or what rumors they've been concerned about, and think ahead and anticipate those types of emergencies in the future, and sometimes they have to do with the way people think. Sometimes they have to do with our culture, and sometimes they have to do with just communication, like we've messed up. And now we've got a problem. So you know, we can think of it in that way. But it's a good way to sort of say. and to not be surprised when we have to deal with one of these rumors. and we also have a range of different interventions that we can use. So you know, you can think all right if we look at the individual level right or the information level, we can try to address rumors by amplifying factual information or filling information voids. We can work on that individual level right at the you know, the person level where we try to enhance their information literacy, or we try to debunk or inoculate them against the misinformation or the rumors that they're going to see.

And then we can think about this interpersonal or community piece, right where we're trying to get trusted communicators out there, resources for public health communicators, community engagement work, that type of thing. And then we have this institutional structural level which sort of frames the work that we actually do. This policies, you know, and other sort of structural systems that sort of make a make. What happen. Happen. The the playbook, though, is really about practical guidance, right? Preparing for those rumors, deciding when to act, to address those rumors. And then, you know, because we can't boil the ocean right? We can only choose some rumors to address. There's just too much to deal with. We've got big a lot of stuff on our plates, and so we just have to figure out what's the most important to us, and what do we have the resources to deal with? But then the next step here is to determine what actions to take to address rumors, developing messages, to address those rumors, and then gathering feedback on those messages to see if what we did works.

So for setting yourself up. This is just a very brief overview we think about, okay, is there pre-work? Can we put together our team? Can we build those connections? Do we know our audiences? Do we have a way to identify rumors before they become a disaster? And then can we answer audience questions and concerns quickly before they become something that moves beyond our control. When we also, when we think about you know the spectrum of what we're trying to deal with here, you know, we start with questions and concerns and information voids, and this is much easier to address before we move towards these more strong rumors or false narratives. These are much harder to contain. So if we can get it over here, that's where we're that's where we're the most effective right? And so the you know, step one. When we think about all right, we've got a rumor. Now we need to decide whether we're going to deal with it or not. We have to think about what our goals are, what influences our decision to respond so that could be seriousness, capacity to act potential consequences of acting. There's a worksheet. This is just an example of the worksheet that's in the playbook that provides some examples for you to think about. If you want to sort of work through it and get your ideas on how you want to sort of make your decisions. And then you know, at the end of the day you decide whether you'll address the rumor, and then you move on to taking action to address rumors. So this is really about what type of rumors spreading? Can I refer to other types of rumors and things that have worked with those. What's my priority audience and what is my goal for them? We can't just respond without having actually a goal for that response for that group that we're trying to work with choosing an action approach. What channels? And trusted messengers are we going to use a lot of times. You know, you want to use the same channel that the rumor is spreading on right. So if you have a rumor on Tiktok. A flyer in a doctor's office may not be the solution for that. You know, we might need to be able to respond more effectively on social media or some other similar platform strategic ways to frame your message right using different ways that may resonate more with the values and beliefs of your particular audience things that they're specifically concerned about. So these framing, you know, not always framing it in the things that public health professionals think are the most important. But what do our audiences think are important? And then the last action step here is really creating and disseminating those messages using good practices. I won't go into that right now. There's a lot in the playbook, and many of you are communication experts. So you know this. But there are some practices that can help us sort of not have to start from scratch every time. And then the last step here is evaluating those messages. So can we do user testing? Can we track? How how far it went? What do our partners think about these? Evaluation is a traditionally very difficult thing to do, especially with Comms, because there's so much going on that that affects our ability to measure. But these are a few things that we can sort of use. And then, if you have more time and resources, there are some more particular things you can do. So I just want to direct folks to the trust in public health website if they have questions or they want to sort of access some of these resources. But with that I'll turn it over to the rest of the panel.

MARGAUX HAVILAND:
So much, Terry. Thank you. So we've also provided a link to the playbook in the chat. So for folks that have joined us today you can find that resource by following that link as well. So before we get into additional facilitated discussion, I would like to introduce our health agency professionals that we have included with us today. And after I introduce them they're going to provide you a little bit of an overview of some of the work that they have been doing in this space recently. So we have Brookie Crawford, the Risk Communications manager from the Virginia Department of Health, Brookie, would you like to say hello to everybody today.

BROOKIE CRAWFORD:
Yes, hello, as she said, I I work with risk communication. So we have really focused our work so far. On emergency and risk communications. Things that are not blue sky. Messaging things that come out of the blue, that it's really critical that we build that trust and share critical information during these disasters to people. So that's where we've really focused. And we've done a couple things to do that we really focused on the pre bunking that Tara mentioned. So we try to think about what rumors might happen. We find that when there's a void in information is where those rumors develop. So we're trying to get out as much information as quickly as possible and accurately as possible at the beginning of a disaster to help people. And then we've set up what we call incident pages. It's a specific page on our website where we funnel all people to regarding that disaster, and we keep an FAQ. Where we can anytime. There's a question or a rumor, and we kind of address it there. We also furnish that FAQ. To anybody that might speak with the with the public. We share it with the media. We put it on our call center. And so that's one of the ways that we've keep directing people back there. And so there's a source of information for them. And that helps alleviate the rumors. And then, when we do find that there are some rumors, we've also developed some social media posts to address those. For instance, we've had a number of boiled water advisories. And it one happened during Hurricane Helene, and it really became clear that people didn't understand when they needed to use bottled or boiled water, and when they could use their tap water like to take a shower. So we developed a social media graph. That's just shows this is what's boiled water and how to list. And this is tap water, and how to list and that really helps alleviate a number of the calls that we were getting.

