Table 2 Case studies illustrating strategies for community-centred resilience and health emergency communication

1. Facilitating community structures as channels for communication

• Creating a contact list, register or network of active community members to distribute health emergency information

• The US Centre for Disease Control and Prevention’s (CDCP) “Access and Functional Needs Toolkit: Integrating a Community Partner Network to Inform Risk Communication Strategies” [164] has been developed to support health communicators to build partnerships and engage in meaningful communication with communities. The toolkit highlights the communication needs of diverse communities including children, pregnant women, older people, people with limited literacy or English language, people with limited transportation, people with disabilities, people with chronic; and provides tips for engaging partners and dissemination pathways and sustaining networks

• Launching targeted social media campaigns to involve the public in resilience planning and communication efforts by utilising existing online platforms and online communities to engage a broader audience, gather feedback and disseminate information in an accessible and inclusive manner

• An international team of health communication researchers have developed a novel precision public health campaign framework [91] to structure and standardise the process of designing, developing and delivering tailored health messages to target particular population segments using social media–targeted advertising tools. The framework consists of five stages: defining a campaign goal, priority audience and evaluation metrics; splitting the target audience into smaller segments; tailoring the message for each segment and conducting a pilot test; running the health campaign formally; and evaluating the performance of the campaigns. The precision public health campaign framework has the potential to support higher population uptake and engagement rates by encouraging a more standardised, concise, efficient and targeted approach to public health campaign development

• Encourage communities to develop digital skills for social medial engagement, and to develop the skills to be able to critique different sources of digital information

• During the COVID-19 pandemic US community members’ social media engagement was significantly associated with their perceived community resilience [165]. While helping others on social media led people to perceive their communities as less resilient, the use of social media for social support helped foster social capital, leading to more perceived resilience at the collective level. Overall, social media use played important roles in shaping people's perception of community resilience, helping community members and organisations evaluate their strengths and weaknesses, and make improvement to better address future challenges in the times of global disasters

2. Respecting personal data and private boundaries in health communication

• Organise community forums or dialogues focused on health-related topics, creating safe spaces for open discussions to encourage individuals to share experiences, concerns, and perspectives, promoting a sense of community understanding and support

• In 2019, The New York Public Library launched a pilot series in select library branches across three boroughs. “Community Conversations” encourages open dialogue where everyone’s voice can be heard [175]. Health dialogues using Community Conversations Café serves as a platform where the scientific and non-scientific communities can both gain insight and perspective. The goal of the programme series is for both groups to learn from each other through an organic, informed and respectful exchange. These programs are meant to inform participants in a meaningful and constructive way, discuss current scientific endeavours, shed light on the unknown, and dispel misinformation or fear

• Establish peer support networks within communities, where individuals can connect with peers facing similar health-related challenges to facilitate interpersonal connections, reduce stigma, and provide a supportive environment for sharing thoughts and experiences

• In Norway, a recovery-oriented Internet-based portal called ReConnect was used by service users in two mental health communities for 6–12 months [176]. The portal included an online peer support group which also facilitated participation in local offline peer support groups. Both group formats were moderated by an employed service user consultant. Online and offline peer support groups complement each other, and that combining them was mainly described as beneficial by service users

• Implement educational programmes that emphasise the interconnectedness of individual and community wellbeing to encourage a shift from exclusive focus on personal coping to understanding the role of collective resilience in maintaining community health

• Schools play a crucial role in providing safety and mental health assessments and interventions for children, especially in the context of disasters and crises, making them a critical setting for the delivery of health communications and resilience building interventions. Tailored, school-based interventions in Gaza [177] have proven effective in providing educational and psychosocial support for conflict-affected youths, addressing issues such as academic underachievement and its impact on mental health

• Train community members as health ambassadors to serve as approachable figures for discussions around specific health concerns, to bridge the gap between formal health communication and community members, fostering trust and open dialogue about health issues and risks

• A wide range of health ambassador schemes at one English NHS trust in Bradford [178] include pathways to Action–training for community health activists, ‘Healthwise’ tutors running groups around physical activity and health topics, health apprenticeship schemes, health trainers, breastfeeding peer support, Asian outreach workers, buddy schemes around HIV/AIDS, voluntary walk leaders, community coaches, lay workers running food co-ops & cook and eat sessions, healthy living centres, sure start initiatives/children’s centres

• Create diverse communication channels, including online platforms, helplines and community meetings, to cater to various preferences and ensure that health information reaches individuals through channels they are comfortable with, promoting engagement

• American Hospital Association [179] web-based information (tip sheet, key considerations and reflection questions) on communication strategies for public health emergencies emphasises health care leaders must be prepared for increasing threats to public safety. In emergency situations, informed decision-making relies on timely, accurate and coordinated communications. Part of an effective strategy is to use diverse communication channels to reach different communities so there is not an over reliance on any one mechanism

3. Targeting outreach for effective crisis communication

• Establishing decision-making forums or platforms for active community participation in decision-making processes related to resilience planning, empowering community members to contribute to and shape initiatives, ensuring cultural relevance and increasing community engagement

