Focus On Healthcare/UV Disinfection: Rethinking How We Communicate about GUV

Troy Cowan IUVA Healthcare/UV Working Group facilitator

Over the last 12 months, in conferences, workshops and meetings, there has been the constant message that those in the germicidal ultraviolet (GUV) industry need to do a better job of communicating and educating the public about the benefits and advantages of GUV technologies in the disinfection world.

• It came up big-time in Cincinnati last September, where 120 of the 179 Issues and Objectives dealt with education.
• It emerged again as one of three central themes in the recent “Advocating for GUV in Public Spaces” workshop in Atlanta.
• It is a heightened focus of the International Ultraviolet Association (IUVA) Board’s Education Committee in its efforts to establish an Education Resource Center to be presented at the World Congress in Dubai.
• It was a key focal point in the Call to Action presentations at the 1st International Congress on Far-UVC Science and Technology (ICFUST) at Columbia University.

A long-running complaint is that technologists and scientists don’t do a good job of talking to the general public about GUV. Frustration arises because of term selection, which sometimes leads to a lack of understanding from the public about what scientists are trying to communicate. When the public doesn’t understand the terminology or the issue, scientists then become frustrated by the seeming lack of care from the general public, even when important topics are discussed. It leads to the question, “Why don’t they care?”

Ahh, but a basic rule in communication can’t be avoided: The responsibility for incomplete or non-existent communication lies with the communicator, not the listener. So, how do GUV professionals change the message? Dr. Kathleen McPhaul has quietly attacked the issue, and her presentation at ICFUST on “…A blueprint for communication with the public about GUV” ¹ is a great place to start.

At ICFUST, Dr. McPhaul reminded attendees that the public is a not a monolith (i.e., one message doesn’t fit all), is not very technically savvy (i.e., 88% of the US population scores ‘below proficient’ in health & science literacy) and is not in tune with the importance of Indoor Air Quality. ² She pointed out the importance of communicating through personal stories, the need for accessible information that is understandable and that can be used, and how access is especially important to the lower economic communities that typically have less opportunity but could benefit most from technology. ³

Dr. McPhaul is interested in learning how this communication gap can be bridged. How can the public be engaged in a way that is understandable, useful and usable? Who needs to be engaged in order to convey the message – and when? How? Dr. McPhaul is researching that gap and how to solve it through her research project “Indoor Air, Human Health and Germicidal UV (GUV) Light,” ⁴ using a disciplined focus-group methodology to engage the public across select demographic segments of the population – economic, cultural, geographic, age, etc.

Thanks to a gift from Balvi Philanthropic Fund to the University of Maryland’s Public Health AeroBiology Laboratory and its Maryland Institute for Applied Environmental Health, Dr. McPhaul’s project is being funded as part of an over-arching public health research project in GUV. ⁵ In a recent interview with Dr. McPhaul, she shared several insights that make this approach most intriguing:

• Dr. McPhaul is a trained nurse with a Ph.D., retired from the Veteran’s Administration, where she was experienced in occupational health and deeply schooled in participatory research. To use her words, “… there is this thread that has run through my career that I like to do research, but I also like to practice and I like to talk to people. So, this notion of participatory research out in communities, hearing what communities have to say, has turned out to be a pretty good method for me.” ⁶
• Dr. Donald Milton, who directs the Public Health Aerobiology lab, recruited Dr. McPhaul as soon as she retired from the federal government. Dr. Milton always has been interested in the prevention of airborne infectious diseases and saw a natural fit for Dr. McPhaul’s public health background, occupational health skills and participatory research approaches in his lab.
• The Balvi gift is focused broadly on the science of airborne infectious diseases and helping affordable technologies, e.g., germicidal UV, become more widely used and more widely available, particularly for low-income countries. With that in mind, Dr. Milton carved out a scope and funding for Dr. McPhaul on this effort to study public acceptance and communication related to GUV, to help understand how it could be more widely accepted. ⁷
• In addition to Dr. McPhaul, Dr. Milton also has involved the School of Public Health’s Horowitz Center for Health Literacy, run by Dr. Cynthia Bauer, for her contribution to other studies involving the issue of communication and the science behind word choices. So, there’s a unique combination of communication research and public health research in one project with broad latitude to do exploratory, formative research using qualitative (vs. quantitative) analytical techniques.

