Today, the U.S. Food and Drug Administration (FDA) published a new report titled Communicating Risks and Benefits: An Evidence-Based User’s Guide, edited by Baruch Fischhoff, Noel Brewer, and Julie Downs. The report is freely downloadable in PDF format.
I haven’t had a chance to read it in detail (yet), and I’m sure it will be a long time before I fully absorb the volume of useful information contained therein. But, even a cursory review of the chapter topics, authors, and key sections has left me deeply impressed.
Put simply, I think this document should be required reading for anyone and everyone interested in and/or practicing risk communication (in medicine, health, or otherwise). Period.
Why am I so strong in my language? Because as much as the last decades have seen advances in our understanding of people’s risk perceptions, the cognitive and emotional processes that people use to translate risk information into personal meanings, and the types of techniques that can (sometimes) result in improved understanding of risk, we still see a large number of risk communications using fundamentally flawed approaches. Even when we see risk communications using evidence-based approaches in some aspects, they don’t follow the evidence in other ways. And that’s not good enough.
The report includes four major sections:
- Cogent discussions of basic principles of risk communication (e.g., identifying the goals of risk communications, approaches to evaluation, duty to inform, language)
- Cutting-edge summaries of research on processes of risk communication (e.g., communication of quantiatitve data, communication of qualitative risk understandings, health literacy, affect and emotion, communication across the lifespan, and issues when communicating with healthcare professionals)
- Multiple chapters on key principles of communication design (e.g., readability, human factors, warnings, shared decision making, media coverage, and inter-organizational communication)
- Perspectives on implementing evidence-based communications (from agency, researcher, and practitioner perspectives).
What impresses me the most about this document is that it combines both good summaries of research evidence but also clear guidance for practitioners. Many chapters have subsections titled “What general practice advice can the science support?” and specific advice for evaluating communications based on these criteria.
Kudos to the FDA for supporting this initiative. Kudos to the editors for assembling the volume and to the authors for their hard work in not just writing the chapters but in making them useable.
Now it’s our turn. Our turn to read, to learn, and most importantly to put the lessons and advice assembled here into day to day practice.
I bear this responsibility as much as any one of you does. Yes, my research is part of what is cited and summarized (in particular in the chapter on quantitative data communication authored by my friends and colleagues Angie Fagerlin and Ellen Peters). But I know I don’t know as much as I should about readability, warnings, literacy, etc. Topics that I should know about as a researcher in this field. Topics I need to use to inform my work and to pass on to my students.
It has been too easy to put off reading the research in these areas because it has seemed too daunting of a task to catch up on all of these disparate literatures. I can barely keep up with the literature in risk graphics, let alone everything else. But, today’s FDA report takes away that excuse, because it’s all there, condensed and available.
It’s time for me to step up to the plate and make sure that I truly embody the goal of being an evidence-based practitioner of risk communication in all of its many dimensions. It’s time for me to get reading.
I hope you all will join me.
Brian J. Zikmund-Fisher is an Assistant Professor of Health Behavior & Health Education at the University of Michigan School of Public Health and a member of the University of Michigan Risk Science Center and the Center for Bioethics and Social Sciences in Medicine. He specializes in risk communication to inform health and medical decision making.