Write a paper on Health Literacy can help support your final project by reviewing how to incorporate plain language into your communications plan.

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Write a paper on Health Literacy can help support your final project by reviewing how to incorporate plain language into your communications plan.
For this communications plan, use the Strategic Communications Plan Template.

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Disasters and emergencies create chaotic communications environments. This chaos is full of mental noise or distractions precluding full attention to messaging.1 It is during this time, when the importance of information and the impact of distractions are both increased, that individuals have a reduced capacity to remember the information they receive. In fact, it is estimated that people in crisis mode retain only about 20% of the information with which they are provided.2 However, failure to effectively communicate during a disaster is costly not only in terms of rescue operations but also in increased rates of morbidity and mortality.3 Trying to process critical, rapidly disseminated, and complex information in a disaster/emergency environment oftentimes results in conflicting information, decreased self-efficacy, and significant costs of response and rescue operations (not including loss of life).3, 4 Post-hurricane analysis after Hurricane Ike hit the coast of Texas in 2008 determined the failure to follow official evacuation orders increased rescue operation costs by nearly 2000%. Similarly, 4 years after the 2011 tsunami and subsequent nuclear reactor meltdown in Fukushima, Japan, thousands of Japanese citizens now note increased mistrust of authority after mixed, conflicting messages disseminated by the government forced people to be evacuated into contaminated areas twice before they arrived at a safe location.4 Risk and crisis communication are very similar concepts, which may be defined as the effort by concerned experts to provide information to allow an individual, stakeholder, or an entire community to make the best possible decisions about their well-being within nearly impossible time constraints and help people ultimately to accept the imperfect nature of choices during the crisis.5 Currently, evidence-based practices for risk and crisis communication include a focus on being concise by limiting the number of key messages for dissemination and ensuring the timely release of consistent information.69 Such messages may include information on sheltering in place, curfews, infection control, and evacuation routes. Research has shown individuals will believe in and follow such guidance when the person or entity delivering the information is deemed trustworthy.10 Trustworthiness, however, is a complex construct encompassing both perceived empathy and expertise.11 However, expertise is now proving to be a complex concept in and of itself, with individual experiences and perceptions leading to different denotative and connotative definitions of expertise even within seemingly homogenous populations.12 In its current state, then, risk and crisis communication is an inherently complicated practice, despite decades of research into evidence-based guidance and training, consisting of multiple moving parts. Training for those responsible for sharing information with the public in times of emergencies and disasters is offered through state and federal emergency management agencies such as the Texas Division of Emergency Management and the Federal Emergency Management Agency (FEMA). These courses emphasize the importance of a consistent message disseminated through a unified response structure.13 However, different emergency response organizations often have different information that needs to reach different targeted audiences, as well as different resources and capacity. In addition, the relationships established between such response agencies and the public outside of emergencies and disasters may often lead to individuals seeking information from one organization when another has stepped in during an emergency to take the lead in a given area. This indicates the important need for agencies to think more broadly about going beyond just a consistent messagethat is, to develop interagency communication processes that build a flexible foundation enabling them to easily guide the public to the information and resources they need on what could potentially be the worst day of their lives.
Case Study
On August 25, 2017, Hurricane Harvey hit the Texas coast as a Category 4 hurricane with sustained winds of close to 130 mph, nearly 27 trillion gallons of water falling over Texas and parts of Louisiana, and 33 Texas counties under federal disaster declaration.14, 15 More than 31,000 federal employees were joined by a similar number of state employees and more than 300,000 volunteers from nongovernmental organizations (NGOs) to assist in the response effort.16 The challenges faced by these responding agencies and organizations included how to ensure people who needed assistance were connected with those who had resources to provide the assistance. As of November 30, 2017, approximately $31 billion had been spent or committed for Harvey relief and recovery efforts.17
A large portion of the response effort involved a significant number of rescues of both animals and people by responders entering into hazardous conditions. By September 22, 2017, it was estimated more than 122,000 rescues had been conducted.18 Both rescuers and the rescued alike faced significant public health risks.
