National Risk
Communication
Conference
Held in Conjunction with
Annual National Forum on
Contaminants in Fish
Proceedings Document
Sponsored by
U.S. Environmental Protection Agency
(under Cooperative Agreement No. X-82825101-0)
Minnesota Department of Health
Society for Risk Analysis
Chicago, Illinois
May 6-8, 2001
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National Risk
Communication
Conference
Held in Conjunction with
Annual National Forum on
Contaminants in Fish
Proceedings Document
Sponsored by
U.S. Environmental Protection Agency
(under Cooperative Agreement No. X-82825101-0)
Minnesota Department of Health
Society for Risk Analysis
Chicago, Illinois
May 6-8, 2001
Health Care Insurance
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National Risk Communication Conference
May 6-8,2001
Proceedings Document
Sponsored by
U.S. Environmental Protection Agency
(under Cooperative Agreement No. X-82825101-0)
Minnesota Department of Health
Society for Risk Analysis
Prepared by
Research Triangle Institute
P.O. Box 12194
Research Triangle Park, NC 27709
August 2001

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Foreword
A conference was held in May 2001 to bring together representatives of state, tribal, and
community programs involved in communicating health risks of eating chemically contaminated
fish. The focus of the conference was communicating risks to fish-eating populations who are
hard-to-reach because they may not hear, understand, or be receptive of health risk messages
about contaminated fish.
A technical advisory committee made up of stakeholders and experts in the field helped
plan the content of the conference and designed presentations, panels, and a classroom lecture
series on the steps of risk communication. Interactive discussion sessions among conference
participants were intended to elicit best practices in risk communication and identify priorities for
research needs.
The planning committee identified speakers from around the country who had expertise
in the various steps in risk communication and had past experience in communicating with hard-
to-reach communities. Speakers from academia, federal and state government, tribes, and
community-based organizations were asked to present at the conference.
Funding from the U.S. Environmental Protection Agency made it possible for the
planners to pay the travel costs of a large number of participants. Each state was asked to
nominate one representative from their fish consumption advisory program and a community
partner. Tribal governments with past involvement in water quality standards or fish
consumption advisories or those identified by EPA Regional offices were invited to attend. In
addition, water quality planners from each state and a large number of community-based or
nonprofit organizations were also invited. A total of 356 people attended the conference.
This document contains the details of the presentations and discussions that took place
over the two days of the conference". The recommendations and research needs identified by the
conference participants are described in the record of the breakout discussion sessions. These
recommendations will be shared with each conference participant, each state fish consumption
advisory program, and EPA's National Fish and Wildlife Contamination Program.
Pamela Shubat
Co-Chair
Conference Technical Advisory Committee
iii

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Acknowledgments
This proceedings document was prepared under Assistance Agreement X-82825101-0
between the U.S. Environmental Protection Agency (EPA) and the Minnesota Department of
Health. We would like to acknowledge the following individuals who served on the Technical
Advisory Committee for their help in planning and organizing this National Conference on Risk
Communication:
¦	Dr. Henry Anderson, Wisconsin Division of Public Health
¦	Henry Folmar, Mississippi Department of Environmental Quality
¦	Kristin Ryan, Alaska Department of Environmental Conservation
¦	Mike Haars, Alaska Department of Environmental Conservation
¦	Edward Horn, New York State Department of Health
¦	Faith Schottenfeld, New York State Department of Health
¦	Andrew Smith, Maine Bureau of Health
¦	Patricia Cochran, Alaska Native Science Commission
¦	Moses D. Squeochs, 14 Confederated Bands of the Yakama Nation
¦	James Thomas, 14 Confederated Bands of the Yakama Nation
¦	Amy Kyle, University of California, Berkeley
¦	Brian Merkel, University of Wisconsin-Green Bay
¦	Steve Blackwell, Agency for Toxic Substances and Disease Registry
¦	Jeffrey Bigler, National Fish and Wildlife Contamination Program, U.S. EPA
¦	Elizabeth Blackburn, Community Affairs and Outreach of the Office of Children's
Health Protection, U.S. EPA
¦	Kathryn R. Mahaffey, Office of Science Policy and Coordination (Office of
Prevention, Pesticides, and Toxic Substances), U.S. EPA.
In addition, the committee relied on Milton Clark, U.S. EPA Region 5 Health and Science
Advisor, and Edward Ohanian, U.S. EPA Health and Ecological Criteria Division, for assistance.
Subcontractors Patricia A. Cunningham, Research Triangle Institute, and Barbara Knuth,
Cornell University, played an integral role in the planning committee, including development of
the conference agenda, identification of speakers, and development of technical materials.
Carolyn Walker and Tanya Bethel, ICES, Ltd., provided logistical support for securing
conference facilities and services and travel arrangements for the invited speakers and attendees.
Although the information in this document has been funded wholly or in part by the U.S.
Environmental Protection Agency, it may not necessarily reflect the views of the Agency and no
official endorsement should be inferred.
iv

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Table of Contents
Contents
Page
Foreword 	iii
Acknowledgments	 iv
Part I: Conference Summary
National Risk Communication Conference	 1-3
Part II: Presentations and Panels
Conference Welcome/Introduction 	II-3
Kathy Svanda	II-3
James Hanlon	II-4
Keynote Address: Risk Communication Challenges: Are Audiences Hard to Reach?
Or Are the Messages Hard to Send? 	II-7
Barbara Knuth
Session 1: Perceptions of Fish Safety: Voices from the Community	11-11
Introduction-Pat Cunningham 	11-11
Josee Cung	II-12
Maria Maybee 	11-13
Jose Cuevas	11-16
OraRawls 	11-17
Patricia Cochran	11-19
Session 2: Risk Communicator Presentations 	11-23
Ed Horn	11-23
Stephanie Allen 	11-25
Henry Anderson	11-27
Session 3: How to Gather Information on Target Audiences	11-29
Sharon Dunwoody
Case Studies of Fish Advisory Scenarios 	11-32
Kerrie Pflugh	11-32
Henry Anderson	11-36
Session 4: Choosing the Message Content	11-39
Joanna Burger
Session 5: Choosing the Medium for the Message 	11-42
John Cahill	 11-42
Kristine Wong 	11-50
Josee Cung			11-52
v

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Table of Contents
Contents (continued)
Page
Session 6: Evaluating the Risk Communication Program 	11-54
Barbara Knuth	11-54
Barbara Hager	11-55
Tom Nighswander 	13-57
Closing Remarks 	11-61
Elizabeth Southerland
Part III: Breakout Sessions
1: Determining What the Audience Wants to Know 	III-3
IA.	Women's Health Issues-Pregnant, Nursing, Child-bearing Age	III-3
IB.	Cultural/Traditional or Geographically Isolated Subsistence Fishers,
Including Native Americans 	III-5
IC.	Fish Eaters Whose Native Language Is Not English	111-10
ID.	Economically Dependent Fish Eaters—Urban and Rural Poor	111-13
IE.	General Population Sport Anglers	111-14
2: Issues in Developing Message Content 	111-16
2A. Mercury, Especially as It Relates to Child Development - Also to
Pregnancy, Nursing, Child-bearing Age 	111-16
2B. Communicating Risk-Benefit Information 	111-19
2C. Developing One Message Vs. Many Messages for Diverse Audiences .... 111-21
2D. Communication Paradigms 	111-23
2E. Issues in Developing Message Content: Common Misperceptions 	111-25
Tribal Breakout Session	111-27
3: Issues in Evaluating Health Advisory Risk Communication Programs	111-33
3A. Women and Children-Reproductive Concerns	111-33
3B. Cultural Enclaves-Native American and Other Cultural and Traditional
Communities 	111-34
3C. English as a Second Language	111-38
3D. Costs of Evaluation Methods - Reducing Costs 	111-40
3E. Measuring Success to Improve Communication 	111-41
Part IV: Risk Communication Basics	IV-1
PartV: Written Comments	 V-l
Part VI: Appendixes
A Conference Materials and Information 	 A-l
B Biosketches of Conference Presenters	B-l
C Registered Conference Participants	C-l
vi

