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.