Storm surge from the coast brought copious amounts of saltwater inland, contaminating sources of freshwater. The U.S. Department of Agriculture reported a significant number of unevaluated animals were at high risk of salt toxicity from the remaining brackish water.19 In addition, much of the floodwater entering the drinking water supply was reported to be contaminated with sewage and chemicals, many of which are known to be extremely toxic to humans and animals.20, 21 The extreme heat and humidity created ideal conditions for explosive growth of mold and bacteria. Indeed, public health officials regularly reported worrisome daily coliform counts, as well as an increasing number of deaths and injuries due to drowning, electrocutions from downed powerlines, and asphyxiation due to carbon monoxide poising (from using generators in closed environments).
Another long-term public health concern resulting from Hurricane Harvey was the increased risk from mosquito-borne disease. The Texas Department of State Health Services (DSHS) reported that, in addition to 990 medical response missions, 3200 medical patient evacuations, 1800 patients treated by mobile medical units, and 70,000 vaccinations provided, 6,765,971 acres were treated for mosquito control as a preventive action against infectious diseases such as West Nile virus, Zika, and chikungunya.22 Anecdotal evidence also arose regarding rashes and skin conditions from exposure to contaminated floodwater.
The Challenges of Communication
With information about evacuations, food safety, illness and injury prevention, assistance with resources, resource donation, and hazard risks all needing to be communicated to a diverse audience of government officials, responding organizations, and the public, there was a significant challenge in coordinating messages across multiple agencies focused on their specific area of response and across large distances. How do you inform people, who are already in a crisis state, about the health risks they face from mosquitoes, mold, mildew, bacteria- and toxin-laden water, food safety, and other environmental hazards without creating confusing messages? How do you connect people in need with those who can provide? How do you place more than 30,000 responders on the same page between the public in need and those responsible for guiding the response effort?
Indeed, it has been noted that when disaster strikes, [this] complex task environment requires multiple organization to transform from autonomous actors into interdependent decision-making teams . . . [and] the ability to provide quality and timeliness of information shapes the effectiveness of emergency response efforts.23 Because of the fluid, ever-changing nature of disaster response, it is common for response agencies to focus on their specific mission. As an agency is often required to spread out its resources, elements from within the same agency may find themselves operating in a disconnect from the larger whole. This necessitates a need to communicate internally as well as across agency lanes.
Based on phone calls and social media inquiries during Hurricane Harvey, it was evident that people were seeking places to evacuate to with their animals (including livestock) and needed supplies both for their animals and for their families, and that others had those resources to offer. The question became how to facilitate the connection between these groups. If each agency just responded to the inquiries it received, many connections would have been missed. In addition, as the rain dissipated, leaving standing water and high humidity in many places, impacted residents began to express concerns about mold, mosquitoes, and muddy water.
The decision was made to include all animal response agencies (Texas A&M Veterinary Emergency Team, Texas Animal Health Commission, sheltering partners, Texas A&M AgriLife Extension) and the DSHS in a once-daily (twice-daily, if needed) phone conference to evaluate requests. As an outgrowth of these phone calls, the creation of #HarveyHotline, a phone number and corresponding social media hashtag, enabled all agencies to consistently steer those in need of information or items to one central location so they could be connected with those who had information to provide. The Harvey Hotline was included in every agencys social media presence, in traditional media interviews, and across both animal and human internal agency communications. The spanning of these boundaries ensured information and resources were shared with a broader spectrum of the public, both urban and rural, in a consistent and efficient manner. Given the diversity of the area hit by Hurricane Harvey, the ability to recognize and respond to the differing needs of the people impacted facilitated a more unified step toward recovery. Using multiple platforms to create essentially a net, each agency not only reached its specific audience but also those tuned in to other agencies.