• The Council of Europe [180] have reviewed different forms of young people’s participation in decision making. Drawing on various international case studies, the key findings are that co-management, co-production, digital participation, deliberative participation and for some, the concept of ‘participatory spaces’ are seen as the more innovative forms of participation. Recommendations centre on establish a strategic approach to promoting youth participation practice. Strategies should be developed with all young people, including those from minority and disadvantaged groups, and encompass a broad definition of what constitutes youth participation in decision making, encompassing a myriad of forms for involving young people in decisions about all matters that affect them

• Conducting interactive emergency preparedness workshops within communities to educate residents about emergency preparedness and response in order to foster a sense of community ownership, encourage dialogue, and empower individuals to actively participate in resilience-building efforts

• The CREATE Resilience project [181] centered on co-creating a community vision of resilience, specifically as it relates to natural hazards and climate change by focusing on a positive narrative. By engaging youth, artists, municipal officials and community members in a variety of activities, including surveys, story-gathering and photovoice exhibits, forums, artist-created murals, and ripple effect mapping (REM), the project increased knowledge of weather and climate, risks from local hazards, and strategies for mitigation, while leading the community in thinking about what resilience means

4. Building resilience through training and communication initiatives

• Implementing cultural humility training programmes for emergency responders, healthcare professionals, and community leaders to enhance understanding of diverse cultures, promote sensitivity, and improve communication before and during emergencies

• In 2012, Seattle Fire Department implemented a culturally inclusive strategy [183] including cultural awareness training programme for its emergency responders to better serve the diverse population in the city. The programme included workshops, simulations and ongoing education to enhance understanding of cultural nuances. This initiative resulted in improved communication during emergencies, increased trust within communities, and a more effective response to incidents in culturally diverse neighbourhoods

• Training and deploying community health ambassadors who can act as bridges between official channels and diverse community groups to facilitate culturally sensitive communication, address community-specific concerns, and enhance trust in health initiatives

• Toronto Shelter Networks Peer Health Promotion Project [185] focuses on health promotion across many sites including the shelter sector, respites, 24 hour women’s drop-in, and COVID hotel programme sites. TSN Community Health Ambassadors are engaged in activities which include providing education and raising awareness to peers about disease prevention and health improvement, speaking with peers to address fears, questions and misconceptions and working alongside shelter staff and Toronto Shelter Network to plan and provide health promotion and education at their shelter sites

• Creation and training of community champions for community-based outreach activities with a focus on inclusion of at-risk communities

• During the COVID-19 pandemic, the UK government set up a community champions funding award scheme for local authorities to develop local programmes that addressed emerging inequalities [186]. All local programmes aimed to reduce health inequalities by involving at-risk communities in local prevention efforts, adapting the approach to local priorities. Two levels of community engagement were volunteer mobilisation and subsequent community-based outreach activities. Elements of capacity building, such as training and creation of networks, were common. Stronger relationships with communities were regarded as a key mechanism to support more equitable prevention strategies. Local Authorities handed over the design of schemes to people who knew their neighbourhoods and their needs best. This enabled community champions to innovate in response to the immediate situation rather than audit goals introduced from the top down. This resulted in more diverse CCs and third sector organisations that were willing to work with the council when it did not prescribe the terms of engagement

• Conduct place-based round tables or consultation workshops that bring together individuals and community leaders to explore and discuss resilience-building strategies collectively, identify community assets, foster collaboration, mutual understanding, and a shared commitment to building resilience within the community

• Led by Anglesey Council in Wales, a community resilience model was developed [60] based on a citizen-centred approach and asset-based community development principles; with the aims to create a shift in the balance of power between service providers and service users and involving local people in the decision-making. Delivery involved a 12-week period of consultation (including public meetings, mapping activities, informal chats with local residents, community groups and local organisations). Emphasis was placed on engaging seldom heard communities in the process. Results from the consultation were used to develop community-based initiatives addressing issues such as low levels of health and wellbeing, loneliness, and social isolation

4. Demonstrating commitment to equity and inclusion in health emergency communications

• Develop targeted information campaigns addressing sensitive health topics, emphasising the importance of open communication to increase awareness, reduce stigma, and encourage individuals to feel more comfortable discussing health-related matters within the community

• In emergency situations the World Health Organisation’s Incident Management System (IMS) [117] helps to expedite the development of technically sound and timely guidance and interventions to reduce health risks. As needed, WHO will deploy the WHO Emergency Communications Network (ECN)—a network of health communicators who undergone intensive pre-deployment trainings and have been certified to have the right skills to join response teams whenever needed

• Developing and disseminating emergency communication campaigns in multiple languages and a range of formats to ensure that crucial information reaches all sectors of the population, overcoming communication barriers and promoting inclusivity

• The WHO’s Strategic Communications Framework for effective communications [117] aims to broaden reach to diverse audiences and ensure that health information reaches the people who need it. The framework includes processes and tools, with a commitment to publish in six languages. Multilingual content makes access to health information and WHO communication resources more equitable and effective