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Part I
Conference Summary

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Part I: Conference Summary
National Risk Communication Conference
May 6-8, 2001
Background
The first national conference on risk communication to address the risks of consuming
chemically contaminated fish was held in Chicago, Illinois, May 6-8, 2001. The conference was
convened by the Minnesota Department of Health and the U.S. Environmental Protection
Agency's (EPA) Fish and Wildlife Contamination Program and cosponsored by The Society for
Risk Analysis. Participants from across the United States were invited to share information on
risk communication methods that are effective for populations exposed to and susceptible to
chemical contaminants in fish, especially those who may have difficulty receiving,
understanding, or accepting risk information. The purpose of the conference was to develop
recommendations on risk communication techniques that are effective in reaching specific
audiences and informing them of the risks from eating contaminated fish. A complete description
of the conference goals and objectives is provided in Part VI, Appendix A, of this proceedings
document.
EPA helped identify the agencies and organizations that have produced fish consumption
advisories and the nongovernment organizations that have used fish advisories in education and
outreach to communities. Representatives of these groups made up the primary audience for the
conference and included state and tribal fish advisory contacts, riverkeepers and other
community-based organizations, as well as university, private contractors, and representatives
from various federal programs.
A geographically and institutionally diverse planning committee (see Acknowledgments),
co-chaired by Patricia McCann and Pamela Shubat of the Minnesota Department of Health,
identified topics to be addressed and speakers for the sessions. The planning committee included
individuals with experience in state fish consumption advisory programs; individuals
knowledgeable of Native American tribal concerns regarding fish consumption and advisories;
academicians experienced in issues of fish consumption, indigenous communities' concerns, and
environmental justice; and representatives of EPA and the Agency for Toxic Substances and
Disease Registry.
The conference officially opened on Sunday, May 6th, with a Risk Communication
Display Session (see Part VI, Appendix A). Various state, federal, and tribal programs displayed
examples of their fish advisory communication materials and were available to discuss the
programs they represented. All display materials were made available to conference participants
on a CD-ROM and will be included in a fish advisory information clearinghouse to be
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Part I: Conference Summary
established on the EPA fish advisory website www.epa.gov/ost/fish. Copies of the CD-ROM are
available from EPA.
This proceedings document is organized in six parts. Part I offers a summary of the
conference proceedings and recommendations. Part II contains the text of the presentations made
by invited speakers and panel participants. Part III summarizes the breakout session discussions
and recommendations. Part IV provides an overview of the Risk Communication Basics course
that was offered concurrently with the Breakout Sessions. Part V contains the transcribed
questions and comments submitted by participants throughout the conference. And conference
background and presentation materials are provided in Part VI.
Conference Organization
The conference was organized around the six primary steps of risk communication:
¦	Identify and get to know the audiences
¦	Determine what the audiences need and want to know
¦	Choose and develop the message content
¦	Choose the medium for the message
¦	Implement the communication program
¦	Evaluate the risk communication program.
These components were explored through a variety of session formats. Presentations,
breakout discussion groups, and lectures allowed conference participants the opportunity to learn
more from experts in the field as well as from one another through active participation in
discussions. The contents of these sessions are presented in Parts II and III of this document. In
addition, participants were encouraged to submit questions and comments in writing. These
questions and comments were intended to allow participants to comment on the record when
time or session format did not allow discussion. The written comments have been transcribed and
are presented in Part V, Written Comments.
Conference Summary
Welcome and Introduction
Kathy Svanda, Minnesota Department of Health, followed by James Hanlon, U.S. EPA,
welcomed conference participants and explained the purpose of the conference. The number of
fish advisories has been steadily increasing nationally over the last decade, with 48 states
currently having fish consumption advisories in effect for some state waters. Advisories now
cover 71 percent of U.S. coastal waters including all waters of the Gulf of Mexico, and all of the
waters of the Great Lakes. Health effects are not abstract or theoretical and exposure to
contaminated fish can lead to a range of health problems. States and EPA have made
improvements in communication, but traditional communication mechanisms may not be
effective in reaching at-risk groups, including the rural and urban poor, women, and those who
eat large amounts of fish. EPA's role has been to provide guidance to the states for their fish
advisory programs through the document series, Guidance for Assessing Chemical Contaminant
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Part I: Conference Summary
Data for Use in Fish Advisories. The most recent risk communication endeavor undertaken by
federal agencies was the National Mercury Consumption Advisory issued by EPA for locally
caught freshwater fish and issued by the Food and Drug Administration for commercial marine
fish. The conference objectives are to better understand how different at-risk populations receive
risk communication messages and what the barriers are to communicating effectively with these
hard-to-reach populations.
Identifying and Getting to Know the Audiences
Barbara Knuth, Cornell University, began the morning plenary session with the keynote
address, "Risk Communication Challenges: Are Audiences Hard to Reach? Or Are the Messages
Hard to Send?" Dr. Knuth introduced the process of risk communication as it pertains to fish
consumption advisories: Risk communication is a process of sharing information about perceived
and potential dangers and benefits associated with fish consumption. Audiences can be hard to
reach for a variety of reasons; they may not speak English or have only a limited command of the
language, they may be geographically isolated, or they may be suspicious of the agencies
delivering the advisory information. Some audiences choose not to follow the consumption
advice because they feel the benefits of eating fish outweigh the risks. To communicate risk
information with these audiences requires understanding the elements of culture and
communication and how they affect the communication process as well as the response process.
Session 1: Perceptions of Fish Safety: Voices from the Community addressed the first
step in risk communication with a panel of five diverse community representatives. Josee Cung,
Minnesota Department of Health, spoke of the concerns of Minnesota's Southeast Asian
immigrant community regarding cultural traditions, chemical contamination, and consumption
patterns. Maria Maybee, Great Lakes United, discussed the objectives of her project and related
a few of her successes in risk communication. She spoke specifically of the challenges in
reaching Native Americans and women. Jose Cuevas, Commissioner for Human Rights,
Elizabeth, New Jersey, described the efforts of the New Jersey Department of Environmental
Protection to perform a fish consumption study in his Spanish-speaking neighborhood. He also
discussed his recommendations on how to make this study more successful. Ora Rawls,
Mississippi Rural Development Council, voiced the concerns of the rural poor and, specifically,
African-Americans. She stressed that the amount of fish consumed is underestimated and that
advisories are not yet communicated effectively to the rural community. Patricia Cochran,
Alaska Native Science Commission, described the goals and objectives of the Traditional
Knowledge and Contaminants Project. She also related the concerns of the Alaska Native
Communities about the overall cultural and environmental health of their communities and the
changes observed in fish and wildlife species in Alaska.
Session 2: Risk Communicator Presentation examined the process of getting to know the
audience from the risk communicator's point of view. Ed Horn, Bureau of Toxic Substance
Assessment, New York State Department of Health, discussed the different aspects of at-risk
populations and hard-to-reach audiences. He described some of the major challenges facing New
York State (lack of funding and staff) and the nontraditional communication strategies that have
been used to address these challenges, such as partnering with other agencies or groups.
Stephanie Allen, Sagamok Anishnawbek First Nation, described a case study of the Effects on
Aboriginals from the Great Lakes Environment (E.A.G.L.E.) project and discussed key points for
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Part I: Conference Summary
working in partnership with First Nations and Tribes. Henry Anderson, Wisconsin Division of
Public Health, examined how to realistically promote and establish fish consumption advisories
with limited resources. He stressed the importance of developing a common message to avoid
confusing the audience.
In Session 3: How to Gather Information on Target Audiences, Sharon Dunwoody,
University of Wisconsin-Madison, discussed the need to determine who your target audience is
and what information they need to know. Dr. Dunwoody discussed the advantages and
disadvantages of various information-gathering techniques, such as focus groups, purposive
sampling, and mail, telephone, and in-person surveys and presented a case study to further
illustrate the point.
Determining What Your Audiences Need and Want to Know
Following lunch, conference participants chose to attend either the Risk Communication
Basics Course, Session 1: Overview of Risk Communication Process, Problem Identification,
and Target Audience Identification (see Part IV), or one of the five topic sessions within
Breakout Session 1: Determining What Your Audience Wants to Know. Randy Manning,
Georgia Department of Natural Resources, led the first session of Risk Communication Basics
Course. A facilitator and notetaker (is this one word or two words???] led the discussion within
each breakout topic session. The groups condensed their discussions in the five breakout sessions
into recommendations for best practices and information needs, which were presented in the
plenary session following the breakout sessions.
For Breakout Session 1, recurring themes included involving the target audience
(community) at all steps of the risk communication process and investigating potential
alternatives that would make sense to the target audience to reduce exposure to consumption of
contaminated fish (e.g., fishing at different sites, eating a variety of fish species, and using
various trimming and cooking practices to reduce exposure). Recommendations of the five topic
sessions include the following:
¦	Women's Health Issues—Pregnant, Nursing, Childbearing Age. Go to
community organizations and leaders as well as health care providers to better
understand the information needs of women and how to best reach women.
Include women in the communication process and test messages and evaluate
success throughout.
¦	Cultural/Traditional or Geographically Isolated Subsistence Fishers,
Including Native Americans. Communicators must spend time with tribal
communities; government-to-government relationships must be developed with
tribes; and the social, cultural, spiritual, as well as nutritional benefits of fish and
native diets and the need for replacement protein must be addressed in
communicating fish advisory information. Messages that emphasize options and
choices are better received than the "do not eat" message. In addition, fish
advisories are not a substitute for reducing toxic discharges or removing existing
contaminants from the environment.
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Part I: Conference Summary
¦	Fish Eaters Whose Native Language Is Not English. Involve and use
community-based organizations to build trust, understand the community, and
carry out a communication plan. Each ethnic group may learn and communicate
differently. An important research effort is to understand each community's risk
perception, customs, traditions, and practices.
¦	Economically Dependent Fish Eaters—Urban and Rural Poor. Involve and
use leaders within the community targeted for a communication project. Use
positive messages that emphasize options and choices rather than the "do not eat"
message.
¦	General Population Sport Anglers. Provide anglers with core information on
advisories, but also let them know where to find in-depth information. Focus
messages on family members and friends as well as the angler. Include a range of
healthy choices to reduce exposure, and research the health benefits of eating fish
and the safety of alternatives to eating fish.
In Case Studies of Fish Advisory Scenarios, Kerry Kirk Pflugh, New Jersey Department
of Environmental Protection, discussed a community outreach project for at-risk urban anglers in
New Jersey. The project also included work with children and women. Ms. Pflugh explained the
challenges and successes of this project in detail as well as the lessons learned. Henry Anderson,
Wisconsin Department of Health and Family Services, discussed two projects with which
Wisconsin is involved, then focused on an evaluation of mercury advisory awareness by 3,000
women in 12 states and suggested how these results could affect fish consumption advisory
program development.
Choosing and Developing the Message Content
The second day of the conference opened with Session 4: Choosing the Message Content,
presented by Joanna Burger, Rutgers University. Dr. Burger discussed two case studies that
revealed the importance of choosing a message that takes into consideration cultural and
socioeconomic characteristics of the target audience. The case studies were based in the Newark
Bay Region of northern New Jersey and the Savannah River region, which straddles the states of
South Carolina and Georgia. Through these studies, Dr. Burger emphasized the need to look at
local consumption patterns and the appropriateness of the message.
Conference participants then attended either Breakout Session 2: Issues in Developing
Message Content, or Risk Communication Basics Course, Session 2: Developing the Message
and Selecting the Medium for the Message. Christine Arnesen, California Department of Health
Services, taught the Risk Communication Basics course. As in Breakout Session 1, the
discussions in the five breakout sessions were summarized into recommendations for best
practices and information needs and were presented in the plenary session following the breakout
sessions. In addition to the five facilitated breakout group sessions, a sixth breakout session met.
Participants in the sixth group met to discuss fish consumption concerns specific to indigenous
communities. They also presented a summary of their discussion in the plenary session.
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Part I: Conference Summary
Recurring themes in Breakout Session 2 discussions included the need to know the
audience, problems with a lack of communication about risks associated with commercially
available fish, and the desire to weigh the benefits of eating fish against the health risks.
Recommendations of the six topic area sessions in Breakout Session 2 include the following:
¦	Mercury, Especially as It Relates to Child Development—also, Pregnancy,
Nursing, Childbearing Age. The audience must be well understood because
message content must be adapted to the audience. Test the message and provide
risk communicators with the risk assessment information necessary for
interpreting messages and answering questions. A five-part message can be used
to describe the problem, the impact, the alternatives, the importance of good
nutrition, and the importance of nursing. Carry out further research on the acute
effects of contaminants on the fetus and conduct a risk/benefit comparison of fish
that are typically eaten.
¦	Communicating Risk/Benefit Information. When fish are consumed for
subsistence purposes, there is no clear alternative to eating fish; consequently, a
"do not eat" message is not well received. It may be appropriate to factor the
benefits of eating fish into the risk assessment equations, especially for tribal
communities. Articulate information on a holistic approach to diet and the
benefits of fishing and fish consumption in communicating risks, and involve
consumers in creating and testing messages. In addition, risk communicators must
be very clear about why they are providing benefits information and information
needs, including collecting data on contaminant levels in commercial fish and
refining the accuracy of health benchmarks to try to reduce uncertainty of the risk
assessment equation.
¦	Developing One Message vs. Many Messages for Diverse Audiences. There is
a trade-off between one simple message and many messages that meet the needs
of a diversity of audiences. Messages should be consistent across agencies and be
simple, visual, and capable of leading people to learn more about the advisory, for
example, through a state toll-free telephone information hotline.
¦	Communication Paradigms. The content makes a message effective. Use
combinations of the different types of messages (prescriptive vs. explanatory,
simple vs. complex, general vs. site-specific), create multiple messages, and use
special features to direct people to the more detailed information they might want.
Establish an information clearinghouse to improve sharing of currently available
examples of advisory messages using different media.
¦	Issues in Developing Message Content: Common Misperceptions. Ensure that
messages from different agencies are consistent; empower the community in
decisions, messages, their creation, and solution; and create messages specific to
each audience using media appropriate to the audience. Information needs include
how to translate technical data into practical information for the target audience
and research on comparative risks of consuming fish to other risk sources.
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Part I: Conference Summary
¦ Native American Viewpoint. Most of the indigenous community representatives
wanted to meet separately so that they could provide constructive suggestions to
EPA about future meetings. The tribal representatives wanted more participation
in developing the program for this Risk Conference and more opportunities to
make presentations. They also want an opportunity to meet and network among
themselves and the involvement of additional tribal groups in any future meetings.
They discussed inviting EPA staff to their regional meetings and possibly using
any future conferences as in-service training opportunities. Emphasis was placed
on the sovereignty of the tribes and their need to be recognized on a government-
to-government basis. They emphasized that their tribal peoples are concerned
about rapid changes in traditional diets, that tribal communities need to be
involved from the beginning in the risk communication process, that they need to
be included in federal meetings, that they will receive documents or proceedings
from this conference, and that the burden of action should not be placed on the
tribal communities, but on the polluters who are creating the need for advisories.
Choosing the Medium for the Message
John Cahill, New York State Department of Health, presented Session 5: Choosing the
Medium for the Message—Overview. Mr. Cahill examined current media and communication
channels and discussed the advantages and disadvantages for each of these methods. He stressed
the importance of identifying and understanding the audience to be reached by age, gender,
race/ethnicity, income, and whether they were licensed anglers. He emphasized that nearly half
of the potential audience for fish advisory information includes unlicensed anglers. He also
discussed the use of focus groups that were used in New York to obtain information from
minority and other hard-to-reach community audiences. In addition, he discussed advantages and
disadvantages of special events, produced programs, and gimmicks and giveaways and provided
lists of potential organizations with whom states/tribes might partner to get the advisory message
to the target audience.
Implementing the Communication Program
Session 5 continued with examples of state and community communication activities.
Kristine Wong described the methods used by the Seafood Consumption Information Project at
the Save San Francisco Bay Association. Through survey methods, the project was able to best
determine the target population and design the most appropriate public education campaign for
that audience. She discussed using multilingual interviewers to obtain information from the
many ethnic community members that fish in San Francisco Bay and the components of the
project's public education campaign. Josee Cung, Minnesota Department of Natural Resources,
related her department's efforts to design culturally appropriate models of education for
Southeast Asian immigrants. She gave examples of these communication methods, including
standard classroom training workshops, meetings at anglers' homes as a version of the
storytelling tradition, day field trips that included travel to fishing sites, visits to the state biology
laboratory, production of translated materials for the purpose of reinforcing the message, and
radio announcements and videos for airing on community TV network.
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Part I: Con ference Summary
Evaluating the Risk Communication Program
Barbara Knuth, Cornell University, presented Session 6: Evaluating the Risk
Communication Program—Overview. Dr. Knuth described the three elements of evaluation—
formative, process, and summative—and ways the elements could create a useful evaluation.
She also discussed how to judge advisory success. It can be evaluated by determining its effects
on a range of indicators, such as overall diet quality, local economy, and human health.
Evaluation endpoint behaviors include fishing-related, information-related, and fish-eating
behavior. She also emphasized that not seeing a change in behavior does not necessarily mean
the message has had no effect. Audiences may make a conscious, informed decision about not
following voluntary health advisories, or baseline behaviors may be already within the
recommended guidelines and the risk communication information helps maintain those desired
behaviors.
Following the introduction to the topic by Dr. Knuth, two presentations focused on
examples of methods used to evaluate the effectiveness of the message. Barbara Hager,
Arkansas Department of Health, discussed the evaluation efforts for the Arkansas Mercury in
Fish Project. She spoke of the challenges in evaluating health advisory risk communication
programs and the lessons that could be learned. She discussed questions that Arkansas used to
evaluate their program. Thomas Nighswander, Alaska Tribal Health Consortium and University
of Washington Medical School, used lessons learned from the Exxon Valdez oil spill to discuss
how to create an effective message and then evaluate its success. A primary point of his talk was
that the subsistence fishers in the area of the spill needed to be involved early on in the planning
and execution of the sampling program, reviewing the results, developing the message, and the
tools to deliver the message to the tribal communities affected. A question-and-answer period
followed these two presentations.
After Session 6, conference participants attended either Breakout Session 3: Issues in
Evaluating Health Advisory Risk Communication, or Risk Communication Basics—Session 3:
Implementing and Evaluating the Message. Eric Frohmberg, Maine Bureau of Health, led the
final session of the Risk Communication Basics Course. As in previous Breakout Sessions, a
facilitator and notetaker led the discussion within each topic session. The topic groups condensed
their discussions in the five breakout sessions into recommendations for best practices and
information needs, which were presented in the following plenary session.
A theme common to many of the groups in Breakout Session 3 was to include the target
audience in the work of designing and implementing the evaluation. Another common theme
was that face-to-face evaluations, through individual contacts, interviews, and focus groups,
provided the highest-quality data, particularly when carried out by members of the target
community. Recommendations of the five topic area sessions include the following:
¦ Women and Children—Reproductive Concerns. Conduct a formative
evaluation as the risk communication materials and plan are developed. Find an
already assembled audience (at a boat show, environmental or health fair), include
an evaluation piece in the dissemination of the risk message, and use focus groups
and interviews. Questions asked during the evaluations are critical and must be
carefully designed and tested on the target community.
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Part I: Conference Summary
¦	Cultural Enclaves—Native American and Other Cultural and Traditional
Communities. Plan communication goals and message content with the target
audience from the beginning of the advisory process. Assess what messages were
actually heard by the target audience. Evaluation of the message needs to be an
ongoing process as the demographics of the target audience may change or the
advisory message may need to be revised to reflect changes in contaminant
concentrations or revision in health benchmarks based on more recent
information. Fish advisories should contain information on the nature and sources
of contamination so that the affected community is empowered to take action to
reduce pollution sources and clean up existing contaminated sites or obtain
financial compensation for the loss of the natural resource.
¦	English as a Second Language. Build trust, know the community, and provide
follow-through by identifying a respected community leader to partner with.
Show that program goals are achieved. Take time to evaluate the message
effectiveness and response of the community members. Involve the target
audience in designing and implementing evaluation through focus groups or
community meetings.
¦	Costs of Evaluation Methods—Reducing Costs. Carefully assess past
evaluations when planning the evaluation of a program. Partner with other state
agencies, nonprofits, other federal agencies, and universities to save costs on
evaluation. Reduce costs by asking evaluation questions of callers who request
additional fish advisory information and focusing evaluation on the populations of
greatest concern to the program. Use evaluation data collected by others to make
programmatic decisions. Communicate fish advisory success stories to legislators
to obtain more funding.
¦	Measuring Success to Improve Communication. Begin with baseline data,
create measurable objectives and a timeline for the planned communication, and
have an end goal in mind. Involve stakeholders, maintain flexibility, and use both
qualitative and quantitative evaluation. Human biomonitoring currently
conducted by the federal government should be expanded to include more fish
contaminants.
Closing/Summary
Elizabeth Southerland, U.S. Environmental Protection Agency, summarized conference
achievements and discussed EPA's future actions to be developed based on the conference
findings and recommendations. She emphasized the enormity of pulling together the conference,
which included a broad spectrum of participants (over 350 attendees) from state health and
environmental staff, tribal representatives, various federal agencies, university researchers, and
community-based organizations.
One objective of the conference was to have a meeting that would generate discussion
and recommendations that would result in substantial improvements in Volume 4: Risk
Communication of the Agency's Guidance for Assessing Chemical Contaminant Data for Use in
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Fish Advisories. This volume was first published in 1995 and reflected state practices for
communicating fish advisory information primarily to recreation and sport fishers. This
conference provided the Agency with current recommendations on communicating fish advisory
information to sport fishers but also to hard-to-reach populations—subsistence fishers or
traditional or cultural users of this resource.
A second objective was to obtain examples of communication and outreach materials
from state, tribal, and community organizations to establish a clearinghouse for this information
on the EPA fish advisory website. These materials were provided to conference participants on
CD-ROM . The Agency is committed to the development, maintenance, and updating of this
clearinghouse.
Dr. Southerland closed her presentation with an explanation of the funding for attendance
at the National Forum on Contaminants in Fish, which was held in conjunction with the National
Risk Communication Conference.
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Conference Welcome/Introductions
Kathy Svanda, Assistant Division Director, Environmental Health Division, Minnesota
Department of Health
I want to thank everyone for joining us in this risk communication conference. My name
is Kathy Svanda. I am the Assistant Division Director in the Environmental Health Division at
the Minnesota Department of Health.
This conference is co-sponsored by the U.S. Environmental Protection Agency (EPA), the
Minnesota Department of Health, and the Society for Risk Analysis. We at the Minnesota
Department of Health are pleased to have taken a lead role in planning this conference.
During the past year, we have solicited risk communication ideas for this conference from
a wide range of individuals. Our technical advisory committee was especially helpful in
providing valuable input in planning the content and format of this conference. I would like to
thank the members of the committee:
¦	Dr. Henry Anderson, Wisconsin Division of Public Health
¦	Patricia Cochran, Alaska Native Science Commission
¦	Henry Folmar, Mississippi Department of Environmental Quality
¦	Mike Haars and Kristin Ryan, Alaska Department of Environmental Conservation
¦	Ed Horn and Faith Schottenfield, New York State Department of Health
¦	Amy Kyle, University of California-Berkeley
¦	Brian Merkel, University of Wisconsin-Green Bay
¦	Barbara Knuth, Cornell University
¦	Andrew Smith, Maine Bureau of Health
¦	Moses Squeochs and James Thomas, Yakama Nation
¦	Patricia Cunningham, Research Triangle Institute
¦	Steve Blackwell, Agency for Toxic Substances and Disease Registry
Also on the planning committee, from EPA, were
¦	Jeffrey Bigler, National Fish and Wildlife Contamination Program Manager
¦	Elizabeth Blackburn, Office of Children's Health Protection
¦	Kathryn Mahaffey, Office of Prevention, Pesticides, and Toxic Substances
with support from Milton Clark, Region 5, and Ed Ohanian, Health and Ecological Criteria
Division.
Leading the planning for the Minnesota Department of Health were
¦	Patricia McCann, Fish Consumption Advisory Program
¦	Pamela Shubat, Environmental Toxicologist
¦	Molly Madden.
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The turnout here today is impressive. As of last week, there were 336 registrants for the
conference from
¦	Forty-nine states, the District of Columbia, and Canada
¦	State and tribal fish advisory programs and state and tribal natural resource and
water quality programs, as well as the federal government
¦	Academic institutions, community groups, and health and environmental
protection advocacy groups.
With this diverse mix of participants, we look forward to many stimulating discussions
during the next 2 days.
The Minnesota Department of Health became involved in planning this conference
because we knew we would learn from the discussions that take place here. Understanding risk,
recognizing the barriers to communicating risk, and ensuring our communication is effective are
all very basic issues for environmental health initiatives. The discussions that we will have
during this conference are relevant to every issue in environmental health where disparities in
exposure or prevention may occur. We are especially pleased to focus these discussions on
eating chemically contaminated fish, because of our own long history and experience with fish
advisories.
The Minnesota Department of Health also became involved because
¦	We feel it is important to bring together local, state, federal, and tribal experts to
share information in order to take advantage of expertise gained at many levels of
organization, from community activism to federal policymaking.
¦	We believe it is important to work collaboratively not just to share these
experiences, but also to critically evaluate what has been done and recommend
our successes to others.
There is a wealth of experience represented in this room. We want to learn from all that
you bring to this conference over the next 2 days. Thank you for coming.
James Hanlon, Acting Director for Office of Water, U.S. Environmental Protection Agency
Thanks to the Minnesota Department of Health for their leadership role in co-sponsoring
this conference. About 15 to 18 months ago, a conference like this was a glimmer in the eye of a
couple of people. I don't think they had any idea we could attract a crowd like this with the
interest that you all bring to the subject. Again, thanks to Minnesota for stepping up and playing
a key role in getting this conference together. For a successful conference, probably in excess of
50 percent of the input that drives the success of a conference is the preorganization: setting the
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agenda, bringing in the appropriate speakers, and bringing in the participants. I also want to
recognize Pam Shubat and Pat McCann for their efforts in bringing us all here this morning.
Why is this conference important? From EPA's perspective, we have three reasons or
background elements. We have contamination, effects, and communication issues to deal with.
One way to identify the background levels of contamination is to look at actions the states
and tribes have taken in terms of advising the public of contamination in their waterbodies and in
the fish they eat. Based on our information, on an annual basis, beginning in the 1990s, every
year that the states have looked at their waterbodies, fish contamination numbers have increased.
In 2000,48 states issued fish consumption advisories for in excess of 63,000 lakes across the
United States and 325,000 river miles.. Advisories cover 71 percent of our national coastline, all
the Great Lakes and connecting waters, and all of the Gulf of Mexico. In all those locations and
many others, fish are not safe to eat in unlimited quantities.
What do we know about effects? Because of widespread mercury contamination, we are
especially concerned about risks to fetuses and young children. The health threat posed by
contaminated fish is not abstract or theoretical. We know it is real. Studies demonstrate that
exposure to contaminants in fish can result in a range of health problems. For example, studies of
mercury show that women who consume contaminated fish put their babies at risk of increased
learning disabilities and developmental problems. Other studies indicate concerns such as
increased cancer risk and liver disorders associated with exposure to contaminants known to
occur in fish, such as PCBs, dioxins, and a litany of banned pesticides.
Effectiveness of communications: States, together with EPA, working on our risk
communication messages, have made dramatic increases in our efforts to reach out to the public
to communicate associated risks.. Monitoring is key. Many states have significantly increased
their investments in monitoring resources in terms of taking fish samples, doing the risk
assessment, and providing that information to the public. Despite our best efforts, the concern is
are we communicating effectively? In particular, these at-risk populations often include urban
and rural poor and those who regularly consume fish in significant amounts. These groups are
also those for whom many of our traditional communication mechanisms may not be appropriate.
That is one of the major reasons we brought you all together here to look at these traditional
communication techniques and provide advice to EPA and the states to improve them over time.
EPA's role in the national fish contamination program is one where we have gathered
information over the years from states. We've also played a role in providing guidance to states
on how to establish fish consumption advisories. In the early 1990s, EPA developed a four-
volume set of guidance documents for the states to use to develop their monitoring, sampling,
analysis, and communication protocols. We have also conducted special studies from time to
time. One of those studies is now in the third year of sample collection. We are in the process of
gathering fish tissue samples from a random sample of 500 lakes across the country, and we are
analyzing those samples for approximately 90 individual contaminants. The preliminary data
from that study will be available in late 2001, and we're hoping to have the study complete and
published in 2003. That will give us a perspective across the lower 48 states, based on a
statistically random sample across 500 lakes looking at a wide range of pollutants in terms of
what's in fish tissue. This will allow us to begin to look at policy options for dealing with
pollutants identified in that effort.
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The Agency also develops communication materials about fish safety and, in conjunction
with the Agency for Toxic Substances and Disease Registry, regularly distributes that
information to a wide variety of stakeholders. In rare instances, the Agency has also taken the
step of issuing fish consumption advisories ourselves. An example of that was based on the work
of the National Academy of Sciences last summer. EPA, together with FDA, issued a national
fish consumption advisory-the FDA advisory dealing with fish in commerce; the EPA advisory
dealing with fish caught locally. We believe the fish advisory is an important piece of the risk
communication puzzle. Certainly we have made every effort in our communication materials to
make it clear that, where there are local advisories that have been issued by states, the public
should rely on those first. That is the most relevant information. However, some states have not
been able to issue wide-ranging advisories across the waterbodies in their states. In those cases,
the void that the national advisories are designed to fill is to communicate risk to those
populations.
What are our objectives for this conference? We believe 50 percent of the work has
already been done in terms of putting together a strong agenda for the next 2 days and also in
getting the right people here. What we want to do is, first, to better understand how different at-
risk populations receive risk information. The perspective that the state representatives bring is
critical. I believe there are representatives from over 50 tribes at this meeting. They also bring
perspective to this discussion that is very powerful. Other federal agencies are in the room as
well. Together with the EPA participation, our hope is that we will be able to communicate with
each other regarding appropriate mechanisms for risk communication.
Second, what are the barriers? What are the issues with these at-risk populations that we
are not aware of? The federal government and the states have traditional communication vehicles
as evidenced by the exhibitors (and I thank all the exhibitors for sharing them). These exhibits
show traditional communication techniques. Are there other more focused, more enhanced, more
targeted communication techniques that will allow us to get the word out? We are looking
forward to that input in terms of communications at this meeting. Additionally, this is a golden
opportunity for EPA, other federal agencies, and the states here to establish relationships with
people who we haven't had a chance to deal with very directly on an ongoing basis. We look
forward to beginning those relationships and nurturing them over time.
Everyone who is registered for the conference will receive a copy of the proceedings from
this conference. As we begin the conference-no, let's call this a workshop, albeit a large
workshop. It's very important to the success of this workshop to have your input. It's only
through your input and the give-and-take in that will occur in the breakout sessions that we can
receive the important information that we need from you to take the next step in this program.
Our plan, based on that input, is to update the risk communication volume of the EPA guidance
that supports the fish advisory program. Based on your input, we believe we will have the
information to make a material improvement to that document. We hope to have it out late this
calendar year. That will be an important next step in terms of our ability to communicate with
the public and, in particular, at-risk populations.
Thank you very much. Again, I encourage you to participate in the workshop.
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Keynote Address: Risk Communication Challenges: Are Audiences
Hard to Reach? Or Are the Messages Hard to Send?
Barbara A. Knuth, Human Dimensions Research Unit, Cornell University
Today we're going to be talking about risk communication challenges. What makes
audiences hard to reach and what makes the message in a fish consumption advisory (FCA) hard
to send? There are three major elements of concern: the audience, the message, and the
communicators. Risk communication must be thought of as an interactive process. It is truly a
process of sharing information about perceived and potential dangers associated with fish
consumption.
The risk communication process starts with problem analysis and leads into audience
needs assessment, which will be the focus of today's discussion. Tomorrow, we will look at
communication strategy design and implementation of those communication strategies. We will
also talk about the elements of evaluation: formative evaluation, process evaluation, and
summative evaluation.
We must lay the groundwork for problem analysis and consider the context of the
problem. The context differs depending on who is involved, who is affected and what their
concerns are, and what your objectives are. The health effects—what are they and to whom do
they accrue? Communities and individuals affected—what are their concerns? What are
elements of culture and communication and how does that affect the communication process as
well as the response process? Think of the multiple agency mandates and the different objectives
that implies you are trying to reach. Think about the program budgets that you have to work with;
sometimes those are quite limited. And think of the staff background; many of you dabble in risk
communication and other agencies don't have any risk communicators at all.
Another element is the message—what is the message?
¦	Eating fish is good for you
¦	Fishing is a healthy activity
¦	Fish meals are part of tradition
¦	But—some fish are not safe
¦	Some people are more affected than others
¦	Advice depends on who is giving it.
Who are the audiences we're dealing with?
¦	Licensed anglers
¦	Other anglers; studies have been done that show at least 25 percent of anglers are
not licensed
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¦	At-risk fish consumers, friends, and family
¦	Cultural considerations—issues of sharing, of community building
¦	Economic issues—importance of fish as a food source
¦	Demographics—the characteristics of potential audiences.
Let's look at this first audience—the more traditional outreach:
¦	35 million licensed anglers
¦	75 percent with income greater than $30,000
¦	27 percent with at least college education
¦	73 percent male
¦	90 percent white.
Demographics, culture, and level of education have implications for how we
communicate with this audience:
¦	58 million women of childbearing age in United States
¦	9 percent pregnant in 1 year
¦	Licensed anglers: 73 percent male.
Looking at education statistics, the U.S. Census Bureau reported last year that
¦	42 percent Asians/Pacific Islanders with college education
¦	26 percent Whites
¦	15 percent Blacks
¦	11 percent Hispanics
¦	Licensed anglers: 27 percent.
If we break this out further and look at those who do not have a high school education, we
find 16 percent among Whites, 23 percent among Blacks, and 44 percent among Hispanics. This
has real implications for the level of language and type and complexity of language we use when
we communicate about fish consumption.
Other elements of demographics and culture are
¦	82 percent of U.S. population, White
¦	1 percent American Indian, Aleut
¦	4 percent Asian, Pacific Islander
¦	12 percent Hispanic
¦	13 percent Black
¦	Licensed anglers: 90 percent White.
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What are the challenges? How do we interact with populations who are exposed and
susceptible to contaminants in fish, especially those who may not receive, understand, or accept
risk information?
What makes audiences hard to reach? We can think about the difficulty of addressing the
complexities of cultural practices and tradition, including religious and spiritual traditions that
involve fish consumption, traditions that build community cohesiveness, rituals, and community
celebrations. They complicate the message and the way the message is received. Why might
people be hard to reach?
¦	Language differences/how language is used is also very important.
¦	Fourteen percent do not speak English in the home.
¦	Eight percent speak Spanish in the home.
¦	U.S. Census Bureau identified 50 languages.
¦	They may be economically disadvantaged.
¦	They may be unable to meet minimum family needs (e.g., nutrition).
¦	They may be suspicious of government and those sending the message.
¦	They may be isolated geographically and lack access to communication channels.
¦	Lack of access to information: Two-thirds of Americans have Internet
access—86 percent of college graduates have access; 53 percent of high school
graduates have access; and 31 percent of nongraduates have access. This mirrors
access to other kinds of communication vehicles.
¦	Fishing is a social identity. It defines who you are and is an outlet for stress
reduction and for being with friends and family. The audience may be hard to
convince.
Are people really hard to reach or hard to convince? Some choose not to follow advice;
they may believe the benefits outweigh the risks. Looking at a variety of ways people can reduce
risk, they may be more likely to change the amount they eat and less willing to change the
cleaning method, fishing location, species fished, size fished, and cooking methods. These,
especially cooking, reflect your history, tradition, and culture. We need to provide a range of
options to be successful over all.
When we think about communication strategies, think about two major elements: the
ways we can convey the message and also partnerships. By partnerships, I mean partnerships in
two ways: partnering with the audiences with whom you are trying to communicate and
partnering in terms of getting your message out. What are the vehicles by which people normally
receive health-related information and how can you work with those groups?
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What is effective risk communication?
¦	Did we identify the problem
correctly?
¦	Did we identify audiences
correctly?
¦	Did audiences receive advice?
¦	Did audiences follow advice?
¦	If not, why not? We need to
understand more about the
linkages between motivation
and behavior.
To judge an advisory's success,
evaluate its effect on
¦	Overall diet quality
¦	Support for toxics reduction
¦	Local economy
¦	Tourism
¦	Public trust in government
¦	Human health.
All of these are important evaluators. Risk cor
about perceived and potential dangers associated
with fish consumption.
What media should we use to deliver the message?
¦	Posters giving general information with 800
number
¦	Metal signs at sites on water/or specific posters
at fishing locations
¦	Posters, species lists, consumption advice
¦	Specific advice in small print
¦	Color-coded graphics
¦	T-shirts with 800 number
¦	Paper pads and magnets
¦	Children's text book covers
¦	Canvas bags
¦	Specific advisories with specific fish pictured
¦	Partnering with physicians
¦	Expectant mother's guide showing fish that are
safe and those that arc not and showing cleaning
techniques.
unication is a process of sharing information
with fish consumption and benefits associated
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Session 1: Perceptions of Fish Safety: Voices from the Community
Introduction
Pat Cunningham, Research Triangle Institute
It is with great pleasure that I introduce the speakers in our first conference session—
Voices from the Community. The conference organizers agreed that the best way we can begin
to understand how to improve risk communication messages is to listen to some of the concerns,
fears, and frustrations of the recipients of those risk communication messages.
These voices from the community represent the surprising diversity that exists among
hard-to-reach populations—a diversity that challenges even the most sensitive, conscientious,
and caring of risk communicators. The speakers represented on this panel today reflect this
diversity.
One voice speaks of a geographically isolated community in Alaska whose members are
dependent on traditional hunting and fishing for their subsistence and often have no alternative
to consuming locally caught fish because there is no such thing as a neighborhood grocery store
on the tundra.
Another voice across the continent comes from an urban community member from the
New York metropolitan area who represents a Hispanic community, one of the fastest growing
ethnic groups in America. While Hispanic groups may share the same language, they often
represent very different cultures and traditions.
Another speaker represents the voice of an economically isolated community in the South
whose members struggle with rural poverty and supplement their diet, by necessity, with locally
caught fish.
A voice from Minnesota represents still another important ethnic segment of our
population, the Asian American community whose members struggle with language and cultural
traditions often quite different from those of the mainstream U.S. population.
Last, a Native American voice from the Great Lakes region represents the voice of
women—and especially pregnant women and nursing mothers who have concerns about the
safety of consuming contaminated fish not only for themselves but for their developing fetuses
and nursing infants.
By prior agreement with these voices from the community, I will introduce each one to
you now only by name—and let them frame their lives and their communities' concerns by
describing in more detail for you their experiences from the communities that they represent.
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Josee Cung, Program Manager, Southeast Asian Program, Minnesota Department of Natural
Resources
Here are the voices of Minnesota's Southeast Asian immigrants, a community of four
distinct ethnic subgroups: Cambodian, Hmong, lowland Lao, and Vietnamese. Estimated at
130,000, Southeast Asians are the state's largest and fastest growing minority. Back in their
homelands, they practice all forms of fishing, primarily for food. This tradition continues here in
this country.
Fish continues to be an important part of Southeast Asians' daily diet, and so the
community's main concerns around the issue of fish consumption are
¦	Where to go and catch fish
¦	What the less contaminated fish species are
¦	Where to find cleaner and safer fish for the family table.
As to cultural traditions and views regarding contamination, they have very little
understanding of, and little experience with, contamination by pollutants. Southeast Asians are
more familiar with, and better prepared to deal with, fish diseases (e.g., parasites, worms). Major
challenges include
¦	To provide concrete examples when discussing and teaching about chemical
contaminants
¦	To overcome major cultural and language barriers because
—	Southeast Asian has an oral tradition of passing on/sharing information
and learning.
—	There are no easy equivalents of technical/science-related terminology in
any of the four Southeast Asian native languages.
—	The majority of learners have no, or low, educational background and
especially lack basic science knowledge.
—	They are unfamiliar with fish advisories that are seen as too complicated,
difficult to use, and not user-friendly; most people would go out to catch
fish with not the slightest thought for current fish advisories.
There have been important changes in Southeast Asian traditional consumption patterns
as a result of education and, therefore, better awareness of health risks associated with
consumption of contaminated fish. Changes are in two main areas:
¦	Fish species: There is now a tendency to stay away from bottom feeders and a
preference for smaller and leaner fish.
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¦ Fish preparation: There is more acceptance and practice of discarding fat parts,
skin, and internal organs and to fillet fish.
But Southeast Asians still believe that, if waters look clean and clear, fish from these
waters are also safer to eat. They also believe that ocean fish are safer; therefore, there is
increased reliance on imported frozen fish from Asia for food.
Maria Maybee, Great Lakes United
I am Haudenosaunnee, People of the Longhouse. I am a member of the Seneca Nation of
Indians, born into the Heron clan. I live on a reservation about 30 miles south of Buffalo, New
York, and about 50 miles south of Niagara Falls. Currently, I am employed by Great Lakes
United and have been with them for a year-and-a-half. Great Lakes United is an international
coalition dedicated to preserving and protecting the Great Lakes and St. Lawrence River
ecosystem. We represent environmentalists, conservationists, hunters, anglers, labor unions,
community groups, and citizens of the United States, Canada, and First Nations and Native
American tribes. At Great Lakes United, we develop and promote major policy initiatives, carry
out educational programs, and promote citizen action and grassroots efforts within the Great
Lakes Basin. We do this to ensure clean water and air for everyone and to provide better
safeguards to protect the health of people and wildlife—a conservation ethic that will leave a
healthy Great Lakes ecosystem.
Great Lakes United has five major task forces:
¦	Healthy Community
¦	Sustainable Water Use
¦	Nuclear-Free Great Lakes
¦	Clean Production
¦	Biodiversity and Habitat Protection.
The goal of the Biodiversity and Habitat Protection task force, of which 1 am a member,
is to develop strategies to reestablish self-sustaining diverse native fish and wildlife communities
throughout the Great Lakes Basin. I provide information to citizens on aquatic habitats and key
initiatives around three different funds. The first is with the Great Lakes Aquatic and Habitat
Fund. We provide wetlands and grassroots support with networking and financial support, which
is provided to citizens and groups. Basically our work is within the shoreline, inland lakes, and
rivers that include the aquatic habitat within the basin.
We have a newsletter that goes to all members, we provide an online resource directory
that goes out to all the members, and we have access to 22 professionals across the entire basin to
help with any issues. Fish is one of our key objectives—to maintain healthy and sustainable fish
populations.
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We have hubs in every state and are going on line with a new hub to target First Nations
and Native American tribes around the entire basin. This new project deals with fish
consumption, fish habitat, aquatic habitat, wetlands issues, and water quality on a grassroots
level—not just what our governments can do but what the tribes can do as well. Another one of
my hats is with the Marsh Monitoring Program out of Canada. I help recruit volunteers. I think it
is very important that all peoples of the Great Lakes Basin can identify fish, plants, and habitats,
which all leads to knowing your environment.
The reason I am here today is because of my work with fish advisory outreach in western
New York, which is part of the Lake Erie Binational Public Forum outreach program to provide
fish consumption education. These efforts grew out of the environmental justice task force's
commitment to protect the health and welfare of people in the basin regardless of race or
economic standing. Cultural consideration and economic diversity contribute to high fish
consumption rates among minority and tribal groups around Lake Erie, as well as in the rest of
the country. Populations tend to be concentrated in urban areas along the Lake Erie shoreline.
This is also where minority and lower income populations are found, including African
American, Latino, Asian American, Arab, and Native American communities. My reservation is
on the Lake Erie waterfront. This project is in partnership with the Ohio Environmental Council,
Great Lakes United, and workers for environmental justice, and it is managed through the Delta
Institute under Kate Bloomberg. Last year, the working groups and partnerships developed a
family guide for eating fish in the Great Lakes Basin. The guide is handy and easy to read and is
developed so that everyone down to the 7th-8th grade reading level can understand it. My work
area is Buffalo River, Buffalo Harbor, and Niagra River, but that is hard to do in western New
York because lots of people come to fish in many different areas along the lake front. Regardless
of where they are from, we try and get them the information because it is also relevant to the
entire state.
Some of my successes have been collaborations that I have had with the Boys and Girls
Clubs of Western New York. 1 have been instrumental in helping to develop outreach programs.
One child can teach 10 adults faster than I could ever think of doing. The children helped me last
summer create papier-mache fish heads; during this process, several volunteers and I were able to
educate the children about what we were doing and why we were doing it. This was a fun thing
to do for the children, who took information back to their families and their communities. They
worried about their parents, aunts and uncles, and other family members eating contaminated
fish. Sending information out this way was a great tool, because the children are not going to let
their family member eat the fish. When given the facts, children know the risks associated with
eating the fish and they take their own actions.
Another group that I have worked with is the Sisters of Mercy. They help spread the
message to the women they serve who are most at risk because of their economic status. The
Sisters know that these women will eat fish, if given it, in order to feed their families. The Sisters
try to make them aware of the problem and give them choices as to where the safer places are to
catch fish, but in western New York this is very hard to do. Another one of my successes in
doing this work is that I need more people to help me. I have to identify more people within the
communities that I serve. I work effectively in my community and, when I go to some of the
other reservations, I feel the people are listening to me, but when I go to the Asian community,
I'm clueless as to how to reach them. I still try my hardest and give the message to the people,
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but right now I rely on volunteers, and getting enough volunteers is a struggle in itself. The New
York Anglers Study basically agrees with me, that it has to be someone from the community and
that it has to be a message that is understandable and comes from someone who can relate to
their own experiences.
I grew up in the Cattaraugas Creek area. All summer long we fished and swam in
Cattaraugas Creek. I had 18 brothers and sisters, so the work I do now is very relevant to me. We
grew up going to the creek. We would all go to the creek after we had finished our chores. On the
way, we would pick berries, rhubarb, whatever was there that we knew we could eat. We would
get to the creek and go fishing, and we would cook the fish there. We would enjoy the afternoon
swimming and frolicking in the water. My brother came home last summer, and we said we were
going to take all the children down to the creek since they had never had that experience. It was a
flop; some of the children got rashes and it was terrible.
I worry about the long-term effects for my family as well as my community. In my own
family, there is a history of diabetes and thyroid disease. Some of our children were born with
neurological problems or developmental disabilities. Where did these come from? It cant all be
from our diet and our lifestyles, unless our lifestyles are because of the environment that we live
in. There is a Superfund site within a few miles of our reservation right along the Cattaraugas
Creek, and there is also the West Valley Nuclear Waste Facility farther upstream from the
reservation, Both of these are known to have discharges in Cattaraugus Creek. There is no
monitoring of this creek, which makes it hard for me to tell women what to eat and not to eat or
what their options are when I really don't know myself. When I speak with the New York
Department of Health, they say they don't have the money to monitor the creek. So I have said to
them: What if we find the opportunity to do the sampling ourselves? But this will not work
unless we go into a close working relationship with them to collect the data. If we do it ourselves,
it won't be recognized by the state. The New York State tribes and the New York State
government do not always agree on an issue.
Some of the challenges that I hear from the people are that they do not want the
contaminants in their water—they want 0 ppm. They don't want to have to worry about how
much is in the water. They just don't want the pollution. Why should they have to worry about
it? They would rather change their behavior and their consumption habits, whether it is a product
or food. They don't want to have to worry about whether fish have mercury or cadmium in them
and how much of each, or not to exceed 52 meals a year. Should they eat one meal per month or
one meal per week? If the fish are deformed, then they obviously won't eat them. But what
about the contaminant effects on the fish that you can't see? It's a very confusing advisory. Out
of respect for the people who spend a lot of time creating these advisories, I am sorry to say that
they just don't work. People want to go to a list of the waterbodies and know what is safe and
what is not safe and what they can or cannot eat. How much can they eat safely? They really
don't care what the contaminant is until they are more educated about it. They just don't want the
exposure to the contaminants. What about radionuclides? There are no fish advisories for
radionuclides. That is an issue for me as well as my community.
From my own experience, within 6 months of stopping eating fish, I developed diabetes
and had to struggle with it. But when I resumed eating fish again my levels came down to
normal. That is the fact of the world. So, if I can drink the water, if I can swim in the water
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alongside the fish and not develop rashes or nausea, and if I can eat fish for my welfare—without
worrying whether it is in group 1 or group 2, or whether I can have one fish or two fish—then I
will know that our ecosystem is in a good state. Thank you.
Jose Cuevas, Commissioner for Human Rights, Elizabeth, New Jersey
I am not a hard-core environmentalist. I do have concerns about the environment,
especially around where I do most of my living and breathing. My involvement in environmental
issues started with serving as a stakeholder in a Brownfield Task Force in Elizabeth, New Jersey.
This was my first contact with Department of Environmental Protection (DEP) staff in the form
of DEP inspectors. I developed a good working relationship with these inspectors, because I am
always brutally honest in these types of meeting so as not to waste time. The inspectors, for their
part, were always ready to provide any information we requested.
At about the same time, I received a phone call from a staff person working for the
Science and Research Department of the DEP, requesting to meet with me to talk about a study
that was going to focus on the effects on Hispanic women and children who were consuming fish
caught in the Arthur Kill waterway between Elizabeth, New Jersey, and Staten Island, New York.
This sounded interesting to me, so I invited them down to my home for a meeting. Four people
came down for that meeting, and we had a very informative discussion. I was impressed with
their knowledge and manner, which gave me the impression that they collectively had a real
concern for the people targeted in this study.
I was extremely surprised and amazed to discover that none of the four people meeting
with me could speak Spanish. So, my first question was: How are you going to communicate
with your target group if you cannot speak Spanish. Their answer, logically, was: We are going
to hire someone fluent in Spanish. Someone from this area I asked? Yes, if possible, was their
answer. You are going to have problems getting information from people in this area if your
outreach person is not from this neighborhood was my answer. The only way around this is to
hire an experienced community organizer or an activist in the area and, in the case of an activist,
to be sure to win their buy-in to the program.
They had other priorities that needed to be considered and hired a graduate student,
because they needed a case study written up, and other considerations may have been a factor. A
Spanish graduate student was hired, but she was not very successful in her outreach efforts. I
was called to see if I could offer any suggestions. I receive requests from people from time to
time and it's not a problem to provide some information. But they had hired someone to do this
and I was not offered any compensation, so my general rule is that you get all you can out of me
on that first meeting because I have little spare time. In the case of this study, because it was in
my neighborhood dealing with my neighbors and because I felt that there was a real concern for
the people targeted, I agreed to meet with them one more time on this issue.
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Here are the recommendations that I made to them:
¦	Go out to the fishing spot and fish. There is no need to talk right away, just to be
seen.
¦	Contact the two area schools; they both have community liaisons who are always
looking for information to give parents. (This will also make them look good.)
¦	Science and research has tons of materials on the fish found in these waters.
Bring color pictures, coloring books, etc.
¦	Don't mention the signs; everybody in this area knows what they say.
¦	Focus your discussion on the dangers to children. (There are adults in this area
who have been eating this fish for 20 to 30 years.)
¦	Be aware that it will take time to develop relationships.
¦	Once you begin to talk with people, try to get one name from them and ask if you
can use them as a referral.
¦	Within sight of these no-fish areas, there is commercial fishing going on, or at
least that is people's perceptions.
¦	People want to see data about the dangers; if there is no data, explain why.
¦	Translate all the information that you do have.
¦	Health fairs go over well in this area.
¦	Undocumented residents have no health insurance.
¦	Study the people carefully in each spot. There will be a leader or leaders; these
are the people you must win over to get the rest to open up.
Ora Rawls, Executive Director, Mississippi Rural Development Council
By way of introduction, I am a native Mississippian, born in the Delta Region, which is
very poor, rural, and has some of the most gruesome statistics in the country concerning health
care, education, infrastructure, economic development. I will not belabor you with the details of
the region.
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Currently, I serve as the Executive Director of the Mississippi Rural Development
Council, State of Mississippi. For a few minutes, I will step out of that role as I share with
you—as a voice of the community—views, concerns, and responses concerning perceptions of
fish consumption in the rural Delta in Mississippi. We were given approximately 8 to 9 minutes
to tell you about a way of living that has expanded over five generations. I lived in several states
(Florida, Texas, Illinois, Michigan, Louisiana) and by choice returned to Mississippi.
I come from a very large family; therefore, fishing, hunting, and farming are part of the
landscape. We had our own gardens, cows, pigs, etc. I can remember walking a mile to carry
water and was very, very happy when the pipes were finally installed to run water outside of our
home, and, later, as water was finally put inside (never mind that it was only cold water). This is
the same water that we drank and used to wash clothes, plant our gardens, feed our animals—that
was safe. Yet, you say: Don't eat the fish that comes out of this water. You see, I lost both my
parents at early ages. Maybe there was something in the water and the fish and everything else. I
provide this background as a framework for your understanding the attitudes of the community
toward fish consumption advisories.
I talked to my 85-year-old brother, who has cancer and gets shots that cost $400+. He
said, "Darling, they say don't eat the beef (mad cow disease), don't eat the pork (causes high
blood pressure), don't eat the chicken (they are raised overnight in poultry houses and never see
daylight); you tell me that all of these things we cannot now eat. I believe that I'll die with
something, so I'll continue to eat the fish." This attitude is indicative of the attitudes within the
region, considering that fish is economical—cheaper than most meat, more often than not
free—and that fishing offers good recreation at the same time. Remember the Tuskegee Project?
Mistrust of the government is not limited to any one group. But, in particular, when you
purposely "disease-infect" individuals, mistrust is elevated to a new level. It doesn't make sense
to them that you would be honest about the contents of water, food, or anything else.
For 2xh years, I served on a task force for clean drinking water (State of Mississippi),
whose primary effort was to ensure that access to water was made available to every citizen. The
level of contaminants was a secondary issue. Many communities, due to sparse density, racial
composition, or a low tax base, did not have access to the minimal level of clean water. So the
initial priority for rural communities was clean running water and, yes, inside water.
What are the concerns in your community regarding the safety of fish consumption, the
importance of fish consumption in your community, and chemical contaminants in fish?
One concern is level of awareness. The message has not yielded the outcry for attention
that one might think as you talk to African Americans about the issue. The priorities are jobs,
health (access, medicine), housing, etc. There is a general assumption that foods obtained from
your own gardens or local streams are safer than those obtained from grocery stores. Every year,
several groups issue warnings about what impacts your health, longevity, etc., which include
advisories on what not to eat.
Fish consumption (volume) has been underestimated. As I shared with a DEQ (EPA)
official, many individuals (African American) eat fish two to three times a week—in rural areas,
as often as five times a week. Where I lived on the Coast (Gulfport/Biloxi), four to five times a