MARGAUX HAVILAND:
Thanks, Ricky, and thanks so much for joining us today. And next we have Maggie Koontz, the health planner from Carroll County Health Department.

MAGGIE KUNZ:
Hi, everyone so excited to be here today, I bring a little bit different perspective because I don't really work in the preparedness realm. I work for the Full Health Department, so kind of cover all of the services communications for all of our services. And so, you know, we kind of approach the issue with health rumors in a broad way, and also, as Brookie had mentioned, sort of in a pre bunking way, and sort of both pre-bunking and sort of training staff, I think, to be prepared to deal with, you know, emergency time rumors. So a couple of examples pre-bunking we did with some new moms around the pertussis vaccine. When pertussis was spreading more in the fall, we were able to put together some resources and work with our community partners to get that out to new moms.

We also do a lot of monitoring of social media to just kind of keep our ear to the ground. to talk to partners kind of figure out what's circulating. And we live in a relatively rural small community. So that's an important way for us to kind of target different topics. So, for example, we've had a cannabis survey out there, and cannabis recently became legal in Maryland. So by sort of monitoring that conversation, we're coming up with more ideas for education that's needed in the community and addressing some questions. And then we're also just looking at the importance of rebuilding trust through a wider campaign for the whole agency to talk about what services we offer, and the fact that there's something for everybody here at the Health Department. So that's 1 way that we're kind of working with all of our staff to to really rebuild trust in the community and be prepared when there is when some, when disaster strikes hopefully, people will turn to us for that answer. So those are some of the things that we've we've been working on recently.

MARGAUX HAVILAND:
Thanks so much, Maggie, and thanks for being here with us today. And so in rounding out our panel, we have Danny Vassalotti, the Training and Education Coordinator from Hawaii Department of Health.

DANI VASSALOTTI, HAWAIʻI DEPT. OF HEALTH:
Everyone. It's 8 Am. Here. Good morning. My coffee hasn't quite kicked in yet, so, Margo, if you don't mind, can you repeat the question?

MARGAUX HAVILAND:
Yes. So we were just looking for you guys to provide an overview of some of the recent work that you're doing as well as interest. Introduce yourself and your current kind of role to those have joined us today.

DANI VASSALOTTI, HAWAIʻI DEPT. OF HEALTH:
Thank you. So I do work for the Office of Public Health Preparedness currently. And in my position for most of the time that I've been at the Department. I have been working on preparedness and response activities of years ago. It was mostly just preparedness. And then in the last 3 to 5 years. It's mostly been on response and some preparedness to include training for all of our staff, you know, workforce development and training and also risk communications training.

Because as my colleagues and I have witnessed over the years, communication at all levels during a response is just it's always challenging. It's very challenging and that's including with the public and within the response, so the current work that we're doing in collaboration with the Region 9 Pacific Southwest Center for Emergency Public Health. We're utilizing them for technical assistance. And we have been collaborating through them with University of Hawaii at Manoa and the University of California and San Francisco to work to, to use this wonderful playbook as a guide, to help us strategize what we're going to do in a response. And we recently had a workshop.

We brought together some colleagues in the Department of Health. It was specific to the Department of Health. This particular workshop we brought together. It was a small group, some communication staff communications office staff, some preparedness staff. And then, because of the scenario which was based on a measles outbreak which happened right at the time that there was 2 measles cases. We brought some technical staff from the immunization branch, and we worked through using this scenario of a measles outbreak. We worked through the playbook. It became a very operational conversation, but because of what was happening. But we worked through that.

And now we're looking at next steps. This is a very specific thing. We're doing other activities, too. But this is very current. So we are looking at what we learned from that workshop, and then how to develop trainings and functional exercises based on what we learned and who to bring in based on that. Thank you.

MARGAUX HAVILAND:
Thanks so much, Danny, and thank you everybody for your overviews. So we're going to get into some facilitated conversations here. And I'm going to start with Tara. And we're going to start in the concepts of trust. So how can public health professionals and communicators build and maintain public trust in the environment that we're working in right now.

TARA KIRK SELL:
Yeah. So it's a tricky environment for trust and dealing with rumors, because we have a lot of baggage from from Covid. And so you know, I think that being out there in the community, you know, sometimes we're there to talk about vaccines. Sometimes we're there to talk about these public health emergencies. But sometimes we're there to like help, support healthy kids day or like some other community event. And so, being part of the community building up back up that trust being present, being there and making it clear, the work that's being done to help protect people from. You know everything, from pandemics to like bad food in a restaurant, or, like, you know, contaminated waterways is really, I think, the foundational step. Public health is not just about emergencies. Public health is about this whole suite of work that we all do. And so I think that that's really important to sort of be present and and be there in our communities. It goes beyond sort of this rumor response, and I don't know if I should go beyond this rumor response for this, but I think it's a bigger piece, you know. It's part of being part of our communities.

