Appreciate the post, comment and link.

Blogs, wikis and new media don't try to replace authoritative sources like CDC, but we can engage the public about things for which there is not yet consensus (e.g., use of masks or tamiflu, rationing, prioritizing flu vaccine for children, complementary medicine) so that informed discussion can take place. Citizen participation using new media, be it from interested laypeople or physicians, can only enhance the CDC's ability to do its job to help us. In addition, because it's more interactive than traditional media, reaction and ideas can be more of a dialogue and less than a monologue.

Welcome to the 21st century! Glad you're here with us.

DemFromCT
Editor, Flu Wiki

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This comment is sparked by two of Jay's entries: "This blog can save your life!" and "Health Communication: Science and Art."

Dr. Jay Bernhardt wrote: "New media efforts to engage and galvanize the public like FluWiki, Green Hammer, and the Slidell Hurricane Damage Blog are critical to CDC's ability to prepare for and respond to an influenza pandemic and to other possible public health emergencies"

Here we are—a bunch of talented people (and I explicitly include the FluWiki and other blog participants, alongside those of us who are communicators by profession)—struggling to prepare for problems of potentially unprecedented magnitude and completely unknown near-term likelihood, like a flu pandemic. And we are communicating with each other, and noticing that it helps in our planning.

There is real two-way risk communication going on between government officials at CDC, private consultants, international agency advisors, and citizens from a broad swath of backgrounds. Input from "unofficial sources" is hitting our radar screens (more than that, we are seeking it out), and it is mostly being received with respect and gratitude.

And the participant-citizens are—just maybe—starting to see some of "us" agency types or agency advisors as human, even though we are representatives of our agencies.

I am heartened by the launch of Jay's blog, and his reaching out to the participant-citizens.On a broader scale, I am heartened, grateful, and full of admiration for HHS' welcoming response to all the outside input it has received since its August 2004 draft pandemic plan. Some of the input it received was scathing—I know, because I submitted some of the most scathing—but HHS was open to it all, and used it to improve its risk communication.

That is the encouraging news, reflected in Jay Bernhardt's blog and in the work of his agency.

But as Dan Rutz commented:

"the need for messaging will often exceed both the science that ideally would fully inform its content, and the science by which such messaging is crafted and dispensed.

"A bit of humility in considering how strong a foundation we stand on should, I think, help reconcile tension over which communication discipline is or should be dominant. We shouldn't let the science of communication lull us into a sense of self assurance. The point is, the science just isn't good enough, and until it is we are forced to experiment in our actual communication practice. It is most appropriate for CDC to recognize this and, through our National Center for Health Marketing stretch the envelope, and thereby advance the field."

Dan and I have argued hard over the years, in ways that nevertheless cemented our friendship, about all the unknowns and uncertainties about various risk communication strategies. But we have never pretended that we were sure we were right. Although it isn't quite as dark as it used to be, we still know that we are working in the dark. The field still isn't fully the "science-based" field that some practitioners portray it as. We have to humbly own that, and be ready to notice when our recommendations are not working, or when other people come up with better ideas to try.

Congratulations on opening up this blog, Jay. And it is particularly fitting that Dan Rutz, who has for so long been corresponding on these issues with an unusually open mind—and insisting that others keep their minds open—is your first guest-blogger.

(My comments here represent my own views, and are not made as a representative of the World Health Organization.)

Warm regards,

Jody

Jody Lanard M.D.
Short-term consultant in risk communication (until November 1),
Emergency and Humanitarian Action unit,
Western Pacific Regional Office of the World Health Organization
Manila, Philippines

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Thank you for mentioning my blog Greenhammer, and for letting me know that you did! I am always happy when my work is useful in some way.

I am currently engaged in a project of "social marketing": I am organizing my neighbors to respond to an earthquake. The biggest barrier is a feeling of isolation and discontinuity, even among people who live close to one another. There is no common culture that binds people together into a naturally cooperative unit.

I am watching and listening carefully to discover what my neighbors have in common. We all share a fear of disaster, but beyond that our joint intentionality must be generated ex nihilo, as it were. My best guess at this point is to supply tangible materials for my neighbors to benefit from (I am delivering cases of bottled water) and to provide concrete activities for my neighbors to participate in (I am planning an earthquake response drill).

I hope a tangible and concrete approach will breach social isolation and provide a foundation for cooperation. I want to see how the folks talk to each other when they're walking around the neighborhood during a drill, trying to accomplish urgent tasks. Perhaps the reality of that activity will reveal a commonality of which we are not aware.

Thanks again for your attention!

Best regards,

—David Baum
Greenhammer.net
Bellevue, WA

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Regarding David Baums plan to organize an earthquake response drill in his neighborhood… Please research whether there is a CERT team in your city/neighborhood. CERT stands for Community Emergency Response Team, whose goal is to train citizens to care for themselves and others in time of disaster… be that an earthquake or pandemic. This vital training is of benefit to EVERY citizen. The national site is www.citizencorps.gov/CERT.