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week. This volume is from personal fishing (streams, lakes, ponds), not from retail sales data
that is used to capture consumption patterns.
Fish and hunting licenses currently are the major method of advisories along with
newsletters. Advisories are not communicated through a mechanism that the rural community
uses.
How do you get the message (fish consumption advisories) out?
¦	Choose a message that is consistent. (Remember what A. Hitler said: If you tell a
lie, and you tell a lie over and over, then it becomes the truth or perceived as the
truth.)
¦	People believe that which is consistent. Tell them that, if the water is
contaminated for the fish, then it is rightly so for the soil and everything else. Yet,
ingestion of the fish provides more direct contaminants to individuals due to the
high levels of carcinogens and the frequency of times eaten.
Present that message in layman's terms.
Use local health departments, churches,
general stores, laundromats, day care
centers, Headstart facilities, etc., as a
means of providing advisories.
Work with other agencies—state and
nonprofits—to ensure that all concerns
are delivering a similar message and, for
sure, not a conflicting message.
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name of a young girl who had died very early in her life. I was given the gift of her name to carry
on her life, to remind me every day of my life that I live my life for another person, and to remind
me, in all that I do, that I should live my life in the benefit of other people.
I wanted to come today to talk to you about a project that we have been working on in
AJaska at the Alaska Native Science Commission and to bring to you the words of our own
community rather than my words. The project is call the Traditional Knowledge and
Contaminants project. Most of the information that I will present today you can call up from our
website, www.nativeknowledge.org.
The goals of the project are to help Alaska Native communities identify and address their
concerns about contaminants, human health, and environmental changes. I am bringing this to
you in this way because in our world view—in our Alaskan and in our Native world view for all
Alaskan and Native American people, our world view incorporates everything—all things are
related. For us, we cannot talk about the health of the fish without talking about the health of our
land, our water, our air, our people, our communities; all things are related. It is a very western
way of thinking that we can take only one issue and look at that and find and solve the problems.
We must look at this as an issue that addresses all of these concerns.
The project objectives are, first of all, to use our own native ways of knowing, learning,
and teaching to gather information. We held our own talking circles in our own communities. We
did not send out survey forms. We didn't have people that had focus groups. We went and sat
with our people for days at a time—laughing, singing, dancing, and eating a lot of food—because
this is a part of what we all do. So, we could really gain the knowledge from our communities.
Our communities, we understand, are the first observers of what happens on our land, to the
people, in the air, in the water, and in the environment around us. Long before a researcher or
scientist or anyone else enters the community, our people are the ones who perceive what
happens every day, and also generationally over centuries and beyond from information that has
come down from their people. We are also providing grant opportunities to our communities and
we are looking at developing a common research agenda that answers concerns and questions
about our communities and not just of somebody's Ph.D. dissertation research topic. And we are
also developing a database. We held regional meetings across the state of Alaska. This is an
overview of things that we heard from communities across the state of Alaska, communities that
were concerned about global warming, abnormalities in subsistence foods, human health, the
impact of commercial and sport fishing, local sources of contaminants and outside sources of
contaminants, changes in the ecosystem, and perpetuation of our culture.
Concerns about Global Warming:
¦	Ice conditions are changing—the thickness of sea ice has decreased.
¦	Warmer ocean temperatures appear to be bringing tuna, mackerel, barracuda,
sunfish, giant turtles, and white sharks to the region. Dirty ice conditions and the
number of sharks has increased dramatically.
¦	The weather is changing, with warmer and wetter seasons.
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¦	Lakes and normally wet areas are drying up.
Concerns about Abnormalities in Subsistence Foods:
¦	Abnormalities are appearing in animals and fish (e.g., wormy whitefish, lesions on
salmon, fish swimming in circles [whirling disease] introduced from outside
fishers fishing in Alaska waters.
¦	Moose meat tastes different and there are water bags in their lungs.
"People on the island are very concerned about the
animals we eat now. They think there might be
something wrong because they are getting very skinny.
A couple of years ago there was a lot of dead birds all
over the beach. I wonder why this is happening?"
Herman Toolie, Savoonga,
St. Lawrence Island
¦	Residents are alarmed by high
rates of cancer and perceive there to be a relationship between rates and local
military sites.
¦	People's diets are increasingly including store-bought foods, pop, and improperly
stored canned and frozen foods.
¦	More people are dying from stomach cancer, ulcers, and other cancers.
Concerns about the Impact of Commercial and Sports Fishing:
¦	Sports fishing has increased (hard concept for native peoples to understand),
resulting in increased waste in rivers and destruction of habitat.
¦	Fish are being destroyed. Too many people are touching them, measuring them,
and tearing up their mouths.
¦	Commercial fishing pressures exist for herring and habitats.
¦	There is a need for marine buffer zones.
Concerns about Outside Impact on Subsistence Foods, Culture, and Environment:
¦	Russian sources of contaminants
¦	Tourists who are uneducated about the environment and local customs
¦	Trans-boundary pollution from Russia and Europe
¦	Muskrats have spots on their
liver and lungs.
¦	Caribou have runny bone
marrow.
Concerns about Human Health:
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¦	Ballast water from barges that introduces foreign organisms, species, and
pollutants.
Concerns about Changes in Ecosystems:
¦	Loss of old-growth forest habitat
¦	Increase in number of otter, beaver, bear and wolves. Beaver weren't there before
because there were no trees, we now have tree growth.
¦	Decrease in edible plants
¦	Decline in herring spawning areas and a shift to earlier spawning
¦	Decrease in availability of medicinal herbs and plants
¦	Decline in number and size of fish.
Concerns about Local Sources of Contaminants:
¦	Mines, military sites,
chemicals used for dust
control, vehicle oil leaks, fire
retardants, and acid rain
¦	Local sources of contaminants
ranging from fuel tanks,
asbestos, lead-based paints,
and pulp mills
"You know when you see a dead fish in a river you
know something is wrong. . . .the people have been
mining that area since I can remember. What have they
been putting into that lake? It makes you wonder."
John Starr
Tanana, Alaska
¦	Mercury from mining camps in rivers.
Concern about Perpetuation of Culture:
¦	Loss of spiritual connection and traditional training relating to the environment
¦	Loss of traditional medicine people and an increased use of the clinic
b Need to return to using traditional medicines and to draw on healthier lifestyle
practices
¦	Need to teach our youth to be caretakers of the ecosystem
¦	Changes in traditional diet and lifestyle
¦	Failure to follow traditional restrictions
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Session 2: Risk Communicator Presentations
Ed Horn, Bureau of Toxic Substance Assessment, New York State Department of Health
I have been involved with fish advisories since the early 1980s and was working with the
New York State Department of Environmental Conservation. This is the agency in our state that
actually catches the fish and grinds them up and analyzes them for various contaminants. Since
1990,1 have been in the Health Department and am currently the bureau director there. I am
involved in deciding what the message should be on the basis of the analytical data and how to
get the message out to those who fish or eat fish.
We are concerned about at-risk populations and hard-to-reach audiences. These are really
two different aspects of our populations. For our conversation, it is important to recognize a
distinction between the two. There are two aspects to at-risk populations: exposure (eating
contaminated fish) and sensitivity. (Young and unborn children are more sensitive to many of
the contaminants that are found in fish, particularly PCBs and mercury.) Therefore, women who
may be having children are at greater risk. It is not because the women themselves are at greater
risk, but it is the children they carry who are at greatest risk.
Hard-to-Reach Populations:
¦	People who are unaware of the advisories: They don't receive the message
because of the traditional ways we disseminate them, which is through fairly
lengthy and complicated booklets and documents. We also provide that
information through guidelines that go to licensed anglers (1 million licensed
anglers and an estimated 0.5 to 0.75 million unlicensed anglers). What about the
unlicensed anglers? You don't need a license in New York State to fish in tidal
rivers such as the Hudson or in marine coastal waters.
¦	People who don't understand the advisories: We can't change the fact that the
risk of consumption is a complicated message. In addition, the risks associated
with contaminated fish are still a matter of controversy, particularly at the levels
we are finding the contaminants, which are typically at the lower levels of
contamination. There is not a clear, well-documented scientific fact of what
exactly the risks of low levels of contamination are.
¦	People who don't read and understand English: About 80 to 90 percent of the
target population does speak English, but it is important to communicate to at-risk
and hard-to-reach communities particularly when they do not understand English.
¦	People who don't believe the advisory message for various reasons: For example,
if the fish taste fine, they must be ok to eat, and many individuals think they can
distinguish a chemically contaminated from an uncontaminated fish simply by
looking at the skin of the fish. It's ok for commercial fishers to catch the fish, but
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not ok for us to catch the fish; the perception is that the government is protecting
certain interests and not others. Response of government to the Hudson River
PCB contamination incident was to prohibit fishing (even the possession of fish)
altogether on 70 miles of river.
¦	People who don^t trust the agency generating the advisories: There is a problem of
not trusting government or individuals who are supporting interests different from
those of the people receiving the message.
¦	People who are geographically isolated: This is not a major problem in New York
State, although there are some isolated areas in upstate New York, but they are
nothing compared to the isolation in Alaska or northern Canada.
What are some of the major challenges in New York State?
¦	Communicating uncertainty and complexity in the advisories: Some of our
populations want species-specific, waterbody-specific, length-specific information
in advisories, and they want the advice to be relatively simple. There are others
who don't discriminate one species of fish from another and simply want to know
if "the fish are safe to eat at this location." Despite an extensive database of
information, the contaminant levels from year to year, even among the same
species, are difficult to interpret. Complex waterways like the Hudson River are
not easy to monitor or evaluate. For example, what is the effect of the striped bass
migration up the Hudson on the levels of contamination in the fish? It's not easy
to decide precisely how much fish is safe to eat. There is still scientific
uncertainty. Part of our role is to communicate that uncertainty—and that's not
easy to communicate to the urban poor and those who don't have college
educations.
¦	Our ability to measure the success of communication efforts other than
anecdotally: We have attempted to do a number of different things, but we
discovered that the better the information you want to get about the target
population, the more expensive and difficult it is to collect. We use an
information hotline and postcard responses, but the number of returned postcards
is very, very small. A survey of the Hudson River over a summer reached only
about 200 anglers. While we have a much better understanding of the licensed
anglers in the state, other populations are very difficult to identify, reach, survey,
and get information that allows us to develop a program. And there are
considerably more differences within the groups we are trying to reach than we
had anticipated.
¦	Marine fish and fish from the market: How do we communicate that there are
health benefits and some species can be eaten without concern for health
consequences while others are of greater concern (swordfish, shark, etc.)?
Focus groups have been extremely helpful from time to time in talking with small groups
of people, which can allow a more lengthy conversation about what is important to them and
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what we can do to change our way of communicating with people so that they will both
understand and follow the advice. We used focus groups extensively in development of the
advisory signs. We took a variety of signs to the focus groups to get responses from the
participants. Signs are seen as no fishing signs rather than warnings to not eat certain types of
fish, and they anger anglers. The state has used signs primarily in the Hudson River, only where
we know we do not reach many of the anglers through the traditional methods.
We have also used public radio and public service announcement. Spanish radio
announcements generated 800 phone calls. Last year, we had free public service announcements,
and these also got good responses in both English and Spanish and many of these spots were
played at prime times during the day.
Bait-and-tackle shops have been found to be a good place to list advisory information
(one-page summaries of our advisories for regional areas). We have not been able to evaluate
posters completely. The commercial fishing industry is upset with posters and we had to be very
careful about the language on the posters, because they think the posters will turn the public off
to eating all fish, no matter where they are caught. The state would like to evaluate this at some
time in the future.
Providing promotional items (refrigerator magnets, t-shirts, bandanas) is surprisingly
effective (although results may be biased).
Networking with community organizations, we think, is one of the most important ways
to communicate with the target population. It is probably the only method left that will allow us
to reach many of the groups that we have not been able to reach via any other methods,
particularly those that are culturally different from our staff risk communicators. It is, however,
very difficult to measure the effectiveness of this effort since we have to communicate with a
leader in the community and then have the leader communicate with the target population.
The most effective ways of communicating with hard-to-reach populations are extremely
labor intensive. They are going to require someone in the target community who has the respect
of the community and an understanding of the community. It requires constant work; it's not just
a matter of sending a brochure out. We can send 20,000 brochures out fairly easily and
inexpensively, but if we have to travel to meet with the target population in small groups, then
this requires additional staff. In New York State, we only have l-Vi FTEs (full-time equivalents)
working with fish advisories to reach several million people. These are some of the challenges
and we are hoping to make progress in meeting them.
Stephanie Allen, Sagamok Anishnawbek First Nation
I'd like to present a case study on the E.A.G.L.E. (Effects on Aboriginals from the Great
Lakes Environment) project, to give you some ideas for working in partnership with First
Nations, the term used for tribes in Canada. I'd like to present an overview of E.A.G.L.E., which
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created fish consumption guidelines for the First Nations; what lessons we have learned from the
project; and what we feel are the next steps as they relate to the fish consumption guidelines
work; and then to discuss the key points that I hope that you take from this for work that you may
consider doing with First Nations or tribes.
Overview of E.A.G.L.E.:
¦	Initiated in 1990 /Canadian Federal Green Plan
¦	Effects on aboriginals from the Great Lakes environment
¦	Partnership approach to research—critical to success
¦	Holistic definition of health—looking at physical, cultural, and economic health.
E.A.G.L.E.	Research Programs:
¦	Eating patterns survey
¦	Freshwater Fish and Wild Game (FF&WG) Program
¦	Contaminants in human tissues (community populations eat fish that no sport
anglers would fish for); body burden, levels of mercury in hair, 26 nations
participated
¦	Health survey (29 First Nations, 2,400 people); background information on health
status—high rates of diabetes, long-term and reproductive health effects
¦	Sociocultural program: impacts on community health and well-being.
Fish Consumption Guidelines:
¦	One of four objectives of FF&WG research programs
¦	Interactive CD-ROM version for 33 First Nations; first time guidelines created;
project ended in 1989, no subsequent work
¦	First Nations need information. First Nations have to be involved and have
control. Limitations of state of science need to be known and communicated.
Infrastructure exists. We have community health centers; we're easy to find.
Capacity doesn't exist: most communities don't have environment committees or
resources; training is needed to understand information.
Commitment must be there, both time and resources. Once E.A.G.L.E. ended,
commitment ended.
Culturally appropriate and relevant communication is the key to success.
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Next Steps:
¦	First Nations fish monitoring program—lot of general information out there, but
we don't know what's happening in our lakes and rivers.
¦	Fish consumption guidelines—information is critical.
¦	Public education campaign.
Related Benefits:
¦	Further research
¦	Policy directions.
Key Points:
Partnership approach—First Nations ownership is essential.
Difficulties are not in identifying at-risk but in action.
Guidelines alone will have little success.
Goal should be to provide information to allow First Nations to make informed
harvesting decisions.
Success is not measured by decreasing consumption.
Success is measured by First Nations action on the real issue—contamination of
our environments.
Henry A. Anderson, Wisconsin Division of Public Health
As a risk communicator I thought we should have some audience interaction—so I
thought I would give you a little quiz to bring you all back to reality.
¦	How many of you believe you have enough funding—all the money you need for
risk communication?
¦	How many think you have half of the money you need?
¦	How many have $50,000 or more specifically allocated to risk communication for
fish advisories?
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What are the chances of marketing a product with a budget of less than $50,000? Zilch.
So given the amount of resources we have all been given to do this job, we probably
aren't doing too badly. That's the positive note, but then there are the challenges. We don't have
enough money—how do we go about getting more resources?
How do we go about realistically promoting and establishing fish consumption
advisories?
If you are a cynic, then you say go for volunteers, do it for nothing. Does that work? It
doesn't usually fly very well in the community because people may be stressed out from a lot of
other volunteering. On the other hand, how many of you in the audience represent community-
based volunteer organizations? We face serious challenges and have to be realistic here about
what we have and build on what we do have. One commonality is that we all agree that, if you
want to be effective, you have to have as close to a common message as you can have. If you
have conflicting messages in your fish advisories, that only confuses the audience.
The reality is what we can try to do is decrease the confusion and have some
commonality. You will see, for example, that there is some commonality in the Great Lakes area
concerning posters, magnets, other fish advisory materials.
Look for what is a means of communication that we can work on together. Share
resources of developmental materials. For example, you have the conference CD-ROM that has
examples of fish advisory information that may be helpful to you in your state program. Please
feel free to use this as a resource if you feel it can be effective.
How many of you have a fish forum or workgroup in your state or region that brings
together the disparate communities to come to common ground? A program that would bring the
angler community and the tourism trade together for discussion?
How do you communicate when you don't have resources? You can use the press
(newspapers) and people will be aware that it's an issue if it gets a lot of coverage, but that
doesn't always give you positive coverage.
What can we do with resources that we have and move forward on a communications
strategy? The awareness in certain communities is not very good and that is probably directly
proportional to the amount of money or activity in those areas. If we feel risk communication is
an important area, then we need to come up with effective strategies. How can we more
effectively get a message out? This should be a goal of some of the workshops later today. We
may have some disagreements on some issues, but we need to come together and look at those
commonalities.
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Session 3: How to Gather Information on Target Audiences
Sharon Dunwoody, Evjue-Bascom Professor and Director, School of Journalism and Mass
Communication, University of Wisconsin-Madison
First, decide whom you need to reach.
¦	Audiences is a plural—not a singular—word.
¦	Different audiences require different information strategies.
¦	What's lethal—opting for too general an audience or for the wrong subset.
Decide what you want your audience to know.
¦	Do you want to explain or prescribe?
¦	Increased knowledge may not be closely linked to behavior change.
¦	How can you be persuasive?
What's lethal?
¦	Assuming a tight fit between your information and their behavior
¦	Assuming that one message channel will meet all your needs.
Understanding your audience well enough requires systematic evidence of
¦	Current knowledge about a risk
¦	Level of worry about the risk
¦	Preferred channels of information
¦	Perceived ability to cope.
How do you gather systematic information to help you target your audience?
¦	Focus groups (nonprobability sample): 8-12 individuals, selected to meet certain
demographic criteria
¦	Purposive surveys (nonprobability sample): can be much larger, chosen for
reasons of availability or demographics
¦	Mail surveys (probability samples)
¦	Telephone surveys (probability samples)
¦	In-person surveys (probability samples)
¦	E-mail surveys (probability samples).
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Pros and Cons of Information-Gathering Techniques
Technique
Pros
Cons
Focus group
¦	Economical
¦	In-depth information
¦	Bias risk
¦	Can't generalize
Purposive survey
¦	Can focus on rare population
subgroups
¦	Can generate large samples
¦ Can't generalize
E-mail survey
¦	Representative sample is
possible
¦	Economical
¦	Low response rate
¦	Lots of missing data
¦	Who actually filled out the
questionnaire?
Telephone survey
¦	Representative sample is
likely
¦	Can gather a lot of data
¦	Declining response rates
¦	Expensive
¦	Closed-ended questions are
not always ideal
In-person survey
(the cadillac of surveys)
¦	Maximizes respondent
coorperation
¦	Maximizes response rate
¦ Very expensive for any but
the smallest populations
How about e-mail surveys?
Surveys are still too risky.
E-mail is the domain of higher socioeconomic status people.
Sampling is very difficult.
Individuals will not tolerate lengthy questions.
Case Study:
The goal of this effort is to better understand how to communicate about the risks of
eating contaminated fish to women of reproductive age living in the households of anglers.
The Problem:
¦	Women are less likely to fish than are men.
¦	Most risk messages are sent to anglers.
Do anglers talk to women? Do anglers protect household members by avoiding
contaminated fish? Can we reach women in angling households directly?
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Field Experiment:
"Trickle down" condition
Direct message condition
Redundant condition
Control condition.
Can we influence
Perceived importance of the issue
Knowledge of the risk
Risk estimates
Perceived worry?
Randomly selected fishing licenses in Wisconsin counties
Screened for women of childbearing age
N = 1,600
400 in each of the four conditions
Response rate: 82 percent
What did we find? Information interventions influenced all four goals:
Perceived importance
Knowledge
Risk estimate
Level of worry
What did we find?
¦	The most successful intervention? The newsletter produced the biggest jump in
knowledge levels.
¦	Trickle-down does not work well. It had no effect on either perceived importance
or on knowledge.
The take-home message? Agencies can communicate successfully with at-risk women in
angling households, but that communication needs to be direct, not indirect.
The process includes
¦	Focus groups
¦	Mail surveys
¦	Field experiments.
Sample
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Case Studies of Fish Advisory Scenarios
Community Outreach to At-Risk Urban Anglers: A Case Study in Risk Communication of
Fish Consumption Advisories
Kerry Kirk Pflugh, Bureau Chief, Raritan Watershed, Division of Watershed Management,
New Jersey Department of Environmental Protection
I will talk to you today about a project that has evolved into a program that started in New
Jersey in 1993. This project has taken on a life of its own. I will summarize its aspects and some
of the lessons we've learned over the past 8 years. I want to first acknowledge three key people in
this project who are here today: Captain Bill Sheehan, the Hackensack RiverKeeper; Dr. Joanna
Burger; and Jose Cuevas.
In New Jersey, we have approximately 130 miles of coastline, and fishing is a
multimillion dollar business. It is concentrated primarily in the lower part of the state, and the
part of the state that I'm going to talk about is very actively used for recreational fishing. That is
the New York/New Jersey Harbor, and I further subdivide it into the Newark Bay Complex. The
complex consists of the tidal portions of the Hackensack and Passaic Rivers, the Newark Bay, the
Arthur Kill, and the Van Kull. It's a highly industrialized urban area with 5 counties and more
than 20 municipalities. It's part of the port of New York and New Jersey and the third largest
port in the country. It's heavily used by urban anglers on a daily basis during the fishing season.
Also in this region, we find very diverse cultures and a rapidly changing population from year to
year, in terms of who we need to reach with information.
In the early 1980s, the DEP and the Division of Science Research and Technology, in
particular, began to explore the subject of contaminants in fish. Several research projects were
conducted and fish tissue analyses were done, and we found that there were elevated PCBs and
dioxin in the fatty portions of the fish and crab that we investigated. Advisories were issued for
the entire state and for Newark Bay in particular. We developed both regional and statewide
advisories. For the Newark Bay Complex and for some other areas of the state, the species we
have under advisories are the blue claw crab, striped bass, white perch, bluefish, American eel,
and white catfish. These species are primarily bottom dwellers or bottom feeders with a high
lipid content and, therefore, have absorbed and stored contaminants that they are feeding off the
sediment of the Harbor area.
The contaminants of concern are PCBs and dioxin. These are colorless and odorless, and
do not affect the appearance of the fish. They bind to the fatty tissue of the fish and to the
sediments of the estuary. Therefore, your perception, your ability to sense danger, is not a way to
evaluate whether or not fish contaminated with PCBs or dioxin are in fact dangerous to eat.
The health outcomes of concern are reproductive disturbances and developmental
problems, and an increased chance of developing cancer if consumed over a lifetime.
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For the Newark Bay Complex, the advisories that we have in effect include
¦	For striped bass: Do not eat.
¦	For American eel: Do not eat more than once a week.
¦	For blue crab: This is the only species for which we have a ban on the taking of
the species and it's an enforceable ban. We can issue fines anywhere from $100 to
$3000 for the first offense for one crab; however, that has yet to be tested. We
have issued warnings; those cases where we attempted to give a fine, the local
courts threw them out because they didn't have local ordinances that supported
that fine.
In the tidal portion of the Passaic River, there is an advisory not to eat any fish or
shellfish from those waters. For the high-risk population that I am most concerned with, the
advisories are essentially to not eat any of those species. How did we communicate these
advisories? Historically, in two ways
¦	Fish and Wildlife Digest—issued twice annually, marine and fresh water versions,
goes to licensed anglers
¦	Press releases.
The problem with anglers in the Newark Bay Complex is that, because the waters are
tidal and New Jersey does not have a marine license, this has not been an effective way to reach
urban anglers with the advisories.
In 1993, a gentleman from the Bay Keeper Program approached the department and told
us that there were a large number of people who were not complying with the advisories. They
were very concerned as an advocacy organization and they demanded that the department do
something about it. Our response was to obtain funding from EPA Region 2 to do a concentrated,
extensive public outreach program. We surmised at the time that the reason people were still
eating, despite the issuing of advisories, was that somehow they were unaware or didn't believe
them or weren't picking up the information that we were distributing. We decided we needed to
do a more grassroots or community-based approach to talk about our advisories in this critical
area. The reason this area is critical is that it is highly contaminated and highly populated and
there is substantial recreational fishing taking place.
We needed to go into the community and have a better understanding of people's
knowledge and understanding of the issue and their level of concern. We went in through the
health departments. The first year of the project was spent getting the health departments to
believe that this was an important issue. We presented a lot of the data that we had collected over
the many years and finally convinced several of them to participate as partners in this effort.
From there, we developed some goals:
¦	Inform anglers of the advisories.
¦	Explain health risks from consumption of these fish and crabs.
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¦	Come up with strategies to reduce exposure.
¦	Establish mechanisms that we could depend on to funnel information through.
b Don't discourage fishing.
Our Division of Fish and Wildlife feels very strongly about the message of fishing. To
say "don't fish" as a solution to the whole fish advisory problem was unacceptable to them. We
had to work with our Fish and Wildlife Division on developing a message on catch and release.
Of course, this is a complicated message for people who are relying on fish for economic
reasons, for cultural reasons, and for traditional family reasons, but that has become part of our
overall message.
We tried to be consistent with some of the basic tenets of risk communication in
developing this project by looking at the inequity of traditional communication channels and
coming up with alternatives to these traditional methods such as press releases and the Digest
and just communicating to local leaders and not going to that next step beyond.
We also designed the project so that local leaders would direct us in terms of what they
needed to have developed and how we would communicate within their communities. We did
this by establishing site teams. The site teams were organized around areas that had been
identified as very active fishing sites. The site team consisted of city officials, community
activists, civic groups, anglers, the environmental community, and average concerned citizens.
We had three site teams: one at the northern end, the southern end, and in the middle. We
probably could have had more because the population is vast, but that worked pretty well. Each
team emerged with its own personality, own level of concern, and own approach in terms of how
their communities communicated.
In doing an assessment of the site team members, one fact came out—that information
needed to be developed. Up to this point, there had been very little information put in any form
for distribution to the public. We had some early publications back in the early 1980s when
advisories were first issued, but nothing had been reprinted or issued in an ongoing way. There
was a desperate need for information materials and that was what we focused on in the first
couple of years.
We created a checklist of things that should be developed and things that we should do.
The checklist included information meetings, publications, a video, and signs. We designed an
education program and conducted research.
This document was one of the first things we developed and it is still in circulation. It was
for the general population, something that we could make available to anyone and everyone.
Very quickly, we realized we needed to develop something specifically for women who were, in
fact, our target, our key audience. This document was developed in both English and Spanish
under guidance by both citizens and people internally. This was a bear to try to create. We
modeled it after Minnesota. It was a process; the review that we went through to get this out the
door was just extraordinary.
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"In one of his travels up and down the river, Captain
Bill met a family who were crabbing and they had
taken the sign from its spot and had placed it on a car
tire that was on fire; they had a pot on the sign and in
the pot was Hackensack River water and the crabs that
they had just captured."
We also developed an 11-minute
video. It goes through what the advisories are, how they affect women, what to do to reduce your
exposure, and how to clean fish. It was all shot locally and we have distributed that to the
population and will have it translated into Spanish so that we can get it out to other communities
as well.
We wanted to know more about our anglers. We had done a midpoint evaluation and
found that, despite all the wonderful things we had developed, all the great stuff we were doing,
and how the community was so much more informed, the target audience still were eating the
fish and were largely unaware. So we did an in-person survey during the course of one season
and interviewed 300 anglers at the site. It was a very deliberate decision to do this kind of survey
because we wanted to get to the people who were actually doing the fishing and crabbing, so we
had a better understanding of their demographics, their perceptions, and their consumption
patterns. One interesting result was that when it comes to learning about advisories, they were
using traditional kinds of methods to seek that out. However, when they wanted information
about fish and fishing, they were relying on fishers and bait-and-tackle shops. We needed to use
both avenues to get that message out.
The one project that I am very proud of developing and that has received accolades both
regionally and nationally is our Harbor Estuary Urban Fishing Program. This is a 4-day in-
classroom program that we do with 5th and 6th graders. It came out of a suggestion made by health
officers to take kids fishing if you want to teach them about advisories. It started as a 1-day
fishing course and I began to think a bit broader in terms of water and water quality and what
kids ought to know about fish. We designed this 4-day program that deals with the function and
value of the estuary and knowledge of the advisories, bioaccumulation, the link between what
humans do on land and how it affects the water. It starts with a classroom day, a storm water
drain stamping day, and a waterfront cleanup. We do water quality monitoring and Captain Bill
takes the kids out on an eco-cruise of their estuary. For many of these young people, it's the first
time they've ever seen their community from the water. We also take them fishing. Something
that many of them have never done in their own community. We do pre- and post-tests and the
curriculum is linked to core curriculum standards, which is critical if we want teachers to
participate. The Fish and Wildlife Division is a major part of this and delivers its message about
resources, conservation, and being an ethical angler.
We are very much focusing on the negative and not on the positive of the (Newark Bay
Complex) area. I wanted the children to feel proud of where they live. So we did a study of the
species that you can find only in this area and did a poster by an award-winning artist. We
distribute this to classrooms, along with a brochure, so that teachers can use them as part of their
science program.
We also created signs. Everyone
wants signs—they think that if you have signs
up you've done your job. I was on the fence
about signs but the community wanted it. So
we put the signs up. Signs can work—but not
for providing information!
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Lessons Learned:
¦	Local liaison is critical.
¦	Understanding local issues, networks, and communication patterns is essential.
¦	Partnerships are necessary.
¦	No one model works everywhere even if the waters are shared, the city is the
same, and the environmental issues are similar.
¦	Be flexible, take time to visit, listen, and learn.
¦	Offer alternatives that are real and safe.
Where are we now? We're doing a women's Latino study; our Harbor watershed program
is ongoing; our fish advisories in New Jersey are being updated. Exposure studies are being
conducted and our whole communication program is going to need to be reexamined, particularly
as we issue our new advisories.
Henry Anderson, MJ)., Chief Medical Officer, State Environmental and Occupational
Disease Epidemiologist, Wisconsin Department of Health and Family Services
One of the first things I did when I arrived in Wisconsin in 1980 was to evaluate our
advisories. A common evaluation method in the past was to mail or telephone surveys to licensed
anglers. Generally, the level of awareness among licensed anglers in the Midwest was very high.
Compliance, on the other hand, wasn't so good. Just putting a little information in the license
booklet and getting press out once a year is simply not enough anymore to have an effective
program.
We have two projects that have been funded by ATSDR and EPA. One project, started by
special legislation, created the Great Lakes Initiative and, since 1992, we have established a
Great Lakes Sport Fish Consortium. We meet once a year with all but one of the Great Lakes
states to come up with a strategy, a new theme, and an approach, and then work together to have
some commonality in our approach. This project specifically looked at advisory effectiveness,
largely awareness and understanding. We wisely listened to expert counsel and did not address
the issue of whether we actually effected behavior change. We then did a number of health
outcome studies, and now the seven states are working on collaborative advisory
implementation.
The second project was initiated by Maine and is a consortium of two states, Maine and
Wisconsin. Here, there was a lot of interest in mercury, whereas the other project looked at
organochlorine, specifically PCBs. The emphasis in the Great Lakes has been on PCBs since the
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early days, and most of our focus was on PCBs. In fact, we have far more waterbodies that are
covered by mercury. The vast majority of fish that are caught in our state are more likely to be
contaminated by mercury. The largest fish, on the other hand, are PCB concerns.
This project was started in 1998 and is ongoing. We asked for volunteers from states to
allow us to conduct random digit dialing surveys with states. For the first time we tried a mailed
biomonitoring process. We interviewed the women in the states by phone but at the end of the
interview, they were offered information from their states on advisories. Since we quizzed them,
if they got the information wrong, we wanted to be sure that they left the interview with correct
information. We also asked if they would be interested in sending in a hair sample. Interest was
high but the response rate was not as high as we'd like, because people saw they had to send
more than just a hair in the sample pack. We did get 413 specimens. And we did prove that, as a
methodology, one could do a biomonitoring project through the mail cheaply for hair.
The state has diversity of advisories: different levels of advisory, different
implementation. One of the prerequisites from Wisconsin and the Great Lakes is that we've
always been the research center, the focus. Everyone has had the concept that the only place with
the problem is the Great Lakes; therefore, we've tried to encourage federal agencies and others to
look elsewhere, that this is not a single source issue for the Great Lakes. We have quite a spread
here with the 12 states, different degrees of effort. We interview both in English and in Spanish.
We have also found that people in some states people will actually answer their phones and are
thrilled to talk with you, whereas in others, for example, the response rates in Florida and
California, leading up to an election, were not as strong as we would have liked. Timing your
interview is critical.
We really wanted to know how many people are eating Great Lakes or other sport fish. In
Minnesota, with a wealth of waterbody and fishing, 54 percent had eaten a combination of Great
Lakes or sport fish. So, mostly it's an inland water fishery with Michigan, which is surrounded
by Great Lakes, leading the list with the number of people who had actually fished and eaten out
of the Great Lakes. There is some variability in New York, where much of the state is quite a
distance from the Great Lakes and, thus, has a low percent of Great Lakes anglers and
consumers.
For mercury, we decided to focus exclusively on women of childbearing age, 18-45. The
other study included males and females. Here, we focused on 3,000 women in the 12 states.
About 80 percent eat fish every year and that was the same as in the Great Lakes, but there is
quite a difference between these states when you look at the number of women who have eaten
sport fish in the previous year. Fish fillets and tuna are right up there at the top.
Advisory awareness ranges quite a bit. Maine came out on top. Wisconsin didn't do too
badly. This parallels quite nicely the aggressiveness of these programs, but you can see, when it
comes to women [about 20 percent], we have a ways to go..
For adult residents, males and females, across the Great Lakes it's quite a bit better when
it relates to PCB rather than to mercury. This is an area of the country that has had advisories in
place. There's been a lot of information that's been out. When you combine both men and
women, it looks quite a bit better than when you look at just women.
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What we did in the mercury study that we did not do in the other was to ask them
questions that concerned their knowledge such as: Where would you find the highest level of
mercury in a fish? One of our concerns was that we pushed so hard on cooking, cleaning, and
removing the fat and the skin that the message to the public was that they were reducing risk by
removing skin and fat. That is a misperception for mercury. In answer to the question on the
health effects of mercury, most of the women identified that it harms developing children. There
was a pretty good response on muscle function as well. Cancer risk was not an issue. So, here the
broad issue of understanding mercury was pretty good.
We asked a series of questions on where people get their information. Most get their
information from TV and newspapers. Our strong government program is at 8 percent and
talking with a doctor is the lowest. Friends, about 15 percent. We need to rethink how we address
our program. Government communication in Montana is good, but, in general, the source of
information for women across the country seemed to be quite uniform.
We looked at awareness vs. whether they were sport fish consumers. Those that were
sport fish consumers had higher awareness of the advisories than those who were nonconsumers.
In a couple of states, it's reversed: California, North Carolina, and Connecticut. We don't know
whether they were aware of the advisory and quit eating fish all together. Good news is that those
who were eating sport fish were more aware of the advisories. What we couldn't sort out was
whether they were in compliance with those advisories.
We go by fishing licenses, keeping in mind that those states with saltwater fishing may
not even have a requirement for a license. If they had licenses, they were more likely to be aware
of advisories. But the percentages are relatively low.
Looking at the comparisons of different groups in the Great Lakes: males with 58 percent
awareness vs. females with 39 percent. The White population was much more aware than the
non-White population. Those with college degrees, 62 percent; those with less than high school
at 34 percent. Of those who ate a lot of fish, 62 percent were aware; of those who didn't eat
much fish, 35 percent were aware. There is room for improvement, specifically targeting the
high-risk or hard-to-reach.
The analysis of hair mercury is not a random sample. The numbers, when you spread
them out among the states are relatively different, but they did show that levels, in general, are
quite low.
We really need to continue to work to make the advisory messages easy to read and
understand and to put more effort into finding new creative, effective ways to reach all the
populations, as well as at-risk groups. We need more collaboration among the interested parties.
Recommendations:
¦	Each state needs to reevaluate its programs.
¦	We need multiple messages for low-awareness groups, specifically women who
do not fish, minorities, and those with a lower level of education.
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Session 4: Choosing the Message Content
Joanna Burger, Consortium for Risk Evaluation with Stakeholder Participation
Environmental and Occupational Health Science Institute, Institute of Marine and
Coastal Sciences, Rutgers University
Fishing and fish consumption are important aspects of culture in many parts of the United
States, and fish can be a significant part of the diet. Yet, data to evaluate the risk to consumers, to
understand compliance levels, and to effect changes in consumption patterns for high-risk
populations are insufficient. Many types of data are essential to understand fishing practices,
consumption patterns, and compliance, including sources of information, reasons for fishing, and
the ethnic, cultural, and socioeconomic reasons for fishing and consumption. One key aspect of
risk communications about the risks from fish consumption is choosing the appropriate message,
which should be based not only on site-specific data on contaminant loads and consumption
patterns, but also on the cultural and socioeconomic factors that contribute to fishing and
consumption. Such information is as critical to choosing the message as the risk-based
information.
Several studies conducted over the last 15 years have indicated that there are ethnic,
socioeconomic, and educational differences in consumption patterns that suggest that one
communication message is not enough for the diverse fish-consuming public. Instead, targeted
messages are essential to meet the different needs. Where fishing is part of a traditional culture,
alternative methods of reducing risk must be found that do not rely on cessation of fishing, and
where fish is an important part of the diet (whether for economic or cultural reasons), alternatives
must be found to allow continued consumption while reducing risk.
We all have an impression that there are a lot of factors that affect the decisions we make
in our lives, not only qualitatively in terms of a holistic approach, but also in terms of getting
hard data.
How important is fishing? Is there really risk? If there isn't, we don't need a message.
How do we choose the message once we get there? And how do we evaluate?
The number of total anglers, saltwater anglers, and even freshwater anglers has increased
dramatically over the years. If you look at who's doing the fishing, it's mostly males. However,
certain populations include quite a few female fishers. If you look at the percent of men fishing
by ethnic groups, there are different fishing rates. But the rates are quite high, even in southern
states with White fishers, and much higher than in the northeastern states.
Case Study: Newark Bay Region
In this region, the ethnic composition changes dramatically depending on the latest influx
of people. The fastest growing group was primarily Hispanic, but now is Asian. One problem
with choosing a message is that the target population may change. There is a clear difference in
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who ate their catch; a fairly high percentage are eating them. A particular problem is blue crab;
this presents a higher risk than any other risk. People think that because they are filter feeders
they can filter it out. "If they look healthy, I can eat them." Paradoxically, because there is no
commercial harvest of crabs, the crabs are significantly larger than anywhere else. Ask people if
they don't know, so that you can gather the most complete information. No matter how scientific
you are, we all have biases. It's important to try and sort those things out.
One of the questions we asked was: Where do you want to get information about fishing?
The public may not see fishing as a health-related issue. Many fishers say they're getting their
information from other fishers. So, who has the information? We're all getting information from
those around us. Bait-and-tackle shops are a big source. Not too many from the newsletter.
I was interested in who is aware of the warnings. We often ask people if they've heard of
any warnings; they respond yes or no. But if you ask how many actually know what the warning
says, the percent who do is very small. That is disturbing because they don't know what to do
even though they know there is a warning. The relevant question is: Do you know what the
warning contains? Many think the fish are fine, regardless of the warning. How many people
know about the potential increase in risk? There's really not a good information base. Is there a
difference in the places you go for information based on your language? The largest non-English
group at the time (Spanish) of a previous study in all cases had lower rates of looking at the
traditional sources of information.
There are a number of people who are social scientists who look at why people do what
they do. In the case of hunting and fishing, there are lots of journals dedicated to these issues.
There is almost no relationship between why people want to fish and consumption and risk. We
recently asked people why they went fishing. We did this in two different ways. We asked open-
ended questions and we gave them a list of characteristics to rate. Respondents rated relaxation
and to be outdoors as a fairly important reason; they rated eating fish as fairly unimportant. In the
South, they give them away. Not in Newark. Low-income folks still consider the reason they fish
is to relax and be outdoors. Risk communicators need to realize the people fish because they like
it; I don't recommend that we ask people to change doing what they like to do. In this area, the
only place to see trees is to go along the river. Their view from a small boat is of a reasonable
ecosystem. People rate most of the social aspects of fishing higher than practical value.
Case Study: SC and GA Study
In another study on the Savannah River, it was important to collaborate with the local
people who are involved. It's very important to have collaborators and advisors who understand
the local situation. Surveys should be done by local people who know the culture. That means the
surveys took much longer because the local people have to chat, but you're also getting more
correct information. The only exception was in Puerto Rico at a Superfund site, where we had a
local person, male, start out doing interviews who was perceived as a potential undercover. As a
female, I was able to get better answers because I was not perceived as a government agent. It is
important to involve lots of people all along.
How many fishers do you need to interview to get statistically sound results? We did a
pilot study of fishermen on the river and we changed the survey instrument based on what the
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people wanted (citizen advisory board). It was very important to go back to all the people
involved, but it does take longer. But then you have results that everyone can buy into.
Consumption patterns can differ from place to place and should factor in wild-caught fish
and other fish. Clearly, there is a significant interaction between ethnicity, education, and
consumption, but not what we expected. The reasons people think the fish are safe differ.
Another aspect to look at is the length of time the population stays and fishes in one place. In
some places, people stay in the same place all their lives. We found out that the Black
community is eating a lot more fish than the White community. It becomes an environmental
justice issue.
Look at the relationship between wild-caught and supermarket fish. The more fish you
eat, the more likely that these are all wild-caught fish. But you must consider that people are
getting fish from other sources and the fishing seasons (risks can differ throughout the year).
Consider mercury levels; it matters which fish people are eating. If you look at new guidelines,
there are a lot of fish above guidelines in the Savannah River.
In choosing a message, the key items are the species of concern, contaminant of concern,
who's at high risk, and chronic vs. acute exposure. There are relative risks; eating fish is a good
thing to do. Look at the benefits and risks. You need to realize there are trade-offs: red meat vs.
fish vs. no protein. Top-level predators vs. bottom-level. Large vs. small fish. Fillets vs. whole
fish or stews. Deep-fried vs. broiled. We need to do more science to know more about risk.
We need to think about the appropriateness of the message in relation to education level,
culture, visual appeal, risk benefit level, and length. You need to understand why people fish.
You need site-specific information—what are the people doing and why. Aim at a target
audience. Provide alternatives that fit cultural imperatives—catch and release (doesn't make
sense to most people), alternative species, sizes. The best alternative is cleaning up the
contaminant.
Fishing may be correlated with income and it may not be. Fishing can be very important
despite income, education. What are the consumption patterns rather than subsistence? It's
important to know the target audience, to provide information on health effects and the time
course of effects. We don't often consider or have the science to know the effect of acute
exposure during pregnancy. Nobody relates to a 10'6 risk; it doesn't mean anything to many. Tell
them in quantities that they can relate to: what does it translate into in meals. People also need to
know how body weight affects it.
We need to know about daily intake vs. one large meal (e.g., large fish fries in the South).
We need to think about mixtures of contaminants. We can add the risk together but don't really
know what's happening in the body.
Evaluation is very important: did people get the message that they can reduce their risk?
Yes, they did get the message but whether they change is a different issue. Risk communication
is an iterative process. It is critical to have everyone involved at every step!
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Session 5: Choosing the Medium for the Message—Overview
John M. Cahill, Director, Bureau of Community Relations, New York State Department of
Health
Before you can begin to select media or communications channels, you must know as
much as possible about the group(s) of people you're trying to reach. For example, in 1996, the
demographic characteristics of New York's Hudson River anglers included:
Age	<24 yrs	13.3%
25-34 yrs	25.9%
35-44 yrs	32.7%
45-59 yrs	16.0%
60+ yrs	11.9%
Refused	0.3%
Gender	Male	87.4%
Female	12.6%
Race/
Ethnicity	White	69.4%
Black	12.2%
Hispanic	13.3%
Other	5.1%
Income	<10K	15.0%
$10-29K	27.6%
$30-49K	21.8%
$50K+	9.5%
Refused	26.2%
License	Yes	57.5%
No	42.5%
Each of these characteristics provides clues regarding the media that would be most
appropriate for reaching segments of this group of anglers. It's important, too, that your audience
information be as up-to-date as possible. For example, between 1992 and 1996, the following
changes occurred among Hudson River anglers:
h Those under age 24 decreased by 8 percent, while those aged 35-44 increased by
9 percent.
¦ The percentage of women doubled, from 6.6 to 12.6 percent.
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¦ Whites decreased by 10 percent, while Hispanics increased by 9 percent.
Perhaps the most telling statistic is that nearly half of the anglers were not licensed. This
means that up to half of the audience cannot be reached through license-related activities.
As important as who makes up your audience are their media habits. For example,
African Americans spend more time watching television—75.8 hours per week—than either
Hispanics (58.6 hours) or non-Blacks (53.6 hours). Compare this to the average amount of time
Americans spend reading. Currently, Americans spend only 1 hour per week reading newspapers
and only 1.8 hours per week reading books or magazines.
Imagine, between 1989 and 1999, daily newspaper circulation fell from 62.3 million to
56 million—this in a country that has 103.9 million households. In the same period of time,
cable TV subscribers climbed from 50 million to 65.5 million.
What about the Internet? Last year, 56 percent of Americans used the Internet. However,
only 23 percent of African Americans had Internet access, compared to 46 percent of White
households. A majority, 82 percent, of Americans earning $75,000 or more had access,
compared to only 38 percent of those earning less than $30,000. Nearly three-quarters of
American children go online (including in school), compared to only 15 percent of those ages 65
and older.
Equally important is the target group's perception of the reliability of various sources of
information. In the health arena, health care professionals—doctors, pharmacists, nurses,
chiropractors—are seen as most reliable. Spouses, other family members (including children),
and friends are in the second tier. Media sources—including magazine articles, newspaper
articles and TV commercials—are seen as least reliable.
The Internet, too, fares pretty poorly. Nearly half, 45 percent, of African Americans with
access use the Internet to get health information, compared to 35 percent of Whites. However,
30 percent of those who seek information on the Internet don't use it; 51 percent use it, but
warily; and only 19 percent use it and trust it.
Sometimes, when looking for ways to communicate with minority and other hard-to-
reach audiences, it is necessary to go beyond quantitative data and seek qualitative information
from the audience members themselves.
In 1999, the New York State Health Department sponsored a series of focus groups of
Latino anglers in Buffalo. The purpose of the groups was to elicit information regarding
participants' risk awareness, risk perception, and fishing practices.
As with our general audience of Hudson River anglers, noted earlier, only about half of
the Latino anglers were licensed. While they were aware of the advisories that came with
licenses, they found them difficult to understand because they were in English. As well, some
who could read the advisories simply did not pay attention to them. Similarly, signs posted near
waters that advised against fishing or eating the catch were not always understood because they
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were in English. Also, participants noted that the signs did not detail which they should not fish,
leaving them with unanswered questions.
Participants who believed that the waters of western New York were generally clean and
safe also felt that any polluted waters could be avoided based on smell or appearance. They
generally opted for areas of rapidly running water free of debris, other waste, or foul odors. They
also believed that they could judge if a fish was contaminated by its appearance. They thought
that sick or contaminated fish would be different in color around the gills, contaminated by
worms or parasites, or have a cancer or growth. It was also believed that they would smell like
dirt or mud or have an oily smell.
Information regarding good or safe places to fish was usually communicated by word of
mouth. Since there were seldom any announcements on television, the water looked clean, and
there were no outreach efforts to heighten awareness in the Latino community, the anglers felt
that most people were not aware of any hazard or did not believe there was any risk associated
with eating sport fish.
Preliminary results of a set of focus groups, conducted among African Americans in 2000
by the University of Buffalo, yielded results that mirrored those of the Latino study, with the
exception of the language barrier.
Similar information must be gathered about other target audiences—pregnant women,
children—and subsets of the larger groups—subsistence fishermen, high-end fish consumers,
etc.—before you can even begin to think about how you plan to reach them.
According to the proceedings of the 1999 American Fisheries Society Forum on
Contaminants in Fish, states have used a variety of locations to make fish advisories available to
the public and use a variety of ways to communicate the information. The top ten
methods/means of communication were
¦	Press releases distributed to media (46 states)
¦	Mailed information upon request (40)
¦	Posted signs (34)
¦	Internet postings (32)
¦	Annual fishing regulations booklets (30)
¦	Printed pamphlets/fact sheets (29)
¦	Public meetings (22)
¦	Targeted newspaper stories (21)
¦	In state 305(b) reports (21)
¦	Agency telephone information services (12).
We will look at the pluses and minus of each of these as we explore the vast array of
communications media and channels that are available to you.
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Available Communications Media Analysis
Media/
Target Audience/
Formats
Target
Audiences
Advantages
Disadvantages
Broadcast
Broadcast TV
PSAs
Paid advertising
News shows
Talk/interview
shows
Program adjacencies
Station I.D. with
voice-over (V.O.)
All
Reaches broadest audience; can
direct audience to other
resources; visual with audio
allows emotional appeals; can
reach low-income/other
audiences that do not access
health sources; easy to
demonstrate behavior; station
l.D. w/V.O. is very inexpensive
No control over PSA use;
information may be
insufficiently detailed for
specific target groups;
viewer is passive; viewer
must be present when
message is aired; less than
full attention is likely;
message may be obscured
by clutter; production is
expensive; time is
expensive; access to other
formats is time-consuming
and uncontrolled.
Cable TV
PSAs
Paid advertising
Local access
programs
Program adjacencies
All
Allows geographic and
demographic targeting; can
direct audience to other
resources; visual with audio
allows emotional appeals; local
programming (30-minute
blocks) possible; easy to
demonstrate behavior; PSA time
is more available than on
broadcast TV; paid time is less
expensive than broadcast TV
Limited control over PSA
use; audience limited to
subscribers; information
may be insufficiently
detailed for specific target
groups; viewer is passive;
viewer must.be present
when message is aired; less
than full attention is likely;
message may be obscured
by clutter; production is
expensive.
Radio
PSAs
Paid advertising
News shows
Talk/interview
shows
Program adjacencies
Announcer spots
All
Variety of formats eases
audience targeting; can direct
audience to other resources;
audio alone may make messages
less intrusive; can reach low-
income/other audiences that do
not access health sources;
allows direct audience
participation in call-in shows;
announcer spots very
inexpensive; production is less
expensive than TV; time is less
expensive than TV.
Limited control over PSA
use; information may be
insufficiently detailed for
specific target groups;
audience is generally
passive; audience must be
present when message is
aired; less than full
attention likely; message
may be obscured by clutter;
spots must fit station
format; access to other
formats is time-consuming
and uncontrolled.
(continued)
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Available Communications Media Analysis (continued)
Media/
Target Audience/
Formats
Target
Audiences
Advantages
Disadvantages
Other In-home
Daily Newspaper
Public service ads
Paid advertising
News coverage
Feature stories
Community calendar
Info-line directory
Letters to the editor
Op-ed pieces
All
Reaches broad audience rapidly;
can convey information more
thoroughly than radio or TV;
feature placement possible;
audience access to in-depth
coverage; ads are inexpensive to
produce; paid space is less
expensive than TV time; foreign
language and minority dailies
exist in major cities
Requires 8lh-grade reading
level; reaches fewer people
than radio/TV; short
lifespan limits re-reading
and sharing with others;
public service space
virtually nonexistent;
feature article/letter/op-ed
piece placement may be
time consuming
Weekly newspapers
Public service ads
Paid advertising
News coverage
Feature stories
Community calendar
Letters to the editor
Op-ed pieces
All
Allows geographic targeting;
can convey information more
thoroughly than radio or TV;
news and feature placement
easier than dailies; audience
access to in-depth coverage; ads
are inexpensive to produce;
public service space may be
available; paid space is less
expensive than dailies/radio/TV;
foreign language and minority
weeklies are more common than
dailies
Requires 8lh-grade reading
level; reaches fewer people
than radio/TV/dailies; only
a slightly better chance of
re-reading and sharing than
dailies; production
schedules not conducive to
hard-breaking news.
Internet
Web page
Ads
Banner ads
Links
Listservs
Chat rooms
Discussion groups
Search engines
All
Immediate worldwide access to
audience; allows targeting by
interest; messages can be
individualized and detailed for
each group; allows interaction;
can direct audience to other
resources; audience access to in-
depth coverage; can be less than
other media; translation/ ethnic
targeting possible; visual with
audio allows emotional appeals;
can emphasize skills
development; information may
be shared; audience can retain
anonymity when accessing
sensitive information.
Audience limited to those
with Internet access;
limited access to low-
income groups; some
reading skills required; the
longer the document, the
less likely it will be read.
(continued)
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Available Communications Media Analysis (continued)
Media/
Target Audience/
Formats
Target
Audiences
Advantages
Disadvantages
Other Print
Newsletters
Public service ads
Paid advertising
News coverage
Feature stories
Editorials
Subscribers
Permits targeting by interest;
messages can be individualized
and detailed for specific
audience segments; permits
active referral; potential for
sharing w/nonsubscribers; may
be read at reader's convenience;
ads are inexpensive to produce;
public service space is available
Reading level depends on
subscriber base; audience
limited to subscribers;
ad/articles must be
carefully targeted to
audience; production
schedules preclude hard-
breaking news.
Literature
Brochures/folders
Booklets
Flyers
Paycheck inserts
Utility bill inserts
Other inserts
Wallet/palm cards
Preprinted Rx pads
All
Messages can be
individualized/detailed/graphic
for each target group; permits
active reference; can be shared;
can be read at reader's
convenience; costs can be
controlled; translation/ethnic
targeting possible; inserts/cards
best for promoting special
events, hotlines, etc.
Requires literate audience;
may be less effective
among how-income/other
audiences that may not
access materials; the longer
the document, the less
likely it will be read;
distribution and inventory
control are time
consuming; care must be
taken when
translating/tailoring for
ethnic groups.
Out of Home
Posters/signs
Billboards
Transit
Countertop displays
Grocery bags
Bulletin board
notices
Bumper stickers
All
Can reach specific target
audiences; can direct audience
to additional resources;
complements/enhances impact
of other media; reinforces
messages; most appropriate to
promote special events, hotlines,
etc.; some production costs can
be controlled; translation/ethnic
targeting possible.
Requires some reading
sills; provides limited
amount of information;
production can be
expensive; distribution,
posting & inventory control
are time-consuming; care
must be taken when
translating/tailoring for
ethnic groups.
(continued)
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Available Communications Media Analysis (continued)
Media/
Target Audience/
Formats
Target
Audiences
Advantages
Disadvantages
Other
Special Events
News conferences
Health/wellness
fairs
Health screenings
Demonstrations
Open houses
Live presentations
Teleconferences
All
Allows targeting by interest;
messages can be individualized
and detailed for specific
audience segments; allows one-
on-one interactive exchange
with reporters/public; can
emphasize skills development;
ethnic/foreign language
targeting possible;
complements/enhances impact
of other channels; can be very
inexpensive.
Very labor intensive;
requires staffing; may
require staff training;
audience limited to event
attendees; supporting
materials must be carefully
targeted to audience.
Produced Programs
Videotapes
Audiotapes
CD-ROMs
Computer kiosks
All
Allows targeting by interest; can
emphasize skills development;
allows for emotional appeals;
translation/ethnic targeting
possible; can be presented in
waiting rooms; good for non-
readers/poor readers
Production is very costly;
purchase may be costly;
equipment must be secure;
user is passive; audience
must be present.
Gimmicks/Giveaways
T-shirts
Caps/visors
Key chains
Pens/pencils
Buttons
Bags
Water bottles
Magnets
All
Complements/enhances impact
of other channels; reinforces
messages
Production is very
expensive; provides limited
amount of information;
best for promoting
hotlines/addresses
PSAs = Public Service Announcements.
VO = Voice over.
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Available Community Channels/Potential Partners
Government Offices
Associations/Clubs (cont.)
Associations/Clubs (cont.)
Governor's Office
Chamber of Commerce
Colleges/Universities
State Legislature
Local tourism agency
High Schools
State Health Department
Community Centers
PTAs
State Environment Department
Council on Comm'ty Svcs.
Political orgs.
Local health department
Veterans Organizations
Environmental orgs.
Mayor's Office
Elks Club

