I'm Dr. Angela Michelide, the Vice President of Programs and Education here at ACPM, and I'm delighted to welcome you to today's webinar. The American College of Preventive Medicine is a professional medical society of approximately 2,000 physicians dedicated to improving the health and quality of life of individuals, families, communities, and populations through disease prevention and health promotion. Our members are licensed medical doctors who possess an expertise in a broad range of healthcare skills, including biostatistics, epidemiology, management of healthcare organizations, research, and the practice of prevention in clinical settings. They work in a variety of workplaces, including hospitals, government at the local, state, and federal levels, the military, laboratories, business, and academia. In 2023, ACPM will be hosting a series of leadership development webinars focused on the core competencies. These will include advocacy strategies to promote the preventive medicine profession, charting your career journey, and publishing your research. I'm delighted today to have the pleasure of introducing our very first leadership development webinar on Crafting the Message, Media Influence and Public Health. Our esteemed speakers are Dr. Jade Colburn and Dr. Chris Purnell, and they'll be sharing their background with you during the content of their presentations. But for now, I would like to just provide a few housekeeping tips. You'll be prompted to participate in this webinar momentarily, but please stay on mute when you're not speaking. This recording will be posted in the ACPM Learning Management System so that you can view it again or share it with your friends. We ask that for the time being you type your questions into the chat box. And also, ACPM will be sending you a brief feedback survey after the webinar, so please respond so that we can improve our offerings. And now I will turn the podium over to Dr. Colburn. Thank you so much, and thank you all for being here today. My name is Jade Colburn, and everyone can hear me, right? Yes, my name is Jade Colburn, and I'm going to be talking about Crafting the Message, Media Influence, and Public Health with Dr. Chris Purnell. Dr. Purnell is an ACPM Regent-at-Large. She's the former Chief Strategic Integration and Health Equity Officer at University Hospital. She was named one of the best 50 women in business and a public health hero by NJBIZ. She appears across TV, radio, and print media, and regularly speaks at professional symposia and public forums on topics of health equity and racial justice. Dr. Purnell received a bachelor's degree in psychology and neuroscience from Princeton University, a doctor of medicine from Duke Medical School, and a master in public health from Columbia-Millman School of Public Health. She also completed her Johns Hopkins General Preventive Medicine residency. My name is Jade Colburn. I'm a PM2 and Chief Resident at Johns Hopkins General Preventive Medicine Residency Program and an MPH candidate at the Bloomberg School of Public Health. I received my bachelor's degree in biochemistry and molecular biology from Mississippi State University and my doctorate of medicine from the University of Mississippi Medical Center. I also completed my clinical training in pediatrics at the Harriet Lane Pediatric Residency Program in 2021. I have done two formal elective rotations in medical journalism with the ABC News Medical Unit since May of 2021 and remained involved voluntarily since that time. Largely, I'll be speaking from my experience working with the medical unit and what I've learned from medical journalism and how I apply that to health communication. Our objectives today will be to discuss the evolution of health communication and really understand why this is a topic coming up now, what we can learn from the media, and what the media can learn from us as a profession and as public health leaders. By a show of hands, I'd like to get a sense of who all is in the room today. Could you raise a virtual hand or if you prefer to come on video and raise a hand of who has experience with the media? Great. Hi, Srishti. It's great to see you. It would be nice. Srishti, do you mind coming off mute and talking about what your experience with the media is? Dr. Bingham, would you mind saying what your experience is as well? Sure. Yeah. Hi, Jade. Hi, Dr. Purnell. Like Jade, I also recently completed my rotation at ABC News Medical Unit. We were involved in essentially become... Well, we were the medical experts for everything that came on as far as ABC News is concerned. The basic role there was to simplify the language that research studies or any medical... Simplifying medical jargon for consumption for a common public. I think that is a good summary of what all we did. That could be for TV, for news, for various scripts that went out to the nation and so forth. It was a great experience. I recommend it for anybody who is interested in this field. Thank you. Thank you. Yeah. I suppose I would say I didn't work with the media, but I have given some interviews and been quoted in some books. I have been that person. It is an interesting learning experience. It was before preventive medicine. Be very careful what you say. Yeah. Yeah. Thank you. I am glad we have some also representation from behind the scenes and in front of the camera in the group today. Thank you so much for sharing. Now we are going to do another kind of interactive piece with Mentimeter. If you don't mind scanning this QR code, that will take you to the link and we are going to build a word cloud of how you would describe the media using one word. You should be able to submit more than one answer. You could also go to this link if you type that into a browser. I am going to give everyone a little bit of time to get set up. Clara, let me know when I need to stop sharing my screen to share the word cloud. Perfect. Thank you. And if you haven't done word cloud before so as people submit the same word, you start that word becomes becomes bigger so it seems like something really standing out from this group is is biased. We have quite a quite a range of words, both from important to confusing to sensational impact dissemination nonstop. A lot of you are picking up on how much there is in the media, and how much content is shared, both acknowledging some challenges that we have in the media, and some opportunities that we might have as as public health physicians. is now also coming in there with biased. All right, we're going to go to one more question. This will also be, this will also be interactive and it may play on kind of the same thoughts that were coming up when you were choosing these words to describe the media. How does the media influence public health? Thinking about media influence a little bit more specifically to our field. So as you type your answer, we'll start to see things scrolling, but I know some of you are probably just taking time. It affects decisions. Strong effect, yeah, both for better and worse. Can change the perception of risk. And I find risk perception to be something really hard, really hard to sometimes convey from a public health and population level perspective. Disseminates information. It may politicize public health. Conceal dissent, generate strong opinions and reactions. May influence policymakers in people's perspectives. And maybe sways opinion. So again, we're getting a lot of mixture of maybe some pros and cons of the media's influence and what the media has the power to do. But it sounds like we all kind of agree that there is influence on public health in the media. It can create bias. can be fear-based. And so there's a lot of differences in the media and how maybe even how one story is