MARGAUX HAVILAND:
Great thanks. So much so I'm pivoting into. And I want to go back to something actually, that both Brookie and Maggie mentioned as folks that have joined us today, maybe thinking about this work in their own space, wanted to talk a little bit about that pre-work and the pre-work activities. You talked about pre bunking. But can you guys comment maybe a little more on what health agency staff should be thinking about before and ahead of rumors? And I'll start with Brookie if you have. We have a comment.

BROOKIE CRAWFORD:
Sure. And I always think it's really nice as a communications person and not a health expert. That this is a role I play here is, I'm gonna ask you, well, what about this? And what about this? Because I don't know the answer. And so I'm more like the general public and can stop and think about what are the things that that the public are? Gonna ask and I think that's really where you got to start is, what is what is it that the public's going to ask about this? And you have all your health experts who are amazing people, I know very detailed information about the situation, but it's sometimes hard to break it down to plain language for the the public.

So we gotta think about how we can do that. Because if they don't understand what we're telling them, that also leads to rumors and what information they need to know the who, what, when, where, why, how and what we can tell them. Of course we can't always tell them everything. We have our privacy, laws and things like that. But what can we tell them? And what do they need to know? That's most important? And then you need to have all the players involved.

So sometimes our responses are on the ground. I can think of a one where we had a fire at a fertilizer plant. It involved multiple agencies. The runoff from the chemicals in the plant ran into the water, and then, of course, the fire had smoke and went into the neighborhood. To those people living. And so we had a lot of questions that even we didn't think about like, what about the furniture in the house? Does it need to be cleaned? Or does it have to be disposed clothing things like that?

So, as those questions came up, we immediately got messaging out for them, too. So as soon as somebody asked, we got an answer, and we added that to our incident page, so it was very much included. Those people with boots on the ground that we're getting those questions by people sharing that with us. It's very important that the communications team have a seat at the table so that they can help say, Okay, oh, that's definitely something, you know. One person asked it more than one's gonna ask it. Let's get that information out.

MARGAUX HAVILAND:
Thanks Brookie. Maggie.

MAGGIE KUNZ:
This is some great suggestions, and, Brookie, I will echo what you said about plain language. Maryland has really had a push due to a new law to make sure that all of our health information is provided in plain language, and the consumer health hub at the University of Maryland has really been helping all of the Pios across the State of Maryland and our health departments to really ensure that we're using plain language in our materials. And so that's really been helpful.

So that's 1 thing, as you said. If people don't understand what we're saying, then it's and we've got a lot of people who want to get messaging. but can't always translate it for for everybody to understand. So that's really important. We also continue to like, as I said, to proactively share positive information about what we're doing in the community and just building that continue to build that connection with the community. As Tara mentioned that, I think will really help serve us, you know, in times when when things get tough and we need people to turn to us for trusted information. The other thing, I think, that has been really important for us is to make connections with other communications professionals. So within our county we have. you know, a jic that we meet regularly, even when there isn't something going on to just develop those relationships. I coordinate a group of Pios and communications professionals from all the health departments in Maryland. And so when one person has an issue, we can reach out and help and help them kind of cope with it, and we can also. Often many of us have the same issue at the same time, and we can support each other so that support has been really essential. So I encourage people to reach out, if you haven't already in your own. and even beyond, to find communications, professionals who you can kind of rely on when something happens and you need you need some support. And and then I think the other thing we need to do is, listen. I think we really, the more. We listen to people in our community, as Bricky had mentioned, just kind of monitoring, but also just being aware of people's concerns, and in addition to rumors, and then just being prepared to address those in a nonjudgmental way. So I think that continues to build trust as well. So that's something that we're working on to just do more listening and addressing things. Your local epidemiologist had a fantastic vaccine handout recently that she developed after talking with people who had some questions and concerns about vaccines, and it's really just has a little bit of different angle. So framing things a little differently, I think, is really important.

MARGAUX HAVILAND:
Great thanks for that insight. And so, and also, Danny, I have a question for you in the same space. So, since you mentioned you had recently conducted that training. So how did you decide who should be at the table to have a robust, like multidisciplinary team? And what insights from that process. Would you like to share with others? And is there anything you would do differently.

