How to inform the public about protective actions in a nuclear or radiological incident: a systematic review

Abstract

Background/objective How the public behave following a nuclear emergency will help to determine overall levels of morbidity and mortality. Pre-event education might help to shape behaviour, but how best to engage people with emergency communications for low likelihood, high impact events is unknown. We conducted a systematic review to identify factors which predict behaviour in preparation for a nuclear incident; factors which predict behaviour in the immediate aftermath of a nuclear incident; and preferences among members of the public for information designed to educate them about actions to take in the event of a nuclear incident. Method We searched multiple databases for relevant papers. Papers were included if: they included a sample of the general public, related to an actual or hypothetical radiation incident, explored factors associated with pre-or post-incident behaviour or preferences for information receipt; used self-report or objective outcome data; and were published in English. Results We included sixteen studies which reported factors associated with preparatory behaviour, 23 for factors associated with post-incident behaviour and 26 studies which examined information preferences. In general preparedness, behaviour was predicted by factors including perceived coping efficacy and having children amongst others, but a lack of preparedness was attributed to fatalistic attitudes. Importantly, for pre-incident communications to be accepted and recommendations adhered to, the source must be trusted and perceived to be credible, though it is notable that family needs, such as collecting children from school, are a stronger predictor of behaviour in a nuclear emergency than communicated directives from authorities. Conclusions If pre-incident education about nuclear incidents is to be used, a number of factors, including the source and method of communication, as well as the content and format of messaging, may increase public engagement with messages and promote the uptake of protective behaviours in a radiation event.

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