Dr. Peter Sandman
Precaution Advocacy
(High Hazard, Low Outrage)

I got my start in risk communication – before the phrase was coined – as someone who helped environmental groups arouse public concern about the need for recycling, the dangers of factory emissions, and the like. My earliest publications, most of which are not available on this site or anywhere on the web, dealt with how to design and carry out environmental advocacy campaigns. For a list of these early publications, check out the entries for the 1970s in my C.V.

In the terminology I now use, my focus was on high-hazard low-outrage situations. The job was precaution advocacy: to arouse some healthy outrage and use it to mobilize people to take precautions or demand precautions.

I never abandoned this focus, but starting in the 1980s more of my time was spent on the opposite problem: reducing outrage in low-hazard high-outrage controversies. (See Outrage Management (Low Hazard, High Outrage).) There were two main exceptions.

One exception was work with Neil Weinstein and others on radon. Radon is an odorless, colorless gas and a naturally occurring carcinogen; it accumulates in buildings (especially well insulated buildings) and ends up in the lungs of the residents. When I first got involved in radon communication, authorities were afraid people would panic; Neil and I assured them the dominant problem would be apathy, not panic – and we launched a research program to figure out how to persuade people to test their homes for radon and, if high levels were found, to mitigate the problem.

The other major exception was employee safety. From time to time a client that had first employed me to help figure out how to reduce community outrage about one set of hazards came back for help when employees were ignoring or mishandling a more serious set of hazards. A mining company in Australia, for example, needed to persuade employees to obey safety regulations. The work I had done for environmental activists on arousing outrage was helpful here, but other approaches were needed too – sometimes the problem wasn’t really insufficient employee outrage at the hazard, but rather excessive employee outrage at the precaution: safety rules and safety equipment that chafed. I haven’t done any radon work in a long time, but I continue to consult and write on environmental activism and on risk communication aspects of employee safety.

Much more recently I have become heavily involved in a third venue for precaution advocacy: mobilizing people to take action with regard to infectious disease outbreaks, especially the risk of an influenza pandemic. My writing on pandemic communication is indexed in the “Pandemic Flu and Other Infectious Diseases Index.” But some articles focusing on arousing apathetic audiences are also listed here, while some that focus on helping people cope when the time comes are also listed in the “Crisis Communication Index.”

So the “Precaution Advocacy” articles listed below are derived from four main sources – work with environmental activists from the early 1970s through the present; work on radon communication in the 1980s and 1990s; work on employee safety from the 1990s through the present; and work on pandemic preparedness in the 2000s.

Topical Sections in Precaution Advocacy

On Precaution Advocacy Generally

• “Watch Out!” – How to Warn Apathetic People

  Website column

  Posted: November 9, 2007

  This column is a primer on precaution advocacy – that is, on high-hazard low-outrage risk communication, where the job is to increase outrage and thus to motivate apathetic people to take precautions (or demand precautions). Apathy isn’t always the problem when people are ignoring a serious risk – they could be in denial, for example, or they could have reasons to dislike the recommended precautions. But when apathy is the problem, this column is a good place to start. It’s a quick rundown on twenty precaution advocacy basic principles.

• When to Release Risk Information: Early – But Expect Criticism Anyway

  Website column by Peter M. Sandman and Jody Lanard

  Posted: April 16, 2005

  In February 2005, the New York City health department issued a warning about a possibly disastrous new strain of AIDS. It was widely criticized for alarming people before it had solid evidence that the strain was spreading. Also in February 2005, the United Kingdom’s Food Safety Authority held off announcing that many prepared foods were contaminated with tiny amounts of the banned red dye Sudan 1, because it wanted to prepare a list of affected products first. It was widely criticized for the delay. Obviously, when to release risk information is a tough call. In this column, Jody Lanard and I lay out the pros and cons, and conclude that early is almost always better than late. We also analyze the New York City decision in detail, and offer some ways to reduce the downsides of early release.