DANI VASSALOTTI, HAWAIʻI DEPT. OF HEALTH:
Thank you so initially, we had asked our communications lead. who he felt would be should be at the table, you know, because it would be communications based workshop. and he had said he wanted to keep it small, I think, to keep the conversation. to. Probably just I don't know exactly what he was thinking, but I I think it was to keep it going and controlled conversation. and also to bring in subject matter experts from within our department, and this was really helpful to bring in, especially for this scenario, to bring in individuals that were subject matter experts from the immunization branch and the preparedness, our preparedness office, and also several communications office staff. you know, to do things differently. I think we ran out of time during the workshop. It was a 2 h workshop, and it was a very lively and robust discussion, and we we hit a lot of the points organically that we wanted to hit, using the playbook as a guide. but there was so much going on because of the 2 cases that had been announced during that week that, as I had mentioned before, it became very operational, which was good. but I don't think we were able to. I don't know if it was as helpful to the communication staff as it could have been. If we weren't in the midst of that real life situation. I've given a lot of thought to what we would do differently. And we need to get more information from the Comm staff before we design the next steps, because they're integral in this. But I wonder if. moving forward, we should focus more on bringing in those from within, from all all programs in the department that might have a public health educator or a communications person. So a subject matter expert in communications, specifically people that we may have identified in our office as being part of the Pio role or support for Pio role in our departmental operations center. Anybody that might be asked to respond during a asked to respond to an event that might be related to communications, office or communications. Activities bring them in for the workshop. and then, after that, maybe bring in some subject matter. Experts based on a scenario like a measles, outbreak, or something else. Because I really think it's important for us to prepare our Communications staff and any staff that might help them with, you know, to to hone these skills. So that's how I'm I'm kind of thinking about evolving this moving forward.

MARGAUX HAVILAND:
Thanks, Danny. I think one thing that resonated throughout everyone is really the work that needs to be done before we're responding and trying not to have to do them simultaneously, training and developing at the same time, while in a response making sure you can. you have those kind of networks established. You can phone a friend when you're in a response and making sure you guys have that support network. So I appreciate all of that. Thank you so much. So I'm going to move on to kind of like a process question. And, Maggie, I will tee this up for you first.st How do you balance the need for a quick response with some of the systematic decision making that should happen.

MAGGIE KUNZ:
Oh, that's a tough question. Definitely. That's definitely challenging. You know, I think having those relationships and knowing who you can talk to and who you need to talk to right away, you know, is important. you know, just even if you don't. If you need to talk to someone else, at least in our small community. If you don't know that person, you know somebody who knows that person, and the same thing in a small agency, you can hopefully get to that person quickly and kind of you know. Talk about how important things are, you know, since I'm not in preparedness directly, but I do work closely with our preparedness folks both within our agency and in our community. And they understand what needs to happen. And so that's a good way to kind of get things done. But I think, as we've talked about kind of having some evergreen messaging. I love Brookie's suggestions about having these, you know, developing these graphics and developing these messages that are pretty simple and pretty easy to adapt a little bit for the situation at hand. And so, when you know those things have already been vetted, approved. They're already in in a good format to share just being able to tweak them a little bit to fit the issue at hand is really helpful. And I think we're, you know, we're working to develop that. And the same, I think same goes for training your staff. I think that really sets things in motion makes people more comfortable responding. I think when they've been doing this in quieter times, and then when something happens right away, they're more confident to respond. And so I think that's 1 of the things that we're working towards using this framework is to get Staff more involved in taking the steps, practicing the steps kind of like riding a bicycle. Right? So then, when the time comes and you need to ride your bike, you're going to be ready to go with this kind of worksheets. And just the thought process that it requires to make sure that your messaging is complete and accurate, but also timely.

MARGAUX HAVILAND:
Great. I love that and the concept of practice, making sure that kind of we. It's like that muscle memory. So when we do need to respond that we kind of are familiar with the territory. Brookie, do you have anything else you'd like to add.

BROOKIE CRAWFORD:
I think it's a lot about that pre work again. I'm thinking ahead of time, knowing which things that you are going to respond to, and which ones you aren't. Things that are fact based are much easier to respond to. You can come straight up with the answer. I know we had a question in the the Q&A. About those highly politicized issues, and those take a little. Those are a little bit harder. Those go through senior management. We don't get to those quickly whenever possible. If you're sticking to the facts, it's easier to not be seen as taking aside. But sometimes there's still just some issues that you know we work for the government. So those are things. But those those will go through our senior management for review beforehand. If it's a lot that's coming up on social media, I suggest strongly that you have a social media policy. And have it reviewed by legal. We you know, there's a balance between freedom, freedom of speech, and you know, not spreading rumors. And definitely have a conversation with legal way before the event happens, so that you know what you can respond to, what you just delete what you address and what you just move past.

MARGAUX HAVILAND:
Great. That's a great point. I appreciate that. Thanks for bringing that up. So some of our next questions, we're gonna take another little pivot here. So in terms of partnerships. So, Brookie, I'll come back to you again. So what partnerships have you found most valuable when addressing misleading rumors or public health myths, whichever you would like to call them in your community.

BROOKIE CRAWFORD:
The other state agencies. Anybody else responding to an emergency is number one. And as Maggie mentioned, we have a a joint information team that we always pass those things through to if we're all staying the same message. And it's consistent. That also leads to less rumors. What we don't want is the Health Department saying one thing and environmental quality saying another. So it's very important that we're cohesive but then it's about knowing your community. So, depending on your community, then you find the best partners. Maybe it's religious leaders. Maybe it's community leaders. Somebody that speaks their language. We just had a case in a with a Tb case in a community that was mostly non English speaking, and luckily we had a nurse on staff that spoke with them, and had spoken with them that community during previous events. And so they had that trust with her because she spoke their language. So sometimes it's about having that connection. So I think that comes the best partners come from knowing your community best.