City Council
Girls Club
Private Sector
Boards of Supervisors
JAYCEES
Hospitals
Town Board
Junior League
Health clinics
County Executive's Office
Kiwanis
HMOs
County Legislature
Knights of Pythias
Insurance agents
Fire Department
Knights of Columbus
Sports teams
EMS Unit
Labor Council/labor unions
Fitness centers
Police/Sheriff's Dept.
Lions Club
Local industry/businesses
Parks/Recreation Dept.
Masonic Lodge
Pharmacies
School districts
Rotary Club
Shopping malls
Local social services dept.
Volunteer Centers
Sporting goods stores
Local national guard/reserve unit
YMCA/YWCA
Bait & tackle shops
Libraries
YMHA/YWHA
Supermarkets/bodegas

WIC programs
Utility companies
Associations/Clubs
Planned Parenthood
Department stores
Sportsmen's clubs
Prenatal Clinics
Restaurants
Rod & gun clubs
4-H club
Bars/taverns
Boy Scouts
Grange
Hotels/motels
Boys and Girls Clubs
La Leche League
Resorts
Business/professional orgs.
Church/Temple groups
Campgrounds


Car rental agents
A final note...
No matter how important you think your message is, it will never reach the people with
whom you wish to communicate unless you
¦	Carefully segment them by common attributes and interests, including media
preferences
¦	Carefully identify the media/channels they commonly use
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¦	Carefully present the information in a form and format that is acceptable to the
group
¦	Carefully select the most appropriate languages and/or reading levels.
The more time and money you spend on up-front research, the more likely it will be that
your end product will be effective.
Fish Suits or "Fish Tales": Choosing the Medium for the Message
Kristine Wong, MPH (No affiliation)
The Seafood Consumption Information Project (SCIP), a former project of Save San
Francisco Bay Association (Save the Bay) in Oakland, CA, addressed the environmental justice
issue of people of color and low-income people who fish from San Francisco Bay. The Project's
components were community outreach, education, advocacy, and gathering information as a tool
for community organizing.
In 1994, the San Francisco Regional Water Quality Control Board conducted a San
Francisco Bay fish tissue study. They found that several types of Bay fish were significantly
contaminated with six chemicals: DDT, dioxin/furans, PCBs, dieldrin, chlordane, and mercury.
Exposure to these chemicals has been associated with cancer, learning disabilities, and
dysfunction of the nervous, reproductive, and immune systems. As a result, the California
Environmental Protection Agency's Office of Environmental Health Hazard Assessment
(OEHHA) issued a health warning recommending that adults eat no more than one meal of Bay
fish, while pregnant/breastfeeding women (as well as women planning to become pregnant) and
children under age 6 should eat no more than two meals of Bay fish per month.
In 1995, recognizing that people of color and low-income people regularly fish San
Francisco Bay (whether it be due to cultural habits, subsistence, hobby, or for a combination of
all these factors), SCIP conducted a survey of Bay fisherpeople (Wong, 1997). The purpose of
the survey was to give SCIP a greater profile of who fished the Bay: their ethnic composition,
whether people were eating their catch (as well as how much they were eating), if they were
aware of the health warnings, and whether or not the health warnings had any impact on their
consumption. SCIP used this information as an organizing tool in outreach and education, as well
as when briefing and advocating government agencies and elected officials. For example, SCIP
used the information about the prevalence of organ consumption to successfully lobby the San
Francisco Bay Regional Water Quality Control Board to sample and test fish organs in the
followup to the Bay fish tissue study completed in 1994.
Using multilingual interviewers, SCIP found that the 228 respondents were mostly people
of color (70 percent). Of those who had eaten Bay fish, 80 percent were people of color, and 90
percent of those who had eaten fish in the past week exceeded OEHHA's recommendations.
Organs, some of the most contaminated parts of the fish, were eaten frequently. In addition, 42
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percent had not heard about the health warnings; Latinos and non-English speakers were the least
likely to have heard the warnings. Less than one-third (28 percent) changed eating habits after
hearing the warnings. This led SCEP to conclude, among other things, that people of color are
disproportionately impacted by contaminated fish, which makes it an environmental justice issue;
government-issued health warnings are not reaching the most affected populations, and health
warnings have little effect on their consumption habits.
Based on the survey conclusions, SCIP designed a multilingual public education
campaign focused on people-of-color communities. SCIP's goals and beliefs were not to make
people eat less fish, but rather to have them make their own decisions after being informed about
the health warnings. Through workshops, SCIP demonstrated alternative ways to cook the fish
that reduced their risk and retained cultural traditions. SCEP believed that the public education
campaign was a two-way learning process and that the communities were experts in their own
right.
The components of SCIP's public education campaign were multifold. They consisted of
community-based workshops; the SCIP educational video, "Fish Tales" (Wong and Plutchok,
1997); public outreach through piers, schools, and street festivals; multilingual brochures and
posters; the ethnic and mainstream media (TV, radio, and newspapers); and advising on a task
force with the State of California Department of Health Services and OEHHA on sign
postings/education materials.
When choosing the medium, one must first determine the target population. SCIP
accomplished this through its survey, through talking to fisherpeople regularly, and consulting
related reports and statistics already published on the subject. One must consider several factors
about the target population that will determine which medium is chosen to disseminate the
message. Each media outlet should also pass a list of criteria as well—not just its reach or
reputation among the population, but its history/ties to the community or its ability to transcend
community politics. When choosing the medium, one should consider how complex the message
is; media where the message can be explained more in depth (radio talk shows, videos) as well as
absorbed visually (newspapers) should be chosen for more complicated messages. Statistics
should be avoided—simpler is better. For illiterate populations, or populations where the
language is steeped in more of an oral than a written tradition, pictoral materials or radio should
be used. For the challenge of reaching fish cookers vs. the fish catchers, get the message home
through kitchen giveaways or through workshops. Keep in mind that translations must be
backtranslatcd—small differences in tone or character can represent significant changes in
meaning.
Although choosing the medium for the message was a complex process, the take-home
message was simple.
SCIP's Goals and Beliefs:
Respect cultures.
Present alternatives.
Acknowledge that it's a two-way learning process.
Listen to the community!
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Wong, K. 1997. Fishing for Food in San Francisco Bay Part II: An Environmental Health and
Safety Report from Save San Francisco Bay Association. Oakland, CA: Save San Francisco Bay
Association.
Wong, K. and R. Plutchok. 1997. Fish Tales: A Health Education Video from SCIP at Save San
Francisco Bay Association. Available in Cantonese, English, Spanish, and Vietnamese.
Oakland, CA: Save San Francisco Bay Association.
Choosing the Medium for the Message—State and Community Communication Activities
Josee N. Cung, Program Manager, Southeast Asian Program, Minnesota Department of
Natural Resources
In the past 5 to 6 years, the Minnesota Department of Natural Resources (DNR) Southeast
Asian Outreach Program has collaborated with the Minnesota Department of Health (MDH) to
provide education to Southeast Asian immigrants on health risks associated with the
consumption of contaminated fish. In this joint effort, DNR works with community leaders to
design culturally appropriate models for education—the medium—and then coordinates with
MDH to deliver the curriculum—the message.
Several education delivery models have been devised and carried out, among them
¦	Standard classroom training workshops held at a community center or facility
¦	In anglers' homes, as a version of the storytelling tradition and often involving
elders
¦	Day field trips that include bus travel to fishing sites, the education component
followed by a hands-on session of actual fishing and fish cutting and preparation
¦	Visits or tours of a DNR biology lab where fish are studied, followed by the
biologist's demonstration and explanation
¦	Translated materials for purpose of reinforcing the messages and reference, not to
replace the above models
¦	Radio announcements and video, for airing on community TV networks.
Some unique aspects of the above education delivery models include
¦	Both English and the native language translation are used.
¦	Color photos or live samples are presented.
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¦	Several sessions have ended with a communal meal of the caught fish prepared
jointly by instructors and students.
¦	All activities are planned and take place under community sponsorship. Heads of
community organizations promote and pubiicize the educational sessions and
work with DNR to recruit and enroll participants.
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Session 6: Evaluating the Risk Communication Program—
Overview
Barbara Knuth, Associate Professor and Co-Leader, Human Dimension Research Unit,
Department of Natural Resources, Cornell University
Evaluation can help ensure that programs are meeting the needs of health evaluators and
communicators. It helps monitor whether a program is being implemented as intended. There are
three elements of an evaluation:
¦	Formative (in early stage)
¦	Process
¦	Summative.
Evaluation requires institutional support, philosophical and budgetary. It requires staff
who have the skills and experience to do the evaluation.
A formative evaluation takes place in the early stages, as audience objectives are being
identified. What is the problem and how should it be addressed? It assesses the likelihood of
attaining your objectives through the identified process. Processes involved include
brainstorming, readability testing, focus groups, and pretesting.
In the process evaluation, we look at whether resources are being used as intended and
staff are doing what was intended.
The summative evaluation focuses on how the objectives have been met and on
examining the impact our outcomes have had. You have to allow enough time and
implementation to see outcomes. What changes in the audience have occurred; what changes in
the problem context have occurred? These objectives are extremely critical.
Objectives associated with health advisory programs may be conflicting. How many can
be obtained simultaneously and how many are mutually exclusive?
1.	To enable potential fish consumers to make informed decisions about eating fish
2.	To encourage risk-reducing behaviors (fish cleaning, fish cooking, species,
locations, sizes) that are appropriate to the audience
3.	To protect public health (minimize risks).
If we want 1, we assume they are truly informed and that we are willing to live with their
decision. That's very different from 3.
1. Inform potential fish consumers about the health benefits of eating fish.
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2.	Encourage public support for toxic cleanup programs.
3.	Encourage public use and enjoyment of fishery resources.
1-800-GOT-FISH; National fishery agencies. In many states, budget comes from licensing fees.
How do we judge advisory success? We determine its effects on a range of indicators:
¦	Overall diet quality
¦	Support for toxics reduction
¦	Local economy
¦	Tourism
¦	Public trust in government
¦	Human health.
Evaluation endpoints include
¦	Use of information sources (what are they)
¦	How that relates to advisory awareness
¦	Beliefs, attitudes, and knowledge
¦	Fishing and fish-eating behaviors (affected by culture, traditional behaviors)
¦	Health status—expensive to measure.
There is a suite of endpoint behaviors:
¦	Fishing-related behavior—locations fished, species sought, and fishing frequency
¦	Information-related behavior—sources of information and frequency used
¦	Fish-eating behavior—source locations, amounts and frequencies, species,
preparation methods.
The key to a useful evaluation is to plan early so that you can build up to do a summative
evaluation. Be clear about your objectives. One caveat: if you see no change, it doesn't mean you
haven't had an effect; you have to understand the before and after.
Risk communication is a process of sharing; it should start early on.
Barbara Hager, Director, Health Education and Promotion, Arkansas Department of Health
How we evaluated the mercury in fish risk communication program:
¦ Segmented intended audiences—women of child-bearing age and children up to 7
years of age, sports fishers, and subsistence fishers
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Part II: Presentations and Panels
¦	Developed messages unique to each intended audience group.
¦	Use of several methods to collect evaluation data.
The challenges in evaluating health advisory risk communication programs, particularly with at-
risk and hard-to-reach audiences include
¦	Delineating which methods worked better than others
¦	Determining if intended audience groups were being addressed
¦	Assessing actual behavior change.
Lessons learned through evaluation:
¦	Specific information doesn't need to be developed by county or body of water.
Instead, aggregate information can be provided as well as general guidance.
h Intended audiences really do respond positively to information that is designed
specifically for them.
Mercury in Fish Campaign, Results 1996—1997
Evaluation questions:
The information in the brochure was clear and easy to
understand.
I am more aware of the mercury in fish problem and
how it can affect me.
As a result of reading the brochure:
I plan on limiting and/or not eating fish from
advisory areas (depending on guidelines)
I will follow the guidelines for eating fish from
advisory areas and feeding my children
I plan on sharing the information I learned with
others I know that eat fish.
Question and Answer Session
Q: For Barbar Hager [tape is unclear]
A: Yes, it did. We started working with them immediately with some short-term measures, but
we knew we had to do the long-term change strategy. It picked up within a year. They also
got a dedicated tax and are just rolling in money now.
Yes	No	Other
8%	1%	1%
91%	1%	8%
88%	2%	10%
83%	1%	17%
95%	1%	4%
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Q: You indicated that you had measured blood mercury levels and that they did change in
response to the advisories? Could you tell us a little more about that?
A: Yes, when we went back and said it's a problem that we could live with, we took a group of
volunteers—self-selected—to have their blood levels tested. We did the interventions with
them and after a period of time we went back and tested theirblood levels again, and their
blood mercury levels had been reduced in all cases. Although they were still fishing, they
were fishing smart and they were limiting their intake. Although we didn't test any children,
they took their kids out and they were limiting the consumption for their kids. Again, this was
a self-selected group.
Q: When you said you do an evaluation and it doesn't show any change, it doesn't mean you're
ineffective. Could you say a little more about that?
A: Depends on what conditions you start with. If you start with a population that engages in
behaviors that are acceptable, why try to change them? It's important to know your baseline.
Q: I'm curious about your "mercury is something we can live with." Is that the message? Do
you have an environmental community in Arkansas and how did that message fly? They're
the ones driving the environmental process in New Jersey and something like that would not
have been acceptable at all.
A: You have to understand the nature of methylmercury. We don't think that industry is the
offender here. We have a lot of slow-moving waters that have a lot of vegetation and the
mercury methylates. Now, where the mercury came from, we don't know. If you eat smart,
you're good; you can still use it as a protein source. That was our overarching message and
we didn't get any potshots from the environmental community.
Cross Cultural Risk Communication—Lessons Learned from the Exxon Valdez Oil Spill
Thomas S. Nighswander, MD, MPH
On March 24,1989, the Exxon Valdez oil tanker ran aground, spilling 10.8 million
gallons of North Slope crude oil, which eventually fouled 800 miles of shoreline. This
represented the world's largest ecological disaster and the first time an oil spill had impacted the
subsistence food collection area of a native population (15 villages) highly dependent on
subsistence food. In addition to nutrition,
subsistence food gathering and distribution „ . . ... , r , .	.
b	b	what white men do for sport and recreation, and
help define the culture. Walter Megabuck, money, we do for life: for the life of our bodies, for the
then tribal chief of Port Graham, described life of our spirits, and for the life of our ancient
this event as the "The Time the Water Died." culture."
In his written commentary he said	Walter Megabuck
The Time the Water Died
Pre-spill household surveys had	^^====^=^====^=
revealed per capita annual consumption of
subsistence food that ranged from 200 to 600 lb coming from 19 to 25 different subsistence foods
such as shellfish, finfish, ducks, and seals.
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From the summer of 1989 through the summer of 1991,1,062 samples from 18 different
invertebrate species and 312 samples from 15 different fish species were tested for polycyclic
aromatic hydrocarbons (PAHs) at parts per billion levels. Based on insignificant levels of PAHs
in non-oiled beaches in the oil spill areas, the Oil Spill Health Task Force (OSHTF) was able to
provide consistent and reassuring advice: Subsistence food from beaches not obviously
contaminated with oil were safe to eat.
A variety of tools were used to communicate this information to the villagers, including
five state department health bulletins, nine issues of the Oil Spill Health Task Force Report
mailed to 4,500 households in the oil spill communities, subsistence sampling maps and results
for each village, a video entitled The Oil Spill Threat to Subsistence (featuring villagers telling
the story of the testing and the results), and two series of village visits by member of the OSHTF
for village meetings and discussions. Additionally, in 1990, a risk communication workshop was
held with village representatives to assess the effectiveness of the communication strategy.
There were significant lessons learned through this process. The most important was
gaining an understanding of the difference between the native science and the western science
paradigm: The western science community compartmentalizes the whole to study the pieces; the
native community observed the local ecosystem, compared it to their previous observations and
oral history of observations, and made a judgment about the system being in balance. In the
native view, the water, shoreline, vegetation, fish, shellfish, birds, and animals are a vast network
of interrelationships; an abnormal observation indicates the ill health of all.
Of almost equal importance was the importance of early, significant inclusions of native
subsistence users from the oil spill area in the planning and execution of the sampling, reviewing
the results, developing the message, and the tools to deliver the message. More native
participation would have been even better.
There also was inherent ambiguity in our message: PAHs were present in subsistence
food in insignificant amounts, but the food was safe to eat. The question from the villagers was
that if there was any contamination (PAHs), how could the food be safe to eat.
In spite of the above difficulties, positive results included
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Part II: Presentations and Panels
In 1988, the year before the oil spill, the average per capita consumption of subsistence
food in 10 affected villages was 345 lb of subsistence food. In 1989, after the spill in March, the
average consumption fell to 181 lb. Two harvesting seasons later, 1992, the average
consumption returned to 324 lb. This was a result, in part, to the subsistence sampling and the
risk communication to the villages using a western science approach. This was coupled with a
general improvement in the ecology and clearing of the oiled beaches of Prince William Sound,
thus providing data to the native science approach that subsistence food was becoming safe to
eat.
Question and Answer Session
Q: For Dr. Nighswander, did you say that blood levels in humans were checked?
A: No, we did not do blood levels in humans. We were getting values of 5 and 6 ppb, the highest
samples we got were in some shellfish from oil spill areas. And that was in the advisory not
to pick shellfish from affected areas. They went up as high as 122 ppb; over a 3-yr period, the
levels dropped. What happened is people stopped eating, and they still don't pick from
Windy Bay. The other piece of the evaluation we had is that, although it came back in the
amounts, species choice was different. So they are still harvesting the same food but changed
a little in amount of subsistence food they were eating. Finfish were always safe because they
degraded the. stuff.
Q: Has the health status of these individuals been affected in any way?
A: Not that you can tell, but remember 15 villages were involved, with a total population of
7,000 people, and cancer risks are measured in one cancer case per 100,000. In fact, the
biggest health impact was the mental health issue. Not only did the waters die, it was so
lucrative to go with the cleanup that we had some villages that were abandoned and there
were only elders and kids left. The public safety officer disappeared; he was off working on
the cleanup. It was a very disruptive time. The social disruption was the big health impact.
Q: The problem was when the message given to commercial fishers was to not harvest,
especially that first following year and we were telling subsistence fishers to go ahead. And I
knew the reasoning was that we could trust them to tell that the fish was oily and not to eat
them and we couldn't trust the commercial fishers to do that.
A: It was an issue about marketing. They really stopped harvesting fish during the height of the
oil spill. Part of it was a concern that you bring your nets up through the oil and you
contaminate the fish. But deep down we think it was a marketing ploy. So the message went
out that it's ok to eat and collect your subsistence food but it isn't all right to go out and
commercially harvest fish. Talk about a double message. That came back to plague us again
and again. We didn't have any control over the commercial fishing fleets.
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Part II: Presentations and Panels
Q: Why are there no fish advisories issued in Alaska? Is it because the levels are low or is it for
other reasons?
A: [Referred the question to Patricia Cochran.] Because we're just getting there; there have been
some.
Q: Alaska is not so pristine; we have over half the military sites in the U.S.
Q: For earlier speakers, I want to share something with you that I learned just recently. We have
health educators that work with various cancer programs across the state. We have cancer
coalitions, various groups of NGOs mostly and county health people who get together and
discuss ways to get the message out about cancer One of the community health nurses told
an interesting story. She wanted to get a smoking cessation message out but had only
$50,000. She got a video camera and went into 5th grade classes, asked them to create a
commercial, and said the winner would run on a local station. This cost her almost nothing
and got lots of coverage because they were local kids. Since that time, even bigger cities have
picked up this same idea. I think it could be converted into a fisheries message. You might
have to teach the kids first in a health lesson. You can imagine how innovative some of the
kids were in those messages.
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ParJ II: Presentations and Panels
Closing Remarks
Elizabeth Southerland, U.S. Environmental ProtectionAgency
I want to thank the Steering Committee who organized this conference, especially Pam
Shubat and Pat McCann for the fantastic job they did leading the planning. They've been
working on this for over a year. The Steering Committee did a magnificant job putting together
an excellent combination of plenary and breakout sessions.
I want to try to explain how unique this conference was for us. At EPA Headquarters,
we're used to working with state health department representatives and with the state water
quality agencies. That's generally what we do. We're used to working with the bureaucrats
involved in public health protection and pollution control. We depend on the regional offices or
the state offices arranging public participation opportunities when they are doing rule making or
undertaking a project at the local level. We do not generally bring community activists together
for a national meeting. To my knowledge, this is the first time we've ever done anything like
this with regard to fish contamination. We normally depend on the state and local government
public participation processes to include community activists.
When we decided to do this conference, we knew we needed a lot of travel money to pay
community activists to attend. We went to every EPA office to ask for travel money. I think we
achieved an excellent turnout. Registration as of this morning was over 350 people. I want to
acknowledge the individual EPA offices that contributed funding:
¦	Office of Water
¦	Office of Pollution Prevention and Toxic Substances
¦	Office of Pesticides
¦	Children's Health Office
¦	Office of Research and Development
¦	Office of Air.
All of these offices have participants here who have been taking notes for their own risk
communication purposes.
What were our objectives in having this critical mass of community activists come
together in this precedent-setting conference? First, we wanted to make substantive
improvements in our national guidance document on how to communicate risk regarding fish
consumption advisories. We published the guidance several years ago, focusing on state practices
for communicating with recreational and sport fishers. We realized that we need a different
approach to communicate with subsistence fishers and traditional/cultural fishers. That's why we
had you come together. It certainly has been an eye-opener and will result in substantive changes
in our national risk communication guidance.
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Second, we wanted people to give us examples of their communication and outreach
materials. We have collected those and will establish a clearinghouse of that information on our
fish consumption advisory Internet site. We will commit to updating and maintaining that
information with all the successful outreach materials that you develop at the community or state
level.
Finally, I want to give an apology. Every year we have a meeting with our state health
departments and our state water quality agencies; that's the annual fish forum conference that we
scheduled for tomorrow. The reason we were not able to have everyone stay for that forum was
strictly because of our limited budget. We collected half a million dollars to pay for travel
expenses for the risk communication conference and tomorrow's forum. We just didn't have
enough money to pay for everyone to stay over for the forum. The people we invited were state
fish advisory and water quality agency representatives and Tribal representatives who have either
treatment as a state and water quality standards or fish advisories. As a result, only a small group
out of this 350-person conference has been funded to stay over for the annual forum. Those of
you who can stay are certainly welcome to stay.
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Part III
Breakout Session I
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Part III: Breakout Session 1
Breakout Session 1: Determining What the Audience Wants to
Know
1A. Women's Health Issues—Pregnant, Nursing, Childbearing Age
General Discussion
Determining Information Needs
Participants discussed methods to
determine the information needs and wants of
the target audience (pregnant women, women
of childbearing age). The first step in
determining the information needs is to find
out what women do not know and what
questions they have. There are many ways to
find this information—survey women who
apply for fishing licenses, find local leaders
willing to assess the needs in their
communities (especially for non-English
speakers), ask women who have had children
what they wish they had known, survey
women at the doctor's office, hold focus
groups and surveys in different communities,
and survey other states to find out what
information needs they may have assessed
already.
Many participants preferred to discuss
the actual needs of women, rather than just
the methods for determining those needs. Women need to know if they are at risk and what their
level of risk might be based on their exposure. There was general concern that women need to
hear this information before they are pregnant, ideally when they are teenagers. Ideas for
communicating with younger women included reaching them through schools, health classes,
youth groups, doctors, and nurses. The group also spent some time discussing who should be
conveying this information to women. Survey results show that, in most cases, health care
providers (doctors and especially nurses) are the most trusted for conveying this type of message.
However, the healthcare providers need to be educated as well—this message needs to be
included in their curriculum while they are in school.

Session 1A Summary
How to determine information needs
¦
Go to community organizations and leaders,
women's groups, churches, etc.
¦
Go to doctors and health care providers, nurses,
midwives.
How to know the audience
¦
Use "profiling" methods to identify the issue, the
community and how it works, and the audience.
¦
Evaluate your methods throughout the process.
Who should be involved
¦
Women must be involved from the beginning to
the end of the process.
¦
It is important to use test audiences to test your
format and message content.
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Part III: Breakout Session 1
How To Know the Audience
A "profiling" method was recommended for getting to know the audience. You first need
to understand the issue and the target audience—the way the audience communicates and what
the history of communication is between the agency and that audience group. Begin talking with
local leaders and local health departments to find out who the contacts in the community should
be and which groups you need to talk to. Talk with them about the issues and identify the issues
from their perspective(s). The community will begin to tell you the best methods for reaching
your target group. The next step is to work with the stakeholders to develop the outreach
program. Conducting evaluation at every step is also important, so you know if you are being
effective and reaching everyone that you need to reach. New Jersey has developed a publication
that describes a profiling method for identifying the audience (Establishing Dialogue: Planning
for Successful Environmental Management, Division of Science Research and Technology, New
Jersey Department of Environmental Protection, 1992).
Who Should Be Involved
To identify the audience and develop the message, women must be involved from the
very beginning and throughout the process. Focus groups should be included as an important
tool to identify many types of information from the audience. For instance, focus groups can tell
you what the current awareness level is, what the information needs are, and the importance of
the issue to women. Focus groups can help to design surveys. Test audiences should be
involved to test the reactions to different message formats and content. It is also important to
remember that the audience will not always be the same—women in a tribal subsistence group
are much different from women who eat sportfish once a month, and the message needs to be
tailored to reflect their specific needs.
The healthcare industry should also be involved in developing the message for women
(including state and local health departments and healthcare providers). It is sometimes difficult
to work with health professionals, because it
is a challenge to convince the health
community that this is an important issue.
The health community needs to be convinced
that this is an important message to deliver to
women in order to get their help in crafting
and delivering the message.
Other Issues
More information is needed about
how to build relationships with this audience
and how to identify their information needs.
One of the important questions is how to get
to the women specifically. One idea is to go
to the places that women go to; including
doctors, schools, and educators, Weight
Watchers groups, community groups, and
	
Other Issues
¦	Communicating with women is different from
communicating with men—need to understand
the differences and how to tailor the message to
women, rather than using the same methods used
for men.
¦	Message must be clear and not conflict with the
message(s) coming from other sources (or the
same source).
¦	Doctors, nurses, and midwives must be educated
about the message, so they will pass it on to their
patients.
¦	How do we communicate with the women we
can't reach through doctors, nurses, and
midwives?
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Part 111: Breakout Session 1
women's organizations. It is also important to tailor the message to women and to recognize the
differences between the ways men and women learn about an issue such as this. It is very
important to craft a message that is clear and not contradictory. The message might also include
information about other foods that may be unhealthy to pregnant/nursing women. Also a subject
of much discussion was how to educate the healthcare providers about the risks to women from
eating fish contaminated with mercury. Doctors, nurses, and midwives need to be educated
about the importance of this issue, because they are likely to be the most trusted source for
communicating this message to the women. "Women are very busy. You need to reach them
where they live."
IB. Cultural, Traditional, or Geographically Isolated Subsistence Fish Eaters, Including
Native Americans
General Discussion
Major issues including best practices
associated with obtaining information from
the target audience were discussed. Ideas
were also solicited on major "data needs"
important for this type of target audience.
Between 60 and 70 people participated in this
facilitated breakout session. Because of the
large size of the group and the large number
of issues that needed to be discussed, the
facilitator decided to have group members
break into smaller groups of 10 to 12 people
to discuss one or two issues instead of
meeting as one body. This was met with
strong resistance from the tribal
representatives; however, they did break out
into six subgroups. Suggested themes were
reread from the "Breakout Session Guide."
Members from the groups then discussed one
or two topics to report back with
recommendations to the whole group at the
end of the discussion. Many groups also suggested several additional themes. From the set of
topics raised by each group, a representative presented the findings to the whole group, so the
whole group could come to a consensus. At the end of the session, Dr. Patricia Cochran further
assisted the facilitator in identifying the major recommendations and research areas. These major
recommendations and needs were summarized and presented at the plenary session.

Session IB Summary
Best Practices
¦
Tribes need to take responsibility to educate
EPA and other agencies.
¦
There is no one answer; we need to look at each
community as discrete population.
¦
People need to learn to listen effectively; to
listen to the perspective of the communities.
Research Needs
¦
Determine realistic subsistence consumption
rates.
¦
Eliminate contaminant sources.
¦
Clean up existing contamination.
¦
Research social, cultural, spiritual, and
nutritional importance of fish consumption
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Part 111: Breakout Session 1
Comments and Summary Notes Submitted by Group Note Takers
Group 1 Comments
Session IB Recommendations
Learn more about tribes/living the life of the
tribes, look at legal issues and trust
responsibilities
Need to work on government-to-government
relationships; tribes need full partnerships; tribes
need to be in charge
Greater government sensitivity to messages
Look at cumulative effects of fish consumption;
look at alternatives
Provide information on replacement protein
sources
Clearly communicate benefits of our traditional
foods
Identify all tribes in Alaska.
Federal/state agencies should
coordinate to provide tribes
with information on past,
present, and future research
projects.
Identify ethnic community
groups by looking at ethnic
differences (i.e., Asian) and
use someone from the target
community to deliver the
message.
Since different ethnic groups
have churches or religious
affiliations, go there to inform
the target audience as appropriate.
Additional information is needed on oil and gas exploration in Alaska and how it
directly affects cancer risk.
Additional funding for research is necessary.
EPA has not done research on fish consumption rates for Native Hawaiians.
Current EPA consumption assumptions for this population are unrealistic.
Look at the amount of fish consumed for each major waterway on a regional
basis.
h Identify point sources of contamination and what is being done about them
(including transboundary and persistent organic pollutants [POPs] issues).
¦	Nutritional benefits of subsistence foods and how health risk is affected by
traditional diet.
¦	More information is needed on consumption patterns of different segments of the
human population and within tribal populations.
¦	Agencies need to understand how tribes view contaminants by merging western
science and traditional tribal knowledge.
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Part III: Breakout Session 1
Group 2 Comments
¦	Alaskans eat a lot of subsistence food—there is a complete difference between
western and tribal ways of looking at food.
¦	There is a conflict between western science paradigms and native science
paradigms.
¦	Native communities look at the total environment and have a global perspective.
¦	Scientists want to measure specific things at the ppb level.
¦	Don't tell the target population what to do—ask them what their problems are and
they will provide suggestions. Use this information to develop solutions.
¦	Have a holistic approach to taking care of the whole ecosystem.
¦	Sharing information with the target population is important.
¦	Consider the option of not issuing advisories if it will cause more harm than good.
¦	The problem requires time, discussion, and deliberation.
¦	We need to understand the health benefits of consuming fish, not just the risks.
Group 3 Comments
¦	Identify the audience.
¦	Find out, within a reservation, the past and present land use practices.
¦	Which parts of natural resources are used traditionally versus present use?
¦	From the federal perspective, don't overpersonalize and stereotype.
¦	Women of childbearing age is the group at greatest health risk.
¦	Capture community perspective by survey. Many target audiences would prefer
that someone come and talk to each member in person. A survey works on a
small reservation and ideally should be conducted by a tribal member.
¦	Ultimately reach individuals. Find out who is the best person to use to survey the
views of the tribe.
¦	What does the audience want to know?
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Part 111: Breakout Session 1
¦	Identify the problem related to the target population.
¦	Listen to the questions people are asking.
¦	People don't need' more bad news.
¦	Just ask people. Talk to people. They won't talk at public meetings. You can't
predict the questions.
¦	Ask, and listen.
¦	Measure concern about more problems through survey.
¦	Send a knowledgeable person to do the survey, so they can answer people's
questions.
¦	Research the role of fishing in the tribal culture.
Group 4 Comments
Recommendations
¦	We need to rebuild burned bridges and trust relationship with the tribes.
n Mandate protocols for treaty responsibilities and obligations.
¦	Look at cultural, social, and spiritual research needs via traditional knowledge.
¦	Provide information on the benefits of traditional diets versus modern consumer
diets.
Research Needs
¦	The state issues advisories without consideration for the tribes.
¦	The audience should be federal, state, and local governments; industries; and
tribes.
¦	There should be full partnership representation and community-initiated and
-owned research.
¦	Fish advisories for 90% White population, not for the tribes (tribal subsistence
harvest).
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Part III: Breakout Session 1
Group 5 Comments
¦	Target audience (audience identified for tribes and states in treaties and in CWA,
reservation population including future generations)
¦	Tribal members—subsistence, live along waterways
¦	Nontribal licensed anglers who fish on reservation, but don't have long-term
exposure
¦	Distribute angler survey to identify target audience.
¦	Include list of fish and space to write in where tribal members prefer to fish.
¦	We need to be able to isolate segments of the community that are at greatest risk.
¦	More information is needed on cumulative risk.
¦	The Cheyenne River Sioux (CRS) are not seen as fish eaters. Big game tribes
brought the fish contamination problem to the state's attention, and the state
assumed that CRS were not fish eaters when preparing the advisory.
¦	Treaties and CWA say we should have clean (uncontaminated) fish. What the
audience wants to know—they want clean fish.
¦	Communicating fish advisory means buying into acceptance that fish are
contaminated, instead of communicating that something needs to be done to clean
up contamination. Identify pollution at source so that tribes can exercise treaty-
protected rights instead of fish size restrictions
¦	The tribe is the audience. What can they eat? Research needs to include mercury,
PCBs, and all other pollutants and their cumulative effects.
¦	The tribes' approach to fish contamination is to stop pollution.
¦	There is cumulative risk (dioxin, PCBs, DDE) and risk from replacement proteins
(e.g., dioxin levels in lamb, cheese, deer, moose, muskrat).
Group 6 Comments
¦ Detection limits need to be decreased
—	Economical and technology issue
—	Budget a limiting factor
—	Contaminant mobility—funding for all waterbodies of concern
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Part III: Breakout Session 1
¦	Research need is to determine actual consumption rate of each tribe. What is the
rate? What segment of target population is actually eating fish and how do they
prepare it?
¦	We need to find a common group—tribes need to have vehicle to tell those
outside.
¦	Lack of knowledge of trust responsibility—only applies to tribes —political status
¦	Fundamental first step of the problem (e.g., federal tribe fishing rights = vested
rights, inherent rights)
¦	Treaty rights are not in any way similar to sport or commercial rights of
nonnatives. Native Americans want government-to-government relationship
(sovereignty of tribes).
¦	What audience wants to know—most people don't even know there is a
contamination issue.
¦	Advice for small tribes—go door to door, but communicator must be someone
tribe trusts (e.g., in open public meetings on issues many people do not
participate).
¦	Fish advisories need to be supported by sampling programs—advertised in the
papers (e.g., South Dakota is not doing any fish sampling or issuing advisories—it
is up to the tribes to do it themselves).
¦	We (the tribes) identify who we are and we determine what is needed.
¦	History of anti-trust by government
¦	Important to educate our people and provide them with information
n Outside risk communicators must approach tribes on a government-to-government
basis.
1C. Fish Eaters Whose Native Language Is Not English
Participants in this breakout session were subdivided into two subgroups for better
discussion.
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Part III: Breakout Session 1
General Discussion (Group 1)
Participants addressed the challenges
of going into communities to communicate
risk information. Discussion centered on
knowing the community and identifying a
community leader. Advice included:
¦	Pay community members to
provide help, even give gifts or
rewards.
¦	Establish an advisory council.
¦	Find a community leader.
¦	Make as many friends as you
can.
Session IC Summary
Best Practices
¦	Build trust (listen).
¦	Know the community.
¦	Ongoing communications practices (follow-
through).
Research Needs
¦	Offer alternatives.
¦	Understand how the community perceives risk.
¦	Understand customs, traditions, and practices.
¦	Look to community-based
organizations, those that are faith-based and culturally sensitive.
¦	Include community members in the decision making and prioritization.
¦	Find the community's self-interest.
Planning is key. Teach the teachers. Educate the community first, then allow the
community to pick its own priorities. There are many needs in each community. You need to
know if there are any factions or stigmas within a community. You need to know the degree of
proficiency of the community, what percentage can read. It is important to listen to the
community and craft the message interactively. Controversy can be good if it raises
consciousness.
Start out fresh with each group; don't use a cookbook approach. How does the
community perceive risk. Once they decide what the problem is, communities can have
ownership in making a decision. For instance, not eating fish results in loss of a protein source,
which in turn can result in a high rate of diabetes. The message has to be presented in the context
of what's happening in the community—not as the "disaster of the day."
The language that EPA uses doesn't mean anything; it's too bureaucratic and technical.
There must be clear communication of what the risks are. Long-term exposure complicates the
message. All agencies should deliver a consistent message. Don't do "vampire" studies; that is,
come in to draw blood and never come back or report back the results.
Target food preparers. Target the elders who transfer traditional knowledge to children.
However, you can't always go through the kids to reach the adults; it may invert their elder
culture. Have residents bring in the fish they catch for sampling.
IH-11
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Part III: Breakout Session 1
There are trust issues. Some cultures have good reason not to trust the government. Also,
some see the United States as a Utopia—they don't believe there are problems.
General Discussion (Group 2)
Group 2 discussed who should be involved in the risk communication process.
Department of Health and Natural Resources has to be involved and collaborate with the
community for communication to people at risk. Providing written information is not effective if
people do not read it. Face-to-face communication is most important. Native speakers should be
involved—there are not enough representatives within the government. It is up to the government
to reach out to those community members who are accessible. (One participant noted that you
can't use interpreters in South Carolina unless they are certified.) We need to identify activists
within the community.
What do we still need to know about the process of building relationships? You need
community-based outreach. Work with community-based organizations—they can reach out to
the community because they already have a relationship.
What does the community need to know about being fully informed? It needs to focus on
what people need to hear and how they can hear it best. An advisory is given, but no alternatives
are given. You need to know what people are eating and how. You have to ask the community
how they want/need to be communicated with. For Southeast Asians, it becomes a moral issue.
Tribal people are isolated—more on guard with acculturation than immigrants.
What is government outreach about—tends to be one-sided. Government equates with no
trust. Risk communicators need to learn how to communicate better and then the message needs
to be translated into different languages. Different ethnic groups learn and communicate in
different ways.
What Communication Networks Already Exist
¦	In Great Lakes, community-funded Hmong radio station
¦	New York City pirate radio stations
¦	Newspapers
¦	Health fairs
¦	Community events (e.g., Taste of Chicago)
¦	Churches/temples, etc.
¦	Fishing guides
¦	Southeast Asian community—incorporate into videos using community to get
word out.
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Part III: Breakout Session 1
ID. Economically Dependent Fish Eaters—Urban and Rural Poor
General Discussion
Participants recommended that before
entering a community, state officials should
find a person who can be a community link to
elicit information you need to use to approach
a community. The community leader(s)
selected for liaison should be knowledgeable
about the community, e.g., a community
matriarch. There may be more than one
community link based on the diversity of the
population.
The state's message to the target
audience should emphasize the positive.
States should not tell the audience (i.e., fish
eaters) what they cannot do but rather what
they can do. For example, states should not
say "don't eat this fish"; they should say
"prepare the fish differently" (to be safer) or
eat another type of fish if cooking is irrelevant
to risk. That is, the content of the message should either give options or prescribe .what to do.
States should develop trust and self-determination in their target audience, i.e., use a
participatory model. States should also reach out to adults through the community's youth—a
proven effective strategy.
New York City recently completed a pilot study of fishermen to test for mercury. The
results showed high mercury levels in blood, hair, and urine. The research is currently
undergoing peer review.

	
Session ID Summary
Best Practices
¦
Identify the target group (e.g., welfare-to-work
participants, churches, schools, physicians),
select a community leader, and then build trust
and self-determination with the target group.
¦
Take a positive approach.
¦
Pretest your message and be receptive to
feedback.
Research Needs
¦
A better way of defining the group you wish to
target (in the areas of education, dietary intake
profile, vital statistics such as birth weight)
¦
Research that is locally and/or regionally based,
not nationally based
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Part III: Breakout Session 1
IE. General Population Sport Anglers
General Discussion
Session IE Summary
What Do Anglers Need To Know
Sports anglers will often want site-
specific "prescriptive" information related to
a public health advisory. Among the types of
"core" information they may want would be
the following:
Locational information (coarse
resolution indication of which part of state)
¦	Higher resolution boundary
information ("start/stop" river
mile locations for streams)
¦	Pollutants involved
¦	Which fish species (and slot
lengths)
¦	Which agency (or agencies)
generated the data to support
the advisory.
In addition to the "prescriptive"
information often contained in public health
agency technical documents or even shorter
communications found on warning signs or
notices in fish licenses, sport anglers are
interested in a range of "explanatory"
information items. Public health agency risk
communication products should contain
"redirect" features. This could take the form
of a Web address, a citation for other
documents, or the e-mail or phone number of
an agency contact person where additional
information could be obtained. Public
interests will vary widely in terms of what
they expect in such explanatory information.
Some people will want a condensation of an
agency's technical document into general terms; others will want leads to databases or scientific
monographs that are even more technical than the typical agency fish consumption advisory
guidelines. Several participants expressed an interest in working up trends data. However, if you
Best Practices
¦	Provide the core information sport anglers need
to make decisions involving risks from fish.
¦	Provide "redirect" leads so anglers can get more
detailed information or other explanatory tools.
¦	Highlight a range of healthy choices and
behaviors that can reduce potential adverse
health impacts.
¦	Show how issues apply to anglers as well as
others (e.g., family members or friends). Take
advantage of "information pass-along" potential
by sharing information through sport angler
networks.
¦	Be resourceful — use innovative ways to
supplement conventional vehicles (e.g.,
brochures or signs) for risk communication.
¦	Guest speakers at angler organizations or fishing
piers make outreach efforts more effective.
¦	Add REDIRECT information to traditional signs
and brochures.
Research Needs
¦	Benefit/cost balance in changing eating patterns
or other behaviors
¦	Current perceptions of anglers
¦	Safety of alternatives to eating fish
¦	Develop ways to measure (quantitatively if
possible) consequences of changes in behavior.
¦	Evaluate the relative effectiveness of different
communication vehicles.
¦	Identify innovative ways to stretch available
resources to produce more effective messages.
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Part III: Breakout Session 1
want comparisons between current conditions and a baseline going back 20 or 30 years, historical
data are often not available to support such "before-after" comparisons.
Effective Messages and Vehicles To Reach Sport Anglers
Several participants stressed that conventional booklets and other prepared documents
can be delivered much more effectively if incorporated in an outreach effort where a guest
speaker makes personal contact with a sport fisher organization or event. In addition to
scheduled events, it is often very easy to reach the target audience if an outreach person visits
public fishing piers. In addition to personnel from public health or natural resource management
agencies, nongovernment organization (NGO) people and grassroots/community-based contacts
are a good idea. Risk communicators should take advantage of virtually any "no cost" ways to
get out the message. Public service TV (especially cable TV) spots are ways to reach a wider
audience even when budgets are limited. Workshops or clinics that attract nature or outdoors
writers can lead to messages included in newsletter or magazine articles or passages in books.
The importance of taking steps to minimize needless confrontations and the production of
misleading or contradictory messages from
different factions was stressed. Working with
land developers (especially developments in
lake-front areas or shoreline development
projects) often pays dividends where needless
confrontations can be avoided. This helps to
promote consistent messages. Sports anglers
are often the most well-informed segment of
the public concerning the technical and
institutional ramifications of fish
consumption advisories. Sport anglers can
even be effective advocates to help clean up
the underlying sources of pollution that lead
to these public health problems. Much of the
underlying body of legal principles (e.g., the
Public Trust doctrine) related to such modern
environmental legislation as NEPA or the
Clean Water Act have benefitted from the
strong backing and encouragement of sport
angler groups.
	
Other Issues
¦	Define a cohesive strategy to tailor risk
communication messages to specific target
audiences.
¦	Aim to increase interagency coordination.
¦	Seek ways to better involve grassroots and other
community-based stakeholder groups.
¦	Identify other aspects of communicating with
sport anglers that require more research.
¦	Identify ways to reach subgroups within sport
angler groups (e.g., unlicensed fishermen).
¦	Identify ways to measure the success of our risk
communication efforts.
¦	Identify ways to avoid "mixed messages" and to
deliver more unified messages.
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Part III: Breakout Session 2
Breakout Session 2: Issues in Developing Message Content
2A. Mercury, Especially As It Relates to Child Development—Also to Pregnancy,
Nursing, Childbearing Age

Session 2A Summary
Recommendations
¦
Need to know the local populations—different
cultures and languages. Listen to their
concerns/ideas and adapt the message.
¦
Test message with target audience.
¦
Risk communicators need enough information
from assessors to understand and be able to field
questions.
Key Needs
¦
Educate medical profession.
¦
Educate children—health class.
¦
Get information—women directly.
Research Needs
¦
Acute effects—what is effect on fetus.
¦
Nutritional benefits vs. risk of lower fish. Most
research has been on fish with higher fat content
and higher levels of beneficial fatty acids.
General Discussion
Developing the Message Content
The first step in communicating a risk
to the audience is for the risk assessor to
educate risk communicators so they can most
effectively develop the message and take it to
the target audiences. To do this job, the
communicator needs the right amount and
type of information from the risk assessor.
The group overall felt that the communicator
needs fairly specific information from the risk
assessor, so she can field questions accurately
and people will be confident that she truly
understands the basis of the risk. There was
some disagreement in the group about how
much detailed information people need to
hear about the risk—most agreed that it
depends on the target audience. People
mentioned that knowledge of acute, sub-
chronic, and chronic health effects is
important in developing a message to target
specific audiences. Detailed information
makes the message valid and gives people
information on why the advice is being given
and why there is a health risk. A dynamic
relationship between the assessor and the
communicator is necessary so that the
audience hears and understands enough detail,
but not so much that the message is unclear.
The communicator decides where to draw the
line and how much information to ultimately
include in the message—but she has to be
prepared and know more in-depth information
as well.
Message Content Should Include:
¦	What the problem is.
¦	What the impact is.
¦	What alternatives do they have (focus on what
you can do).
¦	Importance of fish, especially during pregnancy;
need to work with nutritionists
¦	Nursing is still beneficial.
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Part III: Breakout Session 2
What the Message Needs To Include
Developing a message that includes enough but not too much information is a challenge,
as seen by the many opinions of the group participants. Items that some people feel the message
should include are
¦	Provide options on how to minimize their risk and positive feedback on the things
women can do to lower their risk (such as eat smaller fish, eat certain types of
fish, eat other protein sources).
¦	What is the problem? Mercury. What does it do? Causes problems with the
fetus. What are the alternatives? Minimize risk in these ways (i.e., give advice).
¦	Tell people what they can do about the mercury problem in the environment. It
does not help with the immediate problem, but people may feel more empowered
if you give them some things they can do to help the root of the problem.
¦	Add some "redirects" to the advice that tell women to go to other sources for
more information.
¦	Mercury is different from some other contaminants—they have to know you
cannot get rid of the mercury by cooking differently.
¦	Fish are important, especially during pregnancy. This can be a confusing
message. Maybe present a table of fish, which highlights the fish that are safe to
eat.
¦	Nursing is still beneficial overall, even if the mother has some mercury in her
system (wide agreement in the group on this point). Message has to be balanced
for women, before and during pregnancy; the risk during pregnancy should not
affect the decision to nurse.
¦	Characteristics of mercury in humans—tell women that it will be in their bodies
for a long time, so that even if they are not thinking of having children yet (i.e.,
teenager's health class), what they eat now will still be in their body if they are
pregnant 10 or 20 years later.
Needs To Develop the Message
The group mentioned some types of information that are necessary to develop the
message. For instance, the communicator needs to know about the different cultures of the target
audience. Using focus groups to help develop the message for different cultures can be very
useful, and allows you to adapt the message content based on what you hear from those groups.
Pretesting the message with the target audience is also important—if you test a message and it
doesn't work, you can change the message content to be more effective. Many people also cited
the need for more input from nutritionists on the health benefits associated with fish
111-17
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Part III: Breakout Session 2
consumption, because the message content really concerns nutrition advice as well as the risk of
eating contaminated fish.
Other Discussion Topics
The group spent most of the time discussing issues related to what the message content
should be for pregnant women and women of childbearing age. Many people discussed
problems that they see in communicating the message clearly. For instance, the public tends to
think the fish are fine because they have been eating fish for years. Communicators have to
make sure people understand that these warnings are for women who are, or will, become
pregnant and that the risk is to the fetus more so than to their general health. They may be able to
eat the fish and be healthy, but the circumstances are different when a woman is pregnant.
Another problem might be that the information too often only goes to the men, and it does not get
passed on correctly to the women who are at risk. Additionally, some people brought up the
issue of commercial fish, and the concern that women may be getting mixed messages. Is it
possible to come up with guidelines for the commercial fish industry? Maybe they can take
measures, such as reducing the sale of whole fish, to help reduce the risks.
Another concern raised was the testing
of mercury levels in women, in order to
provide women at greatest risk with the most
specific information. People in the group had
some different opinions about testing mercury
levels—although most were opposed to the
idea. Those opposed argued that such tests
are expensive and can be unreliable due to
differences between labs. Also, if you test
someone and they have a high level, what do
you tell them? Women would get very upset
and worry that they have harmed their baby.
In the U.S. today, the effects of mercury are
likely to be fairly low, so unless the woman
has done something to really raise her
mercury level, it is irresponsible to test her
mercury level and subject her to all of that
worry needlessly. The effects of mercury
from eating fish are not going to be at a high
enough level to require testing. Rather than
testing, it might be a good idea for the woman
to conduct a self-assessment—ask her what
her fish consumption habits are, as part of a
prenatal questionnaire. Then she and the
nurse can figure out what can be adjusted, if
adjustments are necessary. This again
requires education of health care community,
which is a concern that came up in numerous
Don't target the medical community, I recommend,
but go beyond them.
In Hawaii, we have mailed information on mercury
and lead to every registered physician. We also
made it mandatory, by law, for physicians and
medical laboratories to report blood/urine results for
lead/mercury to the Department of Health. Result:
the physicians almost uniformly ignore the mandatory
requirement (penalty: $1500) to test and report, and
the labs always tell the Department of Health of
every result.
Then the Department of Health can look at the
reports, note which ones show high results in women
of childbearing age or children, and then either call
the physician or send a public-health nurse to the
person's home.
But many subsistence fishing families are too poor to
go to physicians or community clinics. The only way
to reach those families is for a Department of Health
van to go to a neighborhood and offer free
blood/urine screening.
So, for mercury exposure to women and children, we
try to cut it off at the source (posting signs at fishing
waters) or at the grassroots level - either information
in schools or at free screenings or from public health
nurses doing home visits.
Leslie Au, Hawaii
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Part III: Breakout Session 2
breakout groups, because there is a perceived lack of education in the medical profession about
the risks of environmental contamination.
2B. Communicating Risk-Benefit Information
General Discussion
Risk-benefit cannot be framed in the
same way for Native American fishers as for
the general population. Fish consumption for.
many tribal people is associated with
physical, spiritual, and cultural well-being
and, for many tribal communities, there is no
clear alternative to eating fish. Fish
consumption is not a voluntary risk for many
tribal and subsistence fishers. For tribal
communities, risk reduction practices such as
fishing at several different locations, eating
smaller fish, eating a variety of fish species,
and providing information on preparation and
cooking practices to reduce exposure are
received better than advisory messages not to
eat the fish. Could the EPA risk assessment
equation be modified to include a health
benefits factor for tribal and other subsistence
populations? This discussion was lengthy
and some participants were strongly divided
on whether this would be an appropriate
public health practice, even though the group
recommended it as an information need.
Ethno-religious, social interaction,
recreation, and subsistence are some of the
benefits of fishing and eating fish. One
participant asked what is a good number of
fish meals to consume to obtain a health
benefit. Perhaps the American Heart
Association recommendation of two fish
meals per week should be more widely
publicized as part of the benefits message.
Risk communicators need to be clear
about why they are providing benefits
	
Section 2B Summary
Recommendations
¦	Provide information on holistic approach to diet
and list benefits of fishing and fish consumption.
¦	Involve consumers in message preparation from
beginning to help meet needs and reduce
advisory complexity.
¦	Test message with sample target audience to
ensure message is clear.
¦	Consider context when communicating
risk/benefit information—especially to
populations with no alternatives; clearly identify
goals of what you want target audience to do.
	
Information Needs
¦	Evaluate modifying the risk assessment equation
to factor in benefits of eating fish for people who
have no clear alternative.
¦	How do we communicate risk/benefit without
implying an acceptance of contamination?
¦	Collect better data on contaminant levels in
commercially caught fish.
¦	Incorporate data on risk perception and
information-seeking behavior to better design
messages for specific audiences.
¦	How do we communicate acute (lethal)
consumption health risks to target population?
¦	Gather more information to refine accuracy of
health benchmarks to try to reduce uncertainty in
risk assessment equation.
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Part III: Breakout Session 2
information and how the information should be used by the target population. If the target
population has no alternatives to eating fish, as is true for many geographically isolated
subsistence fishers, how do we approach benefits? If the target population has alternatives to
eating fish, then we can remind people that eating fish is good, but perhaps they need to buy
some fish in the marketplace rather than eating all of their fish meals from one waterbody.
However, more information is really needed about the safety of commercially purchased fish.
Are we really sure that commercially purchased fish are any less contaminated than locally
caught fish? As risk communicators, we should not be recommending an alternative unless we
are certain about the safety of commercial fish.
Risk communicators are now typically using benefits information to encourage people to
keep eating fish, especially for those with a history of heart disease as well as pregnant and
nursing women. There are benefits to eating fish for children, and breast feeding should be
encouraged.
The risk-benefit message should always be tested on the target population to determine
their understanding of the message, as the message can easily become muddled and confusing. A
general, more holistic approach to dietary recommendations that emphasizes a variety of foods in
the diet might also be helpful information and should be provided to all consumers.
Other Issues and Concerns
¦	Some species of fish may be more beneficial than other species with respect to
their omega 3 fatty acids and nutrients. More information on this should be made
available to the fish-consuming public.
o Elevated blood levels of contaminants may not translate into increased disease.
Consumers may want to take the risk of eating fish over 20 years to improve their
health and lifestyle.
¦	Fish advisories are often very confusing. Keep the information simple and easy to
understand.
b If people don't accept the message, what can we [risk communicators] do?
Paralytic shellfish poisoning (PSP) is lethal; there is no benefit to eating PSP-
contaminated shellfish, but some people still persist in consuming the affected
shellfish.
¦	Include information in the message on the pollutant and the source of the
pollution. Some Native Americans and other subsistence fishers don't want to
change their fish-eating behavior. Give them information to help them change the
problem of pollution and its sources.
¦	How do we communicate risk-benefit without implying acceptance of
contamination?
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Part III: Breakout Session 2
¦ Before we recommend eating more commercial fish species, we need to know if
commercial fish are really safer to eat.
2C. Developing One Message Vs. Many Messages for Diverse Audiences
General Discussion
Participants discussed the need for
many messages for diverse audiences as
compared to the need for one message but
many ways to deliver it. As you try to target
the message, it gets more complicated and
more costly. Cost is a good reason for sending
a simple message.
¦	One simple message: Just be
aware of risk, especially to
pregnant women and children.
¦	Another simple message:
There are fish advisories, be
aware.
What Should the Message Be and Should
There Be One Message
Toxicologists and agencies need to deliver a simple message. However, in a lot of
communities, fish eating is important and you may need to have more complicated advice for
some groups. One message is not very effective. You could send out a first simple message as a
teaser. For example, have one message to draw people in first, then have personal contact such as
through a hotline. You must consider different ways of wording or representing the same
message for different levels of complexity. Use one message to open the door, e.g., be aware of
advisory.
When the message goes to the angler, is his pregnant wife going to hear it and believe it?
What can we do to convince people who have been fishing for years? Even experts don't know.
Use other sources—OB-Gyn doctors, river keepers, Spanish community, fishers. (Sometimes
fishers are hard to convince.) Arkansas used a well-known fisherman as a spokesperson.
Are There More Contaminants than 60 Years Ago
More than 60 years ago, there were less than 10. There was no cohesion with people
working with different chemicals. Water quality is more subtle and dangerous than once thought,
leaving fishers confused.
	