portrayed or one issue is portrayed. Thank you all so much for sharing. We're gonna keep going through the presentation, but I would like you to kind of hold this idea and maybe hold these thoughts the more we talk and the more content that we go over. Some of your thoughts may change and some may be the same. So to first understand why we're talking about this today, I think it's important to understand the evolution of health communication. Before we had a lot of the technology that we do today and kind of mass media, communication was largely between smaller groups of people in smaller networks. And so it was really face-to-face that people communicated. Maybe you talk to people over the phone, but really you were talking in smaller social networks between family members, coworkers, people you've lived near geographically. And when we talk about health communication specifically, a lot of that information was really conveyed at the bedside or the provider and the patient were talking about health information face-to-face. Then we had a new form of communication in television and radio. And this necessarily didn't change those smaller networks of how people were talking to each other, but it did expand how information could be shared among a large group of people. It still was sometimes still limited geographically, but you could get messaging out to a large population at a time for the first time. Then we entered the era of the internet and computers. And this was the first connection that people had really to much more broad networks. And so people both had information and a connection to each other in a way that had never been done before. So this changed how communication was both consumed and communicated. And we very quickly entered the era of smartphones and social networks. And this was a really drastic change, particularly in the social network sharing. It expanded the platforms that information could be shared on, and it created really large online communities where people may have a shared set of beliefs. They wanted to share information or get answers to questions that they had. And it all became accessible through these smartphone devices. And so now you really had access to information all the time if you wanted it. The somewhat in the recent years, this has become very much a part of our everyday life. And if you go back to how we as clinicians have been trained and physicians have been trained through medical education and how we talk to people and how we communicate health information, a lot of our training in medical education is still focused at the bedside because there was a time when that was the only place and the place where people consume their health information. But now we're entering an era that physicians may not be as comfortable in or may not have as much training or experience in entering some of these social platforms and communicating through these broad social networks in the media, which is why we're talking about it today and talking about some things that we could do differently to communicate to these larger lay audiences. When we entered the COVID-19 pandemic, this really shifted, I think, health information in a way that had never been done before for a large group of people. Health information became all that was consumed during this time, and it really built the perfect environment to create also some downsides to us not being as comfortable in the space of health communication and people having access to information from many places. To understand the infodemic, it's important to first define misinformation. And so this is inaccurate or misleading or false information according to the best available evidence. In an infodemic, as defined by the World Health Organization, is too much information that includes false or misleading information in digital and physical environments during a disease outbreak. And this can cause confusion, harmful risk-taking behaviors, mistrust in health authorities. It can undermine public health response and intensify or lengthen outbreaks. I'm sure if we run around the group that's here today, we could all give a real-world example of all of these consequences of the infodemic. Like I alluded to earlier, our competencies in health communication have really been focused in understanding research methodology, understanding the scientific process, understanding biostatistics, having comprehension of these concepts and translating it largely to a scientific audience. Something that I think we largely lack in our education and our skillset or maybe feel less prepared in is communication with a lay audience. I'm gonna talk about my experiences that I draw largely from my work with ABC News. It's been the only opportunity that I've had in my medical education doing these two electives where I could really conceptually understand the principles of journalism and how to apply them to change the way I communicated as a health expert. And so I'll talk about what I've learned and maybe what we all can benefit from this experience with the media. First, accuracy is so important and I think it comes first and foremost for us even in this field. I'm not saying that accuracy is always conveyed in the media but it does build credibility. And I think good journalist and the foundation of journalism is really built on being a credible source of information and that begins with accuracy. I put this up here because it can also be easy when you're trying to talk about a very complex topic to maybe conflate or exaggerate a type of headline or exaggerate a finding. And that can hurt your credibility when you're not being accurate with the information and what it means to people. So I always like to keep that in mind and really check myself to say, is my sentence accurate? Is this true? Don't bury the lead is a phrase that comes from journalism. It's built off of the inverted pyramid of journalism. And this is maybe the most helpful tool that I've used to shape particularly my writing and health information. It's important to remember the points in red. First, that the critical information must go at the beginning. And so you lead with the lead. The most critical information also known as the five W's in news story writing, the who, what, when, where and why. And keep in mind that the audience may stop reading at any time. And so that's why our headline and the information that comes immediately after it is so important. I think we've all scrolled through news headlines, scrolled through social media platforms and you may not read a full article. You may not read the full content. And that is true for most people that are consuming this information. And so thinking about that in our writing is really important. Then after the lead comes the body. This is still helpful information, but it's not critical. It may be useful for understanding, but even if it's left out or if someone doesn't read it, the main message is still communicated. And finally, the tail is always nice, but not necessary details to understand the content or the purpose of the story. Avoid medical jargon. It sounds like a really simple ask, but it's something that I think I've struggled with the most. We get so comfortable talking in medical jargon and using certain words that it becomes really familiar to us. I try and check myself and use a pretty iterative process to go back and always see if there's a word that I can change, that I can simplify and it still maintain its accuracy. Or I ask myself, would my grandmother understand this sentence? Would my grandmother understand this message or would the way it's phrased or the words I've used be confusing? You don't wanna confuse your audience. You want them to be able to consume the information you're giving