Case Study
On August 25, 2017, Hurricane Harvey hit the Texas coast as a Category 4 hurricane with sustained winds of close to 130 mph, nearly 27 trillion gallons of water falling over Texas and parts of Louisiana, and 33 Texas counties under federal disaster declaration.14, 15 More than 31,000 federal employees were joined by a similar number of state employees and more than 300,000 volunteers from nongovernmental organizations (NGOs) to assist in the response effort.16 The challenges faced by these responding agencies and organizations included how to ensure people who needed assistance were connected with those who had resources to provide the assistance. As of November 30, 2017, approximately $31 billion had been spent or committed for Harvey relief and recovery efforts.17
A large portion of the response effort involved a significant number of rescues of both animals and people by responders entering into hazardous conditions. By September 22, 2017, it was estimated more than 122,000 rescues had been conducted.18 Both rescuers and the rescued alike faced significant public health risks.
Storm surge from the coast brought copious amounts of saltwater inland, contaminating sources of freshwater. The U.S. Department of Agriculture reported a significant number of unevaluated animals were at high risk of salt toxicity from the remaining brackish water.19 In addition, much of the floodwater entering the drinking water supply was reported to be contaminated with sewage and chemicals, many of which are known to be extremely toxic to humans and animals.20, 21 The extreme heat and humidity created ideal conditions for explosive growth of mold and bacteria. Indeed, public health officials regularly reported worrisome daily coliform counts, as well as an increasing number of deaths and injuries due to drowning, electrocutions from downed powerlines, and asphyxiation due to carbon monoxide poising (from using generators in closed environments).
Another long-term public health concern resulting from Hurricane Harvey was the increased risk from mosquito-borne disease. The Texas Department of State Health Services (DSHS) reported that, in addition to 990 medical response missions, 3200 medical patient evacuations, 1800 patients treated by mobile medical units, and 70,000 vaccinations provided, 6,765,971 acres were treated for mosquito control as a preventive action against infectious diseases such as West Nile virus, Zika, and chikungunya.22 Anecdotal evidence also arose regarding rashes and skin conditions from exposure to contaminated floodwater.
The Challenges of Communication
With information about evacuations, food safety, illness and injury prevention, assistance with resources, resource donation, and hazard risks all needing to be communicated to a diverse audience of government officials, responding organizations, and the public, there was a significant challenge in coordinating messages across multiple agencies focused on their specific area of response and across large distances. How do you inform people, who are already in a crisis state, about the health risks they face from mosquitoes, mold, mildew, bacteria- and toxin-laden water, food safety, and other environmental hazards without creating confusing messages? How do you connect people in need with those who can provide? How do you place more than 30,000 responders on the same page between the public in need and those responsible for guiding the response effort?
Indeed, it has been noted that when disaster strikes, [this] complex task environment requires multiple organization to transform from autonomous actors into interdependent decision-making teams . . . [and] the ability to provide quality and timeliness of information shapes the effectiveness of emergency response efforts.23 Because of the fluid, ever-changing nature of disaster response, it is common for response agencies to focus on their specific mission. As an agency is often required to spread out its resources, elements from within the same agency may find themselves operating in a disconnect from the larger whole. This necessitates a need to communicate internally as well as across agency lanes.
Based on phone calls and social media inquiries during Hurricane Harvey, it was evident that people were seeking places to evacuate to with their animals (including livestock) and needed supplies both for their animals and for their families, and that others had those resources to offer. The question became how to facilitate the connection between these groups. If each agency just responded to the inquiries it received, many connections would have been missed. In addition, as the rain dissipated, leaving standing water and high humidity in many places, impacted residents began to express concerns about mold, mosquitoes, and muddy water.
The decision was made to include all animal response agencies (Texas A&M Veterinary Emergency Team, Texas Animal Health Commission, sheltering partners, Texas A&M AgriLife Extension) and the DSHS in a once-daily (twice-daily, if needed) phone conference to evaluate requests. As an outgrowth of these phone calls, the creation of #HarveyHotline, a phone number and corresponding social media hashtag, enabled all agencies to consistently steer those in need of information or items to one central location so they could be connected with those who had information to provide. The Harvey Hotline was included in every agencys social media presence, in traditional media interviews, and across both animal and human internal agency communications. The spanning of these boundaries ensured information and resources were shared with a broader spectrum of the public, both urban and rural, in a consistent and efficient manner. Given the diversity of the area hit by Hurricane Harvey, the ability to recognize and respond to the differing needs of the people impacted facilitated a more unified step toward recovery. Using multiple platforms to create essentially a net, each agency not only reached its specific audience but also those tuned in to other agencies.