Session 2C Summary
Best Practices
¦	Consistency across agencies.
¦	Message needs to be simple and visual and
encourage people to find out more (e.g., 800
number).
¦	Know your audience.
Ongoing Issues
¦	Different opinions and standards, different value
systems of recipients.
¦	Commercial fishing industry.
¦	Integrating government teams (audience needs to
see that coordination).
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Part III: Breakout Session 2
What about Risk Communicators, State Agencies, Organizations
The public will give up if different agencies send different, and thus confusing, messages.
If there are many different environmental agencies working together, the team needs to be
cohesive and cooperate so it doesn't lose public trust. It is hard to find consensus between
different interests. The public sees different agencies as all from same "government." They need
to work with the community. Visuals are important, and they should be short and sweet. The
message needs to include alternatives; otherwise, there is more confusion.
Ramifications of Different Messages
Credibility is the first thing to go. Who are they going to believe? The person telling them
what they want to hear or the community person who is culturally involved? What about
commercial fishing? Shouldn't an advisory address more than just catching fish? It should
address eating other fish you don't catch. Admit you don't know about commercial fish; tell the
public to follow advisory for state guidelines. Acknowledge to people that there are different
opinions and standards. The problem is that people aren't given the information for commercial
fish a lot of times because the industry has power. Can't we cut back on the detail of sport
catching and go more toward commercial? (Some people want detail for credibility.) The
message for the general audience is moderation and variety. The real messages should be directed
to pregnant women.
Recommendations
¦	Use simple visuals to catch attention.
¦	Consensus of all groups: Everyone needs to be at the table from the beginning so
as to not send out confusing messages.
¦	Develop the message recognizing the political, economic, and cultural context.
¦	Who is your audience, how broad? Determine the message, who it's for, test it.
When dealing with different audiences, there are different degrees of complexity.
The message means different things to different people.
a Politics is an issue (FDA, etc.); politics complicates the message.
¦	If there is one message, it needs to be strong enough to push people to find out
more.
¦	Don't know where commercial fish come from.
n Difficult to send message to people that includes different issues.
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Part III: Breakout Session 2
2D. Communication Paradigms
General Discussion
Discussion began working from the
two themes of
¦	What types of message content
help make the message most
effective?
¦	How do you define simple
versus complex messages?
There are two major types of
messages: prescriptive and explanatory.
Prescriptive messages are generally issued
through a public health agency and often
include "do this " or "don't do that" types of
statements. Explanatory messages seek to
make the prescriptive information more
relevant to specific target audiences. Where
public health agencies are seeking to alter
behaviors or to teach new concepts, you will
usually need both prescriptive and
explanatory information tools.
Getting people to actually change their
habits (or use the message) is much harder
than simply passing out pamphlets or putting
up warning signs. While different groups in the general population are the targets for the
explanatory messages, many people find the content of the prescriptive messages very valuable.
Both the prescriptive and the explanatory messages can range from simple to fairly
complex items. For instance, a warning sign is a relatively simple kind of prescriptive message,
but most public health agencies will also provide substantive advisory guidelines documents that,
for many people, would be deemed quite complex. Explanatory messages could include
"redirect" information providing links to technical reports or other types of information of a
complex nature. In many cases, however, the explanatory messages would likely show some
degree of simplification. For instance, an explanatory message might be limited to just two or
three major themes to avoid overloading the message. While even simplified explanatory
messages might be expected to contain some qualitative facts and figures, such messages would
often aim to avoid unnecessary jargon and seek ways to relate technical terms to common sense
concepts. For example, relate fish consumption levels to the idea of so many meals with fish per
week as opposed to more technical dosages involving the weight of the fish serving relative to
the weight of the person eating the fish and a time period.
	
Session 2D Summary
Best Practices
¦	Messages need to accommodate both
prescriptive and explanatory information.
¦	Different vehicles are needed that range from
detailed to complex, site-specific to more
geographically generalized (regions, basins, or
whole state).
¦	Redundancy helps get out the message. Multiple
vehicles work better. Messages need to be
updated periodically to make sure content is
current and to help point to trends.
¦	Messages should have redirect features/links to
help people get access to different or more
detailed information (e.g., Internet applications).
Data Needs
¦	More effective ways to evaluate how well
different approaches work.
¦	Clearinghouse system (Internet-based perhaps)
to improve sharing of currently available
examples on getting out the message using
different types of vehicles.
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Part III: Breakout Session 2
Examples of What Seems To Work
Participants shared examples of approaches they felt can lead to effective risk
communication messages:
¦	One state maintains a series of detailed advisory documents and a series of press
releases that vary in the amount of content and the degree of complexity (or
simplification). Your first hunch might be that people will want simplified
information products; it is surprising how many times people actually want even
more technical detail than found in any of their ordinary "prescriptive"
documents. You need a multilayered (or tiered) approach with several types of
messages.
¦	Another state has had success putting out special regional or community-based
documents in cases where a community is concerned over the effects of a major
spill or the offsite effects from something like a Superfund site.
¦	Another state sees a need for documents that give detailed site-specific
information as well as more generalized items that provide summaries for large
regions within the state (e.g., coastal versus inland). It may not make sense to try
to define a single type of message in terms of the level of detail or simplification.
You likely need several different products. For more simplified explanatory
messages, a good rule of thumb is that, if you include more than about three main
points, you will overload things so that people will not "get the message."
Avoiding message overload is also important if you are trying to do polls or focus
groups to see if the message was "successful." You are faced with different target
audiences, so you will need more than a single paradigm. Public interest will also
vary depending on the contaminant. For instance, perceived threats from
something like radiation tend to grab attention more than the more widespread
problems from things like mercury and PCBs. Information also needs to be
updated.
¦	Several participants shared ideas on how to use maps and icons and other
approaches that often lend themselves well when information is put out on Web
sites. Web links allow people to point and click on map images, to zoom in to get
site-specific information; clicking on an icon image of a certain type of fish can
lead to detailed information on risks associated that type of fish. While getting out
the message using the Internet is clearly a growth area, not all people have ready
access to computers, so that noncomputer media still have a role to play. Hard-
copy documents can still achieve many of these effects. Laminated "flash cards"
or other ways of waterproofing documents or brochures can work well if the
materials are to be on or near the water.
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Part III: Breakout Session 2
2E. Issues in Developing Message Content: Common Misperceptions
General Discussion
Participants identified a number of
misperceptions they believe exist. Some
audiences believe that after an advisory is
issued, all fish are too contaminated to eat. In
contrast, other people believe that if the fish
look fine (e.g., no sores), then they are safe to
eat. Other fishers/consumers use an informal,
comparative risk assessment, with the
perception that if everything is bad for you to
eat, then how bad—comparatively
speaking—is the risk of eating contaminated
fish. This dismissal of advisories may be an
attitude of "risk du jour," given the frequency
of health risks publicized for numerous
products and lifestyles.
Another common misperception is
that, if there is no tangible damage to a fish eater (obvious physical ailments), then people do not
consider the fish to be impacting their health. In a similar vein, the public considers that,
historically, people have eaten fish from the waterbody of concern without known visible side
effects, so they choose to continue eating the potentially contaminated fish.
Some people question fish consumption advisories based on their perception of water
pollution. They believe that, if the water is safe to drink, then the fish living in that water are
safe to eat. They do not grasp the concept of bioaccumulation. Similarly, some people believe
that, if there is no visible source of pollution to the waterbody, e.g., a wastewater outfall from a
manufacturing plant, then the fish must be clean. This relates to a perception that manmade
materials (waste) equal bad or contaminated water and fish, whereas natural materials equal good
water and safe fish. One example offered was that of modern-day Eastern European immigrants
who settled and fish along Oregon's rivers. The rivers look pristine to immigrants whose home
rivers were more polluted; therefore, they believe the fish are relatively safer to eat.
The dichotomy of private vs. commercial fishers also poses misperceptions when private
fishers assert that, if the fish are safe enough to allow commercial fishers to catch and sell for
consumption, then the fish should be safe enough for them [the private fisher] to eat.
Participants also believe there is a lack of forward thinking or awareness of health
impacts from eating contaminated fish. Some people have difficulty understanding that their
current actions may not have consequences for 5 or more years. Another theme reported by
participants is that some women disregard advisories because they do not intend to become
pregnant—the condition on which most advisories focus. The assertion that "It [pregnancy] is
not going to happen to me" leads women to eat contaminated fish.

	 —
Section 2E Summary
Best Practices
¦
Deliver unified messages from all agencies for
one waterbody.
¦
Shift power—empower target audience from the
start in decision, message creation, and solution.
¦
Target audiences effectively and use appropriate
media.
Information Needs
¦
Guidance on how to translate technical data into
relevant social information (be practical).
¦
More comparative risks to other risk sources.
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Part III: Breakout Session 2
Finally, there's the public's
misunderstanding about the governing body's
intent with fish advisories. Some people believe
that the government is conspiring to take away
their rights to fish. Other people simply have
difficulty grasping what a fish advisory means and
what it is intended to accomplish. Because a fish
advisory is government-issued, some people may
perceive it as a ban on fishing. They also perceive
an advisory as a regulation when, in fact, it is
guidance only.
Because the risk communicator is not "one of the audience," he or she may mistarget the
audience by addressing it as one group when, in fact, more than one group may exist within the
audience, thus requiring more than one technique of effective communication. This weakness of
the risk communicator may include a lack of understanding of the literacy and education level of
the public as well as language barriers. For example, some cultures comprehend messages better
in a visual (symbolic) or auditory context than in written word. One size or style of message does
not fit all audiences.
Government bureaucracy, though well-intended, may also be a reason for ineffective risk
communication. Sometimes there are "too many chefs in the kitchen"; that is, too many agencies
play a role in the public's consumption offish and these agencies may send conflicting messages.
The government advisory bodies may not be getting along due to different agendas/policies or the
existence of political or turf battles. Also, the messages can be too technical, complicated, and
long.
Messengers may sometimes be the cause of misperceptions. The press does not always
get the facts straight or misfocuses on an aspect of the advisory and risk. Other messengers let
emotions get in the way. Politicians may send mixed messages or counterproductive messages
when they state, "Our state is cleaner than it was." "The contamination source is fixed." These
messages imply things are okay when, in fact, the contaminant that is already in the environment
may persist for years. Industry-supportive messengers may state that the government is going
overboard with cleanup or that the contaminant may come from multiple sources (not just fish).
Reasons why certain risks advisories are frequently misperceived include
¦	Size of risk and saliency
¦	Comparative risk
¦	Mixed messages
¦	Adversarial conditions (us vs. them)
¦	Lack of visual communication
¦	Don't know what to do ("learned helplessness").
The group generated recommendations to the full conference on best practices and
research needs.
"One possible solution is informative/
educational meetings with representatives of the
media. In my [state], we are speaking at
organizational media meetings. The meetings are
not covered as stories and are not press
conferences. It allows us to educate the media so
they understand the topic. It will help when they
are doing stories."
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	Part III: Breakout Session 2
Working List of Best Practices
¦	Target audiences effectively—right message to each audience; understand the
audience.
¦	Incorporate empowerment.
¦	Provide alternatives.
¦	Disseminate unifying messages (among agencies) for each waterbody.
¦	Encourage shared ownership of issue—paradigm shift from control to building
relationships—from the top down and bottom up—at leadership level.
¦	Clarify and make the message unambiguous.
¦	Send messages that are visual and auditory (with minimal wording).
¦	Improve accessibility to messages.
Working List of Research Needs
¦	Gather social information—make technical information relevant practice using the
data.
¦	Gather data on consumption for new groups.
¦	Determine what are the most effective "bridges" to communicate information to
groups
¦	Acknowledge that [the government] doesn't know everything (to create ability to
learn more).
¦	Develop a belter assessment of the comparative risks of fish advisories to other
risk sources.
Tribal Breakout Session
Many of the indigenous community representatives met separately on Tuesday morning
so that they could discuss and provide constructive suggestions to EPA about future meetings.
Their goals were to
¦	Make sure they are getting across the relevant information to EPA
¦	Decide how to interact with the rest of the conference—whether to go to
scheduled breakouts or continue meeting on their own
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Part III: Breakout Session 2
¦	Determine the kind of message to deliver at the Wednesday meeting [National
Forum on Contaminants in Fish] and highlight where the message could be
delivered in the agenda.
This breakout session is summarized below, followed by a summary of areas of concern.
Discussion
There was confusion about the Fish Forum being held in conjunction with the Risk
Communication Conference and difficulty getting information about the Sunday and Wednesday
Fish Forum sessions. Some people were told that there were two complementary conferences and
some were not invited to both. The two meetings were obviously very confusing. The agenda for
the Wednesday meeting includes
¦	Recap of summary reports
¦	Q&A session about Sunday meetings
¦	Mercury update
¦	PCB update
¦	Dioxin update
¦	Arsenic update
¦	Stuart Harris speaking on impacts to Native Americans
¦	Federal overview of 2000 standards.
The tribes want access to that information. Some information is in the CD received at the
conference. Why are we going to a work session when the results are already on the CD? Help
us do the data collection. The Wednesday meeting should be open to the public. Some of us
have data that we've been looking at for a while that may be impacted by what goes on in the
meeting on Wednesday. It was noted that a report from Wednesday's meeting will be in the
proceedings document.
At the fish contamination conference in Virginia 3 or 4 years ago, it was brought up that
more input is needed from the tribes; we are all human beings; fish know no boundaries. Even if
you don't have jurisdiction, you should work with those who do. Four years later, numbers have
increased; still we are like an afterthought. My recommendation-talk to organizers, funding
agencies.
We should have meetings of our own to discuss funding, where we are in our studies,
results of those studies, tribal data, and see what kind of risk management and planning they have
done. Basic concept 4 years ago, when you talk about fish consumption, you're talking about
nontribal. Numbers don't mean anything to Tribes. They eat 7 ounces as an appetizer. If they
want us to piggyback, that's fine; but we should have our own meetings.
Don't regionalize meetings by geographic boundaries but by issues. Having a tribal
conference helps us. This conference has painted an ugly picture for us because we don't think of
contamination in fish and our consumption is very big. Everyone everywhere eats fish. It is
bizarre that a fish consumption advisory says if you're 8 years old, you can only eat so much.
There are no boundaries for fish. How do we tell an innocent people that your fish are
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Part 111: Breakout Session 2
contaminated? In Alaska, we don't worry as much about that as we should. We can't relate to a
Hudson River problem.
There's a fish consumption advisory based on consumption use but it doesn't consider
genetics. How many generations have we been consuming contaminated fish? The human body
can evolve; we can build up immunities to natural things. Who's to say that I don't have
immunity from my great-great-grandfather? For generations, we bathed in arsenic waters and
drank the water. Arsenic is a natural preservative. If someone in Hudson Bay says this fish is bad,
how appropriate is it for us, who have been consuming it for the last 2000 years, to be
concerned? They need to do the study.
The other factor is that we have an outrageously high cancer rate in an environment that
looks so pristine: blood pressure, heart problems, asthma, cancer. To look around, it is hard to
believe that this small population has this rate of disease. The reason we may have all these high
cancer rates is that the government/military is putting toxins here and here, but we're still here.
Take a look at genetics but also at cumulative effect. Maybe not everyone consumes the
same amount of fish, but there are practices of spraying pesticides on berries and fruits. In reality,
there is a cumulative effect no matter what the source is. The government is trying to eradicate
the Indians, they're giving all these surplus commodities that are extremely dangerous to our
health. Yet, they still give them out.
One of our main needs is how we can share information about what is happening to us on
each reservation; who's having high cancer rates, who's seeing tumors in caribou, etc. Maybe we
can have our own meetings to share information and help each other. It's divisive when we don't
know what is happening to each other. It hurts us. There are 50 tribes here, but where are the
others? I don't know of any tribe that doesn't have issues with contaminants. They need to be
here.
Alaska is so new in this fisheries situation. When we talk about regionalizing, I'm
concerned because we can learn from what other tribes have done. Have speakers come to tribal
conferences. Invite others to EPA Tribal Environmental Conference in Alaska, EPA Region 10.
The lower 48 tribes can learn a lot from what the Alaskan tribes are facing. Tribes want to be
participants in all regional meetings.
Our tribe recently formed a commission (Great Plains Intertribal Commission), and it's a
great vehicle for getting together and doing things together-to understand the differences in the
way we are affected and the similarities.
We want to have a different agenda next time; have an in-service training session for all
communicators, and a special tribal session at the EPA conference. Have a geneticist with
expertise in mutation and mutation tolerance.
What is more effective is to become results-oriented, there are a lot of success stories.
Suggestions: more tribal input to next year's agenda; we don't want to separate out from this
conference, we want to share with others.
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Part III: Breakout Session 2
Concerns and Issues
¦	Treaty and sovereignty; case studies; networking and outsourcing with Indian
communities; cooperating agencies work with funding agencies; those of us out in the
middle of nowhere with little funding; dual roles of states and tribes; both have to deal
with any environmental problem. Have non-Indian communities understand where we are
coming from. How do we make this an effective process for next year. We want to get
our message out there.
¦	Some have larger staffs than others. We are capable and we know what environmental
concerns are all about. No one has to teach us that. We have to integrate something
though. Success stories; set agenda for next year.
¦	1 came to this conference for two reasons: to learn from other success stories and to
network. Klamath River Basin Commission has had some success stories; we have many
battles with other agencies. We as Indian people are always being asked to serve as
ambassadors. Tribal sovereignty has to be exercised; let people know that we are not just
another interest group; we are a government entity. You cannot compare the trust
relationship we have with any other group. We as tribes have always been told what is
best for us. We want to explain and determine our own future given the facts. A lot of our
elders are teaching the same practices to our youth as in the past. I see our brothers and
sisters deal with protestors on right to hunt whales and also dealing with political agenda.
We as tribal leaders educate who we are and what our jurisdictions are. Students always
learn about state government, federal, but not tribal. Allow tribes a chance to tell our own
story. Classic example yesterday of what it's like to be in boarding school—putting
outcomes ahead of content.
¦	There is a high rate of cancer incidence in Alaska. We looked at her [mom's] diet for first
30 years; then she went to highly processed foods; developed stomach cancer. In Alaska,
we didn't have highly processed foods like we do now. We forget how bad white sugar,
white flour, and carbohydrates are. It may be the rapid change of diet.
¦	It is important to meet all together; the divide and conquer tactic is still very alive in the
federal government.
n Comprehensive risk profiling is very important; we need to know not just the fish but all
risk factors.
¦	What are they doing about the problem? Are the 49 states and 50 tribes willing to put
together a resolution here? Can we generate some kind of document? We're making
headway but we have to keep pushing issues.
¦	I get a sense from some conversations that some people think the tribal peoples are
beginners in this process and underestimate our legal, restoration, and communication
experience/skills. We are doing a lot of things, from sampling to visiting with our elders.
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Part III: Breakout Session 2
¦	I left my babies for 2 days to come here. I wanted the opportunity to talk with others
about what works; e.g., what about GIS maps. The only message I took is that our
intuitive methodologies in terms of one on one seems to be the only thing that works.
Even the nonnatives are realizing this is the way to go. I'm leaving with more confidence
that what we're doing is right. But I want to learn more.
¦	We're here talking about communication which is at the tail end of the process. First
Nations have their own ways of making decisions. I'm not throwing out the science; I'm a
toxicologist. We are gathering critical information. What kind of message can you
communicate if you don't have the information. When looking at the whole scientific
basis for risk assessment, there is uncertainty.
¦	Risk/benefit. Yes we have to support the benefits of eating fish, but we can see that being
used against us. People are eating fish; our elders are at 95th percentile. Yes, we need to
support our cultures, but don't just put the burden on users. The problem with the risk
assessment formula is if there's no exposure, there's no effect. However, the burden of
responsibility has to be on the remediators and restoration. The law says we have to bring
the resource back to what it is. We have a message for you; we want to push the burden
back on you.
¦	I'm very keen on hearing what the EPA will be doing from here. This group needs to
decide if the focus should be national or regional. Your input to the Tribal Council that
EPA just formed is invaluable. EPA is looking at funding a national subsistence summit
for the fall of this year. They will work with a national advisory group.
¦	Who explains risk to other creatures who are dependent on fish?
¦	If you have a meeting of tribes, get it on tape so that we can communicate it to states and
the federal government.
¦	Tribal input on brochures; I don't want a brochure. I want EPA to turn the responsibility
back to the polluters in our country and not put it on us.
¦	I want everyone to listen to what's being said today. Yesterday we decided to segregate
ourselves because we want to discuss. The people who need to hear us are at this
conference. I don't want to be segregated. Everyone should hear the Native American
perspective on the problem. The problem is not getting the message out to our people.
The message is getting the responsibility back on those who caused the problem. The
U.S. needs to hear the message. Yes, there is a special relationship between tribes and the
U.S. government-but on paper.
¦	Keep it simple; it is our responsibility to take care of the fish. We just want to do what we
know is right. It is important to add Native Hawaiians where appropriate.
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Part III: Breakout Session 2
Tribal Issues Summary
¦	Many indigenous groups did not know about the Fish Forum meeting or were not invited. Please
distribute this information to everyone. Don't separate the technicians from everyone else.
¦	More Tribal participation needed in developing program/giving more presentations
¦	Need opportunity to meet and network among ourselves as populations; be able to support one another,
not just by individual regions
¦	There are many ethnic studies done but not genetic studies; look more at genetics
¦	We want to see more tribes attend these types of meetings.
¦	All of our regions hold environmental conferences; it is important to invite agencies (EPA) to them.
¦	Make sure that we are using existing resources/success stories.
¦	Look at using conference as in-service training opportunities
¦	Dual roles and partnerships of communities and agencies
¦	Indigenous communities are not just another interest group; we are sovereign nations; we have
different relationship with federal government that needs to be recognized
¦	Concern about rapid changes in our peoples' diets
¦	Comprehensive risk profiling
¦	What documents and policies coming from this meeting? How would we know be informed?
¦	Our indigenous communities are experts as well; many have sophisticated programs that have been
going on for many years. We have our own experts.
¦	Make sure that we do get out basic information to all communities
¦	Do sampling in each of our communities
¦	Risk/benefits studies can be used against us.
¦	Burden of action not just on our communities but on those involved in the remediation.
¦	Risk communication is at the tail end of a process, but tribes need to be part of risk assessment as well.
¦	Our message to EPA, we want to turn the responsibilities back to polluters
¦	Mandating protocols; make sure that there are policies mandated on how agencies work within
communities
¦	Want to make sure that our community representatives are being integrated so you can hear from us
and we can hear from you.
¦	Definition of subsistence varies across participants. We need to understand how we all use that word.
¦	Tribes have government that represents them; communicators may not view tribal resources as
collaborators in getting the message out.
¦	Infrastructure, financing, and manpower are pretty well organized.
¦	Seems to be some reluctance to bring this broader view of tribal nations to the rest of the group.
¦	Views of all participants need to be heard.
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Part 111: Breakout Session 3
Breakout Session 3: Issues in Evaluating Health Advisory Risk
Communication Programs
3A. Women and Children—Reproductive Concerns
General Discussion
This group's discussion focused on
sharing new ideas for evaluation methods and
sharing proven techniques for inexpensive
and effective evaluation methods. Overall,
there was agreement that it is important to
conduct evaluations throughout the risk
communication process. Early on in the
process, evaluation with a test audience will
help determine if the right methods and
message content are being used. After the
message has been communicated to the target
audience, you can then evaluate the responses
and opinions of the audience and find out to
what degree the communication effort was
successful. Everyone also agreed that the
questions asked during evaluations are critical
and must be carefully designed. The
evaluation must also accurately describe the
person who is responding—age, sex, ethnic
group, and other information so that you
know which parts of the audience you are
reaching.
Examples and ideas for evaluation include the following:
¦ Go to an event that already has people assembled from the group you want to
target and add your questions onto other surveys, such as fishing surveys (if you
offer a prize, people have a high rate of response). This is effective in reaching
people at boat shows (where there actually are a lot of women and people with
relatively low incomes), also at state and county fairs. Lots of people like to
watch a "fish cleaning" demonstration at these events—you could add to that a
survey of the people to find out the level of awareness about fish advisories.
(However, the fish cleaning demo that Missouri found popular is a lot of work and
expensive.)

...
Session 3A Summary
Best Practices
¦
Go where your audience is already assembled
(boat show, fair) and add your evaluation to an
activity/survey that is already taking place.
¦
Go through healthcare providers—not just OB
clinics—also nurses, midwives, and county
health clinics.
¦
Include all interest groups and different
communities.
Recommendations
¦
Evaluate methods early on, with focus groups or
interviews (before sending evaluation out).
¦
Include all interest groups from the beginning.
¦
Make sure you know that the evaluation results
are actually coming from your target audience.
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Part III: Breakout Session 3
Make the evaluation part of the
dissemination of the advisory—
attach postcards to the advisory and
see who is sending those back and
what the effect of the message is.
"One interesting question for an evaluation
would be to find out if women are also getting
the message that they should be eating fish."
Focus groups or face-to-face interviews give more substantial evaluation,
although these methods are also more expensive.
Use anglers as a vehicle to get information to women who are eating the fish that
the men are catching. That is the vehicle through which some people will have to
be educated.
Wherever women are going, get the evaluation to them there. For instance, have
brochures with surveys in doctor's offices, clinics, etc. Women can drop a card in
a box at the doctor's office; they are more likely to do it there than they would be
if they got it in the mail because of the level of trust in the doctor.
Computer games at state fairs are also popular ways to get input from people.
People will answer some questions in the course of the computer game.
Bring in all stakeholders and have them help with the evaluation (design and
implementation). Have members of the community themselves go out and do the
evaluation if possible.
Immediate feedback is desirable and should be part of the process as much as
possible.
3B. Cultural Enclaves—Native American and Other Cultural and Traditional
Communities
General Discussion
Throughout this group's discussion, there was a very clear suggestion of improving the
evaluation process by including the target population—from the beginning of the problem
analysis phase of the advisory development through the development of the message content,
selection of the media for delivering the message, and evaluation of the message. There was also
a realization that fish advisory communication is not a static process. In many cases, evaluation
of the message needs to be an ongoing process, as the composition of the target population might
change demographically over time or the advisory message itself may need to be changed to
reflect more recent health risk information or changes in contaminant concentrations from
additional sampling/analysis activities.
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Part III: Breakout Session 3
In general, most of the participants
agreed that door-to-door surveys or one-on-
one personal contact with members of the
target population (preferably conducted by a
member of the target community) was the
best way to evaluate whether the message was
influencing fish consumption behavior.
Although the ultimate goal of an advisory is
to reduce adverse health impacts for the target
population, tribal members as well as
members of cultural enclaves indicated that
the fish advisory programs must also provide
information on suggestions for reducing
exposure, healthy alternatives to fish
consumption, and the nature and source of the
contamination, so that the community could
be empowered to take action to reduce
pollution sources or obtain financial
compensation for the loss of the natural
resource.
Another major theme discussed was
that the focus of the fish advisory message
was not only the target population, but also
needed to be heard by the industries
responsible for the contamination and by the
government agencies who are empowered with the responsibility to protect the environment by
regulating sources of contamination. The group then reviewed the topics that had been discussed
and identified a set of key themes to bring to the plenary session as recommendations.
Additional Issues, Concerns, and Recommendations
¦	What is successful is door-to-door communication with person-to-person contact.
¦	You can inform a target population, but whether they change their behavior is up
to them.
¦	When we (the target population) talk about contaminants and still continue to eat
the fish, it puts the blame on us rather than on the polluters.
¦	Best practice is to build local capacity.
¦	The government does not have a lot of funding.
¦	Build a message that is sustainable within the target community and reshape it on
an ongoing basis.
	
Session 3B Summary
Recommendations
¦	The first step in the risk communication process
is to develop clear communication goals in
concert with the community.
¦	Communication is a two-way street, modifying
the behavior of those who eat fish as well as the
behavior of the polluters.
¦	Listen for your message to be repeated from the
target population. Your audience should evaluate
your evaluation of the message.
¦	Empower recipients of advisory messages with
civil rights information.
¦	Educate government agencies and private
industry to change their behavior.
¦	Focus communication on those responsible for
the sources of contamination of natural
resources.
¦	Restoration/remediation of natural resources is
vital to the process.
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Part III: Breakout Session 3
¦	Evaluate what you have done. If the goal is to educate people and then work to
establish a change in their behavior, ask: Did you educate the population?
¦	Clearly state what the communication goals are so you can evaluate the success.
¦	Regulators need to understand that they should be educated by the tribes.
¦	Regulators need to understand the tribal views.
¦	Why do tribal peoples have to change; why don't polluters change their behavior?
¦	The institutional approach is a tradeoff for health and jobs to allow industry to
develop.
¦	Build power and infrastructure—Protocols of Environmental Justice. We (target
population) are recipients of negative action (pollution), but the majority
population does not have to change their lifestyle—Cultural Chamber of
Commerce.
¦	Education is going two directions—framework for restoration side is not having
to have fish consumption advisories.
¦	Natural resources remediation is vital to the process.
¦	Native peoples do not use pollutants, pesticides, or radiation, but they are showing
up in Alaska.
¦	Ask tribal groups what their objectives and programs are. What is causing the
problems?
¦	Evaluation starts at the beginning of programs, and tribes have been left out of
this process.
¦	There should be an international focus on using short, half-life chemicals that will
not be transported via the atmosphere to Alaska.
¦	What are the sources of pollution that are changing our lifestyle? Stop the releases
that continue to destroy the ecosystem and its ability to recover, or minimize the
message to us.
¦	Sometimes contaminants are in the sediment and you can do environmentally
sensitive remediation.
¦	In the Great Lakes region, fish are contaminated from 100 years of pollution, but
we may speed cleanup to 50 years. Money should go into natural resources
damage claims if they [industries] are not going to clean up the pollution.
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Part III: Breakout Session 3
¦	The tradeoffs of short-term remediation are real cultural loss to communities.
What are safe alternative protein sources? Industry should have to pay the
community to compensate for the loss of the resources.
¦	People can sue for natural resource damages, but only if they are Native
American.
¦	Educate tribal peoples. Build a tribal implementation plan. The best practice is to
go to the specific target community. See if you hear the message you gave them
back.
¦	Our tribe used an angler survey to tribal members as part of the fishing license on
the reservation. At almost no cost, we had tribal members fill out a 1-page survey.
When mercury was found in fish, I went door to door in the community to inform
people of the problem. I then went back to the angler survey and it proved useful,
as the answers the tribal members gave changed over time and did reflect a
behavior change in choosing lakes to fish in that had lower mercury
contamination.
¦	When talking to women about risks, the offer of an alternative fishing site that is
cleaner is a good alternative.
¦	During door-to-door canvassing, you can measure the change in behavior. Did we
change the behavior to go to less desirable foods—it then becomes a negative
iterative reassessment.
¦	Evaluate shifts away from traditional foods to foods that are less desirable.
¦	The evaluation must be involved from the beginning of the advisory process.
Make sure that all aspects are dealt with up front. We may not have to change
behavior in the short term or we may have to change, but what do we change to?
What are viable alternatives?
¦	Target populations maintain connection with the traditional lifestyle while the
river is clean, but lose that when the river is polluted. Target community must be
involved in the whole process from the start.
¦	What should we do with naturally occurring contamination? Not much to do, but
for manmade pollutants become very familiar with the Clean Water Act and Clean
Air Act, and take action and make industries clean up their act.
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Part III: Breakout Session 3
3C. English as a Second Language
General Discussion
Participants discussed the best ways
that they have used to reach this audience.
Differences are great about what the
objectives are. We're not here to impose on
personal freedom. These are health advisories;
they are not mandates. Do we provide
information and then let groups make choices
for themselves? It depends on the situation;
there are cases where you have horrific
contamination levels and cases where you do
not. Human studies are not done on humans,
so you should err on the side of caution. There
is evidence of the benefits of fish
consumption.
How much more difficult is it to
communicate to an ESL audience?
Colors are very important for Latinos. The message has to be visual to catch the eye. If
you are going to send messages that must be read, keep them simple. The audience may not be
literate in its own language.
What evaluation methods have you used?
If you can't show you made a difference, you don't get to do it again. Pre-testing and
post-testing are important, but that takes a great deal of time. That's a complexity of this session.
There is always the pressure to produce. It is important that you are confident that the community
knows enough to make a decision. You need to evaluate your program to determine if it is doing
what you want it to do. What is most important is that the public is informed.
If your goal is to inform them, how do you do that?
Maybe a focus group, maybe a survey or a video. Then test them before they leave.
It takes a lot of time. That's the cost of doing business. Consider how you design your evaluation
form if they don't read the language. Some communities have a high percentage of illiteracy.
Focus groups are ok, but they can be badly used (e.g., FDAs on mercury).
How do you get to them in the first place?
Go into the communities. If you have a hard time finding people and getting invited to
things, use every tool at your disposal. Beg and bribe people; spend afternoons with La Leche,
join in fishing roundtable discussions. Go to the community and discuss fish advisories with
Section 3C Summary
Best Practices
¦	Build trust.
¦	Know the community.
¦	Support an ongoing communications process
(follow-through).
Further Research
¦	Offer alternatives.
¦	Understand how the community perceives risk.
¦	Understand the customs, traditions, and practices
of the community.
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Part III: Breakout Session 3
them. In every state, there is an ESL tutorial program or an adult education program. Schools are
not used enough. The local high schools have clubs.
Finding the leaders in the community
is critical. Form a relationship through a
leader; you have to make friendships, to
develop a level of trust. Find out what is an
important issue in their life. Instead of leaders
you can partner with peer teachers. In the
Latino community, you can partner with "promotoras de salud." Invite them and ask what they
need; then get them what they need. Their priorities are very different from ours; you have to
keep that level of communication open.
In some cultures you can get to parents through kids. In Latino culture you can, but don't
go to children first when trying to communicate message to an Asian community. Be cautious
about relying on kids; in some of the ethnic communities that don't have the English language
skills, kids may misinterpret the message to their elders. It's best to get information to mom, who
does the cooking and food preparation.
How do you design the evaluation?
The audience ought to be involved in how you evaluate success. The best evaluation may
not be quantitative, just qualitative. It's helpful in organizing a focus group to go and deliver the
message, and then go back later to evaluate. One key thing is to use somebody within the home
community to conduct surveys, to get honest answers. Having a peer teacher to organize the
community and conducting meetings from the peer teacher's house have been successful. You
can only measure to a certain point; how do you go beyond that? For example, blood drawing is
not accepted in some communities. It usually generates a bad feeling.
What about nontraditional methods?
Fish demonstrations are good or putting together a recipe book; have community
members demonstrate what they have learned. Ask community members to bring 10 different
fish and ask them to pick the safest after your presentation. And they can tell you what they call
it. Ask them to bring the type of fish they like to fish. After the presentation, you can determine
who heard, but you can't determine how people change later. Certain groups fish for certain fish.
For example, the Minnesota Hmong fish for striped bass; they travel to North Dakota where there
is no limit on the number. That is true not only of cultural groups; Iowans come up to Minnesota
to fish bullheads.
How do you explain different types of fish contamination?
In different places it might differ; high in one place and low in another. Don't just teach
them, but empower them how to find their own information, e.g., teach them what "public
library" looks like in English or give them a telephone number for the local advisor. However,
making phone calls is very difficult for those who don't speak English. If they are immigrants,
they are afraid to call.
"You white folks may come up with great ideas, but the
folks who are oul there in the communities can tell it
better."
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Part III: Breakout Session 3
Followup is important.
What's the reality? Do you expect something else to happen? How reasonable is it? Can
you measure it? It is important to identify the goal and make sure it's reasonable. With any
program, there must be a plan; then it's easy to see progress and change your expectations if
necessary.
3D. Costs of Evaluation Methods— Reducing Costs
General Discussion



Section 3D Summary
States should ask the following
Best Practices
fundamental questions when planning to
evaluate a
program:
¦ Initiate methods to reduce cost or find funding:


— Partner with universities/other states.
¦
How was the evaluation
— Use information from universities or other

performed in the past?
states.