in a way that they can receive. And most people read between a sixth and an eighth grade reading level. And so you also have to be conscientious of that. Using active voice is also very important in news writing. And I think it does help to make messages a little bit easier for a lay audience to understand. And so two examples of that would be instead of writing, it's recommended by doctors to get an annual checkup every year. You would say, doctors say to get a regular checkup once a year. Or instead of writing rates of vaccinations, you would say vaccine rates. And keeping in mind this use of active voice can help decrease your word count, but also to be more clear, but more concise. When I've written a news piece or when I'm thinking about writing a takeaway, I again, go back to that iterative process. I always think, how can I phrase something more simply? How can I use, how can I explain a concept more clearly? And this helps to create a story that doesn't let people get lost in the weeds, but it still conveys the appropriate content in a clear and concise way. I'm gonna give an example of how one might take original research or research paper and convert it into language that's better suited for a lay audience. My first example is gonna be a study summary that I did, which is a regular activity that's done in the medical unit rotation, where you're really trying to take a piece of research. You're summarizing it in a way that is not quite like an abstract, but maybe a similar concept. And so where the abstract is kind of your meat of the article, if you'll say, the study summary should convey to a person reading it what the study is about, who it affects, and why it matters. We get into a really good routine in our scientific writing to really stick to this format, where we give our introduction, our methodology, then we say our research findings, then we have a discussion and we take it home with a concluding point. I shuffle this around and it helps me write these more succinct summaries by changing that order so that my results and my findings always come first. I hope the errors aren't too confusing, but I tried to take what was in my brain and put it on the slide for you. Sometimes it may also repeat some information that could be in a conclusion or the conclusion repeats some of those results and findings. My biggest takeaway from here is that your findings come first. Then you can talk about the methodology. Then you can give maybe a little bit more context in the intro or discussion and take it home with a concluding point. This also kind of takes us back to that inverted pyramid where we're hitting that most critical information from the very beginning, so that if someone stops reading, they have a takeaway that they can understand. And so I changed this abstract into this summary. And so with my findings first, my headline becomes a new study shows advanced cervical cancer is more common among black women, but rates are rising the fastest among white women in the South. Those were two of the main takeaway points from the findings of this study. Then I break it down into methodology. And I do like to sometimes combine my methodology with a little bit more detail in the findings of the body, just to reiterate that point that you get in the headline. And so here I said, researchers analyzed nearly 30,000 cases of advanced cervical cancer from 2001 to 2018 using the US cancer statistics data and found that a rare but advanced type of cervical cancer has been increasing, especially among younger white women in the South. Still, this type of cancer is almost twice as prevalent among black women compared to their white peers. This study also found that HPV vaccine rates were lowest for white teens and white women were significantly less likely to have cervical cancer screening done on time. So this body allows me to give a little bit more information about some of the details of the findings that maybe didn't make it completely in the headline. And then I follow with some of the discussion. What's the context of this issue? Overall, cervical cancer rates have been decreasing over the last 20 years, but this study shows that rates of advanced cervical cancer, though rare, are rising in the US. This type of cancer has a low five-year survival rate and could largely be prevented with early screening and HPV vaccination. Finally concluding, this study is only able to analyze reported cases of advanced cervical cancer, so the results may be an underestimate. I put in a little bit of limitation here for context but still these findings show it's important to maintain efforts that target appropriate accessible cervical cancer screening and HPV vaccination. And so this type of study summary in the role of what we did in the medical unit would really be shown to other journalists or maybe producers that wanted to get an idea of what this study means and if it's something that was gonna be covered on the network. This type of study summary can then be converted into a written piece for a more lay audience. I really wanted to highlight this piece because I think the exercise of doing this with studies has helped me in my communication maybe the most overall. And so if this is an exercise that you find helpful if you wanna get practice in your study summaries or in breaking down scientific information into this format for a lay audience, I would encourage you to try this exercise and see what's maybe harder than you thought about it and try it on some people that maybe aren't scientifically minded to say, can you understand what the study was about? Does the way I break it down make sense? And that can help you sharpen these skill sets in writing. So when these get converted into, this is a digital story that was published. I am gonna take that same format and highlight the pieces that pertain to that kind of lead, if you will, in our inverted pyramid. And so my headline changed to late-stage cervical cancer still on the rise, despite ways to prevent, detect, and treat early. I ask myself these questions kind of in that place of those five Ws. I really wanna make sure that my story is to the lay audience. Name, who does this affect? Why does this matter? What information is new? How is it found? And what does this mean? The section of what does this mean is usually where I'll put in a quote from an expert, a final takeaway message, or maybe even an action statement to the audience to tell them what to do with this information. I didn't have time to put this on the slide, but that would go after these top main points. And so right away, you can see that the audience would understand this piece is about cervical cancer that's caused by HPV. And why is this virus significant? Nearly all sexually active men and women will get the virus in their lifetime. And so right away in the first sentence, you give the audience context of what the story is about and why it should matter to them. They also can understand in a simple sentence that the rates of advanced cervical cancer have increased over the last two decades, according to this new study from the University of California, Los Angeles. Again, why does this matter or who does this affect? It affects 13,000 new cases and it takes 4,000 lives a year. I try not to overwhelm people with too many numbers, but it can help to add context as to what is the magnitude of this problem. And then after that information, I'll go into more details of the specific findings and some of the methodology to show what information is new and how it was found. I'd like to start the next section to be a little bit more interactive so that you can take some of this information I've talked about and work through a real world example of what this would look