Action, not talk: a simulation of risk communication during the first hours of a pandemic.

This article describes the design, implementation, and evaluation of a simulation of risk communication in the first hours of a pandemic. The simulation design was based on Crisis and Emergency Risk Communication principles espoused by the Centers for Disease Control and Prevention, as well as the collective experience of the authors. Over 4 hours, 17 local health district risk communicators in Georgia responded to a scenario in which every community in the state had teenagers infected with avian flu after returning from an international conference. The evaluation revealed that local risk communicators had much greater difficulty following risk communication principles under the time pressures of a realistic and stressful event than they did in a tabletop exercise. Strengths and weaknesses of the performance of the local risk communicators are identified in addition to lessons learned about the design and implementation of a risk communication simulation.