MARGAUX HAVILAND:
Great thanks. So, Maggie, same question to you. Partnerships you think that have been the most valuable, or that maybe are insightful to other folks that have joined us today that they should think about partnering with.

MAGGIE KUNZ:
So Brookie had some great points there about knowing your community. We come from a pretty small, as I said, relatively a semi-rural community in Western Maryland. And so we do look to our community leaders. And so we've had campaigns, various campaigns, very successful with our civic leaders. So across our small municipalities, just mayors and city councils. We've worked with our county leaders to do some vaccination campaigns and some other messaging. We've worked well with law enforcement, especially with behavioral health here, since we're doing. And we do a broad array of communications topics here. So overdose prevention. They've really been a great voice for us. And that's this. They're, you know, they're across the community. We've also looked to some peer peer communities when we've done things like we've done different things with college-age students, you know, looking for people that age to kind of be our spokespeople, our trusted messengers. But we've even had luck with with agencies like head start and boys and girls club working with their parents. That's a great way to reach parents. So you know, because our communications goals are so broad. We really look to a lot of different partners, faith-based organizations. and many other community groups. So really, I would just suggest reaching out to anybody, you know, even through other aspects of your life, and making those connections and building those relationships that will really come in handy.

MARGAUX HAVILAND:
Thanks, Maggie. So in the realm of some of that work that you guys have done, and those partners that you've worked with. And, Brookie, I'll pose this to you. Do you have any examples that you could share about space where you felt that was successful in terms of shifting the conversation?

BROOKIE CRAWFORD:
Yes, like, I said. We also have a call center that people can call into and we feel like we're doing. We're we're kind of successful when those call volumes go down, when the number of comments and social media go from comments to just mostly sharing our message. I think that's when we're seeing less rumors. Come up. And so I think that's where we kind of call that a success. Here's an example. We recently had 3 separate measles cases. Our 1st one was in April. and we put out messaging on that. And we did get a lot of concern about infants and those traveling especially abroad. How we got a lot of questions. So when we had the second case, we made sure that we address that in our news release as well is that you know infants could get a shot if they're traveling at an earlier age than their normal one, and that really decreased the comments on that. And we saw that. And then, by the time we had the 3rd case just last week, we're seeing less and less questions about measles because we've given them all the information. So we've got less media inquiries the 1st one we had tons. And then by this time. It's I think the we're still getting media coverage. But we're starting to get a lot of less questions. And I think that's because we've already provided them with the information they need.

MARGAUX HAVILAND:
Great thanks. That's wonderful to be able to see kind of like the needle move, knowing that this is a challenging and ongoing kind of like action that happens kind of and doesn't really let up. And and but it's nice to be able to say that you've made some headway in that space. So so we're moving into some questions about kind of like next steps. And, Tara, I'm going to ask you to start us off, and then, if any folks have had anything to add, so as those that have joined us today might be thinking about how they can do some work in this space? What are some questions or some planning processes that you think would be insightful to others?

TARA KIRK SELL:
Yeah. So we've been implementing this in Region 3, which is, you know, I run the region 3 preparedness center, and we've been doing it in Region 3, as Danny mentioned. It's it's been also in region 9 some other folks in Region 4. We're working on it. So but if other people are interested in using this, I'm happy to to chat with them. We've been trying to sort of. We've been doing 90 min sessions. It feels like very short. But we're also like sort of aware that, like people have so much else on their plates that we're trying to balance like having enough time to really go through this playbook, talk about a potential strategy or action plan, but also be respectful of people's time and all the other work that they have going on. So we're kind of trying to balance it. But we do these sessions. My team is actually headed out to Talbot County tomorrow to talk with them about it and and see how you know they could help them implement some of the playbook. So we've been. We've been doing this process, and and happy to work with others who want to. But you know, even if you're just going to take the playbook and do it yourself, I think the thing that I would say that's most important is that it doesn't have to look the same for everyone, and, in fact, it should look pretty different for everyone. Take it, use it, however, you like to use it. However, it fits your community. Use the piece that you like, and the other piece that you like out of it, because we know that everyone is unique and has different communities that they're responsible for different rumors they're dealing with and so making it so that it, you know. I hope, that people watch this webinar and are inspired on different ways, that you can respond to rumors that fit for your community. And hopefully, we have some of those suggestions in our playbook that you could refer to if you wanted it written down. So you know, that's just the process that we're going through here and implementing, trying to evaluate how it's working.

MARGAUX HAVILAND:
Thanks so much, Tara, and, like I had said earlier, I mentioned the link to that resource is in the chat. So if there was any questions that come up about how to find that resource. The link to that resource is in the chat. As we are going to start to run short on time here. I want to make sure we have a little bit of a time at the end to address some questions I'm going to ask kind of a wrap up question of all of our panelists today. And, Danny, I'm gonna start with you. But what does success for your health agency look like? What do you hope to accomplish in the next 6 months to a year? Whatever timeline you think is appropriate? And how do you feel that your health agency is going to be more prepared to address misleading rumors in the future.