like and how a headline would be built. And so Clara is gonna put in a PDF into the chat box that's about this new study that just came out on maternal mRNA COVID-19 vaccine during pregnancy and Delta or Omicron infection or hospital admission for infants. I don't want you to get overwhelmed by the content because I don't wanna spend time on you all also getting lost in the weeds, but I do wanna give you an opportunity to focus on specifically the findings of this study and work together in a group to write a headline. One member of each group will present their headline and we'll show you the headline. One member of each group will present their headline and we'll show all the headlines together and talk a little bit about what's different about the headlines, what is similar in the headlines, maybe what was difficult about this process or what you didn't expect to find. And so we'll have some time for group discussion. Does anyone have questions about the structure of the breakout rooms or any questions about the content of the activity? I see no hands. All right, Clara, do you have a final count on our number of participants? I'm seeing about 19 who would be sent into breakout groups. If you're able to sort people, we can go ahead and start the breakout rooms. We'll give, let's do about 12 minutes in the breakout room. So you have time to chat with each other, to review the content and then decide who will present for your group. Hi, everyone, and welcome back. I think we've still got maybe about half the groups to come back. Feel free to stay on video. I love seeing other people's faces. Nice to see you, Allison. Good to see you too. Great job. I think we've still got a couple more groups. When you said 12 minutes, Dr. Coburn, it seemed so long and then it went by so quickly. I know, it always does. I wish I could have given you more time, but I think some of the time pressure can also reflect the news environment a little bit more authentically than anything else. I am going to write on the screen and if I could have the first person from breakout room one. Let me know your headline and I'm going to type it here for everyone to see. I'll do that for each group and then we'll have a discussion. See the differences, similarities, talk about what was easy, what was hard. I'll let group one start. So whoever would like to represent that group, you can just come off mute and hit me. Hi everyone. I was in group one. I'm Laura from I'm a first year med fellow at Mount Sinai. Nice to meet everyone. So our headline was obtaining COVID vaccines during pregnancy protected newborns from COVID infection and hospitalizations. All right, group two. I think we were group two, I'm not quite sure. My name is Isha and I am a PrevMed resident at the University of Wisconsin-Madison. And I had John Bingham in my group and Cara, who's one of the ACPM staff people. John's another PrevMed resident. And our headline was, vaccination during pregnancy lowers risk of COVID infection and hospitalization in babies after birth. COVID infection in... And hospitalization. In babies? Yeah, after birth. Awesome. All right, so already with our first two, there's a little bit of differences. Even though kind of our main takeaway, we're both talking about protecting infants against COVID-19. The first, obtaining COVID vaccines during pregnancy protected newborns from COVID infections and hospitalizations. Then we're in a little bit different way. Vaccination during pregnancy lowers risk of COVID infection and hospitalization in babies after birth. All right, group three or the next group if you don't remember your number. I don't remember if we were group three or four. That's okay. So I'm Allison. I'm a PrevMed resident at Texas Department of State Health Services in my first year. And I was with Neil and Adam and Dr. Grande was in there as well. But so we came up with COVID-19 vaccination during pregnancy, lowers risk for infection and hospitalization of newborns. I can repeat that. I talk very fast. That's okay. It helps with my typing skills. COVID-19 vaccination during pregnancy lowers risk for infection and hospitalization of newborns. All right. Still a unique headline, which I love. All right. And I think our last group, I think we just had four breakout rooms. My name is Sven Leamo. I am an attending public health infectious disease epidemiologist at the VA on the Northern edge of Boston. I also teach residents in preventive medicine. I've been doing this for 23 years. We didn't have time to quite come to a consensus. I sort of felt listening to the residents that they got kind of like caught up in technical minutiae about the term trimester. Whereas my experience from talking to numerous town halls, you know, veterans and employees and skeptical relatives and alike, you know, it was best to focus on safety and efficaciousness of a vaccination during pregnancy for both the mother and the infants. But we didn't quite have time to wrap that up in our discussions among the group. Yeah, that's all right. I think that is really helpful for our discussion too. Thinking about our minds do get really fixated on the details and I think that's very natural and that's what we've been taught to do a lot of the times. I think this is a really hard exercise even though it sounds so simple. Just write a sentence, just write a headline, but it's really hard and it should feel difficult. When thinking about the right words to use, I also like to keep in mind, you know, what could confuse the audience? Would everyone know what trimester is? Would everyone know what obtaining is? Or how could we say that in a different way so that there's less room for confusion? Maybe we could say, getting a COVID vaccine or getting two COVID vaccines during pregnancy, protected newborns from COVID infections and hospitalizations. It again, isn't medical jargon, but still thinking about, you know, what people are gonna understand and what people are gonna read and interpret are always things that I like to do. And I think doing it in this collaborative way and using that iterative process to go back and say, okay, how can I say this more simply? How can I leave less room for confusion? Would anyone else like to comment on what they found challenging with this exercise or what maybe surprised them about this exercise? Jade, I think Isha had contributed that she liked the use of the word protected instead of lowers risk or. Yeah, I think that's a great observation because I, let me get off my annotation. Like I said earlier, the keeping in mind like perception of risk and talking about perception of risk, I think is really hard in public health communication. And it's not something that the general audience may understand, you know, what does that mean? And so I think that's a really good observation that you pointed out. Protected gives people a better sense of what you're talking about as opposed to the language we might use in our field of lowers the risk for. Thank you for sharing that. We also have something in the chat from Neil. Even the term rates could be confusing for some. Yeah, yeah, I agree with that. It could be confusing. Is this an exercise that you all find useful in your goals for wanting to be better health communicators is doing something like this and changing the way you think about kind of this idea of a headline or a takeaway? I think synthesizing an article and I think you picked a really good one to try and just like get us to distill it down into a single sentence, even just saying not a headline but just a single sentence summary that anybody would understand is a really good exercise for sure. To build off of that, I would say that it was really helpful because I think, you know, not just in the small groups