• Worst Case Scenarios

  Website column

  Posted: August 28, 2004

  Most of this long column is addressed to risk communicators whose goal is to keep their audience unconcerned. So naturally they’d rather not talk about awful but unlikely worst case scenarios. The column details their reluctance even to mention worst case scenarios, and their tendency when they finally get around to discussing them to do so over-reassuringly. It explains why this is unwise – why people (especially outraged people) tend to overreact to worst case scenarios when the available information is scanty or over-reassuring. Then the column lists 25 guidelines for explaining worst case scenarios properly. Finally, a post-script addresses the opposite problem. Suppose you’re not trying to reassure people about worst case scenarios; you’re trying to warn them. How can you do that more effectively?

• When People Are “Under-Reacting” to Risk

  Website column

  Posted: July 14, 2004

  When you think people are under-reacting to a risk, the usual diagnosis is “apathy” and the usual prescription is some sort of precaution advocacy: “This could kill you! Here’s how to protect yourself.” This short column is a checklist of questions to consider – in sequence – before jumping to the conclusion that apathy is the right diagnosis and precaution advocacy is the right prescription. Some of the alternatives (not paying attention, for example) are very familiar to safety professionals. Others (such as problems with self-efficacy and fatalism) are often missed.

• Communications to Reduce Risk Underestimation and Overestimation

  By Peter M. Sandman, Neil D. Weinstein, and William K. Hallman

  Risk Decision and Policy 3 (2), 93–108 (1998)

  The experiment reported in this article deals with ways of depicting risk when you’re trying to get people to realize how serious the risk is ... or how serious is isn’t. In other words, how do you explain risk data so your audience will neither underestimate nor overestimate seriousness? The study shows some strategies that help, even in the face of outrage. The study also documents – for readers who need it documented – that outrage does make people consider a risk more serious.

• Scared stiff – or scared into action

  By Peter M. Sandman and JoAnn M. Valenti

  Bulletin of the Atomic Scientists, Jan. 1986, pp. 12–16

  This 1986 article aimed at helping peace activists develop communication strategies that wouldn’t deepen people’s “psychic numbing” about nuclear weapons. Though its political content is out of date, its prescription – anger, love, hope, and action – is relevant today to coping with public denial about terrorism. (For terrorism I would want to add to the prescription the need to acknowledge and share the underlying fears – what people are “really” afraid of.)

• Medicine and Mass Communication: An Agenda for Physicians

  Annals of Internal Medicine 85:378–383, 1976

  This discussion of how the media influence their audience and how doctors can influence the media was written 25 years ago – before managed care and before cable. Despite the outdated specifics about both medicine and media, the principles have held up well. This is still a pretty good primer on media impact and how to horn in.

Handout Set

On Environmental Activism

• Chapter 11, “Media Campaigns” in Environmental Education & Communication for a Sustainable World

  Edited by Brian A. Day and Martha C. Monroe

  Published by the Academy for Educational Development, 2000

  Brian Day was my graduate student before going on to do communications for Environmental Defense Fund, GreenCOM, and other environmental advocacy efforts. In this chapter from a book he co-edited with Martha Monroe, Brian outlines a persuasion theory I taught him back in the 1970s – an approach to precaution advocacy that uses both an information-based component and a need-based component.

On Radon Testing and Mitigation

• Experimental Evidence for Stages of Health Behavior Change: The Precaution Adoption Process Model Applied to Home Radon Testing

  By Neil D. Weinstein, Judith E. Lyon, Peter M. Sandman, and Cara L. Cuite

  Health Psychology, 1998, Vol 17. No. 5, pp. 445–453

  This is one of two articles I have posted dealing with the Precaution Adoption Process Model, developed mostly by Neil Weinstein and tested by Neil and me (and colleagues) using radon as the test case. The other article, A Model of the Precaution Adoption Process: Evidence From Home Radon Testing, is statistically heavier going and methodologically less rigorous, but covers more ground: It says more about how people decide to test their homes for radon, and contains a more detailed description of the model itself. This one has more convincing evidence that people decide to take precautions – in this case to test for radon – in stages, and that different interventions work best at different stages.

