Agency for Toxic Substances and Disease Registry (ATSDR) 
Evaluation Primer on Health Risk Communication Programs

Preface

Among agencies of the federal government, the U.S. Department of Health and Human Services (DHHS) and the U. S. Environmental Protection Agency (EPA) share the broadest set of responsibilities for determining and communicating health risks to the public. Risk assessment and communications activities have spanned a very broad range over recent years, as illustrated by the work of the National Cancer Institute (NCI) to determine behavioral risk factors for cardiovascular disease and cancer and public outreach efforts of the Centers for Disease Control and Prevention (CDC) to inform the public about the adverse human health effects of environmental tobacco smoke (ETS).

A growing emphasis within the U.S. Public Health Service (PHS) and other federal agencies on determining the value and utility of public health information has created an increasing need for innovative and cost-effective evaluation strategies. As with other health education efforts, health risk communication programs must be evaluated to understand which strategies are helpful and which are not. Health risk communication messages enter our lives in many forms (e.g., advertisements, solicitations, health campaigns, medical care requirements, and word of mouth). This suggests many compounding factors, many problems, many challenges, and complexities of beliefs, values, and behaviors.

The Environmental Health Policy Committee (EHPC) is a standing DHHS committee. It is chaired by the Assistant Secretary for Health and has representation from the PHS agencies EPA, U.S. Department of Energy , U.S. Department of Agriculture , and U.S. Department of Defense.

In 1993, PHS undertook an analysis of health risk communication policies and practices across its agencies with the goal of developing recommendations to improve health risk communication. EHPC charged its subcommittee on risk communication with the analysis. Member agencies of the subcommittee submitted examples of health risk communication activities or decisions they perceived to be effective and examples of activities they thought had been less effective. These examples and findings are contained in the Subcommittee's report "Recommendations to Improve Health Risk Communication: A Report on Case Studies in Health Risk Communication." A major finding of the analysis was that evaluation was the least understood of the communication components. Collecting process and anecdotal information was the preferred method of evaluation, with relatively little or no emphasis on outcome and impact evaluation.

The Subcommittee on Risk Communication and Education developed A Primer for Evaluating Health Risk Communication to assist federal health risk communication practitioners and decisionmakers to help improve their effectiveness in evaluating health risk messages and campaigns. The primer encompasses evaluation principles and practices as a central means for ensuring appropriate goals, content, and outcome of our health risk communication programs.

To address the perceived evaluation needs of various PHS agencies, the subcommittee recommended that each PHS agency consider developing a set of generally accepted practices and guidelines for effective evaluation of communication activities and programs. This primer presents key principles and techniques to assist federal decisionmakers and health risk communicators to improve their overall effectiveness in evaluating health risk messages and materials.

Primer Content Prepared by:

Tim L. Tinker, Dr.P.H., M.P.H.
Agency for Toxic Substances and Disease Registry

Paula G. Silberberg, M.Ed.
U.S. Food and Drug Administration

EHPC Environmental Health Policy Committee Subcommittee on Risk Communication and Education
	US Department of Health and Human Services Public Health Service

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