but coming back as a larger group, being able to see that all of the groups came up with some aspects of like a way to like make the message more understandable but nobody really, I feel like captured entirely like the simplest possible way to portray this particular message. So I think like just having more people talking about it, like we're able to see like, oh, there's even a way to like make this simpler which is good for us to like always be thinking about like even things like risk, right? Like we talk about risk all the time but like that is something that we need to like really try to convey in a different way if we're trying to talk to a lay audience. Yeah, I agree with you completely. I'm glad that this demonstrated that. Neil, did you have something you wanted to share? I saw your hand up. Well, for most people, no matter what the setting whether you're in private sector and I spent a lot of time in state government and you're asked to do interviews live on radio, sometimes television. And I agree with Alison and Isha that if we think this is hard in 12 minutes trying to say the right thing, clearly avoid jargon, Jade, as you'd said. It just kind of opens up why this is both an art and science that is communication. Risk communication is an entire chapter unto itself, but most of us will have to do it. Not necessarily as a local health officer in COVID but in some capacity in front of executives in front of some audience or as happened with me on COVID I was asked in my faith group when actually two congregations met and they asked three doctors to do a Q&A and it was the same kind of thing. How do you explain it in a way that helps but doesn't move into kind of a scientific logic model that wouldn't help anybody? Yeah, that's a really good point. I'll give my headline just so I can and also share with the group. COVID vaccine during pregnancy can protect young infants against COVID. So even still a little different. I like the word protection often when I'm talking about kind of the purpose of vaccines. So it's a word that I find that I use commonly when I'm talking about what the purpose of vaccines is or what the benefits of vaccines are. Thank you all so much for your participation. And I really enjoyed this interaction through everything and stop my annotation. I am that Neil, your thoughts and your reflections on how difficult it is to spend this message as a perfect segue into turning the floor over to Dr. Chris Purnell, who is gonna share her experiences from being in front of the camera, going from me behind the scenes to Dr. Purnell in front of the camera to talk about exactly that. Thank you, Dr. Colburn. I think this has been such a helpful and fascinating opportunity so far to really understand how one to navigate communications more effectively and to how then to communicate what is the most important, the most priority, or the most salient thing that you think the person, the executive, the faith group or more broadly, the public needs to hear. You can advance the slide for me, Jade. And as some of you may be aware, I lost my father on April 13th, 2020 to the COVID-19 pandemic. And it happened at a time when we knew so little. While losing my father, I was a senior healthcare executive at a state academic health center in Newark, New Jersey. So I was also seeing the disproportionate impact of COVID on our population in New Jersey, in particular in a predominantly African-American, Latino community and neighborhood. And those two occurrences, in addition to my sister being a long COVID survivor, several other family members losing their lives to COVID, influenced my decision to begin to speak up. And it really started with me making the choice to enroll in a COVID-19 vaccine trial. And I think it's so important that I drive that narrative home first for you all, because as physicians, we must be comfortable owning stories and creating narratives so that people can, one, understand what's the most important takeaway point, or what's the most salient fact or truth, or behavior that we want to instruct and guide around. Sometimes when I speak with people, they're like, well, what do you really want me to do? And I start there because I want you to hear that I lost my dad. I want you to hear that I was a healthcare executive, and I want you to hear how that influenced me to enroll in a COVID-19 vaccine trial. And so I use that as an example of how I communicate with the public when I'm before them. And too often, I think that doctors stick to just the science, and human beings don't operate that way. Behaviors do not happen in a vacuum. Behaviors travel in social networks. Behaviors really are social decisions. They're social movements, if you will. And to understand how important the emotional aspect of hearing science information, the emotional aspect of understanding risk, and how we as physicians can navigate that to ensure that we still get out the truth, the accurate information, because people will be bombarded with misinformation that Dr. Coburn spoke about, and disinformation, which I put into the chat earlier. And so around fall 2020 is when I first got asked to talk about my personal experiences, and was my choice to enroll in a COVID-19 vaccine trial. Before then, I had been doing a host of Zooms, meetings before community groups, before faith-based groups, meetings in the hospital, text conversations, phone conversations with very, very frightened and alarmed residents in Newark, in the greater Essex County area, in New Jersey. And so I was comfortable communicating around the specifics of a COVID-19 pandemic, as comfortable as anyone can be, right? Because there was so little that we knew in the beginning of this pandemic. But by fall 2020, I would say, things began to really declare themselves around just how disparate the impact was on black and brown lives. We had a understanding of how the virus was being transmitted, and we knew we needed people to agree to get vaccinated, so that we would have a critical mass of the population vaccinated. And I began to think about those personal conversations I was having with family members, because people knew I was enrolled in the trial. And I said, I would like to use this opportunity to help educate people more broadly. And I got a request from a regional outlet, Y Media, that produces content for New York, New Jersey, and Pennsylvania, primarily Pennsylvania and New Jersey, but some areas of New York, about why I enrolled. And from there, a CNN producer saw that tidbit when it was tweeted out. And I think it's so important that people know that, because people often ask me, well, how did you get on TV? It started from a regional outlet. The site investigator said, Chris, would you be willing to share your story? Someone came to me and said, we need someone to talk about their decision to get vaccinated. And I said, yes, because of what I had experienced personally, and being in public health and preventive medicine, knowing the importance of narrative, knowing the importance of storytelling, especially for groups who are disproportionately impacted or those who are historically excluded, marginalized, or stigmatized. So that really led to an avalanche, and that's the best way that I can describe it, an avalanche of opportunity to help navigate a frightened public, to help translate information for people, whether it was the neighbor down the street, or millions of people across the airwaves, or writing something in a print article, so that people would be able to make choices in a self-efficacious way, right? So self-efficacy is the ability to make an informed choice or decision, especially when there was a lot of misinformation and disinformation, and that was happening at a critical time. And