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No Matter the Technology, Words Matter in Public Health

As important as the actual delivery mechanism is how emergency messages for the general public are communicated, and specifically the choice of words, according to research funded by the Economic and Social Research Council (ESRC).

Photo: Brigitte Nerlich is Professor of Science, Language, and Society at the Institute for Science and Society, University of Nottingham.

Harnessing the power of Internet-based social media for disaster communications is the latest trend in efforts to build effective communication bridges between officials, the media and the general public.

But as important as the actual delivery mechanism is how messages for the general public are communicated, and specifically the choice of words, according to research funded by the Economic and Social Research Council (ESRC), the UK's largest organization for funding research on economic and social issues.

"During the SARS and bird flu scare scientists and health organizations used disaster metaphors, such as 'tsunami,' 'perfect storm' and 'bio-terrorism' to mobilize the media, governments, and individuals to prepare for a pandemic in waiting. Such terms can make people sit up and listen, but they can also lead to panic or cynicism," says Professor Brigitte Nerlich, who led the research. "Recent advice on swine flu has centered on basic hygiene, which makes people feel they can do something practical, instead of being mere victims of so-called 'superbugs' or 'killer viruses'. But obviously this is easier to do when a disease is relatively benign."

Professor Nerlich points out in a news release that easier Internet access might also help people to feel in control, an issue that emerged from a previous ESRC project on foot and mouth disease carried out in Nottingham. Nowadays, and especially in the context of swine flu, "email, Twitter, and public health sites all give information and advice which can be useful to worried individuals and may dampen down panic," she says. "But more research needs to be done in this area."

This research focused on MRSA along with avian flu and was conducted by a multidisciplinary team with expertise in nursing, the social study of health and illness, environmental studies and linguistics. It compared the language of biosecurity, hygiene and cleanliness used in policy documents and media coverage with the language used by hospital matrons and poultry farmers dealing with the realities of MRSA and avian flu. "We found that the way people communicate about a threat largely determines how they understand it and behave towards it," says Professor Nerlich.

Additional findings established that media coverage of hygiene and cleanliness in hospitals tended to portray doctors and nurses engaged in a heroic 'battle' against 'intelligent super bugs. This was personified by the modern matron wielding the weapon of 'cleanliness.' Interviews with hospital matrons revealed a gap between the media portrayal and the reality on the wards. Matrons said that the limitations in their authority over contractors, and time constraints made it impossible for them to spend even half their time as a 'visible presence' on the wards.

"This was another example of the control issue," says Brigitte Nerlich. "Modern matrons have limited powers to limit the spread of infection or improve hygiene. For instance, they can't hire extra nursing staff for barrier nursing or deal with problems with cleaning contractors. Our findings highlight the need for policy messages to be translated more accurately into practice."


Reference: 'Talking cleanliness in health and agriculture,'  a study funded by ESRC. The research was conducted by Professor Brigitte Nerlich, Professor Paul Crawford, Professor Ronald Carter, Dr Brian Brown, Dr Nelya Koteyko and Dr Nick Wright.