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Prioritizing Communication About Radiation Risk Reduction in the United States: Results from a Multi-criteria Decision Analysis

Published online by Cambridge University Press:  23 June 2020

Rennie W. Ferguson*
Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, Maryland
Daniel J. Barnett
Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, Maryland
Ryan David Kennedy
Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, Maryland
Tara Kirk Sell
Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, Maryland Johns Hopkins Center for Health Security, Baltimore, Maryland
Jessica S. Wieder
National Council on Radiation Protection and Measurement, Bethesda, Maryland
Ernst W. Spannhake
Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, Maryland
Correspondence and reprint requests to Rennie W. Ferguson, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205; (e-mail:



The lack of radiation knowledge among the general public continues to be a challenge for building communities prepared for radiological emergencies. This study applied a multi-criteria decision analysis (MCDA) to the results of an expert survey to identify priority risk reduction messages and challenges to increasing community radiological emergency preparedness.


Professionals with expertise in radiological emergency preparedness, state/local health and emergency management officials, and journalists/journalism academics were surveyed following a purposive sampling methodology. An MCDA was used to weight criteria of importance in a radiological emergency, and the weighted criteria were applied to topics such as sheltering-in-place, decontamination, and use of potassium iodide. Results were reviewed by respondent group and in aggregate.


Sheltering-in-place and evacuation plans were identified as the most important risk reduction measures to communicate to the public. Possible communication challenges during a radiological emergency included access to accurate information; low levels of public trust; public knowledge about radiation; and communications infrastructure failures.


Future assessments for community readiness for a radiological emergency should include questions about sheltering-in-place and evacuation plans to inform risk communication.

Original Research
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

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