Sincerely,

Leslie Hogberg RN
Public Education Director
Metro Omaha CERT

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I am encouraged to see some thoughtful responses to my latest posting. I was getting worried that no one is reading it. There is no question that new media can be more than just a communication channel inn protecting and promoting health, and this brief exchange proves it. I agree with Dan's and Jody's statements about the evolving science of health communication, risk communication, and health marketing and the need for expanding and harnessing the evidence base. There are many research gaps that must be quickly filled, including the shift of electronic communication to include more user-developed content. Only though active collaboration and diverse participation, can we hope to "stretch the envelope" and "advance the field." Thanks for contributing to the dialogue.

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I just wanted to let you know that the online preparedness communities are continuing to grow. On November 15, 2006, my online discussion forum will be celebrating its one year anniversary in pandemic flu community planning. Our general planning forum is located at www.AvianFluTalk.com. A few months ago, we also launched a secondary discussion forum website that focuses on local level planning, therefore, each state on this new site has its own respective forum. By each state having its own forum, this allows people to communicate and plan with others who are located within their own area. Feel free to visit the state forums at www.PandemicHelp.org.

Best wishes,
Ryan Evans

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Because of the example of the FluWiki and other fora (planforpandemic) I have started a planning forum specifically for my town (http://monsonpandemicplan.forumportal.us/index.php).

My thought was that the citizens would feel more comfortable with more personally applicable information and this is a great "meeting place" for town planners to interface with the public.

I am just beginning to invite the citizens now. I am still hitting a brick wall but this is a starting point. Instead of announcing a pandemic I can announce a forum that has solutions to some of the problems.

I am sure that there are folks out there who could do a much better job than I at building something like this. If you think it is a good idea people can duplicate the site for their local municipality.

JMVHO, citizen based grassroots efforts are the way to get people planning.

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It's great the CDC is getting into blogging. And I ditto the comment about bloggers and sites like the one I write for About.com being no substitute for the CDC site who build their content on primary research planned and funded by the institution itself. About.com looks to be an everyman's blogger, but aims to source anything that's not clearly an opinion using references that are either official government sites or peer-reviewed journals.

Like you said, the CDC is not as "popular" as sites like MySpace or YouTube, but it should be since the CDC has stacks of the best information in the world. I believe the CDC could do a lot more to be "cool" without losing credibility. Your blog is a good example.

Sincerely yours,

Anna Spector

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It is great to see CDC jumping into the 21^st Century. Your blog is one of several CDC initiatives that indicates the potential for CDC in using knowledge management, intelligent social networks, and vehicles for collective intelligence. I would love to see CDC do more with decision-making and interactive media. Persuasion and social marketing has its place, but ultimately, CDC has to do better with enabling decision-making at the local level.

The most vulnerable in any emergency will live or die based upon decisions made at the household, business, neighborhood, and community level. It is nice to have generalized information about health and risks in persuasion formats, but ultimately the resilience of Americans and their communities will be depend on the resilience of social networks at the very local level. We now have far better tools to enable these resilient networks. CDC will have a very important role to play in enabling and optimizing these local and regional infrastructures over time. We look forward to your leadership in this area in the years to come.

Mike

Michael D. McDonald, Dr.P.H.

President, Global Health Initiatives, Inc.

Coordinator, NDRCI
National Disaster Risk Communication Initiative

Co-principal investigator
Psychosocial Dimensions of Biosecurity Preparedness and Response Initiative

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CDC is not as "popular" as sites like MySpace or YouTube but it can be as long as you think search engines when posting new topics. Try to use key phrases in the topic of each new blog. This way the search engines will list your blogs in priority so that visitors can find the blogs easily and thus the exposure starts to rilly grow. CDC has a very important role to play in getting the message out there.

I like what you said that New media also can be an important channel to disseminate CDC's health information during emergencies. Use the search engines to spread the word.

Warm regards,

Michael Wilson

Search Engine Optimization Expert.
http://www.searchengineoptimizationcompany.ca/
Founder of Google SEO group.

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I have noticed that the site fluwikie is unfortunately not operational anymore. I would like to collect and provide similar services on http://www.medicaladvices.com/. Would you recommend some government and other sources which could be used for the purpose? Thanks in advance.

Sinead from Medical Advices

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I have just found the CDC blog while searching the role of "new media" in health emergency preparedness, risk communication, event response, and mitigation.

It appears that this blog, although informative regarding the state of the CDC, does need to be more visible in regards to an emergency. I would propose Google allow for free "PSAs or "Public Service Announcements" for government emergency purposes in the search engine. This would allow a vast majority of Americans to keep on top of things in the event of an emergency.

For now, keep up the good work, this is a great step forward for the CDC.

Anthony Loera
President, RevGenetics
www.RevGenetics.com

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The link to the Fluwiki site has been fixed. Thank you for bringing it to our attention.

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