This has resulted in a two-year plan to do formative research, meeting people in small focus groups (4 to 10 people), asking questions and embedding researchers in communities to start figuring out what people care about. ⁸ This is where, as Dr. McPhaul shared, “You don’t know what you don’t know, and you just have to go out there, ask questions and listen.” ⁹

Per Dr. McPhaul: ¹⁰

• “In this first year of exploratory research, we have a broad framework around the exploratory core part, trying to understand what people know, what do they care about and whether they even care about indoor air. And if they were thinking about it, and when they’re thinking about it, who do they trust and what type of language should we use?
• “The second year of the funding will take this qualitative formative research and build up the communication products” to fix the problem (e.g., messages, messaging strategies, etc.).”

Dr. McPhaul has quite a bit of latitude with the expected deliverables, and they could include everything from informational research papers to very scholarly types of publications.

• “They’re not read by the general public as much, but they can be read by policy makers. And it is good to have scholarly research on a particular topic because the regulators – for example, OSHA, EPA, Food and Drug Administration – would be required to have all the scholarly research as part of their record if they decide to do something.” ¹¹

Then, if OSHA were to create some sort of a standard around employees exposed to GUV, these research papers could become part of that standard. “Same with FDA, if they do something around certifying the safety of GUV devices or something like that; our research would be out there for the FDA as a resource.” ¹²

These special communication resources will become important to the EPA as it gets more involved in the very public topic of Indoor Air Quality (IAQ) and tries to comply with the Plain Writing Act ¹³ and its three companion Executive Orders. ^{14, 15, 16}

• Per Dr. McPhaul, the federal government is required “…to use plain language when they’re talking to the public and when they’re putting public-facing materials up there.”
• Her staff just recently completed an analysis of several federal websites, including some under the EPA, where “we scored them… specifically… on readability, clarity, plain language – and the federal websites really don’t do very well.”

“And that’s an example of a short, scholarly activity that we hope to publish this year,” Dr. McPhaul explained.

So, the IUVA Healthcare Working Group looks forward to reporting on Dr. McPhaul’s progress and findings over the next one to two years and engaging her and possibly others at the University of Maryland School of Public Health to help with the group’s initiatives. Her guidance will be especially helpful in standards activities and white paper development.

In closing, this interviewer asked Dr. McPhaul what she thought was key to the whole communication process. Her response: “Trust, trust, trust.” When asked who that would be to most of the public, she replied, “Contrary to what you might think, the most trusted sources may not be the doctors and scientists; but in some communities, it’s the barbers, the beauticians and the librarians, the people they talk to more frequently who are part of their routine, familiar network.” ¹⁷

Many thanks for that insight, Dr. McPhaul. And many thanks for doing this work, to the Institute, the University of Maryland School of Public Health and to the Balvi Philanthropic Fund for making it possible. IUVA and this magazine’s readers look forward to any updates that can be shared as the study progresses and certainly to the final report(s). The sooner the better, because it’s all about saving lives…

References

1. Dr. K. McPhaul, University of Maryland, at First International Congress on Far-UVC Science & Technology, (ICFUST), June 14-16, 2023 (https://www.youtube.com/watch?v=uRsU7ZEL9NI)
2. McPhaul at ICFUST, cited above
3. Ibid.
4. “Indoor Air, Human Health and Germicidal UV (GUV) Light, Human Subjects Protocol Number: 1974278-4, University of Maryland School of Public Health, Kathleen McPhaul, PhD, Principal Investigator
5. I. Giram, “Ether Founder Gifted $9.4m Crypto To Fund Study Of Air Disinfection,” on the TechStory website (https://techstory.in/ether-founder-gifted-9-4m-crypto-to-fund-study-of-air-disinfection/ )
6. Dr. K. McPhaul, as interviewed by T. Cowan on 28 July 2023.
7. Ibid.
8. Ibid
9. Ibid.
10. Ibid
11. Ibid
12. Ibid
13. Public Law 111-274, October 13, 2010, “An act to enhance citizen access to Government information and services by establishing that Government documents issued to the public must be written clearly, and for other purposes.” (https://www.govinfo.gov/app/details/PLAW-111publ274 ), last accessed 31 July 2023
14. OMB, Executive Order 12866 of September 30, 1993, “Regulatory Planning and Review” (https://www.archives.gov/files/federal-register/executive-orders/pdf/12866.pdf ), last accessed 31 July 2023
15. OMB, Executive Order 12988 of February 5, 1996, “Civil Justice Reform” (https://www.govinfo.gov/content/pkg/FR-1996-02-07/pdf/96-2755.pdf ), last accessed 31 July 2023
16. OMB, Executive Order 13563 of January 18, 2011, “Improving Regulation and Regulatory Review “ (https://www.govinfo.gov/content/pkg/FR-2011-01-21/pdf/2011-1385.pdf ), last accessed 31 July 2023
17. Dr. K. McPhaul, as interviewed by T. Cowan on 28 July 2023.