¦ Seek alternative funding:
¦
What worked vs. what didn't
— ATSDR

work?
— Private foundations


— Add questions to other studies, e.g., New

What has it cost in the past?
York Creel Census.
¦


Research Needs
¦
How can we best utilize our


resources?
¦ Determine: "Can we afford to evaluate?"
Participants noted that since fish
¦ Very limited resources.
consumption advisory program budgets are
¦ Direct [resources] to high-risk groups.
diminishing, state officials should take
interest in partnering to leverage dollars and
impacts. They can partner with nonprofits and other government programs. States should also
seek to get buy-in from the public interest groups to help with FCA efforts if cleanup has reached
its capacity. They can collaborate with the fish and wildlife services and state commerce
departments to collect information by tapping into their tools. They can tap university research
grant efforts or partner with other states for federal dollars.
One participant believed that states can do a lot with little resources. She suggested state
FCA programs use a booming budgetary cycle to gather information/resources for the long-term
when lean budgetary cycles occur.
The group discussed that surveys give the best information but can cost the most. In
contrast, however, New York said its face-to-face survey of anglers cost only $20,000. They
used a professor's students as interviewers; recycled a survey used 4 years earlier (unchanged)
that was originally written by an environmental interest group; and used the Agency for Toxic
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Part 111: Breakout Session 3
Substance Disease Registry health consultation funds because the area was in a Superfund
cooperative agreement state. New York has also tapped into other programs. Its Department of
Natural Resources is developing a creel census, and the Department of Health has asked them to
add a couple of questions to that survey.
The participants identified two forms of no-cost evaluations:
¦	Ask questions of those who call into the state to learn about FCAs. Questions can
help states know which multiple risk communication strategies are working, e.g.,
newsletters vs. refrigerator magnets.
¦	If one state (or group of states) proved via an evaluation that a particular method
of risk communication worked well, another state would not have to perform that
evaluation again. States should share data from other sources (other states) and
communicate to their own state legislators those success stories about
communicating FCAs. Success stories may be effective in getting more funding.
Two additional strategies to address budgetary constraints were discussed:
¦	Reduce cost by focusing on the most sensitive population (e.g., pregnant women
vs. all women).
¦	If a state has limited resources, they may have to choose which is more important
to invest in—outreach or evaluation of outreach.
3E. Measuring Success To Improve Communication
General Discussion
Many of the participants in this breakout session work in state or federal agencies in
charge of operating risk communication programs. Several participants have worked in
environmental justice programs with a strong community-based dimension—often encouraged by
a focus on risks from Superfund or similar localized "hotspots." There was a very clear interest
in improving very basic efforts to conduct better process evaluations for agency programs or
projects. There was also a realization that, if one of the ultimate goals is to reduce adverse health
impacts for human populations, then fish advisory programs must usually operate somewhat
indirectly. Routine collections of samples from human tissues are extremely limited and almost
never organized into formal registries. Surrogate measures must be used involving behavior
patterns in terms of what fish are consumed, in what quantities, and using what preparation
techniques. This complicates the evaluation of risk communication success, since target groups
must be polled or otherwise checked to see if messages were not only received but translated into
a range of healthful behavioral responses. After the group introduced themselves to each other, a
round robin discussion noted the following ideas:
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Part III: Breakout Session 3
Where a project (or program)
is to be evaluated, it is vital to
secure strong stakeholder buy-
in from Day 1.
Evaluation results are
becoming a pressing need to
ensure support from upper
management or important
interest groups (especially
elected officials). The political
process is beginning to
demand evidence that
programs are achieving their
goals.
Objectives (goals, criteria,
endpoints, or outcomes)
should be clearly defined—
using quantitative measures
where possible. Some criteria,
however, are best handled
using qualitative measures.
Baseline conditions should be
documented and a
commitment made to gather
information at an appropriate
future point in time to allow
for even simple "before and
after" checks on program
effectiveness.
Projects should create roles for local people or other non-agency people that are
respected by the local communities. Grassroots involvement can include actual
data collection or support in evaluation methods, such as focus groups or polling.
More attention is needed to evaluate changes over time within agencies in charge
of advisory and risk communication programs. Have agency perceptions
changed? Are there changes in the way the agency delivers its support or
services? Recognition for hard work by agency staff to make projects a success is
important.
In addition to more attention to working up routine program process evaluations, a
few detailed case studies are very valuable. Such case studies can go into more
depth and help highlight additional criteria to include as part of routine checks.
Section 3E Summary
Focus Topics
¦	How do you measure both short- and long-term
success?
¦	Defining "Best Practices" involves identifying
which parts of programs to measure and clearly
defining the criteria to measure.
Best Practices
¦	Begin with a known baseline, measurable
objectives, a timeline for followup, and an end
goal in mind.
¦	Consider end-to-end stakeholders, including data
collection, process, message refinement, and
message delivery.
¦	Practice flexibility—ability to change and adapt
during process.
¦	Engineer qualitative and quantitative elements
into program (i.e., case studies, interviews,
surveys).
Information Needs
¦	Obtain EPA/CDC support on NHANES studies
on toxins in fish advisories.
¦	Gather more data in projects to help make
before-and-after comparisons.
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Part 111: Breakout Session 3
Best Practices
¦	Begin with a known baseline; define measurable objective(s); identify a time
horizon to do followup evaluations for "before and after" comparisons; have an
end goal firmly in mind. Most evaluations will likely be routine process
evaluations for public health agency projects.
¦	Strive for stakeholder inclusion from the beginning to the conclusion of the
project. Track data collection; major process/project milestones; message
delivery.
¦	Be flexible—ability to change and adapt programs based on evaluation signals.
¦	Include qualitative and quantitative evaluation criteria; use a variety of evaluation
tools, including case studies, interviews, surveys/polls.
Data Needs Recommendations
¦	EPA should coordinate with the CDC to establish NHANES registry coverage for
toxics commonly encountered in fish consumption advisories. (NHANES, the
National Health and Nutrition Examination Survey, is a survey conducted by the
National Center for Health Statistics, part of the Centers for Disease Control and
Prevention, U.S. Public Health Service. This survey has been designed to collect
information about the health and diet of people in the United States. It includes
sampling of human blood, tissues, hair, and so forth to establish the actual body
burdens in human beings of specific toxins.)
¦	Gather more data on risk communication projects to help make before-and-after
comparisons to document successful approaches.
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Part IV
Risk Communication Basics
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Part IV: Risk Communication Basics
Risk Communication Basics Course
Stories from the Frontline: Case Studies in Risk Communication
The three sessions of the Risk Communication Basics Course are designed for conference
attendees who would like to hear practical applications of risk communication techniques. The
course will cover the fundamentals of the entire process as described in US Environmental
Protection Agency document — Guidance For Assessing Chemical Contaminant Data For Use In
Fish Advisories - Volume IV • Risk Communication. Each session is taught by an experienced risk
communicator from three different geographic regions of the United States to give participants a
broad perspective of advisory processes with specific case study examples. All attendees will receive
a copy of the EPA's Volume IV document.
Problem Identification and Target Audience Identification —
The risk communication process - Theory is nice, but how does it really work?
. The first session will present a general overview of the risk communication process and will
then focus on the elements of problem identification and analysis and target audience identification.
Practical experiences from the State of Georgia's own focus group research will be used to illustrate
some points of these processes including what methods work well and those methods that don't work
well at all.
Developing the Message and Selecting the Medium —
What we have here is a failure (or success) to communicate
This second presentation will focus on two projects in large metropolitan areas- San
Francisco Bay and Santa Monica Bay in Los Angeles. Individuals who fish in these two areas come
from a wide variety of ethnic backgrounds, speak many different languages, have varying literacy
rates, and different cultural practices related to fishing and fish consumption. This presentation will
examine issues about how to communicate fish consumption advice, what languages to communicate
in, what additional advice to communicate, how to respect cultural practices while communicating
advice, and what avenues to use to get the information to various populations.
Implementing the Message and Evaluating the Message —
The thrill of victory and the agony of defeat
Maine has recently implemented a new strategy to develop and distribute our new "easy-to-
read" brochure identifying our safe eating guidelines for mercury in fish. This strategy includes a
very targeted delivery to the population most at risk. The new risk communication strategy is
heavily driven by identifying appropriate literacy levels, designing a brochure to maximize an "easy
to read" format, and using focus groups of convenience and key informants to both develop and test
drafts of the brochure. We are able to target and mail advisory information to individuals at risk by
using existing state registries (e.g., birth certificate registry combined with fishing license registry or
marriage license registry). We have used and plan to use several methods to evaluate the brochure -
including mail-back surveys handed out at events, Behavioral Risk Factor Surveillance Surveys
(BRFSS), and random digit dial surveys. This was all done with limited staff and on a limited
budget. This presentation will build on the other two Risk Communication Basics presentations to
identify strategies for evaluation and implementation, and review Maine's successes and failures in
this venture.
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Part IV: Risk Communication Basics
Session 2, Developing the Message and Selecting the Medium
Christine Arnesen, R.N.,	California Department of Health Services
California covers 155,973 square miles and has numerous inland lakes and waterways
including a major Delta and 1,264 miles of coastline. Fish consumption health advisories have
been issued by the California Environmental Protection Agency in seven of the eight large
fishing districts and cover at least 10 specific fishing locations including 2 large Bay areas- San
Francisco Bay and Delta and Santa Monica Bay in Los Angeles. It is estimated that at least 11%
of Californians fish and numerous others consume fish that is caught from various California
waterways. The main chemicals of concern are mercury, PCB's and DDT. Chlordane and other
pesticides have also shown up in fish samples and Selenium is of concern in the Salton Sea, an
inland waterway in the southern California desert.
In California, individuals who fish come from a wide variety of ethnic backgrounds,
speaking many different languages and with varying levels of literacy in English and in their own
languages, and with different customs related to fishing and fish consumption. In the San
Francisco School District, it is estimated that there are 45 languages spoken in the schools while
in Los Angeles, the estimate is 83. Many of the ethnic groups that are represented in the fishing
population also have very specific cultural practices related to fish consumption, some of which
may put them at additional risk
This presentation will focus on two projects; one in the San Francisco Bay and Delta Area
and one in Santa Monica Bay in Los Angeles and will examine issues about how to communicate
fish consumption advice, what languages to communicate in, what additional advice to
communicate, and other issues. Using two case studies, the challenges and lessons learned will
be examined in relation to the following specific issues:
¦	How much information should be included in advisories, or materials about
advisories
¦	How much discussion should there be about specific chemicals of concern and
their potential adverse health effects
¦	Should the information include a discussion about the benefits of consuming fish
¦	Whether, and how to communicate information about fish cleaning and fish
cooking recommendations
¦	What to say, if anything, about the risk assessment process and the lifetime risks
of cancer or reproductive concerns; what to say about scientific uncertainty
¦	How to include information about sensitive populations
¦	How to decide what languages to translate materials into
¦	How to address concerns about commercial fish along with concerns about
recreationally caught fish
¦	How to respect cultural practices while still communicating a message
¦	How to utilize the best avenues for getting information to different populations
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Part V
Written Comments
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Part V: Written Comments
Breakout Session 1: Determine What the Audience Wants to Know
IB. Cultural/Traditional or Geographically Isolated Subsistence Fishers, Including
Native Americans
Recommendations
1.	What fish can we eat and what good are free tribal lands if those lands are contaminated
Restoration—Natural Resource Catastrophe (Settlement agreement, EPCRA, CERCLA.)
2.	To identify the audience, go to the community where audience lives and talk with
community members to see if you have included everyone—only effective method.
3.	Learn about community you are trying to reach.
4.	What audience needs to know? Ask them by talking to them. Go to the audience and ask
them. Let them frame the problem and see if they have a suggestion on how to frame a
solution. Get support from community leader to help "get" to community?
5.	Use culturally appropriate dialogue circles led by a community member or First Nation (FN)
consultant. Have separate meeting with community member or FN consultant and
band/leaders, community leaders, Aboriginal fishers, educators, youth, health providers, and
elders.
6.	Burden of proof is on affected community. Studies prove effects and back up advisories
BUT why doesn't it affect CLEANUP/REMEDIATION!!!
7.	Success is not that the community stops eating fish—that is interim solution. Remediation is
the primary goal.
8.	When collecting data, researchers must disaggregate data by subpopulations to better
pinpoint populations at risk. For instance, the Asian Pacific population is socioeconomically
and culturally diverse. Simply lumping all Asian Pacific Americans together misses the
point that certain subpopulations are much more adversely affected by consuming
contaminated fish because of their subsistence diet. Examples include Southeast Asians such
as Hmong, Cambodians, Laotians, Thais, etc. If you lump everyone together, for the more
affluent Asians, it looks like we don't have any significant problems with fish consumption.
One of the most important actions that should result from this conference is to study the level
or degree to which at-risk populations are adversely affected by contaminated fish. This is
where you will see the stark contrast between subsistence and sportfishing and fish
consumption. The numbers of low income and minority groups who consume contaminated
fish may be relatively smaller than the equivalent white population, but they may be more
affected because of cultural and socioeconomic reasons. Simply looking at the amount of
fish caught and/or consumed does not capture the real issues. Don't just study who is at risk
but the degree to which they are relatively at risk.
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Part V: Written Comments
9.	By the time CLEAN UP is done—generations later—the cultural/traditional practices
may/will be lost!! Language is lost/fishing (traditional) methods are lost if we are told not to
eat fish anymore.
10.	Recommendation—Federal agencies administering advisories need to link REMEDIATION
with the interim solution of cutting back on eating fish (fish advisories).
11.	Identify the target audience by ethnic group and community (tribe). Use community
individual to reach out/educate that particular culture/group.
12.	In Alaska we do not have fish advisories. The audience is usually a Tribe or community who
asks for information about contaminants in subsistence foods or a community near a
contaminated site. To determine what the audience wants to know—we ask them.
13.	The risk assessors need to do more work on understanding the audiences their consumption
advice is going to—need to assess benefits of eating fish and risks of not consuming fish.
14.	Identify audience—this seems straightforward—fishers within tribes.
15.	Generally (tribal audiences) but remember all tribes are different culturally and are different
governments.
16.	What audience wants to know? Is the fish safe to eat?? Actually, they probably don't want
to know anything—if they want the information, it wouldn't be so hard to communicate.
People don't want more bad news.
17.	Define the risk (past activities/traditionally). Estimate who will be affected by the risk
geographically. Meet the community leader. Try to meet expected audience and identify.
Listen to your audience.
18.	Audience: Minority Groups. Identify the problem related directly to the individual.
Communication needs to be in nonscientific terms—people can't relate to the definition of
the problem in scientific terms. They don't understand the terms. Educate the tribes by using
an authoritative person. Target those most at risk and most vulnerable populations—women
of child-bearing ages, children, subsistence fishers and their extended families (tribes).
Conduct survey on reservation, survey tribal members and nontribal members through creel?
Obtain information through the survey. Hold public meetings to get information on
problems.
19.	You can address how to identify the audience and find out what they want to know by having
a tribal member that is a part of the community personally survey the tribal community to
determine what portion of the community are fish eaters.
20.	The audience is known by the community, so find community members to work with.
Because of cultural differences, it is important to include community members in assessing
what the audience needs to know.
21.	Audience: community members (tribal members); non-Indian, but non-English-speaking
people. Survey on a one-to-one basis the target audience. Listen to all their concern; don't
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Part V: Written Comments
turn them off. Ask about their concern, listen. Learn about beneficial diets. Find
partnership representation—CWA in treaty—define—Native American want to be treated on
a government-to-government relationship.
22.	Someone from the village (tribe) knows the audience. Someone from the village (tribe)
knows what the audience wants to know.
23.	Alaskan tribes consider themselves different than Alaskan or U.S. residents, and are similar
to other North American tribes.
24.	Almost all state and federal agencies in Alaska are European American personnel who relate
poorly to tribes. State or federal agency should contract or hire tribal member to do research.
25.	Have to identify the audience, and what they want to know has already been stated by the
Native American/Native Alaskan communities. This does not need to be determined, as
new.
26.	- The best practice is to use the approach provided by these communities and not impose
others' way of communicating.
27.	How do we determine what audience needs to know? Hold public meeting with media.
28.	Get educated about the audience and work on a government-to-government basis with the
tribes.
29.	Ask them what they want to know—My general perception is that the advisories are targeted
to specific groups. What are in the fish and will they cause health problems? People need
information to make their own decisions.
30.	Ask what the audience wants to know? One-on-one communication, points of contact at
tribal conservation office, clinic, elderly nutrition program. Identify the audience? The band
(tribe).
31.	If focus is tribal entities, identify audience through geographical/high-risk assessments.
Survey audience to define their needs, use target audiences and ask what they want to know.
32.	Identify audience—tribes need to educate federal and state agencies, and organizations, etc.
What audience wants to know—is determined by individual communities.
33.	How do we identify our audience? The people who live in the area and the agencies that are
involved. How do we determine what the audience wants to know? Ask them. Start with the
target audience. Empower them.
34.	Tribal audience is already identified, the audience to be identified should be EPA. More
money to do research; not have funding cuts each time we try to get research going. Bring
tribes into advisory process instead of just giving us an advisory.
35.	Western Paradigm: Tribal group—high-risk individuals within fish-consuming
families/high-end consumers. Tribal group want to know how to continue their traditional
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	Part V: Written Comments
practices without endangering their health—"Which fish can I eat without harm? True risk-
epidemiology/health effects from the conglomerate of toxics (multiple contaminant effects)
not each contaminant one-by-one.
Tribal Paradigm: The audience is the policy/power elite who have the responsibility to
protect the environment and keep it clean. It is their responsibility to respond to our tribal
needs—whether they want to or not. How do we get them to respond?
Tribal members want to know if fish is safe to eat. Need to communicate risks and benefits
of fish consumption. Allow tribal members to make choices.
Need to determine actual consumption rates of tribal members, each tribe is unique, develop
survey/interview/other methods to determine actual consumption.
Information Needs
1.	Role of fishing in culture and nutrition needs.
2.	1st priority—tribal partnerships. Mandate protocols for working with tribes. Cultural, social
and spiritual research not just analysis etc. Answer questions of communities— don't just
give science. Include Traditional knowledge.
3.	More specific information on levels of contaminants for children, adults, by weight, etc.
4.	Better information on consumption patterns (not all tribal members consume the same
amount) and contaminant levels in the fish.
5.	Funding for research programs.
6.	How to communicate concept of cumulative effects.
7.	What species of fish are ok to eat and what the particular health risk is.
8.	Cumulative risk.
9.	Better integrated benefits and risks associated with lifestyle choices.
10.	Consumption patterns by different segments of population and seasonal differences.
11.	Contaminant levels in fish and wildlife.
12.	Better cooperation needed between state and tribal entities.
13.	We need to better understand tribal perspectives on contaminants.
14.	Research—study examples of fast food. Show results in a way we can understand and show
benefits of traditional diets vs. fast foods.
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Part V: Written Comments
15.	Cultural, spiritual research—needs our own knowledge and beliefs incorporated into
research.
16.	Tribal involvement in the process—EPA needs to work with tribes and develop real
partnerships within communities.
17.	Contaminant concentrations in foods that would replace the contaminated fish. Is the
alternative food really a better alternative?
18.	We cannot expect our government (state, federal, tribal) to come looking for us to spread
advisories. EPA provides funding or (other federal agency) for state and tribes to apply for
these grants for projects and it is our responsibility to notify our community(ies).
19.	Nationwide advisories should be slimmed down according to community needs, then the
community members will decide whether they should consume fish or not. They know, if
any type of sickness occurs in their blood, they shouldn't blame anyone else or they should
reapply for another grant and develop an alternative strategy. Look at their culture and
come up with alternatives.
20.	What aspects of identifying target audience informational needs do we still need to know
more about? Bring the indigenous people into the process with the state agencies.
21.	Find out past and present land use activities for each government entity—state, tribal lands;
private stakeholders.
22.	Research and receive pointers on local case studies. Each government entity has a staff and
if we could focus research locally it would be better.
23.	Since resources are scarce, are the benefits (cost savings) to study other points in the pathway
contamination of foods? Such as plankton, macroinverts, etc.?
24.	Compare resources spent on community health effects and risks vs. resources spent on
allowing pollution to be permitted? distribute results to community to empower a change in
environmental policy.
25.	Benefits—what are the overall benefits of fish consumption? Benefits are not limited to
nutrition. Include benefits of traditional ways of food gathering, preparation and cooking,
and benefits of traditional diet.
26.	Document traditional ecological knowledge and get direction from Native elders on what
changes have been seen, and where to go to get what information is needed, except for
"Intellectual Property Rights."
27.	Tribes should direct research not Federal.
1C. Fish Eaters Whose Native Language is Not English
1. "Target audience identification and needs assessment phase of a health advisory
communication program."
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Part V: Written Comments
2.	Best practices: Build trust, find out what concerns them, how they eat fish and tailor
education to these needs and practices.
3.	Ongoing process: Also includes initial discussion of what they need (before we assume that
they need certain information).
4.	Involve the community as whole part of process.
IE. General Populations Sport Anglers
1.	We need to provide better answers to the question: Are things getting better or worse?
2.	In general, the aquatic environment is much better today than it was 30 years ago. This
doesn't mean it is good enough, but it is definitely better. Yet, recent surveys have shown
that most people feel that it is worse or getting better.
3.	A participant (from Alabama) noted an EPA/NSF-supported research project that features
stakeholder involvement from such groups as tournament bass anglers to help collect fish for
tissue analysis. The angler organizations also get regular presentations from experts on fish
advisory issues at local bass club meetings and items that are included in organization/club
newsletters. These approaches help secure public "buy in" to help continue the research
efforts. The anglers provide valuable inputs for the researchers to get up-to-date information
on the locations of boat launching sites, issues of concern to anglers, and so forth.
Breakout Session 2: Issues in Developing Message Content
2B. Communicating Risk Benefit Information
Recommendations
1.	Be honest with the target audience
2.	Make the message simple and clear
3.	Avoid using voluntary or involuntary risk comparisons
4.	Have consumers involved in preparation of the message content
5.	Know audience needs and what the audience responds to best
6.	Identify third-party spokesperson to deliver the message
7.	Identify carefully who will deliver the message
8.	Know the outlet for the message information (medium); TV, radio, publications, pamphlets,
posters, etc.
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	Part V: Written Comments
9.	Information needs to come from Tribal members
10.	Give alternatives to eating fish
11.	Target women of childbearing age/pregnant women with risk/benefit information
12.	Cultural body cleansing techniques, i.e., fasting, sweating, use of herbs
13.	Educate the agencies—cultural Chamber of Commerce
14.	Risk communicators need to work through local, trusted, and known women's groups and
organizations or community leaders so that the message is accepted.
15.	Understand the consumption habits of the target population
16.	Identify the advisory and understand the issues related to the advisory before going to the
consumer
17.	Stress dialogue with the target population (2-way communication)
18.	Be clear about who is most at risk and why (e.g., fetuses or nursing children for neurological
development)
19.	Be clear about what contaminant in the fish is causing the risk (PCBs, mercury, or a
combination of contaminants)
20.	Be clear on where in the fish (tissue) the contaminants are concentrated (fatty tissues,
muscle, organs, etc.)
21.	Are we trying to fix the problem (through remediation) or will this advisory go on for a long
time and what about effect on the fish?
22.	We need to stress in our communications that despite mercury exposure, there are benefits of
breastfeeding that outweigh the risks
23.	It should be clear that the end point of the advisory is changed behavior, not just
understanding risk potential
24.	Fish is healthy, especially for those with cardiovascular disease in their health history which
needs to be included in the message
25.	Fish is healthy for the developing fetus, children, and women, BUT emphasize it is important
to choose fish lowest in contaminants
26.	Continue to breastfeed should be the message
27.	Emphasize benefits of fish as a high-protein, low-fat food source
28.	Encourage people to continue to eat fish, but to choose wisely
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29.	Provide statement of benefits for qualitative consideration in considering level of risk to
accept
30.	Quantitate benefits—what is the window of the number of meals to obtain benefit from
eating fish
31.	Provide information on the benefits and what they are specifically
32.	Benefits should be used to discourage over-reaction to risk
33.	Benefits outweigh the risks. Do not use scare tactics when developing the message
34.	Provide clear suggestions about how to continue to eat fish but reduce your exposure to
contaminants (fishing location, sizes of fish, timing of fish meals [large bolus dose versus
one meal per week], store purchased vs. self-caught fish)
35.	In cases where advice is to reduce consumption of certain species, as opposed to avoiding
consumption, we need to really ensure that the benefits message is clearly understood and
communicated so consumers can continue to incur benefits (as opposed to eliminating fish
from their diet altogether)
36.	Need to put the contaminant-risk issue into perspective such that the benefits of fish relative
to other protein sources that are high in saturated fats are clearly communicated
37.	State obvious benefits of fishing and fish consumption—recreation, family, holistic,
nutrition, psychological, ethno-religious
38.	Current risk assessment methodology and risk communication process may not be applicable
or appropriate for all audiences that may need or want a different approach
39.	How can you say eating fish is good for me (protein source, other nutrients, etc.) when
eating the fish might make my family sick? (mixed message confusing)
40.	Native Americans and other subsistence fishers cannot stop eating fish. What you are telling
us is making us angry. Don't tell us we can't eat the fish. It is not acceptable to us that the
fish are contaminated. The government should not be telling us the fish will make us sick;
the government should be cleaning up the water. That is linking the source problem to the
risk in the message
41.	Emphasize healthy eating options such as where to fish, safer species, smaller sized fish,
cleaning and preparation procedures to reduce contaminants rather than prohibitions/limits
42.	If given a range of options, will people always choose the option that results in the least
change and thus the riskiest choice?
43.	Most importantly, we need to be clear on why we want to present benefits information
44.	We need to discuss pro's and con's of comparative risk and benefits
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45.	One needs to consider to whom risks vs. benefits accrue
46.	One needs to consider where information on benefits appears in the printed materials relative
to where risk information appears (i.e., the specific order of this information in the message)
47.	Need to make sure consideration of benefits does not imply acceptance of pollution
48.	List areas where fish have been tested and have been found to be relatively free of
contaminants so people can choose these relatively clean areas to fish
49.	Provide information as to whether some fish are more beneficial to eat than others
50.	State specific benefits of fish consumption
51.	State how many fish meals are beneficial (meals per week)
52.	Voluntary/involuntary risks should not be compared in communication—for subsistence
fishers, consumption is an involuntary risk—there are no alternatives
53.	Provide information on how to reduce exposure by choosing other species, fishing other
locations, and through using other preparation techniques
54.	Better to come up with a very simple risk-benefit message that eating smaller fish and
reducing consumption of bottom feeding fish (carp) will maximize the benefits relative to
risks versus attempting to quantitative (an inappropriate) risk-benefit comparisons
55.	Benefits of breastfeeding probably exceed risks—but reduce exposure to contaminants
should be in the message
56.	Benefits for older individuals primarily
57.	Do not translate a standard public message, message should be developed and directed at the
needs of the target population
58.	Information in the message should be tied with current concerns and timed to fishing season
59.	If the fish are so contaminated that you should never eat the fish, then you should say so.
Otherwise point out that eating some fish from this waterbody is good for you
60.	Do not tell people not to eat fish unless it is lethally contaminated (e.g., paralytic shellfish
poisoning). This is an offensive statement to many whose identity is linked to a way of life
they have fought for generations to preserve, and that is guaranteed by treaties predating
pollution discharge permits by 100 years. Few healthy alternatives for subsistence fishers
61.	Include information on causes of fish contamination and ways it can be prevented, cleaned
up, or reduced through legislation (or list sources for this information)
62.	Cultural identity is a benefit to consider and include in the message
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63.	Include reference to population variability in response to exposure (i.e., some people with
liver dysfunction are at greater risk)
64.	Cannot use or factor in quantitative information on benefits of fish consumption since
comparison basis of cardiovascular benefits vs. neurological/cancer are not the same
endpoints
65.	Can have simple statements that diets based upon the consumption of high fat—beef, dairy,
etc., also have increased cardiovascular and chemical risks. People should minimize fat
intake
Additional information needs
1.	Research on contaminant levels and the risk of eating commercial fish (fish purchased in
supermarkets or fish markets)
2.	More research needed about contaminant exposure to infants?
3.	Risk/benefit comparisons between specific fish and other protein sources need to be
available to consumers
4.	More research on how different cultures want to be able to judge fish consumption in relation
to their cultural and spiritual needs and traditions
5.	Quantify nutritional benefits, refine risk numbers (health benchmark values), quantify
additive or synergistic risks
6.	Evaluate whether it is more effective to include a benefits factor in the risk assessment
equation than offer the individual the option to factor it in themselves
7.	Body burdens are established before people have children—reducing consumption while
nursing does not necessarily reduce a woman's risk if she has been eating fish for many years
(subsistence fishers). We need to know the relationship of exposure levels in fish and levels
in breast milk for specific populations.
8.	For nursing mothers, the message has always been the benefits outweigh the risk—we need a
scientifically supportable message that the public/mothers can believe and that will reduce
their fears. If women feel that they can derive benefits through vitamins, etc., for their
children vs. nursing with contaminated milk where they may not see a way to override those
risks, they may choose the vitamins. How do women make a choice? Women feel—many
people do not nurse and their children are fine, why should I nurse my child and take a risk?
9.	Which fish or fish components confer greatest benefits?
10.	Do benefits of eating fish plateau at some point with increased consumption?
11.	Do children benefit from eating fish?
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12.	Do infants benefit if their mothers eat fish?
13.	Cultural differences as they relate to perception of the message
14.	How women differ from men in terms of risk perception of advisory information seeking
behavior
15.	Who do women trust as sources of information
16.	What are health consequence of high fish consumption for specific high-risk groups?
17.	What are sources of contamination causing the advisories?
18.	Calculate and compare relative risks
19.	How many fish meals/week are necessary for proper fetal development/nutrition?
20.	Some target populations will not voluntarily reduce their consumption regardless of the
message. This is due to many factors including cultural identity, lack of healthy alternatives,
and outrage at destruction of a natural resource guaranteed by treaties that they have fought
long and hard to enforce. The target populations need an alternative way to respond to the
advisory
21.	How might nutritional benefits of subsistence food consumption affect risk calculations
22.	How is risk affected by naturally occurring variations in geology/geography?
23.	How are oil and gas exploration in Alaska affecting cancer risk?
24.	What are uncertainties associated with the studies upon which the perceived risks are based?
25.	What are uncertainties associated with setting the advisories themselves?
2D. Communication Paradigm
1.	Both simple and more detailed information needed. Focus groups and surveys/polls appear
to be best ways to test for effectiveness. EPA resource support for such testing would be
helpful. In more complex messages, a major information item should be to communicate
exposure/dosing in terms of more easily understood concepts of number of meals per week.
For more simplified messages, the following matters could be highlighted: (1) eat more fish
in smaller size ranges; (2) eat fewer bottom-feeder species; (3) make liberal use of pictures of
fish; (4) use maps with good coloring coding for lakes/river (maps from the Great Lakes
Indian Commission are a good example); use scorecard or "thermometer" icon approaches to
highlight places or type of fish that provide healthy alternatives (example noted in materials
from Maine on mercury risks).
2.	Need for more research to document effective techniques to present risk information.
Important items are the number of meals per some time period that provide a relatively risk-
free level of consumption. A single communication "vehicle" (e.g., a brochure) should
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focus on just a small number of message components—but how many? Scorecard color-
coding and various icons could help get out important messages (e.g., fish here/fish
elsewhere; picture of fish; and so forth)—but which presentation formats work better than
others?
3. Exposure information best expressed in terms of meal limits per time period. Need
simplified versions of longer and more technical prescriptive information products.
Explanatory materials need a range of formats from simple to complex. Web sites often a
good way to provide access to a range of different formats (simple to complex). Icons
(starting with pictures of fish or maps) a good way to steer audience to extra information.
Pictures and icons can also be used as "front-ends" to explain how some contaminants are
concentrated in certain parts/ organs in fishes. There is still uncertainty—even among
professional toxicologists—on how incremental increases in fish consumption are expressed
in terms of actual human health impacts. The audience is so vast and complex that using a
single paradigm may not work. Evaluations of a set of vehicles with simple messages and
using icons/pictures to document what works best would be worthwhile. Describing risk to
many target audiences is hard. Reducing risks through alterations in one or more behaviors
is also hard to get across—and hard to tell if behaviors actually change.
Breakout Session 3: Issues in Evaluating Health Advisory Risk
Communication Programs
3B. Cultural Enclaves—Native American and Other Cultural and Traditional
Communities
Recommendations
1.	Go back to the community and survey their understanding of the advisory information. Have
the local community do the survey by contracting with a community member.
2.	Confirm your evaluation of advisory success with the community studied by conducting a
survey of households.
3.	Evaluating success of the message can only be ascertained by a survey—or working directly
with people.
4.	State versus Tribal interpretation and evaluation—they differ because of politics and can be
BIASED. Also, no one can come in and tell the tribe what to do—its their choice.
5.	Send flyers to households.
6.	Visit community to communicate, inform, and follow up.
7.	Need to reduce the half-life of the chemicals used in the environment.
8.	Evaluating success is dependent upon original goals.
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Part V: Written Comments
9.	Are people understanding and using the advisory? Community input is needed in the original
development of the advisory. Has the advisory changed behavior? Is the target audience
eating smaller, less risky fish? Have there been shifts away from eating fish to eating other
foods which are less desirable like fatty foods?
10.	For more information on evaluation techniques, a good reference source is the International
Association of Business Communicators (IABC) Evaluation Course that is available on the
Web. The following book also provides information that may be useful to the fish advisory
process: Doug MacKenzie-Mohr et al. Towards Sustainable Behavior: Community-based
Social Marketing. The author is a psychologist recommending community-based marketing
tools to change behavior, especially regarding sustainable activities—car pooling,
composting, recycling. Good book for community-level activities. Great tips applicable
across environmental issues.
11.	Community-based focus groups are useful in evaluating target audience response.
12.	Settlements should be used to build independent sustainable capacity—within impacted
communities. The ability to have a sustainable program that can characterize and
communicate potential risk. Build culturally sensitive local expertise that will be better able
to deliver an effective message. Bottom up and bottom-owned approach!!! Process-oriented
versus results-oriented.
13.	If you hear your technical messages being spoken in District meetings or in the Council, then
the message was heard.
14.	If anyone asks you about your message, then the message was heard.
15.	Ask the target audience face-to-face if they understand the message.
16.	Actually seeing changing in the environmental (increased regulation or polluting practices).
17.	What is success? Trust is the long-term goal. It is difficult to measure, but critical to achieve.
Go to meetings with the target population and listen for the message. Note how many times
your message is mentioned.
18.	This is assuming the goal of message is to inform and not necessarily change behavior.
Another way I measure success is if the Council approves our resolution. This means that we
have developed something the people like and support.
19.	Mandate protocols instead of trust responsibilities. Lack of knowledge of trust
responsibilities.
20.	Measure what changes in fish consumption practices have been made. Use traditional
approaches in communities; elders, children, talking circles. Seasonal consumption spike of
walleye (treaty rights issues): focus message on children and women of childbearing age.
Evaluate awareness of the safer sizes and species of fishes for unlimited consumption.
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Part V: Written Comments
21.	Responses by phone or in-person requests for information are best for evaluating response.
Evaluate message at annual reservation-wide health fair. Evaluate message to kids in the
classroom.
22.	Have health advisory be bi-lingual. Have health advisory take into consideration cultural
traditions.
23.	How can we empower at-risk communities who are disenfranchised to participate in the
process of delivering risk messages to their people, and how can they participate in resolving
the problem by knowing their rights in terms of action both legally and activism-wise.
24.	Create a tribal fish consumption advisory format, for tribes to follow as a guide. Do
regulators understand why their advisory paradigms are not relevant to tribes? Educate
regulators one on one, face to face, so they understand why advisory goals are different for
tribes. Have regulators "developed capacity" to listen? Our goal is to advise regulators and
assessors, not to change the tribe.
25.	Do tribal members eat the same amounts of fish, but take ownership on addressing the
sources of the problems?
Information Needs
1.	How to get tribal perspectives into the risk framework that results in changes in regulatory
attitude and actions.
2.	How to make industry truly liable for the long-term consequences of historic and present
pollution problems.
3.	Fish residue data and information on sources of contamination.
4.	Trust responsibilities—government to government relationship between federal government
and tribes. Among federal Agencies, are interpretations the same?
5.	Tribal members not aware of problems—who knows what?
6.	Determine benefits of fish consumption and benefits of traditional preparation methods vs.
other methods.
7.	Community-based research of point source contaminants, realistic consumption rates, and
traditional knowledge needed.
8.	Research on transport of fish from one region to another for commercial purposes.
9.	Research is needed on what natural plants were used to help clean the body and are they
being used now. If not, how could these plants be reintroduced?
10.	Develop community-based strategies and risk communication.
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Part V: Written Comments
National Risk Communication Conference Facility Evaluation
1. I am a PIO. Much of the content is information I have gained through City County
Communications and Marketing Association (3CMA). I think for toxicologists this was a
good conference but they should rely on their PIOs to help them with communication
technologies. Many PIOs could teach these sessions.
Evaluating the Risk Communication Program—Overview
1.	Not enough shareholders. Awareness in my opinion is beginning—the problem as I see it is,
what is the root cause, this is the missing component! Example, past companies that were
faulted with EPA violation, related back to human health—the companies are participants
too!
2.	Agencies must focus on their missions of protecting public health and the environment.
Commercial fishing and other interests are secondary. Outreach to grass roots groups not
tied to politics may help with this issue. Agency cooperation is imperative—FDA, EPA,
health departments should pool resources to accomplish goals discussed at conference so
messages to public are consistent. From a grassroots perspective, we hope this effort to
involve local groups will continue.
Choosing the Medium for the Message
1.	Would be interested in knowing more about where/why these programs were funded. What
was the driving factor in getting these programs funded? Did other programs suffer due to
the need to fund these programs?
2.	What is the follow-up after the project? Any follow-ups on any of these projects?
3.	It struck me during Ms. Wong's presentation the importance of identifying different
subgroups within a population, like different Asian groups. Do we need to break down
separate groups in the 'white' or 'black' population—are all 'whites' the same, are all
'blacks' the same?
4.	John Cahill—next time mention Cable Access. I've used it several times with success and it
is free often. Older people will watch televised public meetings and interviews, etc. More
doable in small communities where producers are desperate for copy.
Choosing the Message Content
1.	We still are talking single pathway/contaminant—the larger picture needs to be considered as
well. How do we approach risk management/prevention in multiple pathway/contaminant
issues?
2.	This may not be the conference, but the issue of not only educating people about the risk but
also empowering them with info on how they can solicit change and be an active part of the
reclamation should be part of this outreach effort to the public.
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Part V: Written Comments
3.	Joanna noted that consumption of blue crab was a big problem for all populations, yet for the
black population, nearly 100% ate striped bass. Perhaps this could have been pointed out.
4.	Referring to "educational level" can be insulting. Do you mean "formal education level" or
literacy? Literacy and formal education is more specific to me.
5.	Not everyone will ever have the resources/time to such fully investigate study areas like Dr.
Burger has the luxury to do. Desperately need info/techniques for low-resource programs.
Perceptions of Fish Safety: Voices from the Community
1.	More time, effort, and emphasis should be placed on what the communities need to make
good decisions, not who the scientists are curious about. If you can't answer the
communities questions then everything is for naught.
2.	All panelists provided equally valuable information. However, Mr. Cuevas probably offered
the information that was most relevant to the community or communities in my area. Why?
Because he highlighted the differences within the "Hispanic" community, culturally
speaking. He underscored developing relationships, having a "local" help with translation,
seeking out community "leaders."
3.	This session really illuminates the need for local input and buy-in from the community to
have an effective campaign. Community empowerment is also a key that needs to be
incorporated into public process.
4.	This session had the potential for the greatest impact on attendees. We in government need
to hear the voices from the community. We need to hear what works, what doesn't in terms
of material.
5.	From info from this panel, it seems that the white, male angler is not the population group
which bears the most individual person risk. Yet it seems that the fish advisory program is
targeted at white, male anglers.
6.	I wish they had included a sport angler as part of the voice of the community. We need to
hear from a representative from this group and their perceptions and reasons for resistance to
fish advisories.
7.	Alaska is "pristine." However, I now suspect more that our fish have mercury content and
other POP. Alaska doesn't test for mercury content—my guess is that we need to.
8.	I believe that Josee Cuevas gave an excellent account of the importance of communication in
the community—the importance of being someone from the community. Also, how to
disseminate the information from children to parent.
Response to what did you like least about this session ?
A lot! What about tolerance levels among those who have been eating fish as a lifestyle
(Asians, Alaskans, others). Also, naturally occurring Hg, how much is there regardless,
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Part V: Written Comments
historically! People live longer, healthier lifestyles than before. Diets are better. We should
focus on "this" as a health issue and not as an advisory issue. We need info on criteria of
water quality, this range of parameters vs. normal levels of "toxins." PPB, mg, kg/day, oz
/serving/person.
How to Gather Information on Target Audiences
1.	She needs to put these methodologies on a CD and send to each participant.
2.	It was unclear to me how possible it would be for all agencies and non-pTofits to do this. It
would be good to have the context more clearly displayed.
3.	The next part of what Sharon said was that if we buy into doing risk communication, people
will ask us questions we can't answer; we're not there yet.
Risk Communicator Presentations
1.	Community ownership of risk communication projects is necessary.
2.	Risk communicators are under funded and subject to political pressures. Studies in minority
populations are often inadequate and unfortunately not ongoing.
3.	We only think in terms of the Cadillac of the fish world—all salmon, halibut. We in
Alaska—or I should say, Alaska Natives—have a spiritual connection to our fish and wildlife
and this conference makes that connection stronger.
4.	As someone who is new to this issue, I am surprised with what is done with so little money.
5.	We concentrate on fish tissue and recommend to limit consumption, but how safe are
alternatives, i.e., commercial fish, beef, etc.? What are levels of PCB or mercury in beef?
6.	It's hard in a huge conference like this not to cater to the lowest level of knowledge on this
issue. I hope a future conference can be developed for people with knowledge and
experience to talk about innovative ways and the latest research around communicating our
message.
7.	Limitations on funding were expressed clearly here, and the need to find creative ways to
work together to effectively communicate results—building partnerships is key.
What did you like most
Stephanie's emphasis that cleaning up and addressing sources of pollution should be the
focus of future efforts—organizing local groups to demand change for a brighter future.
Risk Communication Basics - Randall Manning
1. Environmental protection agencies must be sure to uphold their mission of protecting the
environment—-there's a problem when reluctance to publish advisories or share info with the
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Part V: Written Comments
public is occurring due to the possible impact on industry/commercial fishing. Protecting
commercial fishing is not the mission.
2.	Agencies must also look to outside groups (non-political) who can help disseminate this
information and help lead the charge to cleaning up the environment.
3.	The EPA guidance document is too much. It should be re-written by a PIO to be more user
friendly.
Breakout Sessions - Cultural/Traditional Subsistence Fisheries
1.	The issue of what proteins will Tribal members substitute for fish if consumption advisories
are issued and adhered to (replacement proteins). Fish eaters need to know if dioxin levels in
fish are greater or less than those in hamburger, cheese, deer, muskrat, etc. The same can be
(needs to be) done for mercury, PCBs, DDE, toxaphene, etc., so cumulative risks may be
communicated to the audience. Research needs to be done supporting these data gaps,
ensuring that contaminant detection levels address Tribal Treaty and subsistence uses.
2.	It is ironic that in a session talking about the need to understand your audience to
communicate effectively that the expressed audience needs were ignored. This did reinforce
the need to "do it right" to avoid frustration and contention (as resulted in this case).
Breakout Sessions - General Population Sport Anglers
1.	We need to educate anglers to get their support for more funding for programs and pollution
reduction.
2.	Possible sub-populations to address: (1) Trophy anglers; (2) Land developers who oppose
"bad news" (contaminated fish adjacent to their project).
3.	Clearing up the misconception: Money is never THE problem. The problem is putting
together an outline or strategy of WHERE and HOW the money will be used. The problem
is people after receiving the money.
Breakout Sessions - Native American Session
What did you like least about this session?
1.	Were not able to involve the general group (other conference attendees) in the discussion.
2.	There needs to be a forum that all Tribes can come together to discuss, present, quantify,
prioritize, identify, categorize Tribal aquatic resource issues and exchange issues. It may
exist but I and (I'm sure) many Tribes are not aware of this. Kudos to EPA for bringing us to
this level—we have a long way to go—but this conference demonstrates Tribes are at least
on the train.
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Part V: Written Comments
Breakout Sessions - Cost of Evaluation Methods - Reducing Costs
1. Suggestions: (1) Build on existing surveys; and (2) Know the community, sometimes they
are conducting surveys and such—states can as technical support.
Breakout Sessions - Measuring Success
1. Federal partners should partner to issue RFP for risk communication projects on fish
advisories—making funding available to states, tribes, and NGOs.
Comment Card
1.	Use the basic trust doctrine to communicate the fact that polluters have stolen the living trust
creatures under advisory.
2.	How are you going to look at water quality criteria for states that have minimal fish tissue
data for methylmercury? And, therefore, no advisories issued? (Referring to mainly states
such as Idaho where total mercury has been found in sediment.)
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Part VI
Appendixes
A Conference Materials and Information 	 A-l
B Biosketches of Conference Presenters	B-l
C Registered Conference Participants	C-l
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Appendix A
Conference Materials and Information
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Appendix A
Risk Communication Conference
Effectively Communicating Health Risks From Fish Contaminants
Purpose:
The purpose of the conference is to learn about, discuss, and form opinions about risk
communication methods designed for populations that are exposed and susceptible to
contaminants in fish, especially those who may not receive, understand, or accept risk
information.
The desired outcome is to develop recommendations on risk communication techniques
that are effective in reaching and informing specific audiences with information on risks from
eating contaminated fish.
Participants in this conference will:
(1)	Become familiar with appropriate steps to develop and deliver a message about
environmental health risks.
(2)	Learn a variety of risk communication approaches used in health protection strategies
directed at protecting children and others in hard-to-reach (target) populations from
environmental health risks.
(3)	Learn about barriers to risk communication that may be unique to specific target
populations.
(4)	Discuss the use of risk/benefit information in communicating risks from contaminants in
fish.
(5)	Become knowledgeable about risk communication practices currently used by programs
concerned with contaminated fish.
At the end of this conference, participants will be able to choose risk communication
approaches most suitable for informing particular populations about the health risks associated
with eating contaminated fish.
Other desirable objectives include:
¦	Bring representatives of states, tribes, or community groups together to share successes
and failures in communicating environmental health risks to target populations by
soliciting representation and presentations from these entities.
¦	Create a forum for federal programs to share their expertise, direction, and priorities
concerning environmental health risks to target populations by soliciting representation
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Appendix A
and speakers from specific environmental health programs at the Centers for Disease
Control, Agency for Toxic Substances and Disease Registry, Environmental Protection
Agency, and Food and Drug Administration.
¦	Share the most current research in risk communication techniques by soliciting
presentations from academic researchers and other practitioners actively using and
evaluating effective risk communication approaches.
Conference Proceedings/Recommendations:
Conference organizers will structure the agenda so that the conference results in
recommendations for effective communication with target populations. These recommendations
will be the result of discussions held amongst participants and speakers in reaction to
presentations by speakers and questions raised by participants. These recommendations will
focus on what are known to be effective methods for communicating environmental health
information to populations that are exposed but hard-to-reach with risk information.
Who should attend:
Anyone interested in improving their ability to effectively communicate risks from
environmental hazards in general and fish contaminants in particular will find this conference
useful. This conference is designed for those with a special interest in health risks to fish eaters
who may not hear, understand, or accept risk information due to barriers of language, cultural
values, socio-economic conditions, or geographic isolation. Risk communication for these fish
eaters may be directed at the fish eater, family members catching or preparing fish for food, or
individuals who influence the fish eating habits of others.
Conference organizers are seeking representation from
state and tribal government,
local government involved in environmental health,
community groups including environmental and children's health advocates,
health care providers (including those who provide culturally-specific care)
industry, and
academia.
Efforts will be made to promote the participation of and include presentations by representatives
of target populations.
Barriers to communication (corresponding to "hard-to-reach" or reasons why people may
not receive, understand, or accept (believe) risk information)
¦	suspicion of the government or others creating the message
¦	economically disadvantaged
¦	fishing for cultural or social reasons
¦	geographic isolation
¦	inability to meet minimum needs of family (lives in "chaos")
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Appendix A
¦	non-English speakers
¦	no access to the communication medium (e.g., people with low literacy skills)
Examples of groups that may be hard-to-reach
¦	Newly arrived immigrants who prefer fish as a food or fish to be self-sufficient and are
unable to read or hear fish available advisory messages due to language barriers.
¦	People eating fish for social, cultural, or religious reasons.
(Hard-to-reach may be confused with people who receive, understand, and believe risk
information, but choose to NOT reduce their risk)
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Appendix A
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Appendix A
National Risk Communication Conference,
Effectively Communicating Health Risks from Fish Contaminants
Agenda
Monday, May 7
8:00 a.m. - 8:30 a.m.
Conference Welcome/Introductions
EPA and Minnesota Department of Health staff
8:20 a.m. - 8:50 a.m.
Keynote Address
Barbara Knuth
8:50 a.m. - 9:00 a.m.
Description of Conference Organization/Format
Conference Organizer
9:00 a.m. -10:00 a.m.
Session 1: Perceptions of Fish Safety: Voices from the Community
Pat Cochran, Maria Maybee, Josee Cung, Ora Rawls, Jose Cuevas
10:00 a.m. -10:15 a.m.
Break
10:15 a.m. -11:15 a.m.
Session 2: Risk Communicator Presentations
Stephanie Allen, Ed Horn, Henry Anderson, Michel Gelobter
11:15 a.m. -12:00 Noon.
Session 3: How to Gather Information on Target Audiences
Sharon Dun woody
12:00 Noon -12:15 p.m.
Instructions to Audience for Breakout Groups
Conference Organizer
12:15 p.m. -1:30 p.m.
Lunch - On your own
1:30 p.m. - 2:45 p.m.
Breakout Session 1: Determining What the Audience Wants to Know
Conference participants will choose one of the following sessions A through E to
discuss information needs or attend Risk Communication 101, Session 1
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Appendix A
(A)	Women's Health Issues - pregnant, nursing, child-bearing age
(B)	Cultural/traditional or geographically isolated subsistence fishers
including Native Americans
(C)	Fish eaters whose native language is not English
(D)	Economically-dependent fish eaters - urban and rural poor
(E)	General population sport anglers
Risk Communication 101 - Session 1
Overview of Risk Communication Process, Problem Identification, and Target
Audience Identification
Randy Manning
2:45 p.m. - 3:00 p.m.
Break
3:00 p.m. - 3:45 p.m.
Reconvene Plenary Session - Summarize Breakout Groups Findings
Report recommended best practices and research needs
3:45 p.m. - 4:30 p.m.
Case Studies of Fish Advisory Scenarios
Kerry Pflugh, Henry Anderson
4:30 p.m. - 6:30 p.m.
Risk Communication Display Session - refreshments
National Listing of Fish and Wildlife Advisories (NLFWA) Training
6:30 p.m.
Dinner - On your own
Tuesday, May 8
8:00 a.m. - 9:00 a.m.
Session 4: Choosing the Message Content
Joanna Burger
9:00 a.m. - 9:15 a.m.
Instructions to Audience for Breakout Groups
Conference Organizer
9:15 a.m. -10:30 a.m.
Breakout Session 2: Issues in Developing Message Content
Conference participants will choose one of the following sessions A through E to
discuss issues or attend Risk Communication 101, Session 2
(A) Mercury, especially as it relates to child development - also, pregnancy,
nursing, child-bearing age
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Appendix A
(B)	Communicating risk-benefit information
(C)	Developing one message versus many messages for different audiences
(D)	Communication paradigms (qualitative versus quantitative; simple versus
complex)
(E)	Common misperceptions (content and media solutions for misinformation)
Risk Communication 101 - Session 2
Developing the Message and Selecting Medium for the Message -
Christine Arnesen
10:30 a.m. -10:45 a.m.
Break
10:45 a.m. -11:45 a.m.
Reconvene Plenary Session - Summarize Breakout Groups Findings
Report recommended best practices and research needs
11:45 a.m. -1:00 p.m.
Lunch - On your own
12:00 Noon.
Risk Communication Display Session Closes, dismantle displays
1:00 p.m. -1:20 p.m.
Session 5: Choosing the Medium for the Message - Overview
John Cahill
1:20 p.m. - 2:00 p.m.
Session 5: Choosing the Medium for the Message, continued
Examples — State and community communication activities
Kristine Wong, Josee Cung
2:00 p.m. - 2:15 p.m.
Session 6: Evaluating the Risk Communication Program - Overview
Barbara Knuth
2:15 p.m. - 3:00 p.m.
Session 6: Evaluating the Risk Communication Program, continued
Examples — methods used to evaluate the effectiveness of the message
Barbara Hager, Tom Nighswander
3:00 p.m. - 3:15 p.m.
Instructions to Audience for Breakout Groups
Conference Organizer
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Appendix A
3:15 p.m. - 3:30 p.m.
Break
3:30 p.m. - 4:30 p.m.
Breakout Session 3: Issues in Evaluating Health Advisory Risk Communication
Programs
Conference participants will choose one of the following sessions A through E to
discuss evaluation criteria and methods or attend Risk Communication 101,
Session 3
(A)	Women and children - reproductive concerns
(B)	Cultural enclaves (Native American & other cultural/traditional
communities)
(C)	English as a second language audiences - Asian American, Hispanic
(D)	Costs of evaluation methods - reducing costs
(E)	Measuring success to improve communication (general cross-cutting
evaluation issues)
Risk Communication 101, Session 3
Implementing the Message and Evaluating the Message
Eric Frohmberg
4:30 p.m. - 5:00 p.m.
Reconvene Plenary Session
Summarize Breakout Group Findings/Closing Remarks
Report recommended best practices and research needs
Pam Shubat
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Appendix A
RISK COMMUNICATION DISPLAY SESSION
The National Risk Communication Conference provided a forum for the exchange of
information and ideas about barriers to communication concerning fish contamination. In
accordance with the theme, "Effectively Communicating Health Risks from Fish Contaminants,"
state and tribal programs were asked to display their risk communication materials at the
conference. A CD of these materials was prepared and distributed to conference attendees.
Materials on this CD were submitted by programs to be used as examples of risk communication.
Not all materials found here are currently available. To find out more about these programs or
material availability please contact the following display session participants:
1.	Arkansas Department of Health - Jennifer O'Neal
2.	ATSDR and U.S. EPA - Jeffrey D. Bigler and Steve Blackwell
3.	Connecticut Department of Health - Brian Toal
4.	Delaware Department of Natural Resources and Environmental Control (DNREC) and
Division of Public Health - Rick Greene and Chuck Nace
5.	Georgia Department of Natural Resources/Environmental Protection Division - Randall
Manning
6.	Great Lakes Indian Fish and Wildlife Commission - Kory J. Groetsch
7.	Idaho Department of Health and Welfare/Bureau of Environmental Health and Safety - Dr.
Mingyi Wen
8.	Illinois Department of Pubic Health - Tiffanie Saxer
