How to Make Health and Risk Communication on Social Media More "Social" During COVID-19

"...seeks to promote a democratic policy approach that can change how internal and external international and local organizational discourse is conducted in order to reduce the discrepancy between organizational intentions and practical applications in the field."

Health organisations use social media to interact with citizens, to foster citizen participation, to further open government, and to analyse/monitor public opinion and activities. In this paper, based on her previous research in the field of emerging infectious diseases (EID) communication and health and risk communication, Anat Gesser-Edelsburg contends that despite the utility of social media, international and local health organisations have been slow to adopt them, primarily due to the discrepancy between the inner discourse within organisations and the way they communicate with the public. The paper discusses how organisations can transform theoretical notions into risk communication strategies and tactics that can be applied during a global pandemic such as COVID-19 and other epidemiological crises as well.

To help organisations become more "social" in their social media presence and in their health and risk communication, Gesser-Edelsburg proposes an integrative approach that combines three complementary paths:

1. Insert more "social" content into internal organisational discourse - "Effective dialogue with the public is based on transparent, open and diverse health and risk communication, which can only be part of an organization's social media campaigns if they are also part of the organization's own communications culture. Indeed, information transparency begins when an organization recognizes different voices and is able to reveal the decision-making processes leading to a specific policy." The paper discusses the following challenges and makes recommendations for managing each of them:
   • Organisational groupthink and hidden profiles: Health organisations should adopt a decision-making approach that is open to diverse opinions and disputes and does not block discussion.
   • Emphasising on scientific consensus while hiding disputes: Organisations should heed marginal opinions and provide a respectful and reasoned response on social media indicating why they decided on opposing policies and guidelines.
   • Accusing those who criticise the organisation as being "people with agendas": Organisations should welcome engagement with other experts instead of shaming them.
   • Conflicts of interest, including those exposed on social media, that interfere with decision-making: Organisations should minimise conflicts of interest, through steps outlined here, instead of exposing them.
   • The assumption that the public is overly emotional and irrational: Organisations should address the questions and concerns the public raises (e.g., about vaccination) on social networks and reveal the organisational considerations upon which the guidelines were based.
   • Diminished funding for risk communications experts: Organisations should find a way to involve these specialists, who can design appropriate and effective social media campaigns for different population groups based on professional theories and models from the field.
2. Use strategies to enable health organisations to respond to the public on social networks - "During the COVID-19 pandemic, the citizens of most countries across the globe were forced into lockdowns or to practice social distancing. Consequently, more than ever the social media became the arena for social interactions." The paper discusses the following challenges and makes recommendations for managing each of them:
   • Erroneous or false information that triggers skepticism and resistance: Health organisations should change the pejorative framing of the term "infodemic" into something more neutral so as not to generate resistance or a boomerang effect among certain groups when trying to address the problem of misinformation.
   • The categorisation of all unofficial information as misleading: Organisations should address each piece of information objectively and differentiate between various types of information.
   • Failure to address the public's emotional needs: Organisations should consider using narrative - e.g., telling the story of various groups' experiences during COVID-19 to reduce stigma and fear toward these groups.
   • Framing uncertainty in terms of absolute certainty: In the interest of full transparency, organisations should acknowledge and proclaim uncertainty.
3. Engage the public on social media based on the participatory approach, which considers the public as a partner that understands science and can work with the organisations to develop an open and innovative pandemic realm. The paper discusses the following challenges and makes recommendations for managing each of them:
   • The dualistic paradigm of ignorant public versus knowledgeable experts: Organisations should promote online citizen science projects.
   • Insufficient public engagement in solving complex global problems: Organisations should use crowdsourcing to solve complex global health problems.
   • Demographic factors that influence risk understanding and interpretation: Organisations should tailor their messages according to socioeconomic, cultural, educational, and other contexts, rather than using "one-size fits all" messaging.
   • Failure to consider different groups in decision-making: Organisations should implement a "convergence communication approach" that involves regular and ongoing two-way communication with laypeople, scientific experts, and other expert third parties.

Gesser-Edelsburg then explores some of the reasons behind the discrepancies between the approaches in the health and risk communication professional literature and their actual implementation in the field. For example, most health organisations are based on a structure that is primarily hierarchical and much less cooperative and democratic, and this structure affects how information is processed and disseminated. People's egos often come into play as well.

A concluding message: "Effective dialogue with the public is based on transparent, open and diverse health and risk communication in the social media realm....An organization's social media campaigns can only include such features if these are already part of the organization’s own communications culture."