• A Model of the Precaution Adoption Process: Evidence From Home Radon Testing

  By Neil D. Weinstein and Peter M. Sandman

  Health Psychology, 1992, 11(3), pp. 170–180

  For about a decade, Neil Weinstein and I (with colleagues) did research on radon – a high-hazard low-outrage risk that first became important in the mid-1980s. This article uses several of our radon data sets to illustrate Neil’s Precaution Adoption Process Model (PAPM). The PAPM is one of several contending models of how people actually decide whether or not to protect themselves from risks. Different models lead to different interventions, so the competition over which model best explains people’s behavior is important for those trying to persuade publics to take precautions about serious hazards.

  (I've also posted another article, Experimental Evidence for Stages of Health Behavior Change: The Precaution Adoption Process Model Applied to Home Radon Testing, on the PAPM and radon, this one reporting a later experiment demonstrating that the decision to test does happen in separate stages.)

• Promoting Remedial Response to the Risk of Radon: Are Information Campaigns Enough?

  Science, Technology, & Human Values, Vol. 14 No. 4, Autumn 1989, pp. 360–379

  Most of the research on radon risk response – mine as well as others’ – has focused on how to persuade people to test. This article shows that even after people have tested and found a high radon level, persuading them to do something about the problem isn’t easy ... and mere information isn’t what does the trick. When this research was done, radon was a new issue; the findings reported here may be more useful for those working on other new issues than for those working on the now-familiar radon problem.

On Employee Safety

• The Boss’s Outrage (Part I): Talking with Top Management about Safety

  Website column

  Posted: January 7, 2007

  I have long been interested in why corporate managements reject safety improvements that look eminently cost-effective – in some cases, improvements that have a better return-on-investment than the company’s principal product line. This short column explores some outrage-grounded reasons why senior managers might shy away from sensible safety investments. Among them: guilt/responsibility, ego/stature, hostility/contempt, fear/denial, and performance anxiety. The column suggests some ways safety professionals can break the logjam when factors like these are keeping their companies from making safety progress.

• Selling Safety: Business Case or Values Case

  Published in The Synergist, December 2005, pp. 30–35

  I have long argued that corporate environmental performance is better “sold” to stakeholders as a response to pressure than as a self-motivated commitment to the environment; I think claiming to be responsive is both truer and more credible than claiming to be responsible. In this article I make the same case about “selling” safety to employees. When management says it cares more about safety than productivity or profit, I argue, employees are likely to conclude that safety rules have more to do with company PR than company policy, and may “loyally” rather than rebelliously disobey. The article also discusses why both safety professionals and top corporate managers enjoy making a values case for safety, and resist making the business case I think they should make.

• Getting Workers to Wear PPE: Communication Is Key

  By Jennifer Busick, MPH

  Published in Safety Compliance Letter, September 2005, pp. 7, 10

  Employees may resist wearing personal protective equipment (PPE) for all sorts of reasons: It’s uncomfortable; it interferes with productivity; it’s not the macho thing to do; management doesn’t really mean it; the safety person’s warnings sound a lot like my mother. This article discusses some of my ideas about how to be convincing in the face of these reasons.

• Peter Sandman on Safety

  By Dave Johnson

  ISHN E-News, July–September, 2003

  This three-part interview was published in ISHN E-News. Excerpts were also published in the September 2003 issue of ISHN (Industrial Safety & Hygiene News) – the paper version, which is also on-line – under the title “Charting your course: 25 keys to safety success – Advice from Dan Petersen, Peter Sandman & John Henshaw.”

  Part One (ISHN E-News, July 25, 2003) – on persuading management to take safety seriously … and why it’s so difficult

  Part Two (ISHN E-News, August 1, 2003) – on persuading employees to take safety seriously … and why it’s difficult too

  Part Three (ISHN E-News, August 8, 2003) – on reputation management, employee outrage, and finding your niche as a safety and health professional

• Beyond Duct Tape

  By Dave Johnson

  Published in ISHN (Industrial Safety & Hygiene News), March 28, 2003

  Jody Lanard and I wrote “Duct Tape Risk Communication” to analyze the weird public response to the U.S. Government advice to stockpile duct tape for use against some kinds of terrorist attacks. Dave Johnson saw an analogy to the weird way employees sometimes respond to safety messaging, and went with it.