Case Study
On August 25, 2017, Hurricane Harvey hit the Texas coast as a Category 4 hurricane with sustained winds of close to 130 mph, nearly 27 trillion gallons of water falling over Texas and parts of Louisiana, and 33 Texas counties under federal disaster declaration.14, 15 More than 31,000 federal employees were joined by a similar number of state employees and more than 300,000 volunteers from nongovernmental organizations (NGOs) to assist in the response effort.16 The challenges faced by these responding agencies and organizations included how to ensure people who needed assistance were connected with those who had resources to provide the assistance. As of November 30, 2017, approximately $31 billion had been spent or committed for Harvey relief and recovery efforts.17
A large portion of the response effort involved a significant number of rescues of both animals and people by responders entering into hazardous conditions. By September 22, 2017, it was estimated more than 122,000 rescues had been conducted.18 Both rescuers and the rescued alike faced significant public health risks.
Storm surge from the coast brought copious amounts of saltwater inland, contaminating sources of freshwater. The U.S. Department of Agriculture reported a significant number of unevaluated animals were at high risk of salt toxicity from the remaining brackish water.19 In addition, much of the floodwater entering the drinking water supply was reported to be contaminated with sewage and chemicals, many of which are known to be extremely toxic to humans and animals.20, 21 The extreme heat and humidity created ideal conditions for explosive growth of mold and bacteria. Indeed, public health officials regularly reported worrisome daily coliform counts, as well as an increasing number of deaths and injuries due to drowning, electrocutions from downed powerlines, and asphyxiation due to carbon monoxide poising (from using generators in closed environments).
Another long-term public health concern resulting from Hurricane Harvey was the increased risk from mosquito-borne disease. The Texas Department of State Health Services (DSHS) reported that, in addition to 990 medical response missions, 3200 medical patient evacuations, 1800 patients treated by mobile medical units, and 70,000 vaccinations provided, 6,765,971 acres were treated for mosquito control as a preventive action against infectious diseases such as West Nile virus, Zika, and chikungunya.22 Anecdotal evidence also arose regarding rashes and skin conditions from exposure to contaminated floodwater.
The Challenges of Communication
With information about evacuations, food safety, illness and injury prevention, assistance with resources, resource donation, and hazard risks all needing to be communicated to a diverse audience of government officials, responding organizations, and the public, there was a significant challenge in coordinating messages across multiple agencies focused on their specific area of response and across large distances. How do you inform people, who are already in a crisis state, about the health risks they face from mosquitoes, mold, mildew, bacteria- and toxin-laden water, food safety, and other environmental hazards without creating confusing messages? How do you connect people in need with those who can provide? How do you place more than 30,000 responders on the same page between the public in need and those responsible for guiding the response effort?
Indeed, it has been noted that when disaster strikes, [this] complex task environment requires multiple organization to transform from autonomous actors into interdependent decision-making teams . . . [and] the ability to provide quality and timeliness of information shapes the effectiveness of emergency response efforts.23 Because of the fluid, ever-changing nature of disaster response, it is common for response agencies to focus on their specific mission. As an agency is often required to spread out its resources, elements from within the same agency may find themselves operating in a disconnect from the larger whole. This necessitates a need to communicate internally as well as across agency lanes.
Based on phone calls and social media inquiries during Hurricane Harvey, it was evident that people were seeking places to evacuate to with their animals (including livestock) and needed supplies both for their animals and for their families, and that others had those resources to offer. The question became how to facilitate the connection between these groups. If each agency just responded to the inquiries it received, many connections would have been missed. In addition, as the rain dissipated, leaving standing water and high humidity in many places, impacted residents began to express concerns about mold, mosquitoes, and muddy water.
