A critical evaluation of H1N12009 risk communication efforts with children and families

Children are often among the highest risk populations during pandemic. Risk communication before, during and after pandemic is critical to engaging parents in desired behaviors for disease containment. A mixed methods study of pandemic disaster response provides data from 2,608 parents, youth, health care professionals, public health officials, behavioral health providers and legal and ethics experts on their experiences, observations and actions during the 2009 H1N1 pandemic. Findings indicate that unintended consequences occurred, compromising parent compliance specifically and public compliance overall. Parents were overwhelmed by conflicting information from a variety of sources and were uncertain what information to trust and follow. Limited child-focused or family-targeted messages required families to adapt information to their unique circumstances. Vulnerable populations had almost no population-specific messaging, leaving families and children within those groups at even greater disadvantage. Understanding of and compliance with quarantine and isolation instructions and other disease containment measures were compromised. Further, children and their caregivers may have experienced additional and unnecessary stress as a result of incomplete, inaccurate or untimely information. Lastly, risk communicators at local and state health departments were particularly challenged by pace and fluctuation of recommendations that came from federal agencies. Many say they believed the confusion was passed on to the target audiences. Based on these findings, a set of recommended guidelines to develop child-focused and family-targeted peri-pandemic risk communications are proposed.