Communicating Risk and Promoting Disease Mitigation Measures in Epidemics and Emerging Disease Settings

Objective: This review identifies and assesses evidence on interventions to communicate risk and promote disease mitigation measures in epidemics and emerging disease outbreaks. The study focuses on data that are relevant to low and middle income country settings. 

Methods: A literature search used 5 major electronic databases and other sources to identify studies published January 2002-July 2013.  The review focused on interventions in community, healthcare and multisectoral settings. Quantitative studies were selected according to specific study criteria and assessed using the Critical Appraisal Skills Program (CASP) framework. Conversely, qualitative studies, reviews and editorials were not included. 

Results:  Twenty-nine relevant studies from 16 countries were included.  Most focused on a single intervention or intervention level, rather than multisectoral interventions.  Most evidence relates to programs aimed at behavioral and social results.  Two studies include implications for health service delivery, two examine the intervention’s impact on health systems-related outcomes, and three also have implications for environmental health. Cost- and health equity-related implications are also discussed.

Conclusions:  The paucity of well-designed quantitative evaluations of interventions to communicate health risk and promote disease control measures in LMICs does not allow for any definitive conclusions.  Still, the review identifies several promising interventions or areas for future investigation, including community-based interventions and multi-component and multisectoral approaches to intervention design. Research gaps include impact evaluation on health policy adoption or implementation, and social determinants of health, as well as cost-effectiveness research. Overall, this review identifies several research gaps and questions, and discusses potential directions for more rigorous assessments.