DANI VASSALOTTI, HAWAIʻI DEPT. OF HEALTH:
I think success for me would be staff from across our department who feel confident during a response in their role, whether it's their day-to-day job in communications office or as surge capacity staff assisting in the Departmental Operations Center, feeling confident, feeling like we have prepared them to do their job during a very stressful time. In the next 6 to 12 months I hope to continue work with those that are part of this region. 9 Pacific Southwest Center for emergency public health. It's a great resource for us, and I look forward to continued collaboration. To to develop additional trainings as a follow up to our 1st workshop functional exercises to get people to develop that. Maybe someone said earlier muscle memory, you know, you can give someone a training, but if you don't provide the run through the dry run, then it doesn't feel applicable. You know. You have to go through it to make it feel more real, and then it can be a muscle memory during a response. And what was the 3rd question, Margo? I'm sorry. The 3rd part.

MARGAUX HAVILAND:
How do you guys feel that you're going to be more prepared.

DANI VASSALOTTI, HAWAIʻI DEPT. OF HEALTH:
Yeah, I think just going through it, especially because we we've had some staff, as everybody, I think, in public health over the last few years. There's been a lot of staff turnover since the pandemic and the people. There's a lot of people who are new to their role and May may not have experienced what it's like to respond, especially during something that's public of responses. Public health led like the pandemic. And so just making sure trainings are available to people and for for communications. In in our off in our department, I think. Yeah. Getting people comfortable with rumor control. Getting support for them from other programs. Social listening. Monitoring social media things like that, the things that really a lot of times. Maybe you don't have staff. You have staff to help write to draft press releases to help support press conferences, maybe to develop Faqs, because those are maybe things that happen day to day in a public health department, but things that come down to more response oriented activities. You might not have staff to dedicate to social media monitoring things like that really trying to provide support for those activities. If we can.

MARGAUX HAVILAND:
Great thanks so much, Danny. And so for Brookie and Maggie. You guys been piloting this stuff and putting it into practice. So, Maggie, I'll start with you. So what does success look like? What do you hope to accomplish in the next 6 plus months? And then how do you feel like your health agency is more prepared.

MAGGIE KUNZ:
So we took the training with Tara a few weeks several weeks ago with several several folks across our agency, and since then I've been meeting with programs one on one harm, reduction vaccinations and reproductive health to start out. And we're just using. as as Tara said, just part of the tool, just the part of the tool that we can wrap our heads around. You know, these are folks who aren't communicating normally, but they're experts in their areas. And I feel like by working with the programs one on one and using those tools, we've really been able to identify different audiences, different messages, different goals that relate to their work, and that's been really helpful, I think, to start building their capacity to respond to identify health rumors, to respond to health rumors in the moment, and to help bring them back to us in communications to kind of deal with the larger issues. And then I really hope that going across the agency will be able to work with different programs, increase everyone's capacity, and that will really increase our capacity to address these issues as they come up in any sort of disaster issue. So, as Danny said, just kind of getting people to practice and getting people to feel really comfortable responding, I think that's my goal. For the next 6 to 12 months.

MARGAUX HAVILAND:
Great thanks, and Brookie.

BROOKIE CRAWFORD:
I think success looks like when we are the trusted resource that people automatically go to for public health information. What we're hoping to do is the next response is to take it a step further in our emergency part and get really prepared ahead of time. So like we're meeting next week with staff to talk about what are potential rumors that come up during hurricane preparedness so that we can develop messaging and some social media for that. But we also want to take it to our blue sky days, our our normal messaging our our school Nurse program, is working with terrorist people to help them. Feel more comfortable. Addressing rumors about school immunizations, we're starting to think of different ways that we can address rumors during Blue Sky Day. So one of the things we're trying is Trivia Tuesday, so that you can take things that are potential rumors. And then we make them a tribute question. And then highlight the right answer. And did you know? Kind of message afterwards? So those are some of the things we're doing.

MARGAUX HAVILAND:
That sounds really fun, and I love that way of being able to think about it and kind of gamifying it. It's always nice when there's a way that we can spin something that we know is challenging and stressful into something that can be a little bit more lighthearted. So I'm going to cut off our discussion a little bit short today, only because we have so many questions in the chat in the Q&A. Box. So I'm going to start with one of these questions. And really, just for our 4 panelists, ask one of you all to just come off mute. If you feel like you want to answer or provide some feedback based on what's listed. So I'm just going to start at the top and work our way down. So what are some tips for engaging stakeholders who are risk averse in helping address rumors? So, Tara, I don't know if that's your wheelhouse first.st

TARA KIRK SELL:
Yeah, I'll start with that. And and sort of just say, you know, I think that it comes from saying like, Well, what do you expect us to have to deal with in the next emergency? Or what do you think is going to be our next problem that we're going to have to manage, you know, even if it's not an emergency space. Well, a lot of those problems have to do with the communications piece and rumors. And I think a lot of people take comms for granted. They're like I can communicate. How hard is it? And it's like, well. it's very hard, and it hasn't gone well, so you know, maybe we should think about it a little bit. So I think, having those conversations is very helpful. But I also think like when we're doing our strategic planning in health departments. And you know, I'm fortunately on on a health board. So I can see this action happening in real time. But like, when we're building these strategic plans, when we're establishing our plans, we should think about our communication piece, how do we manage rumors and incorporate that into our sort of like. how we deal, how we sort of envision our place in our communities, as you know, a key communicator and someone to help dispel rumors and answer questions health questions in that moment. So I think, you know, taking it to this bigger picture of like, what are we actually trying to manage is really important, and it's also, you know, could be would be a real success. For you know, the communications teams to like have that piece as part of the strategic plan.