The decision was made to include all animal response agencies (Texas A&M Veterinary Emergency Team, Texas Animal Health Commission, sheltering partners, Texas A&M AgriLife Extension) and the DSHS in a once-daily (twice-daily, if needed) phone conference to evaluate requests. As an outgrowth of these phone calls, the creation of #HarveyHotline, a phone number and corresponding social media hashtag, enabled all agencies to consistently steer those in need of information or items to one central location so they could be connected with those who had information to provide. The Harvey Hotline was included in every agencys social media presence, in traditional media interviews, and across both animal and human internal agency communications. The spanning of these boundaries ensured information and resources were shared with a broader spectrum of the public, both urban and rural, in a consistent and efficient manner. Given the diversity of the area hit by Hurricane Harvey, the ability to recognize and respond to the differing needs of the people impacted facilitated a more unified step toward recovery. Using multiple platforms to create essentially a net, each agency not only reached its specific audience but also those tuned in to other agencies.
Case Study
On August 25, 2017, Hurricane Harvey hit the Texas coast as a Category 4 hurricane with sustained winds of close to 130 mph, nearly 27 trillion gallons of water falling over Texas and parts of Louisiana, and 33 Texas counties under federal disaster declaration.14, 15 More than 31,000 federal employees were joined by a similar number of state employees and more than 300,000 volunteers from nongovernmental organizations (NGOs) to assist in the response effort.16 The challenges faced by these responding agencies and organizations included how to ensure people who needed assistance were connected with those who had resources to provide the assistance. As of November 30, 2017, approximately $31 billion had been spent or committed for Harvey relief and recovery efforts.17
A large portion of the response effort involved a significant number of rescues of both animals and people by responders entering into hazardous conditions. By September 22, 2017, it was estimated more than 122,000 rescues had been conducted.18 Both rescuers and the rescued alike faced significant public health risks.
Storm surge from the coast brought copious amounts of saltwater inland, contaminating sources of freshwater. The U.S. Department of Agriculture reported a significant number of unevaluated animals were at high risk of salt toxicity from the remaining brackish water.19 In addition, much of the floodwater entering the drinking water supply was reported to be contaminated with sewage and chemicals, many of which are known to be extremely toxic to humans and animals.20, 21 The extreme heat and humidity created ideal conditions for explosive growth of mold and bacteria. Indeed, public health officials regularly reported worrisome daily coliform counts, as well as an increasing number of deaths and injuries due to drowning, electrocutions from downed powerlines, and asphyxiation due to carbon monoxide poising (from using generators in closed environments).
Another long-term public health concern resulting from Hurricane Harvey was the increased risk from mosquito-borne disease. The Texas Department of State Health Services (DSHS) reported that, in addition to 990 medical response missions, 3200 medical patient evacuations, 1800 patients treated by mobile medical units, and 70,000 vaccinations provided, 6,765,971 acres were treated for mosquito control as a preventive action against infectious diseases such as West Nile virus, Zika, and chikungunya.22 Anecdotal evidence also arose regarding rashes and skin conditions from exposure to contaminated floodwater.
The Challenges of Communication
With information about evacuations, food safety, illness and injury prevention, assistance with resources, resource donation, and hazard risks all needing to be communicated to a diverse audience of government officials, responding organizations, and the public, there was a significant challenge in coordinating messages across multiple agencies focused on their specific area of response and across large distances. How do you inform people, who are already in a crisis state, about the health risks they face from mosquitoes, mold, mildew, bacteria- and toxin-laden water, food safety, and other environmental hazards without creating confusing messages? How do you connect people in need with those who can provide? How do you place more than 30,000 responders on the same page between the public in need and those responsible for guiding the response effort?
Indeed, it has been noted that when disaster strikes, [this] complex task environment requires multiple organization to transform from autonomous actors into interdependent decision-making teams . . . [and] the ability to provide quality and timeliness of information shapes the effectiveness of emergency response efforts.23 Because of the fluid, ever-changing nature of disaster response, it is common for response agencies to focus on their specific mission. As an agency is often required to spread out its resources, elements from within the same agency may find themselves operating in a disconnect from the larger whole. This necessitates a need to communicate internally as well as across agency lanes.
Based on phone calls and social media inquiries during Hurricane Harvey, it was evident that people were seeking places to evacuate to with their animals (including livestock) and needed supplies both for their animals and for their families, and that others had those resources to offer. The question became how to facilitate the connection between these groups. If each agency just responded to the inquiries it received, many connections would have been missed. In addition, as the rain dissipated, leaving standing water and high humidity in many places, impacted residents began to express concerns about mold, mosquitoes, and muddy water.
