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voice is more difficult for people to understand versus content written in the active voice. Using
the Flesch-Kincaid grade level test, the original messages are written at a 12.5 grade level,
which is well above the average American reading level. Approximately 85% of the participants
in this study had completed at least some college and still had difficulty understanding the
technical language used throughout the messages.
Øð I m thinking of my grandparents, or my mom. She speaks English, yes, but for her to
actually follow a message like that& it would be hard.
Øð If you re going to use a term that probably most laymen don t understand, then you
need to also have some sort of definition for us.
Øð I was so busy trying to decode that sentence it pulled my brain out of the message and I
stopped listening to what began to be important information.
Øð When you have a disaster happen, you don t want to have to read the dictionary. You
want point blank this is what s happening. This is what you should do .
Make messages concise.
Participants requested concise and simpler messages. In messages that had no action items,
participants often got lost in the content, and struggled to identify the main idea. Messages
should be less verbose and more to the point. People recalled messages that contained succinct
instructions, even if the message was longer than informational messages.
Health Message Testing: Detonation of an Improvised Nuclear Device 34
Øð Make it a little shorter, then kind of get to the point. The more serious points.
Øð It was informative, but it gave you almost too much information.
Øð The alternate is a little more concise, and it s less information, but giving you more at
the heart of it.
Øð Tightly deliver information& because time is valuable to deliver your message so you ve
got to make sure that you re conveying as much helpful information as possible.
Avoid or define unknown terms and phrases.
Many participants were unfamiliar with radiation terminology. If possible, messages should be
written using as little technical jargon as possible. If usage is unavoidable, unfamiliar terms and
phrases should be defined or explained clearly. Participants were not familiar with the following
terms and phrases:
Øð Background radiation Øð Hereditary genetic damage Øð Radiation particles
Øð Internal/external Øð Radiation protection
Øð Contaminated
contamination standards and practices
Øð Detrimental health
Øð Low/high radiation levels Øð Radioactive material
effects
Øð Dose Øð Potassium Iodide Øð Rem
Øð Health Physics Society Øð Premise Øð Sievert
Impact of Japanese nuclear power plant disaster
Participants mentioned the nuclear power plant disaster in Japan in almost every focus group
as a frame of reference. Groups in Seattle seemed especially aware of the events, and many
reported that they had tried to obtain Potassium Iodide (KI) for themselves or their families in
the days following the events.
Øð I think that we all have an awareness that maybe we didn't have before Japan.
Øð In Japan when they did those, so many miles out, and things like that, at least you could
figure where I was compared to where I am compared to where I need to be. That was, I
think it was really helpful to them.
Øð They re having a terrible time with nuclear reactors in Japan. They re leaking radiation,
and there are villages, towns that completely have moved. People are surviving that, so
that while I don t expect that I would be someone who would survive it if it[IND] goes off
really close to me, radiation is not only one thing. If it's an explosion, there's not only one
way it can affect you.
Øð Did you try to get Potassium Iodide by any chance after Japan? Did anybody? I did. I got
it three weeks, no four weeks after because they were on back order& good luck with
getting anything. Good luck with buying kelp or iodide.
Health Message Testing: Detonation of an Improvised Nuclear Device 35
Øð I knew about Potassium Iodide because of Japan.
Health Message Testing: Detonation of an Improvised Nuclear Device 36
Recommended Next Steps
Health Message Testing: Detonation of an Improvised Nuclear Device 37
Recommended Next Steps
1. Refine messages using lessons learned from message testing research.
Øð Include action items in every message, even if items are as simple as stay tuned.
Øð Empower the public with the knowledge to help themselves.
Øð Tailor messages to time and distance from event.
Øð Write messages specific to delivery method and target audience.
Øð Use an authoritative and urgent tone, but also provide hope.
Øð Write messages that do not contradict themselves (even if contradiction is only
perceived).
Øð Use plain language and focus on what the public needs to do, rather than making
the message a science lesson.
Øð Write concise and direct messages.
2. Conduct a card sorting activity with the general public to prioritize and tailor
questions.
Card sorting is a method to involve the target audience in grouping information for a
particular product. Participants in a card sorting session are asked to review items and then
group these items into categories. Card sorting helps build structure, prioritization, and
organization to a product.
There are two types of card sorts: an open card sort and a closed card sort. In an open card
sort, participants are asked to sort the cards into groups and then name each group. In a
closed card sort, participants are asked to categorize items into pre-defined categories.
ORISE staff recommends a concurrent in-person card sorting technique for future research.
Participants will be asked to participate in a closed card sort. Each session will have 6-8
participants. The participants will be paired and instructed to sort the current 88 questions
in the Improvised Nuclear Device (IND) Response and Recovery Communicating in the
Immediate Aftermath Guide using the following categories: pre-event, first hours, short-
term, long-term and not important to the general public. The facilitator will debrief the
pairs at the end to obtain an explanation for their categories.
3. Create and test instructions for the public to address specific post-IND threats to
health and safety.
In previous focus group research on communicating with the public post-IND, as well as this
study, the most requested information by the participants were action steps they could take
to protect themselves and their families. Participants often wanted more information to
clarify instructions, or to help them adapt instructions to a particular environment. The
Health Message Testing: Detonation of an Improvised Nuclear Device 38
topics below are seen by participants as the most important to ensure their survivability,
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