COVID-19 Risk and Crisis Communication Challenges and Opportunities: Qualitative Insights from Rural Wastewater Surveillance Partners

Objectives Understand perceptions of COVID-19 messages and information sources among rural wastewater treatment plant operators to inform context-specific communication strategies for implementing wastewater surveillance methodologies locally. Methods Eight employees from 7 Eastern Kentucky facilities involved in SARS-CoV-2 wastewater surveillance participated in semi-structured interviews. Respondents shared perceptions of traditional and social media COVID-19 information channels in their communities, as well as factors influencing trustworthiness of sources. Using the U.S. Centers for Disease Control and Prevention's Crisis and Emergency Risk Communication (CERC) framework, 3 investigators conducted iterative, thematic coding of interview transcripts. Results Respondents' statements most frequently related to Be Credible, Be Right, and Promote Action CERC constructs, while mixed messages, high volumes of information, and numerous sources undermined trust in COVID-19 information. Conclusions Understanding the relative importance of CERC constructs and their distractors may improve future risk communication to advance infectious disease surveillance strategies in rural contexts.