9.	Maine Bureau of Health/Environmental Toxicology Program - Eric Frohmberg
10.	Miccosukee Tribe of Indians of Florida - Truman E. Duncan, Jr.
11.	Minnesota Department of Health - Pat McCann
12.	Missouri Department of Health - Gale Carlson
13.	Montana Fish, Wildlife and Parks - Don Skaar
14.	Nebraska Department of Environmental Quality - Michael Callam
15.	New Jersey Department of Environmental Protection - Kerry Kirk Pflugh
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Appendix A
16.	New Mexico Environment Department - Gary Schiffmiller
17.	North Carolina Department of Health and Human Services - Carol D. Schriber
18.	Office of Environmental Health Hazard Assessment (Cal-EPA) - Dr. Robert K. Brodberg
19.	Oregon Health Division, Office of Environmental Toxicology - Kenneth W. Kauffman
20.	University of Washington - Nancy L. Judd
21.	U.S. EPA Region 5, Resources Management Division, Office of Information Services - Dr.
Thomas M. Brody
22.	West Virginia Division of Environmental Protection - Janice Smithson
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Appendix B
Biosketches of Presenters at the
2001 National Risk Communication Conference
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Appendix B
Stephanie J. Allen
Program Manager, E.A.G.L.E. Communications Strategy Program
Chiefs of Ontario
Sagamok Anishnawbek First Nation, ON, Canada
Stephanie Allen is a Mohawk from Six Nations and lives with her husband and children on the
Sagamok Anishnawbek First Nation on the north shore of Lake Huron. She was raised off-
reserve in a community on Lake Erie where her father was a commercial fisherman. She
received her degree in Environmental and Resource Science from Trent University. Stephanie
has worked as a fisheries technician and, for the past 3 years, has been working in partnership
with 47 First Nations and Health Canada on the former E.A.G.L.E. (Effects on Aboriginals from
the Great Lakes Environment) Project, now the E.A.G.L.E. Communication Strategy Program.
During her time with E.A.G.L.E., she has been involved in the production of First Nations Fish
Consumption Guidelines for 33 First Nations in the Great Lakes basin. She also coordinated
development of the E.A.G.L.E. Project Environmental Health Research Tool Kit, a "how to"
guide for First Nations interested in conducting research on environmental health. Currently, she
is preparing the final reports on the E.A.G.L.E. Project, including a technical series of reports
and First Nation community-specific reports.
Henry A. Anderson, M.D.
Chief Medical Officer
State Environmental and Occupational Disease Epidemiologist
Wisconsin Department of Health and Family Services
Madison, Wisconsin
Henry Anderson is certified by the American Board of Preventive Medicine with a subspecialty
in Occupational and Environmental Medicine. Dr. Anderson has been involved in the study of
human exposure to PCBs for more than 20 years and led the effort for a Great Lakes Basin-wide
uniform sport fish advisory protocol. He leads a consortium of five state health departments
funded by the Agency for Toxic Substances and Disease Registry to study the reproductive and
endocrine functions of frequent Great Lakes sport fish consumers. The consortium also assesses
advisory awareness and understanding in the Great Lakes Basin. Together with Maine, he is
assessing women's awareness of mercury toxicity and state fish consumption advisories in
12 states.
Christine Arnesen
Chief, Community Participation and Education Section
Environmental Health Investigations Branch
California Department of Health Services
Oakland, California
Christine Arnesen has worked in the California State Health Department for the past 14 years
and has been involved in developing, implementing, and evaluating programs designed to
communicate information about fish contamination and fish consumption to a variety of
communities throughout the state. Audiences have included anglers, subsistence fishers, non-
English-speaking and low-literacy populations, and the general public, as well as local health
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Appendix B
department staff and health professionals. Projects have used many different approaches,
including PSAs, fact sheets, videos, activities with community-based organizations, posters, and
focus groups.
Joanna Burger
Professor of Biology, Rutgers University
Professor, UMDNJ School of Public Health
Joanne Burger is an ecologist, human ecologist, behavioral biologist, and ecotoxicologist who
has worked with seabirds for over 30 years in many parts of the world. She has worked
extensively with oil spills and edited a volume that made a holistic analysis of the Exxon oil spill
in the Arthur Kill. For the past 15 years Dr. Burger has been involved with examining
recreational and subsistence fishing, in terms of recreational rates, consumption patterns, sources
of information, risk to human consumers and methods of risk management. For the past 5 years
she has been involved with the development of ecological risk methods and bioindicators for
Department of Energy sites, including evaluating attitudes toward recreational, ecological
services, and future land uses. She has authored or co-authored over 300 papers in refereed
journals, numerous book chapters, and six BNA accounts on gulls and terns. She has edited six
volumes on avian behavior and seabirds and written two books on the behavior of colonial-
nesting birds:
John M. Cahill
Director, Bureau of Community Relations
New York State Department of Health
Albany, New York
John Cahill has been director of community relations with the New York State Department of
Health since 1986. He has more than 30 years' experience in conducting health communication,
public relations, social marketing, health promotion, and community advocacy programs on a
wide variety of issues, ranging from AIDS to zoonosis. He has broad experience in planning,
developing, implementing, and evaluating targeted health communications programs for
audiences of all educational levels through a wide variety of media and channels. He provides
consultative services and training in social marketing to health-related agencies and
organizations at the local, state, and national levels.
Patricia A. L. Cochran
Executive Director, Alaska Native Science Commission
Anchorage, Alaska
Patricia Cochran is an Inupiat Eskimo, born and raised in Nome, Alaska. Ms. Cochran serves as
Executive Director of the Alaska Native Science Commission (ANSC), a cooperative program
of the Alaska Federation of Natives, University of Alaska—Anchorage, and the National Science
Foundation. The ANSC provides a linkage for creating partnerships and communication
channels between science and research communities and Alaska Native communities. Over the
past 6 years, ANSC has been conducting statewide regional meetings to discuss community
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Appendix B
issues and concerns and documenting local and traditional knowledge about contaminants and
the environment. Meetings with Western scientists enable scientists and communities to identify
common and divergent understandings of environmental change and the role of contaminants.
Jose R. Cuevas
Commissioner for Human Rights
Elizabeth, New Jersey
Jose Cuevas was appointed to the Human Rights Commission 6 years ago by the mayor of
Elizabeth because of his grassroots organizing efforts in Elizabeth. He served as the first
chairman of the Environmental Equity Advisory Council, an appointment made by Department
of Environmental Protection (DEP) Commissioner Shim. He became involved with fish
contamination when he assisted the DEP with its science and research study on the effects on
women and children of consuming fish caught in the Arthur Kill. An experienced community
organizer, he has worked in Newark, Jersey City, Brooklyn, the Bronx, and Baltimore with the
Industrial Areas Foundation. Currently, he is working in Plainfield, New Jersey, as the lead
organizer with the Community Building Team, a project of the Interfaith Council for the
Homeless of Union County.
Josee N. Cung
Program Manager, Southeast Asian Program
Minnesota Department of Natural Resources
Saint Paul, Minnesota
Josee Cung is the program manager of a special Southeast Asian outreach program that she
created in 1990 for the Minnesota Department of Natural Resources. For the past 10 years, she
has worked with community leaders to break down language and cultural barriers in their access
to education and information and use of the state's natural resources, primarily for fishing,
hunting, and gathering forest products for food. She has organized numerous community
meetings on natural resources topics, such as game and fish laws and environmental issues,
using bilingual or native-language only explanations instead of technical and professional
terminology to provide information to her audience. In 1996, she won a national award from
American Rivers for a project that taught Hmong immigrants about the risks of eating fish from
the Mississippi River and how to use fish advisories.
Patricia Cunningham
Environmental Biologist
Research Triangle Institute
Pat Cunningham has worked for the Research Triangle Institute Water Quality Department for
the past 21 years. Dr. Cunningham has been actively providing support to the U.S.
Environmental Protection Agency's (EPA's) Office of Water Fish Contaminant Program for
over 10 years. One of her first projects for EPA involved development of a database of fish
advisory information. The database, now known as the National Listing of Fish and Wildlife
Advisories (NLFWA), has grown and evolved into an on-line web application. Dr. Cunningham
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Appendix B
also provided technical support as one of the principal authors for the development and revision
of Volume 1: Fish Sampling and Analysis of the EPA national guidance series—Guidance for
Assessing Chemical Contaminant Data for Use in Fish Advisories and for the expansion and
redesign of Volume 2: Risk Assessment and Fish Consumption Limits in this same guidance
series. For the Office of Water, she has developed and presented regional workshops on fish
advisory issues, has written several of the annual NLFWA fact sheet and other chemical fact
sheets for bioaccumulative contaminants, and has prepared fish advisory posters and other
outreach materials for use by states and tribes in their fish advisory programs.
Sharon Dunwoody
Evjue-Bascom Professor and Director
School of Journalism and Mass Communication
University of Wisconsin—Madison
Madison, Wisconsin
Sharon Dunwoody has studied the relationship between risk judgment and information use for
nearly two decades. Much of her risk communication work has focused on how individuals use
information channels to make judgments about the risk of eating sport-caught fish. To
accomplish this, she has surveyed anglers and women who live in angling households, conducted
focus groups of anglers and non-anglers in several cities, and conducted experiments. More
broadly, she studies public understanding of science issues, including how people learn about
science from science Web sites. Her most recent book, co-edited with Professors Sharon
Friedman and Carol Rogers, is Communicating Uncertainty (Erlbaum, 1999).
Eric J. Frohmberg
Environmental Toxicology Program
Maine Bureau of Health
Augusta, Maine
Eric Frohmberg is a toxicologist with the Maine Bureau of Health. He has been involved in the
development of fish consumption advisories as well as the Bureau's fish advisory
communication program. His role in these activities included creating new brochures, testing
efforts with low-literacy focus groups, and developing the fish consumption advisory website.
Before working for the state of Maine, Mr. Frohmberg worked with the Western Shoshone and
Southern Paiute to evaluate risk from consuming traditional foodstuffs affected by aboveground
nuclear weapons testing. Additional projects included working with the Laguna Pueblo to
understand effects on local populations from a uranium strip mine and with the Creek and
Cherokee to evaluate risk associated with a uranium hexaflouride production facility.
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Appendix B
Barbara L. Hager, MPH, CHES
Director, Health Education and Promotion
Arkansas Department of Health
Little Rock, Arkansas
Barbara Hager has been director of Health Education and Promotion at the Arkansas Department
of Health since 1990. She was a member of the team that developed, implemented, and
evaluated education and outreach strategies for the state's mercury in fish advisory program.
She directed the development of focus group selection procedures and questions, summarization
of findings, production of messages, implementation of other educational interventions, and
evaluation of education and strategy results. Audiences included the general population, women
of childbearing age, young children, and subsistence fishers. Ms. Hager has co-authored two
articles about Arkansas's fish advisory experiences.
James A. Hanlon
Acting Deputy Assistant Administrator
Office of Water
U.S. Environmental Protection Agency
James Hanlon is a career civil servant with over 28 years of government service with the U.S.
Environmental Protection Agency. In 1984 he was appointed to the position of Director,
Municipal Construction Division and was responsible for the management of EPA's national
construction grants and state revolving fund programs, providing assistance to municipalities in
their wastewater infrastructure construction programs. He was appointed to the position of
Deputy Director of the Office of Science and Technology in the Office of Water in 1991. In this
capacity, Mr. Hanlon was responsible for the scientific and technical basis of the federal water
quality and safe drinking water programs.
Edward G. Horn, PhD.
Director, Bureau Toxic Substance Assessment
New York State Department of Health
Albany, New York
For nearly 12 years, Ed Horn has been with the Center for Environmental Health in the New
York State Department of Health. He currently directs programs that assess exposures to and
health risks from environmental chemicals and airborne biologicals such as mold. His office is
responsible for issuing the health advisories related to eating fish, many of which are the
consequence of mercury contamination. Prior to joining the Department of Health, Dr. Horn
served for 8 years as Chief of the Bureau of Environmental Protection in the New York State
Department of Environmental Conservation. During that time, he served for 4 years as a
member of the Adirondack Lake Study Management Committee, which provided oversight to an
extensive survey of lakes in the Adirondacks for water quality and biological community status
related to acid rain issues.
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Appendix B
Barbara A. Knuth
Associate Professor, and Co-leader,
Human Dimensions Research Unit
Department of Natural Resources
Cornell University
Ithaca, NY
Barbara Knuth, an associate professor and co-leader of the Human Dimensions Research Unit in
the Department of Natural Resources at Cornell University, has conducted research and
published many articles addressing issues of risk perception and risk communication related to
fish consumption health advisories. She developed Volume 4: Risk Communication in the U.S.
Environmental Protection Agency's series Guidance for Assessing Chemical Contaminant Data
for Use in Fish Advisories. She has served as a consultant on many projects and public outreach
efforts, including fish consumption survey development, fish advisory fact sheets, and fish
consumption advisory brochures. She is a past president of the Water Quality Section of the
American Fisheries Society.
Randall O. Manning, Ph.D., DABT
Coordinator, Environmental Toxicology Program
Georgia Department of Natural Resources, Environmental Protection Division
Atlanta, Georgia
Randall Manning is the Coordinator of the Environmental Toxicology Program with the Georgia
Department of Natural Resources Environmental Protection Division. He is responsible for
providing toxicology and risk assessment support to the division. His interest in fish
consumption advisories began in 1991, when he coordinated the development of guidelines for a
monitoring strategy and risk-based advisories. Dr. Manning worked with focus groups to
acquire input for the program and to develop communication strategies. He continues to manage
the fish advisory program and speaks frequently on fish consumption and risk. He is particularly
interested in uncertainties regarding fish consumption rates and patterns and potential benefits
from fish consumption as they relate to risk communication.
Maria Maybee
Habitat and Biodiversity Coordinator
Great Lakes United
Buffalo, New York
Maria Maybee, who is a member of the Seneca Nation of Indians from the Cattaraugus Indian
Reservation, coordinates fish consumption advisory outreach to at-risk communities as part of a
project of the Lake Erie Binational Public Forum. Emphasis in her programming is placed on
women and children who eat or prepare fish in the New York region of the Lake Erie Basin.
Working in conjunction with the New York State Angler Cohort Study, Ms. Maybee's most
recent efforts may provide better insight into issues relevant to the communication of sport fish
consumption risk to Native American communities in New York. In addition, Ms. Maybee will
be working with researchers and educators to develop an educational outreach program for
elementary school science students that focuses on Buffalo River ecosystem health.
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Appendix B
Tom Nighswander, MO, MPH
Alaska Native Medical Center
Anchorage, Alaska
Tom Nighswander has been active in rural health in Alaska since 1972. The majority of this
time has been spent as a Family Practitioner and Emergency Room physician at the Alaska
Native Medical Center in Anchorage. Dr. Nighswander's work has required extended travel to
the villages and included supervision of community health aides and mid-level practitioners in
the remote parts of Alaska. He is a faculty member of the University of Washington School of
Medicine. During the Exxon Valdez Oil Spill and its aftermath, he chaired the Oil Spiil Health
Task Force, a multi-agency and community-based group charged with evaluation of substance
food safety and communication of this information to the involved villages. He is a joint editor
of a book reviewing this 8-year experience entitled Evaluating and Communicating Subsistence
Seafood Safety in a Cross—Cultural Context: Lessons Learned from the Exxon Valdez Oil Spill.
Today, as well as maintaining a clinical practice, he is the facilitator of the Alaska Telehealth
Advisory Council, which was established by the Commissioner of Health and Social Services in
January 1999 to provide high-level policy development and coordination of telehealth efforts in
Alaska.
Kerry Kirk Pflugh, M.S.
Research Scientist, Division of Science, Research, and Technology
New Jersey Department of Environmental Protection
Kerry Kirk Pflugh has a background in agricultural journalism and environmental
communication and has been employed by the state of New Jersey for more than 13 years and
involved in fish consumption advisory projects for the past 9 years. Her area of expertise is
strategic communication planning, focusing on citizen participation in environmental
management decisionmaking. She developed and coordinated a community-based outreach and
education program on fish consumption advisories, which received an Urban Hometown River
Award from American Rivers for the category of education. Her research on knowledge,
awareness, and consumption patterns of urban anglers has been published in several journals.
Additional research focuses on the perception of risk related to fish consumption advisories in
the Latino community. She is currently coordinating a project to develop information and
education materials for pregnant women. In addition, she has created an award-winning
education program for elementary school students to teach them about fish consumption
advisories and other water-related issues
Ora C~ Rawls, Executive Director
Mississippi Rural Development Council
Ora Rawls serves as the Executive Director of the Mississippi Rural Development Council
(MSRDC) for the State of Mississippi. Council activities in which Ms. Rawls participates
related to environmental issues include: board member for the Mississippi Rural Health
Association, Mississippi Access for Rural Care and Career Forum; member of Ag Summit II,
Task Force on Capital Development, Mississippi State University; member of State Legislative
task force Utilities Committees (Rural Water); stakeholders participant for Mississippi Robert
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Appendix B
Wood Johnson Southern Rural Access Program; and Mississippi Basin Stakeholders Member
(Mississippi DEQ). She has coordinated through MSRDC the 4-H Youth programs (Character
Counts) and served as an advisor for Mississippi Community Development Society. Ms. Rawls
works with State Chambers of Commerce and nonprofit groups on behalf of women and
underserved communities on economic development initiatives at the grassroots level in rural
and urban areas. Her work with the Rural Water Task Force resulted in a statewide water-testing
program requiring rural water systems to advise consumers of water contaminants and notice
timeline for boiling water; to train operators; and to provide financial reporting. A Habitat
project leader, Ms. Rawls also volunteered with transition programs for domestic abuse and
projects involving youth and senior citizens.
Deborah Rice, Ph.D.
National Center for Environmental Assessment
U.S. Environmental Protection Agency
Dr. Deborah Rice received a Ph.D. in toxicology from the University of Rochester and is
currently a risk assessor in neurotoxicology with the National Center for Environmental
Assessment at the U.S. Environmental Protection Agency. She is the co-author of the
background document to derive a reference dose for methylmercury and is the chair of the
working group for the derivation of a reference dose for PCBs. Before joining EPA, Dr. Rice
was a research scientist in the Toxicology Research Division of Health Canada, where she
headed a research program to characterize nervous system impairment produced by
developmental exposure to the major environmental pollutants lead, methylmercury, and PCBs.
Robust behavioral impairment was observed as a result of ongoing exposure to lead at blood lead
concentrations as low as 10 |!g/dl. Dr. Rice identified impairment in visual, auditory, and
somatosensory function as a result of developmental methylmercury exposure; delayed
neurotoxicity as a result of early exposure was also documented, as well as an age-exposure
interaction in functional decrement in aging monkeys. Dr. Rice identified behavioral deficits in
monkeys exposed postnatally to an environmentally relevant congener mixture of PCBs, and
who9 had blood PCB concentrations typical of environmentally exposed humans. Dr. Rice is
currently an Associate Editor for the journals Neurotoxicology, Neurotoxicology and Teratology,
and Environmental Research. She has authored or co-authored more than 100 research articles
and book chapters on neurotoxic effects of specific agents, methodologycal approaches for
neurotoxicology research, and risk assessment.
Pamela Shubat, Ph.D.
Minnesota Department of Health
St. Paul, Minnesota
Pam Shubat has been employed by the Minnesota Department of Health since 1989 as an
environmental toxicologist. Past responsibilities include developing and managing the state's
Fish Consumption Advisory Program and the state's Childhood Lead Poisoning Prevention
Program, which is funded by the Centers for Disease Control. Currently Dr. Shubat is involved
in research, policy, and program development around the issue of children's environmental
health. Past work concerning risk communication for fish consumption advisories included
developing advisory formats and outreach materials for a variety of audiences, including
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Appendix B
Southeast Asian immigrants. Her past work in developing advisories and outreach materials (for
both fish contaminants and lead prevention programs) emphasized community involvement
through advisory groups, partnerships with community-based organizations, and focus groups.
Elizabeth Southerland, Ph.D.
Standards and Health Protection Division
U.S. Environmental Protection Agency
Washington, DC
Elizabeth Southerland has worked for the U.S. Environmental Protection Agency since 1984 as
an environmental engineer and manager of water quality programs. Currently, Dr. Southerland
is director of the Standards and Health Protection Division in EPA's Office of Water. The
Division is responsible for overseeing the approval/disapproval of state and tribal water quality
standards as well as developing national assessments of water pollution and advice on how to
prevent public health effects from this pollution. Ongoing work in the Division regarding
chemical contamination in fish includes monitoring contaminants in fish from lakes and
reservoirs throughout the United States, developing national guidance and data on fish
consumption advisory programs, and preparing public education materials on avoiding risks
from fish contamination.
Kristine A. Wong, MPH
No affiliation
(Currently not working for Save San Francisco Bay Association)
Kristine Wong has been working on environmental health and justice issues for the past 6 years
in the San Francisco Bay Area and Seattle. At Save San Francisco Bay Association, she directed
a project focused on communities of color fishing from the Bay. Her work includes: directing a
community-based study of Bay fishers; developing and implementing toxics education/safe fish
cooking workshops with multiethnic groups; developing multilingual posters and brochures;
conducting policymaker briefings and media advocacy to the mainstream and ethnic media; and
co-producing and directing a health education video translated into multiple languages. The
educational materials have been distributed widely. She also involved youth through a fishing
pier outreach program and has been an advisor and trainer on the issue for various groups.
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Appendix C
Registered Conference Participants
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Appendix C
Conference Participants Contact Information
Eric Aakko
Wisconsin Division of Public Health
One West Wilson, Room 150
Madison, Wl 53701
608-267-2987
aakkoe@dhfs.state.wi.us
Bonnie J. Alexander
Valley City State University
101 College Street
Valley City, ND 58072
701-845-7453
Bonnie_Alexander@mail.vcsu.nodak.edu
Syed M. Ali
CA State Water Resources Control Board
1001 I Street
Sacramento, CA 95814
916-341-5555
alis@dwq.swrcb.ca.gov
Stephanie Allen
Sagamok Anishnawbek
PO Box 1017
Massey, Ontario Canada POP 1 PO
705-865-3223oakes@primus.ca
Catherine A. Allen
USEPA
1200 Pennsylvania Ave., NW, R 2660
Washington, DC 20460
202-564-6115
murray@nwf.org
Henry A. Anderson
Wisconsin Division of Public Health
PO Box 2659
Madison, Wl 53701
608-266-1253
ANDERHA@dhfs.state, wi.us
Don J. Aragon
Wind River Environmental Commission
Building Ten Washakie St., PO Box 217
Fort Washakie, WY 82514
307-332-3164
Daragon@Wyoming.com
Lisa Arcand-Hoy
BBL Sciences
6723 Towpath Rd., Box 66
Syracuse, NY 13214
315-446-2570x452
lda@bbl-inc.com
Glen R. St. Armant
Muckleshoot Indian Tribe
39015 172nd Avenue, SE
Auburn, WA 98092
253-939-3311
Gstamant@muckleshoot.nsn.us
Tom Armitage
USEPA - Fish Forum Speaker
1200 Pennsylvania Avenue, NW
Washington, DC 23060
202-260-5388
armitage.thomas@epa.gov
Christine Arnesen
California Dept. of Health
832 Indian Rock Avenue
Berkeley, CA 94707
510-508-8715
carnesen@dhs.ca.gov
Scott Arnold
Section of Epidemiology, Anchorage AK
3601 C Street, Suite 540
Anchorage, AK 99503
907-269-8000
scott_arnold@health.state.ak.us
Deborah Arnwine
Water Poll. Conrol, TN Dept. Environ.
7th Floor, L & C Annex, 401 Church St.
Nashville, TN 37243-1534
615-532-0703
darnwine@mail.state.tn.us
Mary F. Arquette
Akwesasne Task Force on the Environ.
613 Cook Road
Hoganburg, NY 13655
518-358-9607
mfadden@westelcom.com
Leslie K.L. Au
Hawaii Dept. of Health
919 Ala Moana Blvd., Suite 206
Honolulu, HI 96814
808-586-7539
lau@eha.health.state.hi.us
Laura Au-Yeung
Univ. of Minnesota Extension Service
1525 Glenwood Avenue
Minneapolis, MN 55401
612-374-8430
auyeuOOl @umn.edu
Martha I. Aviles-Quintero
USEPA
77 W. Jackson Blvd., WQ-16J
Chicago, IL 60604
312-353-4227
aviles-quintero.martha@epa.gov
Wayne Ball
Utah Department of Health
288 North 1460 West, PO Box 142104
Salt Lake City, UT 84114-2104
801-538-6191
wball@doh.state.ut.us
Jennie J. Ballew
Gila River Indian Community
P.O. Box 370
Sacaton, AZ 85247
520-562-2234 x 238
jballew@gilanet.net
Richard E. Barrett
Dept. of Environmental Conservation
500 S. Alaska Street
Palmer, AK 99645
907-745-3236
dick_barrett@envircon.state.ak.us
Karen J. Bataille
Missouri Conservation Department
1110 South College Avenue
Columbia, MO 65201
573-882-9880x3215
bataik@mail.conservation.state.mo.us
Thomas A. Baughman
Illinois Dept. of Public Health
245 W. Roosevelt Road, Building 5
West Chicago, IL 60185
630-293-6800
tbaughma@idph.state.il.us
Santina Baumeister
USEPA - Alaska
222 W. 7th Ave. #19, RM#537
Anchorage, AK 99513-7588
907-271-3413
Jennifer Bellman
Gov. of Canada-Dept. Indian Affairs
PO Box 1212
Yellowknife, NT X1A2N9
867-669-2584
bellmanj@inac.gc.ca
David A. Bennett
USEPA (5202G)
Ariel Rios Building, 1200 Penn Ave, NW
Washington, DC 20460
703-603-8759
bennett.da@epa.gov
C-3
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Appendix C
Conference Participants Contact Information (cont.)
Jerry Big Eagle
Cheyenne River Sioux Tribe
PO Box 590
Eagle Butte, SD 57625
605-964-7812
crstgameandfish@sodak.net
Jeffrey D. Bigler
USEPA 4305, RM515B
1200 Pennsylvania Ave. NW
Washington, DC 20460
202-260-1305
bigler.jeff@epa.gov
Bri Bill
USEPA
77 W. Jackson Blvd. (P-19J)
Chicago, IL 60604
312-353-6646
bill.briana@epa.gov
Catriona M. Black
Columbia River Inter-Tribal Fish Comm.
729 N.E. Oregon, Suite 200
Portland, OR 97232
503-731-1315
cat@critfc.org
Steve R. Blackwell
ATSDR
1600 Clifton Rd. NE, MS-42
Atlanta, GA 30319
404-639-6298
srbO@cdc.gov
Kate Blumberg
Delta Institute
53 W. Jackson Blvd., Suite 1604
Chicago, IL 60647
312-554-0900
kateblumberg@delta-institute.org
Darlene H. Boerlage
EPA/Office of Environmental Information
401 M St., SW 2843
Washington, DC 20460-0001
202-260-0353
boerlage.darlene@epa.gov
Mark Bollinger
US DOE Center for Risk
9800 S. Cass Avenue
Argonne, IL 60439
630-252-9126
mark.bollinger@ch.doe.gov
Ron Boquist
Shoalwater Bay Environmental Lab
PO Box 130
Tokeland, WA 98590
360-267-3101 x21
ronbo@techline.com
Raymond Borgen
Grand Portage Reservation
PO Box 428
Grand Portage, MN 55605
218-475-2415
gpenviro@boreal.org
Denis R. Borum
USEPA, Office of Science & Technology
1200 Pennsylvania Avenue, NW
Washington, DC 20460
202-260-8996
borum.denis@epa.gov
Peter C. Boyer
International Joint Commission
100 Ouellette Avenue
Windsor, Ontario NOR 1B0
519-257-6713
boyerp@windsor.ijc.org
Robert Brodberg
Cal/EPA, Office of Env. Health Harzard
P. 0. Box 4010
Sacramento, CA 95812-4010
916-323-4763
rbrodber@oehha.ca.gov
Tom Brody
USEPA Region 5
77 W Jackson Blvd.
Chicago IL, 60604
312-353-8340
brody.tom@epa.gov
Hobson Bryan
University of Alabama
Box 870322, Dept. of Geography
Tuscaloosa, AL 35407-0322
205-348-1950
hbryan@alabama.ua.edu
Joanna Burger
Rutgers University
604 Allison Road
Piscataway, NJ 08854
732-445-4318
Burger@Biology.Rutgers.Edu
Bonnie Bush
USEPA
77 West Jackson Boulevard
Chicago, IL 60604
312-353-6684
bush.bonnie@epa.gov
Linda Bylander
Minnesota Dept. of Natural Resources
1601 Minnesota Drive
Brainerd, MN 56401
218-828-6044
linda.bylander@dnr.state.mn.us
Reggie Cadotte
Red Cliff Tribe
PO Box 529
Bayfield, Wl 54814
715-779-3700
wrc4pres@yahoo.com
John M. Cahill
New York State Department of Health
1748 Corning Tower
Albany, NY 12237
518-474-5370
jmc04@health. state, ny. us
Charlotte A. Caldwell
Indigenous Environmental Network
PO Box 485
Bemidji, MN 56619
218-751-4967
caldwell@northernnet.com
Michael Callam
Nebraska DEQ
Suite 400, 1200 N Street
Lincoln, Nebraska 68509
402-421-4249
michael.callam@ndeq.state.ne.us
Bruce K. Campbell
Pine River Watershed Group
8181 CR 203
Durango, CO 81301
970-259-3968
bkcampbell@arimas.net
Sheila C. Canavan
OPPTS/USEPA
1200 Pennsylvania Ave., NW, MC7101
Washington, DC 20460
202-260-8616
canavan.sheila@epa.gov
C-4
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Appendix C
Conference Participants Contact Information (cont.)
Phillippa Cannon
USEPA Region 5
77 W. Jackson Blvd. (PI-19J)
Chicago, IL 60604
312-353-6218
cannon.phillippa@epa.gov
Frank Carl
Savannah River Basin Watershed Project
14501 Smith Road
Charlotte, NC 28273
704-588-4295
fcarl@carolina.rr.com
Gale Carlson
Missouri Department of Health
PO Box 570
Jefferson City, MO 65102
573-751-6090
Rita M. Cestaric
Great Lakes National Program Office
US EPA
77 West Jackson
Chicago, tL 60657
312-886-6815
cestaric.rita@epa.gov
Lee Cha
IRCO / Asian Family Center
4424 NE Glisan St.
Portland, OR 97213
503-235-9396
s_vanderburg@hotmail.com
Maleva D. Chamberlain
Kentucky Division of Water
14 Reilly Road
Frankfort, KY 40601
502-564-3410
Maleva. Chamberlain@mail. state, ky.us
Kaatz Chary
UIC School Public Health
7726 Locust Ave.
Gary, IN 46403
219-938-0209
lchary@uic.edu
Francis K. Chin
Maniilaq Association
PO Box 256, 733 2nd Avenue
Kotzebue, AK 99752
907-442-7673
fchin@maniilaq.org
Elaine Christian
Section of Epidemiology, Anchorage AK
3601 C Street, Suite 540
Anchorage, AK 99503
907-269-8000
elaine_christian@health.state.ak.us
Dennis E. Clark
Indiana Dept. of Environ. Management
100 North Senate Ave., Box 6015
Indianapolis, MN 46206
317-233-2482
dclark@dem.state.in.us
Milt Clark
USEPA Region 5
77 W Jackson Blvd
Chicago, IL 60604
312-886-1918
clark.jmilton@epamail.gov
James Clift
Michigan Environmental Council
119 Pere Marquette, Ste. 2A
Lansing, Michigan 48912
517-487-9539
jamesmec@voyager.net
Patricia A.L. Cochran
Alaska Native Science Commission
3211 Povidence Drive
Anchorage, AK 99508
907-786-7704
patricia.cochran@uaa.alaska.edu
Maxine A. Cole
Akwesasne Task Force on the Env.
PO Box 992
Akwesasne, NY 13655
518-358-9607
a3235@glen-net.ca
Walter Combs
Rhode Island Dept. of Health
Three Capitol Hill
Providence, Rl 02908
401-222-7790
waltc@doh.state.ri.us
John R. Cooley
Western University of Michigan
2504 Crescent Drive
Kalamazoo, Ml 49001
616-552-4717
Fernhill60@aol.com
William S. Cooter
Research Triangle Institute
3040 Cornwallis Rd
Research Triangle Park, NC 27709
919-990-8694
sid@rti.org
Patricia A. Cunningham
Research Triangle Institute
3040 Cornwallis Rd
Research Triangle Park, NC 27709
919-990-8609
patc@rti.org
Greg Cope
North Carolina State University
Dept. of Toxicology, Box 7633
Raleigh, NC 27695
919-515-5296
greg_cope@ncsu.edu
Ted Copewood
USEPA - Office of Children's Health
1200 Pennsylvania Ave., NW 1107A
Washington, DC 20460
202-564-2197
Nancy Costa
Fond du Lac Reservation
1720 Big Lake Road
Duluth, MN 55720
218-878-8010
nancycosta@fdlrez.com
Jean Cowden
Consultant
5629 Comanche Drive
Madison, Wl 53704
608-244-3407
Douglas G. Cox
Monominee Tribe of Wisconsin
Hilary J. Waukau Env/Forestry Center
Keshena, Wl 54135
715-799-4937
dcox@itol.com
Valerie Craven
Exponent
613 First St., Suite 200
Santa Rosa, CA 95404
cravenv@exponent.com
Jose R. Cuevas
Human Rights Comm. City of Elizabeth
234 E. Jersey Street
Elizabeth, NJ 07206
908-353-0722
jrcpeto@aol.com
C-5
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Appendix C
Conference Participants Contact Information (cont.)
Columbine Culberg
Institute for Fisheries Resources
1230 27th Avenue
San Francisco, 94122
415-566-9703
columbine@mindspring.com
Josee Cung
Minnesota Dept. of Natural Resources
500 Layfayette Road, Box 10
St. Paul, MN 55155-4010
651-297-4745
josee.cung@dnr.state.mn.us
Steve Curcio
Pennsylvania Sea Grant
Penn State Erie - Station Road
Erie, PA 16563-0101
814-898-6358
xsc2@psu.edu
Marc Dahlberg
Arizona Game and Fish Department
221 W. Greenway '
Phoenix, AZ 85023
602-789-3260
mdahlberg@gf.state.az.us
Marjorie L. Davidson
U.S. Food and Drug Administration
HFS-32 200 C Street, SW
Washington, DC 20204
202-205-2127
mdavidso@cfsan.fda.gov
Jennifer A. Davis
Illinois Dept. of Public Health
535 West Jefferson Street
Springfield, IL 62761
217-782-5830
jdavisl@idph.state.il.us
Dana Davoli
USEPA
1200 Sixth Avenue
Seattle, WA 98117
206-553-2135
Davoli.dana@epa.gov
Marion E. Deerhake
Research Triangle Institute
3040 Cornwallis Rd
Research Triangle Park, NC 27709
919-990-8680
med@rti.org
Vicki L. Deisner
Ohio Environmental Council
1207 Grandview Avenue, Suite 201
Columbus, OH 43212
614-487-7508
vicki@theoec.org
John Dellinger
University of Wisconsin - Milwaukee
PO Box 413
Milwaukee, Wl 53126
Sam Dennison
Metro Water Reclamation, Chicago
600 W. Pershing Boulevard
Cicero, IL 60804
708-588-4223
sam.dennison@mwrdgc.dst.il.us
Ticiang Diangson
Seattle Public Utilities
710 Second Avenue #505
Seattle, WA 98104
206-684-7643
ticiang.diangson@ci.seattle.wa.us
Leslie E. Dorworth
IL-ID Sea Grant College Program
2200 169th St.
Hammond, IN 46323
219-989-2726
dorworth@calumet.purdue.edu
Laurie A. Draheim
Wisconsin Division of Public Health
1 W. Wilson Street, Room 150
Madison, Wl 53701
608-266-3393I
draheim@facstaff.wisc.edu
John J. Dreisig
NH Dept. of Health and Human Services
6 Hazen Drive
Concord, NH 03301-6527
603-271-4664
jdreisig@dhhs.state.nh.us
Truman Duncan
Miccousukee Tribe of Indians of Florida
PO Box 440021 Tamiami Station
Miami, FL 33144
305-223-8380 x 2240
duncan2u@aol.com
Sharon Dunwoody
University of Wisconsin-Madison
1306 Seminole Highway
Madison, Wl 53703-2200
608-263-4080
dunwoody@facstaff.wisc.edu
Gail E. DuPuis
EPA Environmental Service
218 Roosevelt
Glen Burnie, MD 21001
Monty J. Elder
Oklahoma Department of Env. Quality
PO Box 1677
Oklahoma City, OK 73072
405-702-1017monty.elder@deq. state, ok
.us
Daniel Ellanak
Native Village of Ouzinkie - Alaska
PO Box 96
Ouzinkie, AK 99644
907-680-2310x907
dellanak@hotmail.com
Steve G. Ellis
Pentec Environmental
120 Third Avenue S., Suite 110
Edmonds, WA 98020
425-775-4682 x 953
steve.ellis@pentecenv.com
Mohamed T. Elnabarawy
3M Environ. Tech. & Safety Services
Building 42-2E-27, PO Box 33331
St. Paul, MN 5133-3331
651-778-5151
mtelnabarawy@mmm.com
Mark Elster
USEPA-Great Lakes Office
77 W. Jackson Blvd. (G-17J)
Chicago, IL 60604
312-886-3857
elster.mark@epa.gov
Jill A. Engel-Cox
Battelle Memorial Institute
2101 Wilson Blvd, Suite 800
Arlington, VA 22201
703-875-2144
engelcoxJ@batelle.org
Rich Eskin
Maryland Department of the
Environment
2500 Broening Highway
Baltimore, MD 21224
410-631-3691
reskin@mde.state.md.us
Thomas J. Fikslin
Delaware River Basin Commission
25 State Police Drive, PO Box 7360
West Trenton, NJ 08628
609-883-9500 x 253
tfikslin2drbc.state.nj.us
C-6
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Appendix C
Conference Participants Contact Information (cont.)
Eugenia M. Flatow
NY/NJ Harbor Esturary Program
121 Avenue of the Americas, Suite 501
New York, NY 10013
212-431-9676x306
flatow@worldnet.att.net
Tony Rood
International Food Information Council
1100 Connecticut Ave., NW #430
Washington, DC 20036
202-296-6540
flood@ific.org
Henry G. Folmar
Mississippi Dept. of Env. Qualtiy
1542 Old Whitfield Road
Pearl, MS 39110
601-664-3910
Henry_F°lmar@deq.state, ms. us
Chuck L. French
U.S. EPA, Office of Air and Radiation
Mail Drop 13
RTP, NC 27711
919-541-0467
french.chuck@epa.gov
Bob Frey
PA DEP
8555, 400 Market Street
Harrisburg, PA 17569-8555
717-787-9637
rofrey@state.pa.us
Eric Frohmberg
Maine Bureau of Health
157 Capitol Street/11 SHS
Augusta, Maine 04333
207-287-8141
eric.frohmberg@state.me.us
Charles Garcia
Oklahoma Dept. of Environmental Quality
PO Box 1677
Oklahoma City, OK 73101
405-702-8220
cgarcia@up.net
Connie Garrett
Florida Dept. of Health
4052 Bald Cypress Way
Tallahassee, FL 32399
850-245-4444
connie_garret@doh.state.fl.us
Margy Gassel
Cal/EPA Office of Env. Health
1515 Clay Street, 16th Floor
Oakland, CA 94612
510-622-3166
mgassel@oehha.ca.gov
Tim Gatewood
White Mountain Apache Tribe
PO Box 220
Whiteriver, AZ 85941
520-338-4385
timgatewood@cybertrails.com
Lisa K. Geist
US Army Corps of Engineers, AK
District
PO Box 898 ATTN: CEPOA-EN-EE-A
Anchorage, AK 99506
907-753-5742
Iisa.k.geist@poa02.usace.army.mil
Glen Gentry
Nevada Division of Environ. Protection
333 W. Nye Lane, Suite 138
Carson City, NV 89701-0851
775-687-4670 x 3097
ggentry@ndep.carson-city.nv.us
Merv George
California Indian Basketweavers Assoc.
PO Box 1449
Hoopa, CA, 95546
530-625-1646
mervgeorge@hotmail.com
Michael Gilbertson
International Joint Commission
100 Ouellette Avenue, 8th Floor
Windsor, Ontario N9A 6T3
519-257-6706
Gilbertson@windsor.ijc.org
Susan Gilbertson
Office of Water, USEPA
1200 Pennsylvania Avenue, NW, 4305
Washington, DC 20460
202-260-1188
Gilbertson.sue@epa.gov
Wayne F. Goeken
Red River Basin River Watch
RR 3, Box 75A
Erskine, MN 56535
218-574-2622
wrg@gvtel.com
Michael Goldberg
Action Media
35786 Northstar Lane
Grand Rapids, MN 55744
218-327-2737
action@uslink.net
Dorothy K. Gonzales
Genesee County Health Department
630 S. Saginaw St.
Flint, Ml 48502-1540
810-257-3190
dgonzale@co.genesee.mi.us
Wendy M. Graham
USEPA
1200 Pennsylvania Avenue, NW, 261 OR
Washington, DC 20004
202-564-6602
Graham.Wendy@epamail.epa.gov
Lester Graham
Great Lakes Radio Consortium
213 Goodrich St.
Jerseyville, IL 62052-2213
618-498-3462
graham@gtec.com
Rick Greene
Delaware DNREC
820 Silver Lake Boulevard, Suite 220
Dover, DE 19904-2464
302-739-4590
rgreene@dnrec.state.de.us
Jean W. Gregory
Virginia Dept. of Environmental Qualtiy
PO Box 10009
Richmond, VA 23240
804-698-4113
jwgregory@deq.state.va.us
Kory J. Groetsch
Great Lakes Indian Fish & Wildlife
Comm.
100 Maple Street
Odanah.WI 54861
715-682-6619 x 189
groetsch@glifwc.org
Jeffrey L. Gunderson
Minnesota Sea Grant College Program
2305 East Fifth Street
Duluth, MN 55812-1445
218-726-8715
jgunderl @d.umn.edu
C-7
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Appendix C
Conference Participants Contact Information (cont.)
Cecilia Gutierrez
Registered Onsite - No Contact
Information Available
Mike Haars
Alaska Dept. of Environmental Conserv.
555 Cordova
Anchorage, AK 99501
907-269-3084
mike_haars@envircon.state.ak.us
Holly Hadock
USEPA
75 Hawthorne Street, SFD-7-1
San Francisco, CA 94941
415-744-2244
hadlock.holly@epa.gov
Barbara L. Hager
Arkansas Department of Health
4815 W. Markham St, Slot 63
Little Rock, Arkansas 72205
501-661-2495
bhager@healthyarkansas.com
Cynthia A. Hagley
Minnesota Sea Grant College Program
2305 East Fifth Street
Duluth, MN 55812
218-726-8715
chagley@d. umn.edu
Michael S. Haire
EPA - HQ - AWPD - Fish Forum Speaker
401 M Street
Washington, DC 20460
202-260-2734
mhaire@epa.gov
Faith Hambleton
Texas Natural Resource Conserv. Comm.
PO Box 13087
Austin, TX 78711-3087
512-239-4600
fhamblet@tnrcc.state.tx.us
Doug Hampton
Cheyenne River Sioux Tribe
PO Box 590
Eagle Butte, SD 57625
605-964-7812
crstfish@sodak.net
Soo Han
International Joint Commission
1250 23rd Street, NW, Suite 100
Washington, DC 20440
202-736-9023
hans@washington.ijc.org
Jim Hanlon
Office of Water, USEPA
1200 Pennsylvania Ave. NW
Washington, DC 20460
202-260-5700
hanlon.jim@epa.gov
Joel A. Hansel
USEPA Region 4
6 Forsyth Street, SW, 15th Floor
Atlanta, GA 30303
404-562-9274
hansel.joel@epa.gov
Keith Hanson
Registered Onsite - No Contact
Information Available
khanson@mnpower.com
Paul Harp
NH Dept. of Health and Human Services
6 Hazen Drive
Concord, NH 03301-6527
603-271-4878
pharp@dhhs.state.nh.us
Barbara L. Harper
Yakama Nation
44803 E. Alderbrook Ct.
Richland, WA 99353
509-967-5174
bharper@nwinfo.net
Stuart G. Harris
Confed. Tribes of Umatilla Indian Res.
PO Box 638
Pendleon, OR 97801
541-966-2408
stuartharris@ctuir.com
Jenny Hayes
Wl Dept. of Health and Family Services
One West Wilson, Room 150
Madison, Wl 53701
608-267-7199
hayesjm@dhfs. state, wi. us
Alan Hayton
Ontario Ministry of the Environment
125 Resources Road
Etobicoke, Ontario L6Z 1P7
416-327-7470
haytonal@ene.gov.on.ca
Jeffrey J. Hayward
NCDENR Division of Air Quality
1641 Mail Service Center
Raleigh, NC 27699-1641
919-733-1475
jeff.hayward@ncmail.net
Maria Hendriksson
EPA
1200 Pennsylvania Ave., 361 OA
Washington, DC 20460
202-564-1897
hendriksson.marla@epa.gov
Diane S. Henshel
Indiana University
1315 E 10th St. #340
Bloomington, IN 47405
812-855-4558
dhenshel@indiana.edu
Kyoungsun Heo
Indiana University
Registered Onsite - No Contact
Information Available
Carolyn A. Hicks
EPA/OIA
1200 Pennsylvania Ave. NW 261 OR
Washington, DC 20460
202-564-6601
hicks.carolyn@epa.gov
Heraline E. Hicks
Agency Toxic Substances & Disease
Registry
1600 Clifton Road, E-29
Atlanta, GA 30333
404-639-5097
heh2@cdc.gov
Jennifer Hill-Kelly
Oneida Nation in Wisconsin
3759 W Mason St, PO Box 365
Oneida, Wl 54155
920-497-5812
jhillkel@oneidanation.org
Deanna N. Himango
Fond du Lac Reservation
1720 Big Lake Road
Cloquet, MN 55720
218-878-8023
deannahimango@fdlrez.com
Razelle Hoffman-Contois
Vermont Department of Health
195 Colchester Avenue
Burlington, VT 05402
802-863-7558
rhoffman@vdh.state.vt.us
C-8
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Appendix C
Conference Participants Contact Information (cont.)
David Hohreiter
BBL Sciences
6723 Towpath Road, P. 0. Box 66
Syracuse, NY 13214
315-446-9120x402
dh@bbl-inc.com
Ed Horn
New York State Department of Health
547 River Street
Troy, NY 12180-2216
518-402-7800
egh01@health.state.ny.us
Thomas Hornshaw
Illinois EPA
PO Box 19276
Springfield, IL 62794-9276
217-785-5735epa8566@epa.state.il.us
Robert Hotchkiss
MS State Dept. of Health
PO Box 1700
Jackson, MS 39215
601-978-7864
rhotchkiss@msdh.state, ms. us
Patti J. Howard
Nez Perce Tribe
PO Box 365
Lapwai, ID 83540
208-843-7368
pattih@n ezperce .org
Jackie Hunt Christensen
Health Care Wtihout Harm
c/o IATP, 2105 First Avenue, S.
Minneapolis, MN 55404
612-870-3424
jchristensen@iatp.org
Orville Huntington
US Fish & Wildlife Service
PO Box 107
Huslia, AK 99746
907-829-2266
orville_huntington@fws.gov
Jerolyn 1. Ireland, RNC
Micmac Health Department
8 Northern Road
Presque Isle, ME 04747
207-764-7219 x 129
jireland@micmachealth.org
Franky L. Jackson
Sisseten Wahpeton Sioux Tribe
Box 509
Agency Village, SD 57262
605-698-4998
wfjackson@basenet.com
Sharon J. Jaftess
EPA-R2, Emerg. & Remedial Response
290 Broadway
New York, NY 10007
212-637-4396
jaffess.sharon@epa.gov
Ronald A. Jamison
Seneca National Health Department
1510 Route 438
Irving, New York 14081
716-532-5582x5296
Charlie J. Jaquez, Jr.
Costilla Cty. Comm. for Env. Soundness
PO Box 333
San Luis, CO 81152
719-672-3511
cjaquez@amigo.net
Cindy G. Jardine
University of Alberta
13-103 Clinical Sciences Building
Edmonton, Alberta T6G 2G3
780-492-2626
cindy .jardine@ualberta.ca
Paul B. Jiapizian
Maryland Department of the
Environment
2500 Broening Highway
Baltimore, MD 21224
410-631-3906
pjiapizian@mde.state.md.us
Robert L. Johnson
Ohio Department of Health
8390 Orchard Knoll Lane
Columbus, OH 43235
614-466-1060
bjohnson@gw.odh.state.oh.us
Marlene Johnson
Native Village of Eklutna
625 Delaware Place
Anchorage, AK 99504
907-245-0674
MJ-Consulting@worldnet.att.net
Ted Johnson
USEPA/Office of Water
1200 Pennsylvania Avenue, NW
Washington, DC 20460
202-260-8142
johnson.theodore@epamail.epa.gov
Thomas Johnson, Jr.
US Dept. of Energy, Savannah River
Site
PO Box A
Aiken, SC 29802
803-725-4319
thomas-jr.johnson@srs.gov
Tom Jones
Neuse River Foundation
PO Box 15451
New Bern, NC 28561
252-637-7972
riverkeeper@neuseriver.org
Nancy L. Judd
University of Washington
4311 Thackeray Place, NE
Seattle, WA 98105
206-616-4876
nlj@yahoo.com
Paul A. Kakuris
Illinois Dunesland Preservation Society
PO Box 466
Zion, IL 60099
David B. Kallander
Indiana Dept. of Environ. Management
100 North Senate Ave., Box 6015
Indianapolis, MN 46206
317-233-2472
dkalland@dem.state.in.us
Chuck Kanetsky
US EPA Region 3
1650 Arch St.
Philadelphia, PA 19103
215-814-2735
kanetsky.charles@epa.gov
Kenneth W. Kauffman
Oregon Health Division
Ste 608, State Office Bldg, 800 NE
Oregon St.
Portland, OR 97232
503-731-4015
Kenneth. W .Kauffman@state .or. us
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Appendix C
Conference Participants Contact Information (cont.)
Becky Kenow
MN Department of Health
121 E. Seventh Place, PO Box 64975
St. Paul, MN 55164
651-215-0732
rebecca.know@health.state.mn.us
David F. Kern
Arkansas Dept. of Environmental Quality
8001 National Drive
Little Rock, AR 77209
501-682-0916
kern@adeq.state.ar.us
Marva E. King
EPA - Office of Environmental Justice
1200 Pennsylvania Ave., NW (2201 A)
Washington, DC 20460-0001
202-564-2599
king.marva@epa.gov
Barbara A. Knuth
Cornell University
122A Fernow Hall, Dept. Natural Res.
Ithaca, NY 14853
607-255-2822
bak3@cornell.edu
Andrew Kolosseus
Washington State Dept. of Ecology
P. O. Box 47600
Olympia, WA 98504
360-407-6440
akol461 @ecy.wa.gov
Bill Kramer
USEPA - Water Quality Standards
1200 Pennsylvania Avenue, NW, 4305
Washington, DC 20460
202-260-5824
kramer.bill@epa.gov
Elaine T. Krueger
MA Dept. of Public Health
250 Washington Street
Boston, MA 02108
617-624-5757
Ekrueger@state.ma.us
Amy D. Kyle
Schl. of Public Health, Univ. of Cal. Berk.
332 Cortland Avenue, PMB-226
San Francisco, CA 94110-5536
510-642-8847
adkyle@socrates.berkeley.edu
Bill Lambert
Oregon Health Sciences University
3181 Sam Jackson Park Road
Portland, OR 97201-3098
503-494-9488
lambertw@ohsu.edu
Regina Langton
USEPA Office of Pesticide Programs
1200 Pennsylvania Avenue, NW
Washington, DC 20460
703-305-7161
langton.regina@epa.gov
Leah M. LaPointe
Red Cliff Tribe
PO Box 529
Bayfield, WI 54814
715-779-3700
Ieahla2001 @yahoo.com
Rosa E. Lara
Multicultural Area Health Edu. Center
5051 E Third Street
Los Angeles, CA 90022
323-780-7640
mahec@msn.com
Shawna Larson
Alaska Community Action on Toxics
135 Christensen Drive, Suite 100
Anchorage, AK 99501
907-222-7714
shawna@akaaction .net
Trina H. Lee
Virginia Department of Health
1500 East Main Street, Room 123
Richmond, VA 23218
804-786-4265
tlee@vdh.state.va.us
Fred Leslie
Alabama Dept. of Environ. Management
PO Box 301463
Montgomery, AL 36130-1463
334-260-2752
fal@adem.state.al.us
Alan S. Levy
Division Marke Studies, CFSAN/FDA
200 C Street, SW
Washington, DC 20204
202-205-9448
alan.levy@cfsan.fda.gov
Gerald C. Llewellyn
Delaware Public Health
PO Box 637
Dover, DE 19903
302-739-5617
gllewellyn@state.de.us
Belindo Lo
Health Canada
1F1 E., Banting Bldg, Ross Ave., PL
2201B1
Ottawa Canada K1A0L2
613-941-6224
belinda_lo@hc-sc.gc.ca
Linda Logan
Haudenosaunee Environ. Task Force
271 Councilhouse Road
Basom, NY 14031
716-542-2243
doof@buffnet.net
Roseanne M. Lorenzana
USEPA Region 10
1200 Sixth Avenue, OEA-095
Seattle, WA 98101
206-553-8002
lorenzana.roseanne@epa.gov
Fidel R. Lorenzo
Haaku Water Office
PO Box 309A
coma, NM 87034
505-552-6604 x 239
haakuwater@aol.com
Jack Lorrigan
Sitka Tribe of Alaska
456 Katlian Street
Sitka, AK 99835
907-747-3207
jackl@ptialaska.net
Susan Loucks
Chelsea Creek Action Group
22 Paris Street
E. Boston, MA 02128
617-569-0059
susan.loucks@noahcdc.org
Chhay Loy
Indochinese Cultural and Service Center
1724 East 44th Street
Tacoma, WA 98404
253-473-5666
chhay_l@hotmail.com
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Appendix C
Conference Participants Contact Information (cont.)
Charlie Lujan
Pueblo of San Juan
P. 0. Box 717
San Juan Pueblo, NM 87566
505-852-4212 x 233
cwlujan@yahoo.com
Kathy J. Luther
Indiana Dept. of Environ. Management
504 N. Broadway, Suite 418
Gary, IN 46402
219-881-6730
kluther@dem.state.in.us
Sean P. Lynch
Atlantic States Legal Foundation
658 W. Onondaga Street
Syracuse, NY 13204
315-475-1170
SeanLynch@aslf.org
David P. Macarus
USEPA, Region 5
77 West Jackson Boulevard
Chicago, IL 60604
312-353-5814
macarus.david@epa.gov
Dorene E. MacCoy
US Geological Survey
230 Collins Road
Boise, ID 83703
208-387-1354
demaccoy@usgs.gov
Richard G. Mach, Jr.
Navy
1230 Cloumbia St., Suite 1100
San Diego, CA 92101
619-532-0913
machrg@efdsw.navfac.navy.mil
Molly K. Madden
Minnesota Department of Health
121 E. 7th Place, Ste 220, PO Box 64975
St. Paul, MN 55164-0975
651-215-0907
molly.madden@health.state.mn.us
Patricia Maddox
Idaho Dept. of Health and Welfare
450 W. State Street
Boise, ID 83720
208-334-5500
maddoxp@idhw.state.id.us
Kathryn Mahaffey
USEPA - Fish Forum Speaker
1200 Pennsylvania Avenue, NW, 7203
Washington, DC 20460
202-260-3573
mahaffey.kathryn@epa.gov
Aaron Mair
Arbor Hill Environmental Justice, Inc.
200 Henry Johnson Boulevard
Albany, NY 12210
518-463-9760
dreams@global2000.net
Ronald W. Malanowski
WSRC/Savannah River Site
220 Bay Tree Ct.
Aiken, SC 29803
803-952-6532
ronald.malinowski@srs.gov
Randall O. Manning
Georgia Dept. of Natural Resources
745 Gaines School Road
Athens, GA 30334
706-369-6376
randy_manning@mail.dnr.state.ga.us
Koenraad Marien
Washington State Department of Health
7171 Cleanwater Lane, Bldg. 2
Olympia, WA 98504
360-236-3175
koenraad.marien@doh.wa.gov
Alyn C. Martinez
Pueblo of Pojaque Tribal Works
16 Viarrial Street
Santa Fe, NM 87501
505-455-3383
alynmartinez@hotmail.com
David Maschwitz
Minnesota Pollution Control Agency
520 N. Lafayette Road
St. Paul, MN 55155-4194
651-296-7255
david.maschwitz@pca.state.mn.us
Joseph Matassino
Partnership for The Deleware Estuary
1009 Philadelphia Pike
Wilmington, DE 19809
302-793-1701
partners@udel.edu
Maria R. Maybee
Great Lakes United
Buff. St. Coll., Cassety Hall, 1300
Elmwood Ave
Buffalo, NY 14222
716-886-0142
mmaybee@glu.org
Kathleen R. Mayo
USEPA
77 West Jackson Boulevard
Chicago, IL 60604
312-353-5592
mayo.kathleen@epa.gov
Freya R. McCamant
National Wildlife Federation
506 E. Liberty Street, 2nd Floor
Ann Arbor, Ml 48104
734-769-3351
mccamant@nwf.org
Pat McCann
Minnesota Department of Health
121 E. 7th Place, Ste 220, PO Box
64975
St. Paul, MN 55164-0975
651-215-0923
patricia.mccann@health.state.mn.us
Ellie McCann
OPPTS/USEPA
1200 Pennsylvania Ave., N.W., MC
7101
Washington, DC 20460
202-260-4168
mccann.ellie@epa.gov
Beverly M. McClellan
Lake Michigan Federation
1327 C South Plymouth Court
Chicago, IL 60605
312-939-9838
bevmcclellan@earthlink.net
Bob McConnell
CO. Dept., Public Health & Env. Water
4300 Cherry Creek Drive South
Denver, CO 80246-1530
303-692-3578
robert.mcconnell@state.co.us
Danna McDonald
USEPA
13900 Longwood Manor Court #302
Woodbridge, VA 22191
202-260-9521
McDonald.Danna@epa.gov
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Appendix C
Conference Participants Contact Information (cont.)
Eric W. Melaro
SC Department of health and Env.
2600 Bull Street
Columbia, SC 29201
803-896-9730
melaroew@columb30.dhec.state.sc.us
Brian J. Merkel
University of Wisconsin - Green Bay
2425 E. Ridge Terrace
Green Bay, WI 54311
920-465-2262
merkelb@uwgb.edu
David J. Micklos
South Dakota State Dept. of Health
600 East Capitol Street
Pierre, South Dakota 57501-2536
605-773-3364
dave.micklos@state.sd.us
Debbie Miller
Texas Natural Resource Conserv.Comm.
PO Box 13087 (MC 150)
Austin, TX 78711-3087
512-239-1703
demiller@tnrcc.state.tx.us
Michael Mills
Water Quality Branch, Division of Water
14 Reilly Road
Frankfort, KY 40601
502-564-3410
Mike.Mills@mail.state.ky.us
Kathleen Mohar
Research Triangle Institute
3040 Cornwallis Rd
Research Triangle Park, NC 27709
919-541-6043
kbm@rti.org
Phillip Moershel
Oklahoma Water Resources Board
3800 N. Classen Boulevard
Oklahoma City, OK 73118
405-530-8800
Mike Montoya
Ute Tribe of Uintah & Ourary Reservation
PO Box 460
Fort Duchesne, UT 84026
435-722-5511
utefish@ubtanet.com
Susan M. Moore
Agency Toxic Substances & Disease
Registry
1600 Clifton Road, E-32
Atlanta, GA 30333
404-639-0616
Smoorel@cdc.gov
Thomas Morrissey
Connecticut Dept. of Environ.Protection
79 Elm St.
Hartford, CT 06106
601-424-3704
thomas.morrissey@po.state.ct.us
William J. Morrow
USEPA -OW-OST
1200 Pennsylvania Ave. NW
Washington, DC 20460
202-260-3657
morrow.william@epa.gov
Ted Morton
American Oceans Campaign
600 Pennsylvania Avenue, SE, Suite
210
Washington, DC 22201
202-544-3526
tmorton@americanoceans.org
Kurt Moser
Lac du Flambeau Band of Lake Superior
Chippewa
PO Box 67
Lac du Flambeau, Wl 54531-71551
715-588-3303
krmoser@newnorth.net
Andrew Mullard
Wisconsin Division of Public Health
1 West Wilson St.
Madison, Wl 53701
608-266-6762
mullaaj@dhfs.state, wi. us
Karl J. Musgrave
State of Wyoming, Department of
Health
2300 Capitol Avenue, 4th Floor
Cheyenne, WY 82002
307-777-7958
kmusgr@state.us
Sonny Myers
1854 Authority
4428 Haines Road
Duluth, MN 55811-1524
218-722-8907
roadwolf@1854.org
Erica Myles
Gov. NW Territories Health & Social
Service
Box 1320
Yellowknife, NT X1A2L9
867-920-3281
erica_myles@gov.xt.ca
Chuck Nace
Delaware Division of Public Health
Jesse Cooper Building, PO Box 637
Dover, DE 19903
302-739-6619
cnace@state.de.us
Phuong Nguyen
EPA Region 5
77 W Jackson Blvd AR-18J
Chicago, IL 60604
312-886-6701
nguyen.phuong@epa.gov
Brian C. Niewinski
Pyramid Lake Fisheries
Star Route
Sutcliffe, NV 89510
775-476-0500
bcn@powernet.net
Thomas S. NighswanderA
laska Tribal Health Consortium
2105 Otter Street
Anchorage, AK 99501
907-729-3682
tnighswander@anthc.org
Ken P. Norton
Hoopa Valley Tribe
PO Box 1348
Hoopa, CA 95546
530-625-5515x303
kentepa@pcweb.net
Gregory L. Nothstine
Alaska Native Science Commission
3211 Providence Drive
Anchorage, AK 99058
907-786-7776
gregory@uaa.alaska.edu
Lydia Olympic
Igiugig Tribal Council
PO Box 4008
Igiugig, AK 996139
07-533-32601
olympic@aol.com
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Appendix C
Conference Participants Contact Information (cont)
John R. Olson
Iowa Department of Natural Resources
Wallace Building, 502 East 9th Street
Des Moines, IA 50319
515-281-8903
john.olson@dnr.state.ia.us
Jennifer K. O'Neal
Arkansas Department of Health
4815 West Markham, Slot 36
Little Rock, Arkansas 72205
501-661-2207
joneal@healthyarkansas.com
Peter Orris
University of Illinois at Chicago
901 S. Wolcott Avenue, Rm E-144 CHS
Chicag, Illinois 60612
312-996-5604
porris@uic.edu
Toney Ott
USEPA, Region 8
999 18 th St.
Denver, CO 80202-2466
303-312-6909
ott.toney@epa.gov
James L. Padilla
New Mexico Department of Health
1190 St. Francis Drive, N1300
Santa Fe, NM 87502
505-476-3583
jamesp@doh.state.nm.us
Ira F. Palmer
District of Columbia Government
51 N Street ,NE, 5th Floor
Washington, DC 20002
202-535-2266
ira.palmer@dc.gov
Rebecca T. Parkin
The George Washington University
2300 K Street, NW
Washington, DC 20037
202-994-5482
eohrtp@gwumc.edu
Glen M. Patrick
Washington State Department of Health
P. O. Box 47846
Olympia, WA 98504
360-236-3177
g.patrick@doh.wa.gov
Neil V. Patterson
Tuscarora Environment Program
2045 Upper Mtn. Road
Sanborn, NY 14132
716-297-5553
tuscenv@igc.org
Steven Pawlowski
Arizona Dept. of Environmental Quality
3033 North Central Avenue
Phoenix, AZ 85012
602-207-4219
pawlowski.steven@ev.state.az.us
Nathan Pechacek
Texas Natural Resource Conserv.
Comm
PO Box 13087
Austin, TX 78711-3087
512-239-1336
npechace@tnrcc.state.tx.us
Rob Pepin
USEPA Region 5
77 W Jackson Blvd
Chicago, IL 60604
312-886-1505
pepin.robert@epa.gov
Jane Perry
Georgia Dept. of Human Resources
2 Peachtree Street, Suite 16.236
Atlanta, GA 30303
404-657-6517
jmperry@dhr.state.ga.us
John Persell
Minnesota Chippewa Tribal Government
PO Box 217
Cass Lake, MN 56633
218-335-6303
mctwQ@paulbunyan.net
Dan Petersen
EPA/ORD
26 W. Martin Luther King Avenue
Cincinnati, OH 4528
513-569-7831
petersen.dan@epa.gov
Kerry K. Pflugh
New Jersey Dept. of Env. Protection
401 E. State Street, PO Box 409
Trenton, NJ 08625
609-633-2312
kkirk@dep.state.nj.us
Jay B. Pitkin
Utah Division of Water Quality
P.O. Box 144870
Salt Lake City, UT 84114-4870
801-538-6087
jpitkin@deq.state.ut.us
Cole Poindexter
Staunton River Watch
1629 Lambs Church Road
Altavista, VA 24517
804-369-4444
cpoindex@lynchburg.net
Motria Poshyvanyk
USEPA
77 W Jackson Blvd. AR-18J
Chicago IL, 60604
312-886-0267
poshyvanyk.motria@epa.gov
Munty M. Pot
Lowell Community Health Center
15-17 Warren Street
Lowell, MA 01852
978-934-0164x210
MuntyPO@ichealth.org
Charles A. Potts
Oklahoma Water Resources Board
3800 N. Classen Boulevard
Oklahoma City, OK 73118
405-530-8800 x 405
capotts@owrb.state.ok.us
Maria C. Powell
University of Wisconsin-Madison
2806 Wilard Ave.
Madison, Wl 53704
608-240-1485
powell@students.wisc.edu
Joan Radovich
Sidley & Austin
10 S. Dearborn St.
Chicago IL, 60603
312-853-7035
jradovich@sidley.com
Paul Rauber
Sierra Magazine
85 Second Street, Second Floor
San Francisco, 94105
415-977-5612
paul.rauber@sierraclub.org
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Appendix C
Conference Participants Contact Information (cont.)
Ora C. Rawls
Mississippi Rural Development Council
6310 155 North, W121, Box 11
Jackson, MS 39211
601-899-5300
msrdc@bellsouth.net
Sam M. Rector
Arizona Dept. of Environmental Quality
3033 N. Central
Phoenix, AZ 85012
602-207-4536
rector.sam@ev.stste.az.us
Marlene Regelski
USEPA, American Indian Environ. Office
1200 M Street, NW, Mailcode 4104
Washington, DC 20460
202-260-7284
regelski.marlene@epa.gov
Dianne M. Reid
NCDENR/DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
919-733-5083x568
dianne.reid@ncmail net
Steve Rembish
Parsons Engineering Science
8000 Centre Park Drive, Suite 200
Austin, TX 78754-5140
512-719-6067
steve.j.rembish@parsons.com
Mary E. Ren wick
Water Resources Center, Univ. of Minn.
1485 Bedford Ave., 173 McNeall Hall
St Paul, MN 55405
612-625-9798
renwi001 @tc.umn.edu
Jeffrey Reutter
Ohio State University
1314 Kinnear Road
Columbus, OH 43212
614-292-8949
reutter.1@osu.edu
Deborah Rice
USEPA
1200 Pennsylvania Ave. , MC 8623D
Washington, DC 20460
204-564-3404
Mike Ripley
Chippew-Ottawa Resource Authority
179 West Three Mile Road
Sault Ste. Mari, Ml 49783
906-632-0072
mripley@northernway.net
Leonard Robinson
NEJAC Fish Comsumption Work Group
12459 Arrow Highway
Rancho Cucamonga, CA 91739
909-899-0631 x 203
RobinsonL@tamcostell.com
Tabitha M. Romero
Pueblo of Pojaque Tribal Works
16 Viarrial Street
Santa Fe, NM 87501
505-455-3383
tabitharomero@hotmail.com
Raymond R. Romero
Minnesota Dept. of Natural Resources
500 Layfayette Road, Box 10
St. Paul, MN 55155-4010
651-296-4945
ray.romero@dnr.state.mn.us
Kristin Ryan
Alaska Dept. of Environmental Conserv.
555 Cordova
Anchorage, AK 99501
907-269-7630
kristin_ryan@envircon.state.ak.us
Samuel H. Sage
Atlantic States Legal Foundation, Inc.
658 West Onondaga Street
Syracuse, NY 13204
315-475-1170
samuelsage@aslf.org
Susan Salter
Georgia Environ. Protection Division
4220 International Parkway, Suite 101
Atlanta, GA 30354
404-362-2568
susan_salter@mail.dnr.state.ga.us
Charlie Santerre
Purdue University
Registered Onsite - No Contact
Information Available
765-496-3443
David Sappington
Registered Onsite - No Contact
Information Available
Joan Saroka
City of Portland, Environ. Services
1120 SW 5th Ave., Room 1000
Portland, OR 97204-1912
503-823-5021
joans@bes.ci.portland.or.us
Neil L. Sass
Alambama Department of Public Health
The RSA Tower, 201 Monroe Street
Montgomery, AL 36104
334-206-5973
nsass@adph.state.al.us
Tiffanie S. Saxer
Illinois Dept. of Public Health
525 West Jefferson Street
Springfield, IL 62761
217-782-5830
tsaxer@idph.state.il.us
Robert Schacht
EPA
Registered Onsite - No Contact
Information Available
Rich Schiafo
Scenic Hudson, Inc.
9 Vassar Street
Poughkeepsie, NY 12601
845-473-4440 x 223
rschiafo@scenichudson.org
Gary Schiffmiller
New Mexico Environment Department
P. 0. Box 26110
Santa Fe, New Mexico 87502
505-827-2470
gary_schiffmiller@nmenv. state, nm. us
Rita Schoeny
USEPA Office of Water
ML 4304 Pennsylvania Ave., NW
Washington, DC 20460
202-260-3445
schoeny.rita@epa.gov
Faith L. Schottenfeld
NYS Dept. of Health, Ctr. for Env. Health
547 River Street, Room 316
Troy, NY 12180-2216
518-402-7530
fls02@health.state.ny.us
Judith Schreiber
New York State Office of Attorney Gen.
The Capitol
Albany, NY 12224-0341
518-474-4819
judith.schreiber@oag.state.ny.us
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Appendix C
Conference Participants Contact Information (cont.)
Carol D. Schriber
NC. Dept. Health & Human Services
2006 Mail Service Center
Raleigh, NC 27699-2001
919-733-9190
Carol.Schriber@ncmail.net
Amanda K. Sears
Natural Resources Council of Maine
3 Wade Street
Augusta, ME 04330
207-622-3101 x 205
asears@rircm.org
Keith Sepulvado
Louisiana DEQ
PO Box 82178
Baton Rouge, LA 70884
225-765-0246
keiths@deq.state.la.us
Bill Sheehan
Hackensack Riverkeeper, Inc.
1000 River Road, T090C
Teaneck, NJ 07666
201-692-8440
captain@keeper.org
Tracy L. Shelley
South Carolina Dept. of Health and Env.
2600 Bull Street
Columbia, SC 29201
803-896-9731
shellet1@columb30.dhec.state.sc.us
Enoch Shiedt
Maniilaq Association
P.O. Box 256
Kotzebue, AK 99752
907-442-7690
eshiedt@maniilaq.org
Pamela J. Shubat
Minnesota Dept. of Health
121 E. 7th Place, Ste 220, PO Box 64975
St. Paul, MN 55164-0975
651-215-0927
pamela.shubat@health.state.mn.us
Nicoline Shulterbrandt
DC Dept. of Health, Env. Health Admin
5th Floor, 51 N Street, NE
Washington, DC 20002
202-535-2194
nicolines@mail.environ.state.dc.us
Don Skaar
Montana Fish, Wildlife and Parks
1420 East 6th Avenue
Helena, MT 59620
406-444-5686
dskaar@state.mt.us
Tracey M. Slayton
Gradient Corporation, Chicago, IL
1612 Shenandoah Drive
Waunakee, Wl 53597
608-850-5556
tslayton@gradientcorp.com
Andrew E. Smith
Maine Bureau of Health
157 Capitol Street/11 SHS
Augusta, Maine 04333
207-287-5189
andy.e.smith@state.me.us
Janice Smithson
West Virginia Division of Env. Protection
1201 Greenbrier Street
Charleston, WV 25311
304-558-2108
jsmithson@mail.dep.state.wv.us
Charanjit S. Sodhi
Confederated Tribes of Chehalis Res.
420 Howanut Road
Olympia, WA 98568
360-273-5911
c.s.sodhi@olywa.net
Betsy Southerland
USEPA - Fish Forum Speaker
1200 Pennsylvania Ave., NW 4305
Washington, DC 20460
202-260-7301
southerland.elizabeth@epa.gov
Tina L. Souza
Gradient Corporation, Chicago, IL
1 West Superior Street, #3502
Chicago, IL 60610
312-649-5838
tsouza@gradientcorp.com
Moses D. Squeochs
14 Conf. Bands of Yakama Nation
1010 State Route 223
Toppenish, WA 98948
509-865-5121 x 4659
mose2yakama.com
Dyan Steenport
Wisconsin Division of Public Health
Registered Onsite - No Contact
Information Available
Alan H. Stern
New Jersey Dept. of Environ. Protection
PO Box 409, 401 East State St.
Trenton, NJ 08625
609-633-2374
astern@dep.stste.nj.us
Steven Strausbauch
Air Force IERA/RSRE; Brooks AFB TX
2513 Kennedy Circle, Bldg 180
Brooks AFB TX 78235
210-536-6134
Steven .strausbauch@brooks. af. mil
Elizabeth Sullivan
Research Triangle Institute
3040 Cornwallis Rd
Research Triangle Park, NC 27709
919-990-8627
ewullivan@rti.org
Maryann E. Suero
USEPA, Region 5
77 W Jackson Blvd. T-13J
Chicago IL, 60604
312-886-9077
suero.maryann@epa.gov
Mardell Sundown
Haudenosaunee Environ. Task Force
6751 Meadville Road
Basom, NY 14013
716-542-2684
mfsun@buffnet.net22
Katherine S. Super
MFG, Inc.
800 Vinial Street, Building A
Pittsburgh, PA 15212
412-321-2278
ksuper@mfgenv.com
Kathy A. Svanda
Minnesota Department of Health
P.O. Box 64975
St. Paul, MN 55164-0975
651-215-0878
kathy.svanda@health.state.mn.us
Lawrence C. Swamp
St. Regis Mohawk Tribe Environ. Div.
412 State Route 37
Akwesasne, NY 13655
518-358-6211
earth2-swamp@northnet.org
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Appendix C
Conference Participants Contact Information (cont.)
Mary B. Swanson
University of Tennessee
311 Conference Center Building
Knoxville, TN 37996
865-974-0642
mswanso1@utk.edu
Barbara Tarbell
St. Regis Mohawk Tribe Environ. Div.
412 State Route 37
Akwesasne, NY 13655
518-358-5937x23
earth3-nrda@northnet.org
Trent N. Temperly
Severn Trent Laboratories, Inc.
966 Saint Ana Drive
Greenwood, IN 46143
317-535-1252
ttemperly@stl-inc.com
Kavita Thakkar
Citizens for A Better Environment
205 W. Monroe, 4th Floor
Chicago, IL 60606
312-346-8870
ilcbe@cbemw.org
Dan Thomas
Great Lakes Basin Publication
Registered Onsite - No Contact
Information Available
bthomas@catg.org
Brian Toal
Connecticut Department of Public Health
28 Lawrence Avenue
Avon, CT 06001
860-509-7741
brian.toal@po.state.ct. us
William Toomey
West Virginia Bureau for Public Health
815 Quarrier St.
Charleston, WV 25361
304-558-2981
wtoomey@wvdhhr.org
Tom Trudeau
Illinois Dept. of Natural Resources
Registered Onsite - No Contact
Information Available
David H. Tunink
Nebraska Game and Parks Commission
2200 N 33rd Street, PO Box 30370
Lincoln, NE 68503
402-471-5553
dtunink@ngpc.state.ne.us
Ralph A. Turkle
Iowa Department of Natural Resources
900 East Grand Avenue
Des Moines, IA 50319
515-281-7025
Ralph.Turkle@dnr.state.ia.us
Eric Uram
Sierra Club - Midwest Office
214 North Henry Street, Suite 203
Madison, Wl 53703-2200
608-257-4994, x 11
eric.uram@sierraclub.org
Tom C. VanArsdall
KY DEP/Division of Water
14 Reilly Road
Frankfort, KY 40601
502-564-3410
tom.vanarsdall@mail. state, ky.us
Darren J. Vogt
1854 Authority
4428 Haines Road
Duluth, MN 55811
218-722-8907
dvogt@1854.org
Chau H. Vu
EPA/Region I
103 Puffer St.
Lowell, MA 01851
617-918-1446
vu.chau@epa.gov
Lynn Waishwell
CRESP
Registered Onsite - No Contact
Information Available
732-445-0920
Randi J. Walker
New York State Department of Health
547 River Street, Room 330
Troy, NY 12180-2216
518-402-7815x7830
rjw03@health.state.ny.us
Jana L. Walker
Law Office fo Jana L. Walker
141 Placitas Trails Road
Placitas, NM 87043
505-867-0579
ndnlaw@sprintmail.com
Rachel C. Walsh
Indian Health Service
401	Buster Road
Toppenish, WA 98948
509-65-2102
cwalsh@yak.Portland.his.gov
Jim Warchall
Sidley & Austin
Bank One Plaza, 10 S. Dearborn
Chicago, IL 60603
312-853-7000 x 7692
jwarchall@sidley.com
Khizar Wasti
Virginia Dept. of Health
1500 E. Main St, Rm 124, PO Box 2448
Richmond, VA 23218
804-786-1763
kwasti@vdh.state, va.us
Shelly Watkins
Illinois Department of Public Health
525 West Jefferson Street
Springfield, IL 62761
217-785-2439
ewatkins@idph.state.il.us
Julie Watts
Massachusetts Department of Public
Health
250 Washington Street
Boston, MA 02108
617-624-5757
Mingyi Wen
ID Dept Health/Welfare
450 W. State Street, 4th Floor
Boise, ID 83702
208-334-5682
maddoxp@idhw.state.id.us
Lora S. Werner
Agency Toxic Substances & Disease
Registry
1650 Arch Street, 3HS00
Philadelphia, PA 19103
215-814-3141
werner.lora@epa.gov
Gwen M. White
Indiana Dept. of Natural Resources
402	W. Washington Street, Room W273
Indianapolis, IN 46204
317-232-4093
gwhite@dnr.staste.in.us
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Appendix C
Conference Participants Contact Information (cont.)
Rita A. Whitehorse Larsen
Jeanette Wolfley
Violet F. Yeaton
Gila River Indian Community
Shoshone-Bannock Tribes
Port Graham Village Council
PO Box 97 ATTN: DEQ
1752 North Elk Road
PO Box 5510
Sacaton, AZ 85247
Pocatello, ID 83204
Port Graham, AK 99603
520-562-2234
208-232-1922
907-284-2227
larzen@gilanet.net
wolfeyj@nicoh.com
vyeaton@yahoo.com
Luanne K. Williams
Gary Wolinsky
Chris Zell
NC. Dept. of Health & Human Services
USEPA, Region 9
MO Dept Nat. Resources/Water
2001 Mail Service Center
75 Hawthorne Street (WTR5)
Pollution
Raleigh, NC 27699-2001
San Francisco, 94105
Conrol
919-715-3730
415-744-1978
PO Box 176
Luanne.Williams@ncmail.net
wolinsky.gary@epa.gov
Jefferson City, MO 65102


