Communicating with diverse populations before, during and after Chemical, Biological, Radiological and Nuclear (CBRN) events: Systematic literature review

Background Chemical, Biological, Radiological and Nuclear (CBRN) events can have substantial impacts on affected individuals and communities. Effective communication is an essential component of preparedness and response in the context of CBRN events. While there is a wealth of literature on communicating effectively with the general public during such events, less is known about the communication needs of diverse populations who may be disproportionately affected during CBRN incidents. Methods We searched eight electronic databases for literature on the communication needs of diverse populations during CBRN events and hand-searched the reference lists of included studies and of relevant websites. Data were extracted and synthesised using thematic analysis. Results Database searches yielded 5,354 citations and 34 were included in the review. Studies considering pre-incident communication needs of diverse populations suggest that knowledge of and preparedness for CBRN events is low across the groups studied. Most studies focused on communication/information needs of diverse populations during CBRN incidents. Within this response space we identified: different drivers for protective behaviours during a CBRN event; three main information needs (basic information about the incident, CBRN health risk information, and protection information); and three key needs relating to the method of communication (trusted sources, different modes and mediums of communication, and inclusive/accessible communication) during CBRN events. We also identified challenges faced by at-risk groups during mass casualty management, which underscored the need for tailored communication. Ten studies considered post-incident needs, with data indicating the importance of ongoing support and information, information on potential mental health effects, and communication relating to ongoing monitoring and research. Conclusion This review highlighted important commonalities in information needs underscoring that transparent, consistent, factually correct information from trusted sources about health risks and protective behaviours is required for everyone irrespective of background. However, it also revealed important differences in health beliefs and concerns, and in trusted sources, that reinforce the importance of tailoring messages for diverse populations.