The decision was made to include all animal response agencies (Texas A&M Veterinary Emergency Team, Texas Animal Health Commission, sheltering partners, Texas A&M AgriLife Extension) and the DSHS in a once-daily (twice-daily, if needed) phone conference to evaluate requests. As an outgrowth of these phone calls, the creation of #HarveyHotline, a phone number and corresponding social media hashtag, enabled all agencies to consistently steer those in need of information or items to one central location so they could be connected with those who had information to provide. The Harvey Hotline was included in every agencys social media presence, in traditional media interviews, and across both animal and human internal agency communications. The spanning of these boundaries ensured information and resources were shared with a broader spectrum of the public, both urban and rural, in a consistent and efficient manner. Given the diversity of the area hit by Hurricane Harvey, the ability to recognize and respond to the differing needs of the people impacted facilitated a more unified step toward recovery. Using multiple platforms to create essentially a net, each agency not only reached its specific audience but also those tuned in to other agencies. Application of CEPH MPH Competencies This case study addresses CEPH competencies 18 and 17. Competency 18: Select Communication Strategies for Different Audiences and Sectors Hurricane Harvey proved to be challenging for response efforts. As mentioned earlier, it was an unprecedented storm requiring unprecedented communication strategies. In the past, multiple agencies were able to disseminate messages crafted for their specific audiences with minimal cross-coordination. In the case of Harvey, however, the overwhelming need to provide aid and the numerous requests for help and guidance quickly overwhelmed the previous strategies used in prior disasters. The population impacted by Harvey was diverse, including both urban and rural residents living in areas of both high and low socioeconomic status. There were pet owners, livestock owners, and those who owned both. In addition, multiple languages are spoken along the Texas coast, with differing cultural values determining whether people responded through evacuation or sheltering in place. For the residents in need to be able to quickly understand the public health hazards from the standing water and downed powerlines, find available resources to move out of harms way, and prepare for recovery by comprehending simple concepts such as food and drinking water safety concerns after a disaster required a multi-agency communication response. Each agency, by sharing information on a daily basis, were then able to disseminate the necessary information through media (both social and traditional) in a manner appropriate to those needing the guidance. Not every resident places trust in every agency, and certainly not every person sought information from the multiple agencies involved in the Harvey-impacted areas. Being able to turn to trusted sources and get a consistent message assured residents they could place confidence in what was being said. One example of how this net had a positive impact on the communities hard hit by Harvey involved the explanation of mosquito control concerns. Even though the actual spokespeople at each agency were not environmental scientists, epidemiologists, or entomologists, gathering information from the DSHS surveillance experts helped all agencies communicate the dangers of an exploding mosquito population post Harvey, as well as explain how residents could protect themselves and their pets from both the mosquitoes and the spraying conducted to eradicate as many of the disease vectors as possible. The agencies dissemination of agency-specific information tagged with the Harvey Hotline number enabled many residents to access a preferred source and then receive information they perhaps would not have received otherwise. Competency 17: Apply Negotiation and Mediation Skills to Address Organizational or Community Challenges This case was also a demonstration of leadership. With so many agencies having so much information to disseminate, each thinking its own message was most important, negotiation and mediation became a necessity to provide the organizational foundation for consistent communication. It was decided that a state agency, the Texas Animal Health Commission, had the best linkages to people in the impacted area, as well as the capacity to create and manage a hotline. This organization became the hub of the net created and established the daily teleconferences. All the other agencies attended the conferences, shared information gathered from the field, discussed important guidance to be disseminated, and invited in other agencies as the environment and response effort changed over time. It has been shown previously that effective and timely communication can save lives in a disaster. Moreover, the bigger the disaster, the more necessary it becomes, as an agency spokesperson, to act as a boundary-spanner and connect the agency and the agencys audience with a broader source of information. This creates a solid foundation of confidence upon which people in need can base their protective action decisions, and it empowers them to do so from an informed perspective.