• Motivated Inattention and Safety Management

  Published in safety AT WORK, 30 October 2001

  This interview focuses on the “other side” of risk communication – how to persuade people to take risk more seriously. It deals mostly with two problems: employees who ignore safety procedures even though they have been well trained, and employers who ignore safety opportunities even though they are cost-effective. Both problems have their roots in outrage.

On Infectious Diseases and
Pandemic Preparedness

• Video and Audiotapes on Pandemic Precaution Advocacy

  Presented to the Texas Department of State Health Services, August 20, 2007

  On August 20, 2007, I gave a five-hour pandemic communication seminar to the Texas Department of State Health Services. The focus was on how to persuade an apathetic public to take pandemic preparedness seriously – that is, on precaution advocacy. There is no transcript available. But the seminar was webstreamed to health department offices throughout the state, and the webstream videos are available online in both audio and video formats. The picture quality is pretty bad (and there’s not much to see anyway), but the audio is okay. And I think these tapes are useful if you’re trying to arouse public concern about pandemics … or anything else.

  There are three tapes. Part One has three segments of roughly 30 minutes apiece: “Pandemic 101: The Four Faces of Bird Flu”; “Risk Communication 101: Hazard, Outrage, and the Four Kinds of Risk Communication”; and “Assessing the Public’s Mood: Apathetic? Burnt Out? Skeptical? Yet to Hear?” Part Two is a 75-minute segment entitled “Selling Pandemic Preparedness” – my effort to list core strategies of pandemic precaution advocacy. Part Three is mostly an hour-long practitioner panel on “What’s Working and What’s Not,” with my interpolated comments. There is periodic audience discussion on all three tapes.

  Systems requirements to access the videos are: (a) Windows Media Player 10 or better; and (b) Internet Explorer 6.0 or better. Access to the tapes is not user-friendly. It took me several tries. Here are some instructions.

• The Fear Factor: Preparing the public for a major disaster like pandemic flu without inciting panic is tricky. But the truth goes a long way.

  By Nancy Shute

  Published in U.S. News and World Report, November 21, 2005; online November 13, 2005

  This is an excellent summary of the dilemma authorities face when trying to alert the public to the risk of pandemic flu – a risk that could be severe or mild, imminent or far into the future. Despite its title, the article does point out that the risk of inciting panic isn’t a major problem, although the (unjustified) fear of inciting panic is. It offers justified praise to the U.S. government and the World Health Organization for their increasing willingness to sound the alarm.

• Bird Flu: Communicating the Risk

  By Peter M. Sandman and Jody Lanard

  Published in Perspectives in Health (Pan American Health Organization), vol. 10, no. 2, 2005, pp. 2–9

  PAHO asked us to combine a primer on risk communication with a primer on avian influenza. The resulting article talks about the challenge of alerting the public to bird flu risks, then offers ten risk communication principles, each illustrated with bird flu examples. The PDF file also includes the cover, an editor’s note entitled “Communication: risky business,” and the contents page. (Note the confusion of “bird flu” with pandemic flu in this 2005 article – and this blurb, also written in 2005.)

  (A Spanish language edition is also available. There is also an online version (same text, but easier to read than a PDF file) posted on the PAHO website. The entire issue is also there.

• Pandemic Influenza Risk Communication: The Teachable Moment

  Website column by Peter M. Sandman and Jody Lanard

  Posted: December 4, 2004

  This is the first column Jody Lanard and I wrote about pandemic preparedness. We wrote it when many experts believed a devastating H5N1 flu pandemic might be just around the corner – and so we thought so too. (We still think the risk is serious, but there’s much less sense of imminence as I write this blurb in mid-2008.) The thrust of this long column is how to sound the alarm. After a primer on why H5N1 is “not your garden variety flu,” the column proposes a list of pre-crisis pandemic talking points. Then it assesses how well experts and officials were addressing those points as of late 2004. The experts, we wrote, were doing their best to arouse the public. But governments and international agencies were undermining the sense of urgency with grossly over-optimistic claims about pharmaceutical solutions.

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