so from those very preliminary experiences that I had in the fall of 2020, I ultimately was asked to start to write about my journey and to start to write about my why. When speaking with the public, and this is true for public broadly, not just specific to the media, but when speaking to the public, it is important to understand the why. Why are you speaking? It is important to understand what do you want to communicate? It is important to say, how do you want to impact people? It is important to say, is there a action or is there a behavior that you want to influence, shape, or guide based on this communication? And there was increasing daylight around the topic of systemic racism and how systemic racism and oppression more broadly was driving the disproportionate outcomes that we were seeing during this pandemic. And I use the word daylight deliberately because as a person who is focused their practice around issues of health equity, around issues of anti-racism and intersectional justice, we have not always spoken about these issues in authentic, open, honest, and transparent ways. And that really became a signature for me. I remember once when I was on CNN, the producer had said, I saw on your Twitter page that you call yourself a health justice and a racial justice warrior. And that became the tagline for how they introduced me, Dr. Chris Burnell, a fellow health justice warrior. Because, and people are like, well, is that okay to do? For me, that was right to do. And I want to give that an example because you are still an individual when representing an organization or when speaking as a translator, because that's what I was, a translator and a navigator to the public. You were still an individual and this was still personal for me. So one of the pieces that really resonated with me personally and resonated with others was when I was asked by NBC Think. NBC Think was an opinion outlet that NBC was trying around the same time that MSNBC was starting MSNBC Daily, so opinionated pieces. And I was asked, would you like to write about how systemic racism has influenced the outcomes in the pandemic through the lens of why did you enroll? Because I hear you talking about it so frequently. And literally this is how the producer approached me. And I said, yes, I'd love to have an opportunity to write about that, because I want it to be able to drive home the point. And then who was I trying to communicate this point to? I wanted to communicate it to decision makers. I wanted to communicate it to policymakers. I wanted to communicate it to the current White House administration. I wanted to communicate it to lay persons. I wanted to communicate it to people in my ministry who are always calling and texting me. I wanted to communicate it to all of the groups in the Newark, New Jersey area who had said, hey, doc, help me understand why you as a black woman, you signed up for this. You know what has happened to black and African-American communities. And using all of that understanding influenced what I chose to write about in a opinionated piece. So there you see, I'm in a COVID-19 vaccine clinical trial to honor my father, fight racism and exercise my power. And I wanna focus really briefly on that title because oftentimes when you are a physician and you have a relationship with someone in media, whether it is an editor or whether it is a producer, they will do just what Dr. Coburn took us through. They'll say, okay, how would you say this? And you say, well, this is how I would like to say it. And then they begin to pull out what they think are the most salient points of how you choose to communicate it. And that came from a mixture of several lines throughout the piece that had been published. And again, I say this because I want everyone to understand this. Sometimes you have power, explicit power around how your words are represented in the press. And sometimes you have partial power. So for instance, you see another print piece there that was in Blavity. And that one talks about where we were in the pandemic. We were in a dip, right? We have ebbs and flow across this pandemic. Still trying to get people to focus on the work of health equity. When I was writing for MSNBC Daily, frequently I would have a conversation with the editor. I don't like the titles that you all choose. And I wanted to have that level of authenticity with you all here, because I would say, hey, this is what I want the outcome of this particular piece to be. I want it to drive understanding. I want it to help create safety for someone who has to make a choice or decision, or I wanna challenge a policymaker. And still the editor would say, this is the best way for us to represent what we believe is the most important thing. And I only wrote for MSNBC Daily four times because that was too much of a struggle for me. I felt that I had less power in that situation than I wanted, right? So here the media can hear from me as a physician, as a black woman physician, as a healthcare executive, as a daughter who lost her father, as a sister who's sister is a COVID-19 survivor. And you can say, yes, I believe this is the most salient thing that should be communicated, but I can retain my agency and say, I don't wanna write anymore in that type of opportunity because sometimes I feel maybe you are pulling out points or you are highlighting points that are not the most important thing. And I think it's really important for you all to hear this because as physicians and as an individual operating in this particular opportunity, you can influence, shape and guide the media. But ultimately, if you feel that the way with what you're communicating is being presented lacks authenticity or lacks accuracy, you can make a decision to exert pressure and to say, I would like to correct that. Sometimes it's easier in print than it is on air, but you never lose sight of that. I wanna make sure everyone listening understands that. And Jade, if you could go to the next slide for me. And so print media is different from being on air. And I'll set this up because I also want you to see the clip. This was, I believe with Aaron Baldwin, this was a 11 a.m. hour, right? And so I give you those context details because producers have certain demographics that they know watch their shows at certain times. They like to put certain things forward. What was important for me and why I chose to appear in the press because you often did not see a black woman physician, a black woman healthcare executive being the person to help the larger public decipher and understand what was happening during an unprecedented crisis. And I wanted to step up to the plate and own that opportunity, especially because black and brown groups were being disproportionately impacted. And so, we'll talk about this a little bit further. I didn't take every media opportunity that came to me even on air, but I was also keen about what would be good to position those broader goals and even goals around helping people to understand what a public health and preventive medicine physician is. And so here, we're gonna listen to a clip. This is around the time that it's around vaccination during pregnancy. And you see CDC study, vaccination during pregnancy can protect baby. Okay, let's play that. This is Dr. Chris Purnell. She's a public health physician, a fellow at the American College of Preventive Medicine. It's great to have you here in person. Thank you. So Walensky's saying, we're assessing, we're gonna follow science. Is the science there? What do you think of what the director said? She said what I expected her to say, and I think what the public needs to hear. Well, Kate, the game clock is still ticking. We can't afford to pause and we can't afford to stop playing