573-751-7428
Johnnie M. Wilson
Donna Wong
nrzellc@dnr.state.mo.us
USEPA - Waste Pesticide Division
Hawaii's Thousand Friends

77 West Jackson Boulevard
305 Hahani Street, PMB 282
Faith Zerbe
Chicago, IL 60604
Kailua, HI 96734
Delaware Riverkeeper Network
312-886-4759
808-262-0682
PO Box 404
johnie.wilson@epa.gov
htf@lava.net
Malvern, PA 19470


610-469-6005
Dwain Winters
Kristine Wong
srk3@worldlynx.net
Office of Water, USEPA
no organization affiliation

1200 Pennsylvania Ave., NW MC 7404
532 14th Ave. E. #102

Washington, DC 20460
Seattle, WA 98112

202-260-8558
206-903-2092

winters.dwain@epa.gov
kristinewong@yahoo.com

David Wolanski
John D. Woodling

DNRGC
Colorado Division of Wildlife

820 Silver Lake Boulevard, Sutie 220
6060 Broadway

Dover, DE 19904
Denver, CO 80216

302-739-4590
303-291-7224

dwolanski@state.de.us
john.woodling@state.co.us

Steve Wolff
Ivan Wynecoop

Wyoming Game and Fish Department
Spokane Tribe of Indians

5400 Bishop Boulevard
PO Box 100

Cheyenne, WY 82006
Wellpinit, WA 99040

307-777-4673
509-258-9161

swolff@state.wy.us
ivanw@spokanetribe.com

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