MARGAUX HAVILAND:
Great. Thank you. Does anyone else have anything they wanted to add. Okay, all right, we'll skip on to the next. So thanks, Tara. So what is the best approach for nonpartisan institutions in addressing topics that are highly politicized when it can be seen as taking a side. Who wants to tackle this one. Don't all jump off mute at once.

BROOKIE CRAWFORD:
I can try again. It's it's not about taking sides. I tell all my spokesperson you stay away from opinions. We stick to the facts. So here are the facts. And then we we start with that. And here are the facts. Here's the facts about measles. If you have the shot, you're less likely to to get it if you're exposed, that's a fact. So we stick with the facts. whatever it is. If you take your medicine, you're less likely to get sick. You know the facts, and and don't address rumors as telling someone they're wrong. It just just stick to the facts. We don't call out people sometimes when we like in social media, when we're responding, we don't actually even respond to that post. It's a it's a post with under that that just talks, you know, the statement of here's the fact. So that it's not coming across as attack or taking sides with anybody.

MARGAUX HAVILAND:
Great thanks. No, that's really insightful. I appreciate that. And the fact of stick to the facts. All right. So, okay, this is what one of the little, probably a harder one, and folks may not have. So how do you handle communicating when official messages like the Cdc recommendations for vaccines and the recent things with Acog and the Academy of American Academy of Pediatrics from different groups. These official messages.

MAGGIE KUNZ:
So I'll try that one. I don't know if I can completely address it, but we're all struggling with some of this. Luckily, in Maryland, our Maryland Department of Health has really moved forward with developing more. more detailed messaging that we can share in addition to sharing data. So that's been really helpful to be able to use that state source of information that's pretty consistent. But one of the things we're working on is making sure that we're sharing reliable sources of data and information and kind of giving people tools, giving people tools to make the decision themselves. So respecting people's need to ask questions and often providing things in a question. Answer format, so that people feel, as Brookey said, that people don't feel intimidated to ask questions. They don't feel like they're targeted because they have concerns or questions, but they feel like their questions are getting answered. So that's not always easy. But those are the things that we're kind of working on is trying to provide reliable sources of information, accessible, very question and answer formatted sources of information and then encouraging people to talk to their doctor. talk to a trusted source of medical information to get the information that they need to make their own health decisions.

MARGAUX HAVILAND:
Great thanks, Tara, were you gonna come off mute, too?

TARA KIRK SELL:
Oh, I was just thinking, you know, another way to sort of talk about some of these hard issues is just to tell a story about yourself or your own decision-making process, or some of the things that you thought about when you were trying to sort of struggle with. Maybe we didn't struggle with some decisions. But how we thought about it. Did we get our kids vaccinated these types of things? So the storytelling aspect? Or if there are people trusted messengers in your own community, prominent pediatricians, or you know others who are, you know. out there who could be part of this conversation. I think that the facts and the data and the foundation are so important. And then we need, then we can interweave those pieces with these other parts of the you know the information ecosystem. Where? Who, we trust, what people we sort of turn to and tell those stories in ways, you know that people can sort of see the data and see themselves in that in that sort of decision-making process.

MARGAUX HAVILAND:
Thanks. I appreciate that. Yeah, being able to share something where you can relate. So okay, so I'm moving on to this next question. It's a long question. I'm kind of break it up a little bit. How do you address things when the misinformation may come from within your agency? So anything else that you would recommend in those situations. Anything else leaders should be doing to educate staff and increase their media literacy potentially within your agency.

BROOKIE CRAWFORD:
I'm happy to address that one. So we definitely have designated spokespersons. And before you can be a spokesperson you must go through training. So that's you. You can't be out there talking until you've you've actually gone through the training and the training. We talk a lot about knowing your agency's policies. Knowing what the message is, we also are developing products in House very important. We, as soon as the topic comes up, we have talking points for it. And those topic talking points are updated regularly. So everybody's on the same point, page and everybody's sharing the same message. It's another reason. that that's another thing. And then we also have again, we have that plain language training so that everybody's doing the same thing. But if somebody's out there that's sending out a message that isn't, it's immediately handled in house and brought in, and we're discussed, why, they're doing it, and and how we can fix it? Have they not done the training where they acting on their own? And do we need to bring them in a little and reevaluate everything. But I think we have clear policies right up front on who can talk to the media and then those community health workers all have talking points to when they go out and talk with the public. So I think if you everybody has the same message in house, then they can. They can spread the same message.