while the movement is still in motion. We need to be watching case levels, case levels in a very hyperlocal fashion, meaning how many infections are there where you live? What are the access to vaccines, to treatments? What's the surge on our hospitals in the community where you are? Are we ready to pull back some of those very bedrock and baseline public health preventions? I don't think that we are. And if we're following the data and the science, then we will be doing what's in the best interest of the most vulnerable. You're hitting on something that I think is really important. With all of the rules of the road on this, this far in, the question is, what is the bar? What is the measure? What is the metric that we think is going to tell us or all of us when we can loosen up and also conversely when restrictions and guidance needs to tighten up again? It's on the case count. And if you look at the case count, they say areas of high transmission, that's essentially the entire country. I think it's 99% of American counties. What do you think the right metric is this far into the pandemic when we are getting through this Omicron wave now? There is no one metric, right? In public health, we're always talking about the multiplicity of strategies, a layered approach. So we're not only looking at our positivity rate. We're not only looking at how many cases per 100,000 people. We wanna know what's happening on the ground for those communities. And in particular, I'm concerned about those very vulnerable and marginalized communities that were devastated by this pandemic. Do they have access to vaccines and therapeutics? Are their hospitals having a surge on beds? Do they have access to the high quality masks? Those are the things that we must be asking in a very, very consistent and critical fashion. On the vaccine front and as it relates to pregnancy, a new study was just published by the CDC that found that infants of mothers who had had two vaccine doses of either Pfizer or Moderna had a reduced risk of being hospitalized with COVID during their first six months. You have to take that as obviously that's great news. What can that data tell us? What should everyone, not just women who are looking to get pregnant, what can that tell all of us, do you think? It tells us the power of good science, right? The fact that we have these mRNA vaccines that are not only able to protect the mom, but to provide protection in utero and then post-birth for the child, that's fascinating. And that shows us that this public health tool is not only safe, but it's effective. And it's the greatest tool that we have in that toolkit right now. And it should just reassure the public that we are following the science in a very methodical and rational fashion because we wanna do what's in the best interest of those who are most vulnerable. And we know that pregnant women can have a higher chance of having more severe disease. Oh, absolutely. And I mean, speak of the most vulnerable, I mean, both pregnant women and their unborn children are the most vulnerable when you're looking at this. So it's right, good on science. It's good to see you. Thank you for coming. Good to see you. Thank you. Thanks for sharing that, Jade. And I think I will just wrap up with saying what I was just communicating, you saw in action. So I go into that segment knowing, okay, we want to talk about what the CDC director, Director Walensky had just said. We wanna talk about this new study that had been published. And there usually is a quick back and forth, meaning via email, very rarely via the phone with the producer of the segment, right? So the person who's off air and says, what are your most important points or facts or what do you wanna communicate to the audience? And I'll lay that out. And then that's the last that I know what they take of what I decide is important and then how it goes into what graphics they show, how it goes into which questions that the on-air reporter will ask. I don't know what questions the on-air reporter is going to ask. So I sit down and it's like game time. Literally, I use that because of the example that I used about the game clock. And I have learned to appreciate that because that's often what people in the public are faced with. They're faced with this pressure of ideas or pressure of facts, pressure of misinformation, pressure of disinformation. And they have to be able to navigate that, decipher that and still focus on or slow down time so that they can make a self-efficacious choice or decision. And so that was one of several appearances on scene and even my most recent out and with this. So for instance, I was asked a question twice. I was asked a question by the one reporter, it's the morning show, so the three, and then I was asked it again by the other anchor. And I felt that they were leading me in a certain direction. I didn't see the graphics. I felt that they were leading me in a certain direction while they kept asking that question, but I didn't think that was the most important point. And I did not think that that was something that we could infer from what we knew. And so this was about Senator John Fetterman. We knew he had a history of cardiomyopathy. We knew he had a history of stroke. And the most important thing, I'm a preventionist. So I wanted to communicate to the public, how do you recognize a stroke? What do you do so that you can save someone's life? And then the process of saying, what are the risk factors that might put someone at higher risk for experiencing stroke or experiencing a reoccurrence? So thanks, thanks for the opportunity to be a part of this conversation and look forward to discussing through questions. Thank you so much. I'm just wondering, you talked a lot about kind of the preparation. I'm wondering what your process is and how much time that usually takes per segment when you go on air. Great, so on air is a fascinating animal, okay? Certain times you are given 24 hours. My most recent appearance on CNN, I got an email at midnight. I happened to see it. And the producers were like, there was a fast breaking story. Would you be willing to come on virtually at 6 a.m. to discuss this? So I had that much time to think about it and still be a human and sleep and get up and clean myself so I could appear virtually. So sometimes I have, I would say several hours to just really give thought, do my own research. I don't just take in what the producers or the editors give me. I do my own research as a physician, right? So I'm saying, okay, what's been published about this? What are others saying about this in the press? What are my peers saying about this? Are there position statements on it? And then I distill that down to what I believe is the most important or salient facts. So that's the range, anywhere from six hours to 24 hours. But the only other thing I want to add to that, I've been in a scenario where literally I'm sitting like I am today. I am about to go on air and a producer says in my ear, hey, there's another study that's breaking. We want to ask you about this. And literally I'm going on air in two minutes and I'm like, okay, show me the study, please. And so, and I did exactly what Jay just taught. I go immediately to the conclusion. I want to know what the study found. And then I skim really quickly to look at the methodology and say, what do I feel that I can talk about accurately and in a constructive way for the public? So that's the variety. If you're going to play this game of on air contribution, you do have to be aware that you can get last minute requests and that those requests can come at odd times. I want to turn over to the chat now. Sven is wondering what your strategies for speaking are about or messaging to vaccine