Public Compliance with Mass Prophylaxis Guidance

Abstract

In 2008, the New York City Department of Health and Mental Hygiene (NYC DOHMH) conducted a series of 8 focus groups to determine what improvements could be made to existing plans to ensure that the public would adhere to instructions issued during an emergency that required mass antibiotic distribution following an aerosolized anthrax attack. Discussion focused on perceptions surrounding public health emergencies, overall point-of dispensing (POD) strategy, willingness to pick up medications for others, and additional information that participants would need before and during an emergency. Participation in each group ranged from 7 to 10 members. Most participants indicated a willingness to actively participate in emergency response and to follow directions issued by authorities. Some said they would wait to see how others reacted to medication being provided before taking theirs. Participants expressed a universal desire for education on both dispensing plans and diseases before an incident occurs. They expressed concerns about anxiety levels among the public and maintaining adequate security at dispensing sites, though they felt that NYC's plans were generally realistic. The most trusted sources identified to disseminate information were the mayor, the city health commissioner, and a local cable news channel. While many participants indicated they would use the internet to find information during an emergency, multiple delivery methods must be used to ensure the broadest reach within the community, as not everyone has internet access. Health authorities must partner with the public before, during, and after an emergency to achieve the best possible outcomes from a response effort that relies greatly on public cooperation.

How to Communicate with the Public About Chemical, Biological, Radiological, or Nuclear Terrorism: A Systematic Review of the Literature

“…Eight qualitative studies (Table 1) [17][18][19][20][21][22][23][24] provided data on the information people would want to receive during a CBRN attack. Table 2 summarizes the main themes.…”

“…23 How will mass prophylaxis distribution sites be used? 23 Efficacy or rationale Evidence that recommendations are ''tried and tested'' 18 Description of the rationale for recommendations 21,22 How effective is treatment for different levels of exposure? 19 How do people become exposed?…”

“…Eleven qualitative studies [17][18][19][20][21][22][23][24]26,28,31 assessed from where participants wished to receive information before or during an incident. These identified a wide range of preferred spokespeople and sources.…”

“…Eleven qualitative studies contained information about the factors that determine why someone would seek information from a given source. [17][18][19][21][22][23][24]26,28,31,34 Several themes were identified (Table 3), of which trust easily predominated. 17,19,23,24 Trust was composed of several more specific subthemes.…”

“…[17][18][19][21][22][23][24]26,28,31,34 Several themes were identified (Table 3), of which trust easily predominated. 17,19,23,24 Trust was composed of several more specific subthemes. These included: preexisting familiarity with a source; the perceived competence, experience, and expertise of the source; the source's perceived honesty; the consistency of messages between different sources and between the statements and actions of individual agencies; and faith that an individual or organization could be trusted, borne out of experience or a lack of any alternative.…”