TARA KIRK SELL:
Can I add something also? There's I think that's it's really great to have that you know that that sort of that message central sort of centralized message. But I also wanted to add something about, you know, there's a second part of this question which is really about? you know. coworkers who may have non science based beliefs about certain health topics. And you know, I think, that a Public Health Department is a hard place for someone like that to work right? And they can feel kind of isolated and feel like they can't have those conversations with their colleagues. And so this is a good moment for civil discourse, right where we can have conversations with people about the things they're concerned about. And this is a good practice for everything we do out in the community. Right? We can start in our own lunchroom and have those conversations. Listen to people's concerns because they probably reflect our community's concerns, so we can have those conversations. Maybe you won't win that you won't convince the person in one day, but having those conversations being open to having those conversations, being, you know, listening to the concerns that people have is really the foundation of what we need to do, going forward to build back that trust. So I think it's a great opportunity, even though it is very tough, you know, to be able to always be managing those conversations. If they're coming at you in the lunchroom.

MARGAUX HAVILAND:
No, I appreciate that. And I think it's 1 of those things like having those tough conversations is never yeah, just like they're tough conversations. But there's also a lot that you can learn sometimes, and the things that there may be avenues that have yet to be addressed in terms of the why. And I think that's really interesting to have those conversations sometimes, because sometimes you learn more, and you learn about new pathways for communication where there may be some things that have been missed in terms of why folks believe a certain thing, and if you can start to find out where all those nodes are and potentially try and address some of those that can really kind of increase the broad base of the understanding. For some folks on both sides in terms of the database and or the thought base of where we're coming from in terms of understanding their perspective and kind of what is feeding into that perspective. So we have a couple additional questions. We only have a couple minutes left. So this is a pretty quick one. Do you put your messages out on media channels that distribute the rumors.

TARA KIRK SELL:
So I'm not sure if this question is about like, do we? If if the media channel is on Facebook, if rumors are being spread on Facebook, do we post on Facebook? I think for most people? The answer is, yes. Some people might not post on Tiktok because they can't use Tiktok at work, but I think I don't know if the question is more about like if it's on like some extremist news site, or like, you know, some web, some questionable website about, like, you know. petals? You know, rumors. And so I think that that's not a place for for public health professionals to be sort of muddling about in. But if it's, you know. a news source that's a little more mainstream, it could be a place for people to go on. But local news is a huge source of of trusted news, and that can be another place to go, which is a little bit more neutral as well.

MARGAUX HAVILAND:
Great thanks, and we got one last question. This is an interesting question. So how do you and I don't know if convince is necessarily the right word. I don't know if we're going to convince anyone anything. It's going to take us a long time to do a lot of convincing, but something is real. They hear a lot of Radon is fake if it's a rumor. But how do you debunk it? If they don't believe in it? Any thoughts from anybody.

BROOKIE CRAWFORD:
Carol probably be the best person for this, but I'm going to weigh in. It's hard to change somebody's belief system. It just does like belief is where actions are and if they're really rooted in it, it's going to be very, very hard to to change it. If and I'm not sure that if that's a rumor out there, I try to address it, if it's somebody's really belief but if they're starting to get other people and having a conversation about it. That's when I would weigh in because I don't want them to deter other people to their belief. But I'm not sure that you're gonna change somebody's belief system.

TARA KIRK SELL:
Not be able to change it. I would, if if there was an avenue of approach that I would take would be like. who are other people that that person might be listening to who may have a story about Radon that they can share, you know, like I found that there was, you know, like, if you were like, I was going to buy this house. And then I got it tested for Radon, and we realized we had to do this massive mitigation prog pro process or something, you know that can be, you know. Maybe they're not going to trust you, but maybe you know their cousin has a story that they could be helpful. So those types of sort of, you know, surrounding people with the information opportunities to change that information belief system that could be the way. But it is hard. I agree with Brookie, I interrupted Maggie, though so sorry about that.

MAGGIE KUNZ:
I was just going to say. The other thing that I try to think about when dealing with health rumors is that you may not convince that person who is making that comment on your Facebook page, or whatever. But you might convince the people who are reading that comment. So I feel like a lot of times. As Bricky mentioned earlier. We don't address. We often do not address things in the comments per se. We address that issue in another post somewhere else, so that this is something that's coming up. We want to address it. But we don't want to get into a conversation with someone that we're probably we're probably not going to change their mind. They're probably just going to get into argument with us. But I do often think about the people who don't comment those people in the middle who don't feel strongly enough to make a comment on our our page, but are reading it and and hoping hopefully, getting that information and seeing that we think it's important enough to respond to.

MARGAUX HAVILAND:
Thank you so much. Everyone. We are exactly all the way up to time. So we appreciate everybody who's joined us today and our wonderful panelists. We will work with Tara to see if we can get those slides clear to see if we can share them with participants.

Thank you so much again. We do have an evaluation link that will be in the chat. So please, we ask if you would, if you enjoyed the conversation today, or if you have some comments for us. please click that evaluation link and let us know. We like to hear your opinions in terms of what you thought about today and want your feedback. It only takes a couple seconds. but thank you so much for joining us. The event was recorded. We will be sharing that out in a post event. Wrap up. But thank you so much again, and have a wonderful afternoon, and be well bye.