hesitant or even anti-vax populations. Definitely. So I use stories. I go to narrative medicine as a tool, a very powerful tool in my toolkit, in my back pocket to help people understand the factors that go into making a choice, a decision and a behavior. I'm very keen on using language that does not force or take someone's choice, but to help them arrive at a decision in the most safe or effective way. I talk about experiences in my family. I talk about experiences in my personal life, or I talk about experiences of people that may have been published, right? Other stories that were very compelling. I definitely acknowledge the truth. I acknowledge the systemic racism and how white supremacy really has infiltrated how communities of color and persons from historically excluded and stigmatized groups perceive clinical research, perceive science. I can tell you establishing that level of authenticity allows the audience to say, okay, this is going to be a truthful conversation so I can trust. This is going to be a respectful conversation so I can trust. Whether or not they trust is a different thing, but it's a signal that you can trust. And then I try to use social math. And some of you may be familiar with that term. I also put that in the chat box earlier. And a person who's brilliant at social math, Dr. David Williams. Dr. David Williams, he talks about how racism, how the toxicity of discrimination and bias leads to premature aging and death in black and African-American persons. And so the social math analogy that he uses is a jumbo jet. So he says roughly 220 people can fit onto a jumbo jet. A jumbo jet worth of black people are dying every day prematurely, right? And so when speaking with groups who are at different literacy levels, when speaking with groups who may have been, let's say in an environment with more misinformation or disinformation, not only narrative, but using data in a way that is easily understandable. And social math is one of those ways. It's something I use, especially around this issue that is very charged. Thank you. Neil is wondering, he mentions a few different types of social media sources, blogs, short videos, podcasts, tweets, et cetera. And is wondering if we could each speak on effective use of social media to advance health and wellbeing as one source better than another, for example. I can start just speaking from my experience. What influenced me to start learning about medical journalism and learning about the power to infiltrate misinformation is the fact that I, you noticed my training was in Mississippi before I came here into Baltimore. And so my communities were very susceptible to misinformation, disinformation across Facebook platforms. And I thought that me being a trusted community member in a lot of those spaces as someone who could create content might be impactful to kind of break up some of that noise. And so that really inspired me to go and seek the first elective I did at ABC News. It was the only one I could find. And I wanted to try and learn how to communicate better, but also produce content that I could share from my own writing that people might be more tempted to click through my Facebook community. And so that was the source I chose because it was the community that I was trying to reach and the community that I had some type of relationship with already that I thought I might be able to influence. Okay. And what I can add to that, and I wanna make sure you all are aware of this, from time to time, I have worked with communications or public relations firms. So what started in the media and the press for me started in an organic fashion, but then became more controlled because I would have to navigate whether or not I could do something in my official capacity as an employee of a state hospital versus something in my personal capacity or versus something representing ACPM. And having a public relations firm was really helpful for me to keep those things totally separate from the hospital. One, I wanted to put that out there. And then working with the PR firm that worked with ACPM around the Vaccine Confident campaign, right? Thinking through what should we put on social media and what different social media platforms where we knew this information was very crucial to get across. I had to train myself to become more regular at using Twitter. It wasn't something I naturally liked to do. And I would say, okay, Chris, you can't just retweet. I'm not a person who sits there and says, let me say something about this. It's more natural for me to be on air and to give a contribution that way. But you have to know where the different environments of 4G, which types of communities and populations, who's on Twitter versus who's on Facebook versus who's on Instagram. Then I would get requests to do Instagram Lives with the Urban League, Instagram Live, with a smaller faith-based group, something that they could portray out to their audience or a network that could be amplified through who was already captive in that audience to hear this information. And finally, those who are able to use social media effectively really become very large voices. There is a medical student, Joel Burville, the young African-American medical student who has become one of the most widely heard, sought after and requested voices on issues around systemic racism and how it impacts healthcare because he understands Instagram. And he knows how to use it. And he understands TikTok and he knows how to use it. And so whether it's been the NMF or other credible agencies partnering with him, he's been able to cultivate those followings to drive understanding. And the final question just to touch on from Laura, she's acknowledging reasons why she may not want to engage, the fear of saying the wrong thing, inaccurate information, or the way people may react negatively like trolls on Twitter, for example. Do you have any recommendations of how to engage but to keep these kind of negative realities in mind? You have to. I'm an African-American woman, Laura, and I can tell you that Tucker Carlson really came after me. He came after me very hard. And for quite some time, I would be called all manner of names. And I knew usually that Fox had done a segment about me from Twitter because the trolls would exponentially increase. I've had people say very hateful things to me, things to harm my person, to harm other people in my family. But I got into this because I made a conscious choice and decision that I wanted to be a truth teller and a translator to help navigate for communities who are being disproportionately impacted. But when it becomes too much, you gotta know where to box yourself out and say, hey, I will engage to this point or I won't. So I put up some responses on Twitter, very thorough responses to some of the sound bites that Tucker Carlson was putting up. And then I did a Facebook Live. I did a Facebook Live on the anniversary of losing my dad. And again, explained to the public why I was doing what I was doing and the importance of combating misinformation and disinformation and how racism shows up even in targeting certain messengers. Thank you so much. I just wanna end with saying Krista's reflection of these stories of lived experiences are essential and would offer that we as preventive medicine leaders work to achieve diverse lived experiences so that we can bring these to the discussions. Thank you for that reflection and that point. And with that, I will conclude and thank you all for your attention and your time.

Dr. Angela Michelid

Vice President of Programs and Education

ACPM

webinar

Crafting the Message

Media Influence

Public Health

health communication

influence of media

crafting messages

Dr. Jade Colburn

Dr. Chris Purnell