We in public health learn early on that our response to crises can protect communities, save lives, and preserve the public’s trust. Effective communication surrounding a crisis and how it will impact the public is a critically important component of a successful response.

The Centers for Disease Control and Prevention’s manual and tools on “Crisis & Emergency Risk Communication (CERC)” are the gold standard for how to approach this important component of emergency response. The manual and other resources, available at https://emergency.cdc.gov/cerc/index.asp, promote six principles:

  1. Be first
  2. Be right
  3. Express empathy
  4. Promote action
  5. Show respect
  6. Demonstrate transparency

In his new book, The Public Health Survival Guide, Josh Scharfstein describes how he used these six principles as he communicated with colleagues and the public during crises at the Food and Drug Administration, the Baltimore Health Department, and the Maryland Department of Health. When I served as the Commissioner of Health for Virginia, I not only used the principles, but I kept a laminated card with CERC’s key principles and messages in my wallet at all times.

It turns out that these principles apply to much more than crisis communications. They can also build trust among colleagues, strengthen partnerships, and resolve conflict.

Whenever I had a complex communication issue, I reviewed my talking points with my subject matter experts and communications team and made sure I read my card right before I had a phone conversation, met with officials, gave a media interview, or made a public statement. I distinctly remember Governor Tim Kaine asking me what was on the card I was reading immediately before a press conference announcing the state’s first death from H1N1.

After reading the card, I would do a practice run. If possible, I would practice with a communications expert, but if not, I would have an internal dialogue with myself. This “dress rehearsal” really paid off and made the conversation more focused and straightforward, and gave me confidence as I shared important and often sensitive information. From H1N1 to contaminated injectable steroid medications and many other issues, the CERC approach served me well.

When I moved out of my role as a state health official, I didn’t think I would need my “cheat sheet” for communications, but out of habit, I still kept it in my wallet. As the medical director for a health plan, I often needed to explain to clinicians complex changes to insurance necessitated through the Affordable Care Act (ACA) implementation, and I got back into the habit of reading my card right before these meetings. These weren’t crisis situations like I had dealt with before, but I found that the principles of clear, honest, and caring communication were transferrable to many settings.

More recently, as the CEO of the American Academy of Pediatrics (AAP), I pulled the card out again in my first weeks in my new role. The New York Times was doing a story on medical societies taking money from the Coca-Cola Company, and we, like many other organizations, had previously accepted funds from the company. Before my arrival, the AAP Board had voted to end the relationship. While other organizations declined to speak to the press, I worked with our subject matter experts to understand our policies, the Board’s deliberations, and how the decision aligned with our mission and values. I once again pulled out my trusty card and was able to have a respectful and positive conversation with the Times reporter, reviewing how our membership and board had thoughtfully reviewed the Coca-Cola partnership and respectfully declined to renew the relationship. Over my next 3 years at the AAP, I encouraged my leadership and communications teams to adopt these principles, and we developed our own “cheat sheet” card for our members.

Now more than ever, it is imperative to have thoughtful, respectful, and honest discussions with people in our professional and personal lives. The six principles will serve you well in a crisis, but they will also help you build trust with your colleagues and partners and strengthen partnerships with other sectors.

The next time you’re preparing for a challenging conversation or communicating about a sensitive issue, see how the principles work for you. Be first, be right, be credible, express empathy, promote action, show respect, and demonstrate transparency. If it works, you might even find yourself carrying the card in your wallet too!

This column first appeared in the Journal of Public Health Management & Practice, March/April 2019. See the final authenticated version.

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